School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China.
School of Nursing, Fudan University, Shanghai, 200032, China.
Obes Surg. 2022 Sep;32(9):3064-3073. doi: 10.1007/s11695-022-06208-4. Epub 2022 Jul 20.
To explore main determinants of dietary adherence among Chinese patients after bariatric surgery based on the Attitude-Social influence-Efficacy (ASE) model.
A cross-sectional survey was conducted by using convenience sampling method to select 288 participants in a tertiary hospital in Jiangsu, China. General information and disease-related information were collected as well as applying the Dietary Adherence Scale after Bariatric Surgery (DASBS) and Attitude-Social influence-Efficacy Questionnaire after Bariatric Surgery (ASEQBS). Univariate analysis, correlation analysis, and multivariate analysis were used to identify determinants of dietary adherence among patients after bariatric surgery.
A total of 288 questionnaires were effectively collected. The mean DASBS score was 54.90 ± 10.08 among post-bariatric patients. Univariate analysis results showed that education level, time since surgery, smoking, exercise, participation in peer support groups, and participation in nutrition counseling had significant effects on postoperative diet adherence level of patients (P < 0.05). The correlation analysis results showed that the total score of dietary adherence was positively correlated with the total score of intention, attitude, social influence, and self-efficacy, and the correlation coefficients were 0.511, 0.550, 0.460, and 0.484, respectively (P < 0.05). The results of multiple linear regression analysis showed that time since surgery, attitude, intention, social influence, exercise, and self-efficacy entered the regression equation (P < 0.05). The standardized regression coefficients of attitude and intention are 0.237 and 0.196, respectively. The regression model could explain 44.0% of the total variation.
The dietary adherence of Chinese post-bariatric patients is at an upper-middle level, which needs to be further improved. Time since surgery, exercise, intention, attitude, social influence, and self-efficacy had significant effects on patients' dietary adherence. Attitude had the greatest effect on dietary adherence, followed by intention. The results shed light on that these factors should be emphasized to take personalized intervention strategy in designing dietary intervention program, in order to improve the patient's dietary adherence and surgical outcomes.
基于态度-社会影响-效能（ASE）模型，探讨中国减重手术后患者饮食依从的主要决定因素。
采用便利抽样法，在中国江苏的一家三级医院进行横断面调查，选择 288 名参与者。收集一般信息和与疾病相关的信息，应用减重手术后饮食依从量表（DASBS）和减重手术后态度-社会影响-效能问卷（ASEQBS）。采用单因素分析、相关分析和多元分析，确定减重手术后患者饮食依从的决定因素。
共有效收集 288 份问卷。减重后患者的 DASBS 平均得分为 54.90±10.08。单因素分析结果显示，文化程度、术后时间、吸烟、运动、参加同伴支持小组和参加营养咨询对患者术后饮食依从水平有显著影响（P<0.05）。相关分析结果显示，饮食依从总分与意向总分、态度总分、社会影响总分和自我效能总分呈正相关，相关系数分别为 0.511、0.550、0.460 和 0.484（P<0.05）。多元线性回归分析结果显示，术后时间、态度、意向、社会影响、运动和自我效能进入回归方程（P<0.05）。态度和意向的标准化回归系数分别为 0.237 和 0.196。回归模型可以解释总变异的 44.0%。
中国减重后患者的饮食依从处于中上水平，需要进一步提高。术后时间、运动、意向、态度、社会影响和自我效能对患者的饮食依从有显著影响。态度对饮食依从的影响最大，其次是意向。研究结果表明，在设计饮食干预方案时，应强调这些因素，采取个性化的干预策略，以提高患者的饮食依从性和手术效果。
