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肥胖症手术后体重减轻不理想的患者参与减肥干预的障碍和促进因素:一项对患者、医生和治疗师的定性研究。

Barriers to and Facilitators of Participation in Weight Loss Intervention for Patients with Suboptimal Weight Loss after Bariatric Surgery: A Qualitative Study among Patients, Physicians, and Therapists.

机构信息

Department of Health Sciences, Vrije Universiteit Amsterdam, and Amsterdam, Public Health Research Institute, Amsterdam, The Netherlands.

Department of Science, Nederlandse Obesitas Kliniek, Huis ter Heide, The Netherlands.

出版信息

Obes Facts. 2022;15(5):674-684. doi: 10.1159/000526259. Epub 2022 Aug 2.

Abstract

INTRODUCTION

Not all patients with suboptimal weight loss after bariatric surgery are willing to participate in postoperative behavioral intervention to improve their weight loss. The objective of this study was to explore barriers to and facilitators of participation in postoperative behavioral intervention.

METHODS

Thirty semi-structured interviews were conducted with patients (18), physicians (6), and therapists (6) (i.e., psychologists, dieticians, or physiotherapists). A thematic analysis approach was used.

RESULTS

Emotional responses caused by confrontation with suboptimal weight loss hampered patients' deliberation about participation; insufficient exploration of their need for help limited patients' ability to make informed decisions; patients were receptive to their physician's advice when their physician respected their autonomy; using visual weight loss graphs helped to explain suboptimal weight loss to patients; and financial costs and time constraints obstructed participation.

CONCLUSIONS

To improve adequate intervention participation, healthcare providers should focus on emotion regulation, support patients in exploring their own need for help, and respect patients' autonomy.

摘要

简介

并非所有减重手术后体重减轻不理想的患者都愿意参与术后行为干预以改善其体重减轻情况。本研究的目的是探讨参与术后行为干预的障碍和促进因素。

方法

对 18 名患者、6 名医生和 6 名治疗师(即心理学家、营养师或物理治疗师)进行了 30 次半结构化访谈。采用主题分析方法。

结果

因与体重减轻不理想相关的情绪反应而阻碍了患者对参与的思考;对帮助需求的探索不足限制了患者做出知情决策的能力;当医生尊重患者的自主权时,患者愿意接受医生的建议;使用可视化体重减轻图表有助于向患者解释体重减轻不理想的情况;以及财务成本和时间限制阻碍了参与。

结论

为了提高充分干预的参与度,医疗保健提供者应重点关注情绪调节,支持患者探索自身的帮助需求,并尊重患者的自主权。

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