社会经济差异与减重手术结果：定性分析。
Socioeconomic disparities and bariatric surgery outcomes: A qualitative analysis.
机构信息
Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI, USA; William S. Middleton Memorial Veterans Administration Hospital, Madison, WI, USA.
Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI, USA.
出版信息
Am J Surg. 2023 Apr;225(4):609-614. doi: 10.1016/j.amjsurg.2022.09.049. Epub 2022 Sep 27.
BACKGROUND
Disparities in socioeconomic status (SES) have been associated with less weight loss after bariatric surgery. The objective of this study was to identify socioeconomic barriers to weight loss after bariatric surgery.
METHODS
We performed semi-structured interviews with bariatric surgery patients and providers from April-November 2020. Participants were asked to describe their post-operative experiences regarding dietary habits, physical activity, and follow-up care. Interview data were coded using Directed Content Analysis based on domains in Andersen's Behavioral Model of Health Services Use and Torain's Surgical Disparities Model.
RESULTS
24 patients (median of 4.1 years post-operatively; mean age 50.6 ± 10.7 years; 12 bypass and 12 sleeve; 83% female) and 21 providers (6 bariatric surgeons, 5 registered dietitians, 4 health psychologists, and 6 primary care providers) were interviewed. Barriers to weight loss included: 1) challenging employment situations; 2) limited income; 3) unreliable transportation; 4) unsafe/inconvenient neighborhoods; and 5) limited health literacy.
CONCLUSIONS
Interventions targeting socioeconomic barriers to weight loss are needed to support patients, particularly those who are socioeconomically disadvantaged.
背景
社会经济地位（SES）的差异与减重手术后体重减轻较少有关。本研究的目的是确定减重手术后体重减轻的社会经济障碍。
方法
我们在 2020 年 4 月至 11 月期间对减重手术患者和提供者进行了半结构化访谈。参与者被要求描述他们术后在饮食习惯、体力活动和随访护理方面的经验。访谈数据根据安德森健康服务使用行为模型和托兰手术差异模型中的领域，采用定向内容分析法进行编码。
结果
共访谈了 24 名患者（术后中位数 4.1 年；平均年龄 50.6 ± 10.7 岁；12 例旁路手术和 12 例袖状手术；83%为女性）和 21 名提供者（6 名减重外科医生、5 名注册营养师、4 名健康心理学家和 6 名初级保健提供者）。体重减轻的障碍包括：1）具有挑战性的就业情况；2）有限的收入；3）不可靠的交通；4）不安全/不便的社区；和 5）有限的健康素养。
结论
需要针对体重减轻的社会经济障碍进行干预，以支持患者，特别是那些社会经济地位不利的患者。
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