Department of Psychology, Grand Valley State University.
Department of Surgery, Oregon Health & Science University.
Health Psychol. 2023 Jun;42(6):403-410. doi: 10.1037/hea0001279. Epub 2023 Mar 27.
Patients' ability to judge health change over time has important clinical implications for treatment, but is understudied in longitudinal contexts with meaningful health change. We assess patients' awareness of health change for 5 years following bariatric surgery, and its association with weight loss.
Participants were part of the Longitudinal Assessment of Bariatric Surgery ( = 2,027). Perceived health change for each year was assessed by comparing it to self-reports of health on the SF-36 health survey. Participants were categorized as concordant when perceived and actual self-reported health change corresponded, and as discordant when they did not correspond.
Year-to-year concordance between perceived and actual self-reported health change occurred less than 50% of the time. Discordance between perceived and actual health was associated with weight loss following surgery. Discordant-positive participants who perceived their health change as more positive than was warranted lost more weight post-surgery and thus had lower body mass index scores than concordant participants. Conversely, discordant-negative participants who perceived their health as worse than what was warranted lost less weight post-surgery and thus had higher body mass index scores.
These results suggest that recollection of past health is generally poor and can be biased by salient factors during recall. Clinicians are advised to use caution when retrospective judgments of health are utilized. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
患者对随时间推移的健康变化的判断能力对治疗具有重要的临床意义,但在具有明显健康变化的纵向背景下研究不足。我们评估了患者在接受减肥手术后 5 年内对健康变化的意识及其与体重减轻的关系。
参与者是减肥手术纵向评估研究的一部分(n=2027)。通过将其与 SF-36 健康调查中的自我报告健康状况进行比较,评估了每年感知到的健康变化。当感知到的和实际的自我报告的健康变化相匹配时,参与者被归类为一致,当不匹配时,他们被归类为不一致。
感知到的和实际自我报告的健康变化之间每年的一致性不到 50%。感知到的和实际健康之间的不一致与手术后体重减轻有关。感知到的健康变化比实际情况更积极的不一致阳性参与者术后体重减轻更多,因此体重指数评分低于一致参与者。相反,感知到的健康状况比实际情况更差的不一致阴性参与者术后体重减轻较少,因此体重指数评分较高。
这些结果表明,对过去健康的回忆通常很差,并且可以被回忆过程中的显著因素所影响。建议临床医生在使用健康的回顾性判断时要谨慎。