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探索减重手术后的社会支持动态:来自患者和提供者的见解。

Exploring Social Support Dynamics After Bariatric Surgery: Insights From Patients and Providers.

机构信息

Department of Surgery, University of Wisconsin, Madison, Wisconsin.

Department of Surgery, University of Wisconsin, Madison, Wisconsin; Department of Surgery, William S. Middleton Memorial Veterans Administration Hospital, Madison, Wisconsin.

出版信息

J Surg Res. 2024 Jul;299:1-8. doi: 10.1016/j.jss.2024.03.047. Epub 2024 Apr 26.

Abstract

INTRODUCTION

Weight loss after bariatric surgery is impacted by several factors, and social support is one of them. Our objective was to characterize patient and provider perceptions about social support after bariatric surgery.

METHODS

We reported a secondary analysis of qualitative data acquired from semi-structured interviews conducted from January-November 2020 with bariatric surgery patients and providers. Participants included primary care providers, health psychologists, registered dietitians, bariatric surgeons, and patients with at least 1 y of follow-up after their bariatric procedure. Interview guides were designed using a hybrid of Andersen's Behavioral Model of Health Services and Torain's Framework for Surgical Disparities. Using directed content analysis, study team members generated codes, which were categorized into themes about social support pertaining to dietary habits, physical activity, and follow-up care.

RESULTS

Forty-five participants were interviewed, including 24 patients (83% female; 79% White; mean age 50.6 ± 10.7 y) and 21 providers (six primary care providers, four health psychologists, five registered dieticians, and six bariatric surgeons). We identified four themes relating to social support affecting weight loss after surgery: (1) family involvement in helping patients adjust to the bariatric diet, (2) engagement in activities with partners/friends, (3) help with transportation to appointments, and (4) life stressors experienced by patients within their social relationships.

CONCLUSIONS

Continued assessment of interpersonal factors after bariatric surgery is essential for weight loss maintenance. Providers can contribute by reinforcing the facilitators of social support and making referrals that may help patients overcome barriers to social support for sustained weight loss after surgery.

摘要

简介

减重手术后的体重减轻受到多种因素的影响,社会支持就是其中之一。我们的目的是描述患者和提供者对减重手术后社会支持的看法。

方法

我们报告了 2020 年 1 月至 11 月期间对减重手术患者和提供者进行的半结构化访谈中获取的定性数据的二次分析。参与者包括初级保健提供者、健康心理学家、注册营养师、减重外科医生以及在接受减重手术后至少 1 年随访的患者。访谈指南是使用安德森健康服务行为模型和 Torain 手术差异框架的混合体设计的。使用定向内容分析,研究团队成员生成了代码,这些代码被归类为与饮食习惯、体力活动和随访护理有关的社会支持主题。

结果

共对 45 名参与者进行了访谈,包括 24 名患者(83%为女性;79%为白人;平均年龄 50.6±10.7 岁)和 21 名提供者(6 名初级保健提供者、4 名健康心理学家、5 名注册营养师和 6 名减重外科医生)。我们确定了四个与手术减肥后社会支持相关的主题:(1)家庭参与帮助患者适应减重饮食,(2)与伴侣/朋友一起参加活动,(3)帮助患者预约交通,(4)患者在社交关系中经历的生活压力源。

结论

在减重手术后持续评估人际关系因素对于维持体重减轻至关重要。提供者可以通过加强社会支持的促进因素并进行转介来帮助患者克服社会支持方面的障碍,从而实现手术后持续的体重减轻。

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