Majstorovic Mia, Chur-Hansen Anna, Burke Anne L J, Andrews Jane M
School of Psychology, The University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia.
School of Psychology, The University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia; Psychology Department, Central Adelaide Local Health Network, Port Road, Adelaide, South Australia, 5000, Australia.
Obes Res Clin Pract. 2024 Nov-Dec;18(6):443-449. doi: 10.1016/j.orcp.2024.12.002. Epub 2024 Dec 12.
Bariatric surgery can be an effective treatment for severe obesity, yet publicly-funded access is often limited. Bariatric surgeons contribute to decisions regarding consumer (non)progression to bariatric surgery. Still, little is known about their views on barriers and enablers to bariatric surgery in the Australian and New Zealand context. The current study addresses this knowledge gap.
A qualitative design was utilised. Sixteen bariatric surgeons and registrars from Australia and New Zealand were interviewed about their views on barriers and enablers to bariatric surgery. The data were analysed using qualitative content analysis.
Five content categories were derived from the analysis: 1. patient-related factors; 2. healthcare experiences and clinician-related factors; 3. societal beliefs and attitudes towards obesity, bariatric surgery and bariatric surgeons; 4. economic, governmental and institutional factors; and 5. bariatric surgery in the context of other treatments. A perceived lack of focus on obesity and publicly-funded bariatric surgery was apparent throughout the data in the form of descriptions of stigma, clinicians' disillusionment, patients not being guided and supported, and inadequate regulation and organisation of the field. The role of patients in determining their surgical progression was emphasised.
Participants discussed numerous barriers but fewer facilitators to bariatric surgery in Australia and New Zealand. Some of their opinions merit exploration with other bariatric multi-disciplinary team members and patients to understand further how the pre-operative process might be enhanced to support patients' needs and improve equity.
减肥手术可能是治疗重度肥胖的有效方法，但公共资金支持的获取途径往往有限。减肥外科医生参与有关消费者是否进行减肥手术的决策。然而，对于他们在澳大利亚和新西兰背景下对减肥手术的障碍和促进因素的看法，我们知之甚少。本研究旨在填补这一知识空白。
采用定性研究设计。对来自澳大利亚和新西兰的16名减肥外科医生和住院医生就他们对减肥手术的障碍和促进因素的看法进行了访谈。使用定性内容分析法对数据进行分析。
分析得出五个内容类别：1. 患者相关因素；2. 医疗保健经历和临床医生相关因素；3. 社会对肥胖、减肥手术和减肥外科医生的信念和态度；4. 经济、政府和机构因素；5. 减肥手术在其他治疗背景下。在整个数据中，以耻辱感的描述、临床医生的幻灭感、患者未得到指导和支持以及该领域监管和组织不足等形式，明显存在对肥胖和公共资金支持的减肥手术缺乏关注的情况。强调了患者在决定其手术进程中的作用。
参与者讨论了澳大利亚和新西兰减肥手术的众多障碍，但促进因素较少。他们的一些观点值得与其他减肥多学科团队成员和患者进行探讨，以进一步了解如何改进术前流程以满足患者需求并提高公平性。
