Majstorovic Mia, Chur-Hansen Anna, Andrews Jane, Burke Anne L J
School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Obes Facts. 2025 Jun 28:1-11. doi: 10.1159/000547169.
Bariatric surgery effectively treats severe obesity; however, publicly funded bariatric surgery in Australia and New Zealand is limited. Bariatric surgeons play an important role in deciding individuals' suitability for surgery. This study explored Australian and New Zealand bariatric surgeons' views on barriers and enablers to bariatric surgery.
Sixteen bariatric surgeons and registrars across Australia and New Zealand were interviewed in 2023 about their opinions on barriers and enablers to bariatric surgery. Conventional qualitative content analysis was used to synthesise the data.
Eight content categories originated from the analysis: (1) patient characteristics; (2) factors related to a patient's residential location; (3) economic factors; (4) lifestyle factors; (5) health-related factors; (6) surgery-related fears and concerns; (7) social factors; and (8) institutional and organisational factors. Surgical demand and supply issues were salient in discussions about the pre-operative process and patient (non)progression to surgery. Patients' financial circumstances were similarly emphasised. Societal values and norms, including gender stereotypes, were featured, and the role of close others was substantiated, with patients' families and friends considered both barriers and enablers to surgery.
Participants discussed more barriers than enablers to bariatric surgery. Their views generally aligned with the patient-based literature; however, the qualitative nature of the study allowed for the perceived reasons underlying the barriers and enablers to be explored. Findings offer potential avenues for modifying the pre-operative process to better support patients' needs and promote equity in access to surgery.
减肥手术能有效治疗重度肥胖；然而，澳大利亚和新西兰由公共资金资助的减肥手术有限。减肥外科医生在决定个人是否适合手术方面发挥着重要作用。本研究探讨了澳大利亚和新西兰减肥外科医生对减肥手术的障碍和促成因素的看法。
2023年，对澳大利亚和新西兰的16名减肥外科医生及住院医生就他们对减肥手术的障碍和促成因素的看法进行了访谈。采用传统的定性内容分析法对数据进行综合分析。
分析得出八个内容类别：（1）患者特征；（2）与患者居住地点相关的因素；（3）经济因素；（4）生活方式因素；（5）健康相关因素；（6）与手术相关的恐惧和担忧；（7）社会因素；以及（8）机构和组织因素。在关于术前流程以及患者是否能进行手术的讨论中，手术需求和供应问题很突出。患者的经济状况也同样受到强调。研究还提及了社会价值观和规范，包括性别刻板印象，并证实了亲近他人的作用，患者的家人和朋友被认为既是手术的障碍也是促成因素。
参与者讨论的减肥手术障碍多于促成因素。他们的观点总体上与基于患者的文献一致；然而，该研究的定性性质使得能够探究障碍和促成因素背后的可感知原因。研究结果为改进术前流程以更好地满足患者需求和促进手术机会平等提供了潜在途径。
