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法国减重手术后随访的定性研究:一种新型医患关系

Qualitative study on postbariatric surgery follow-up in France: a new patient-physician relationship.

作者信息

Hannoyer Dimitri, Tatulashvili Sopio, Morsa Maxime, Garnier Nathalie, Moisan Christine, Molleville Julie, Tresallet Christophe, Reach Gérard, Gagnayre Rémi, Cosson Emmanuel, Bihan Hélène

机构信息

Department of Endocrinology, Diabetes, Nutrition, APHP, Avicenne Hospital, Bobigny, France.

UREN (Unit of Research in Nutritional Epidemiology), UMR U557 INSERM/U11125 INRAE, University Sorbonne Paris Nord, Bobigny, France.

出版信息

BMJ Open. 2025 Jun 30;15(6):e092768. doi: 10.1136/bmjopen-2024-092768.

Abstract

BACKGROUND

Most studies on bariatric patients to date have only examined mortality and morbidities in terms of surgery or no surgery. Few have investigated loss to follow-up in post-surgery patients.

PURPOSE

This study aimed to describe the dynamics behind non-adherence to follow-up in bariatric patients postsurgery.

DESIGN

Using semi-structured interviews, we performed a qualitative study. Using a thematic analysis, we described themes involved in patient adherence to postsurgery follow-up.

SETTING

Participants were recruited from a university hospital near Paris and via social networks.

PARTICIPANTS

17 patients who had undergone surgery, some of whom were lost to follow-up, 15 women and 2 men, were interviewed, during a mean time of 90 min. 10 were adherent, and 7 were lost to follow-up.

RESULTS

Follow-up was seen as a support in which the care provider-patient relationship can act on the four following themes: (1) regaining control, (2) knowledge acquisition, (3) management of fears and (4) overall restructuring of one's life postsurgery.

CONCLUSIONS

Patients' experiences and representations of postsurgery follow-up should be documented in detail in order to define the specific roles of the various care providers offering support to this population, and to strengthen the coordination of care pathways between these actors. In addition, improving the quality of communication could improve adherence to follow-up after bariatric surgery.

摘要

背景

迄今为止,大多数关于肥胖症患者的研究仅从接受手术或未接受手术的角度考察了死亡率和发病率。很少有研究调查手术后患者的失访情况。

目的

本研究旨在描述肥胖症患者手术后不坚持随访背后的动态情况。

设计

我们采用半结构化访谈进行了一项定性研究。通过主题分析,我们描述了患者坚持术后随访所涉及的主题。

背景

参与者从巴黎附近的一家大学医院以及通过社交网络招募。

参与者

17名接受过手术的患者接受了访谈,其中一些人失访了,包括15名女性和2名男性,平均访谈时间为90分钟。10人坚持随访,7人失访。

结果

随访被视为一种支持,在这种支持中,医护人员与患者的关系可以作用于以下四个主题:(1)重新获得控制,(2)知识获取,(3)恐惧管理,以及(4)术后生活的全面重塑。

结论

应详细记录患者术后随访的经历和认知,以便确定为该人群提供支持的各种医护人员的具体作用,并加强这些行为者之间护理途径的协调。此外,提高沟通质量可以提高肥胖症手术后的随访依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9cc/12211837/bf64c47187d3/bmjopen-15-6-g001.jpg

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