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减肥手术后患者的治疗负担体验——一项关于性别差异的探索性研究

Patients' Experiences of Treatment Burden After Bariatric Surgery-An Exploratory Study of Sex- and Gender Differences.

作者信息

Bruto Winberg Elin, Heijmans Monique

机构信息

University of Gothenburg, Gothenburg, Sweden.

Netherlands Institute for Health Services Research, Utrecht, Netherlands.

出版信息

Obes Surg. 2025 Aug 7. doi: 10.1007/s11695-025-08148-1.

DOI:10.1007/s11695-025-08148-1
PMID:40770169
Abstract

BACKGROUND

As treatment for severe obesity, bariatric surgery results in permanent changes to the body and requires lifestyle changes that are often life-long. The problems and challenges that people experience after bariatric surgery have not been systematically studied in regard to sex- and gender differences, although literature suggests that sex differences do exist.

METHODS

To study the problems and challenges that people experience after bariatric surgery, the innovative concept of treatment burden (TB) was used. TB goes beyond the experience of symptoms and looks at the broader challenges that patients may experience such as physical, technical, logistical, and sense-making challenges. Using a literature review of qualitative studies as well as a short qualitative survey among Swedish patients that had undergone bariatric surgery, attributes of TB after bariatric surgery were explored as well as possible sex- and gender differences.

RESULTS

The results of the literature review showed that challenges related to making sense, mentally coping with the period after treatment, and technical aspects of coping with the aftermath of surgery were the most experienced among patients. Although quantitative studies showed clear sex- and gender differences in complaints and outcomes between men and women, these were not assessed in qualitative studies.

CONCLUSIONS

TB as experienced by patients after bariatric surgery is a multidimensional concept that asks for a holistic approach of treatment after bariatric surgery. Although literature suggests sex- and gender differences in the personal experiences after surgery, more research is needed to be able to provide gender-sensitive care.

摘要

背景

作为重度肥胖的治疗方法,减肥手术会导致身体发生永久性变化,并且需要进行往往是终身的生活方式改变。尽管文献表明性别差异确实存在,但减肥手术后人们所经历的问题和挑战尚未针对性别差异进行系统研究。

方法

为了研究减肥手术后人们所经历的问题和挑战,采用了创新的治疗负担(TB)概念。治疗负担超越了症状体验,着眼于患者可能面临的更广泛挑战,如身体、技术、后勤和认知方面的挑战。通过对定性研究的文献综述以及对瑞典接受过减肥手术的患者进行的简短定性调查,探讨了减肥手术后治疗负担的属性以及可能存在的性别差异。

结果

文献综述结果表明,患者中最常经历的挑战与认知、心理应对治疗后的时期以及应对手术后果的技术方面有关。尽管定量研究显示男性和女性在投诉和结果方面存在明显的性别差异,但定性研究中并未对此进行评估。

结论

减肥手术后患者所经历的治疗负担是一个多维概念,需要对减肥手术后的治疗采取整体方法。尽管文献表明手术后个人经历存在性别差异,但需要更多研究才能提供对性别敏感的护理。

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本文引用的文献

1
Sex- and Gender-Related Differences in Obesity: From Pathophysiological Mechanisms to Clinical Implications.肥胖的性别差异:从病理生理机制到临床意义。
Int J Mol Sci. 2024 Jul 4;25(13):7342. doi: 10.3390/ijms25137342.
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Personal, external, and psychological factors influencing adherence to nutrition and diet in patients undergoing metabolic/bariatric surgery: a systematic synthesis of mixed methods research.影响代谢/减重手术患者营养和饮食依从性的个人、外部和心理因素:混合方法研究的系统综合。
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Exploring Social Support Dynamics After Bariatric Surgery: Insights From Patients and Providers.
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J Surg Res. 2024 Jul;299:1-8. doi: 10.1016/j.jss.2024.03.047. Epub 2024 Apr 26.
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Nutritional Deficiencies Before and After Bariatric Surgery in Low- and High-Income Countries: Prevention and Treatment.低收入和高收入国家减重手术后的营养缺乏:预防与治疗
Cureus. 2024 Feb 27;16(2):e55062. doi: 10.7759/cureus.55062. eCollection 2024 Feb.
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Developing a long-term follow up service for bariatric surgical patients in the community: Patient and professional perspectives.为社区肥胖症手术患者开展长期随访服务:患者及专业人士的观点
Obes Sci Pract. 2023 Jan 12;9(4):346-354. doi: 10.1002/osp4.658. eCollection 2023 Aug.
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Finding what works-Patients' long-term experiences of weight maintenance post bariatric surgery: A systematic review and thematic synthesis of qualitative studies.找到有效的方法-减重手术后患者长期保持体重的经验:系统评价和定性研究的主题综合分析。
Obes Rev. 2023 Nov;24(11):e13608. doi: 10.1111/obr.13608. Epub 2023 Jul 30.
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Patients' Pre and Post-Bariatric Surgery Experience of Dieting Behaviours: Implications for Early Intervention.患者在接受减重手术前后的节食行为体验:对早期干预的启示。
Obes Surg. 2023 Sep;33(9):2702-2710. doi: 10.1007/s11695-023-06689-x. Epub 2023 Jul 19.
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The Impact of Bariatric Surgery on Quality of Life in Patients with Obesity.减肥手术对肥胖患者生活质量的影响。
J Clin Med. 2023 Jun 23;12(13):4225. doi: 10.3390/jcm12134225.
9
Patients' Perspectives on Dietary Patterns and Eating Behaviors During Weight Regain After Gastric Bypass Surgery.患者在胃旁路手术后体重反弹期间对饮食模式和饮食习惯的看法。
Obes Surg. 2023 Aug;33(8):2517-2526. doi: 10.1007/s11695-023-06718-9. Epub 2023 Jul 5.
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Patient experiences of weight loss and eating after bariatric surgery: A systematic review and qualitative synthesis.患者在减重手术后的减肥和饮食体验:系统评价和定性综合。
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