Xu Yihong, Li Wen, Zhu Liping, Li Yunxia, Wang Jianan, Zhang Xiaoxiao, Ding Shanni, Wu Mizhi, Pan Hongying, Yu Weihua, Chen Jionghuang
Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
BMC Public Health. 2025 Aug 11;25(1):2725. doi: 10.1186/s12889-025-24035-x.
The retention rate of Bariatric Surgery (BS) remains a critical concern, yet the decision-making mechanism among obese individuals considering BS is still unclear. This study aims to identify key stages and core mechanisms in the BS decision-making process.
Qualitative, one-on-one, and focus group in-depth interviews were conducted.
Semi-structured interviews were conducted in China from September 2022 to February 2023. Using the Straussian Grounded Theory (SGT) approach, an iterative analysis of the BS decision-making process was performed, ultimately constructing a decision-making mechanism for obese patients opting for BS. Reporting followed the SRQR checklist.
Interviews were conducted with 21 obese individuals scheduled for BS one day before surgery. A theoretical model was developed to describe and explain the BS decision-making process. The study identified five key stages in the decision-making process: Initial Attention, Proactive Information-Seeking, Decision-Making Process, Definitive Surgical Decision, Preparation Phase, and Abandonment, with the Decision-Making Process being the most critical. The study examined the influence of External Environment on Cognitive Decision-Making, focusing on social pressure, social support, and peer support. Additionally, the Cognitive Trade-off Theory for Bariatric Surgery (CTT-BS) was established, incorporating five cognitive-level factors.
The identified decision-making stages and cognitive theory provide evidence to clarify the facilitators and barriers to BS motivation retention, offering insights for developing strategies to improve BS retention rates.
减肥手术（BS）的保留率仍是一个关键问题，但考虑接受减肥手术的肥胖个体的决策机制仍不明确。本研究旨在确定减肥手术决策过程中的关键阶段和核心机制。
进行定性、一对一和焦点小组深入访谈。
于2022年9月至2023年2月在中国进行半结构化访谈。采用施特劳斯扎根理论（SGT）方法，对减肥手术决策过程进行迭代分析，最终构建肥胖患者选择减肥手术的决策机制。报告遵循SRQR清单。
对21名计划在手术前一天接受减肥手术的肥胖个体进行了访谈。开发了一个理论模型来描述和解释减肥手术的决策过程。该研究确定了决策过程中的五个关键阶段：初始关注、主动寻求信息、决策过程、最终手术决策、准备阶段和放弃，其中决策过程最为关键。该研究考察了外部环境对认知决策的影响，重点关注社会压力、社会支持和同伴支持。此外，还建立了减肥手术认知权衡理论（CTT-BS），纳入了五个认知层面的因素。
所确定的决策阶段和认知理论为阐明减肥手术动机保留的促进因素和障碍提供了证据，为制定提高减肥手术保留率的策略提供了见解。
