Effects of Nurse-Led Education on Quality of Life and Weight Loss in Patients Undergoing Bariatric Surgery

The roles of nurses in preventing and managing excess weight among adults: A systematic scoping review

BACKGROUND

Nurses are well-positioned to tackle obesity but literature on their roles remains unclear.

PURPOSE

To present an overview of nurses' roles in preventing and managing excess weight among adults.

METHODS

Following the Arksey and O'Malley methodology, 11 databases were searched from inception to September 2023. Eligibility screening showed good inter-rater reliability (κ=0.84). Articles were appraised using the Mixed Methods Appraisal Tool and relevant data were charted.

DISCUSSION

In total, 86 studies were included with 41.9% published in America and 3.5% and 26.7% of the studies addressing overweight and obesity management, respectively. Nurses acted as health advocates (100%), offered psychological support (54.7%), fostered collaboration and networks (48.8%), and facilitated interventions (9.3%) addressing intrapersonal, organizational, and community-level factors of the socioecological model.

CONCLUSION

Further investigations into nurses' roles in the exclusive management of overweight and obesity are warranted. Focus on their contributions at the interpersonal and policy levels is also necessary.

Nurse-led intervention for the management of bariatric surgery patients: A systematic review

The prevalence of obesity has become a global health concern, and severe obesity is associated with various chronic diseases and decreased quality of life. Bariatric surgery has shown success in treating obesity. Nevertheless, some patients experience weight regain and unsatisfactory outcomes. Multidisciplinary interventions have been shown to improve postoperative outcomes. Case managers, often specialized nurses, play a crucial role in patient support and coordination of care. However, the diverse design of case-managing interventions hinders the assessment of their success. Thus, the aim of this review is to identify the most successful structural characteristics of case-managing interventions, with or without the support of e-Health, in the process of perioperative management of bariatric surgery patients. A systematic literature review was conducted following the PRISMA guidelines. PubMed, MEDLINE, EBSCOhost, and CINAHL databases were searched for relevant studies published in the last 10 years. Eligible studies included randomized controlled trials, controlled clinical studies, case studies, or observational studies that evaluated perioperative care in bariatric surgery. The PICO framework was used to frame the search strategy. The initial search yielded 225 articles, of which 10 studies met the inclusion criteria. Nurse-led case-managing interventions with a multidisciplinary approach showed positive results in weight loss, physical activity, and quality of life. Patient-centered care models were found to promote adherence to treatment and patient satisfaction. E-Health technologies improved quality of life but not weight loss. The duration of behavioral interventions and the long-term outcomes after surgery remained unclear. Nurse-led case-management interventions, with a focus on behavioral change and multidisciplinary approaches, show promise in improving outcomes in bariatric surgery patients. Patient-centered care models and longer term interventions may contribute to sustained weight loss and better postoperative outcomes. Further research is needed to determine the optimal duration of interventions and the long-term effects on weight maintenance.

The Effects of e-Mobile Training and Consultancy Services on Bariatric Surgery Patients: A Randomized Clinical Trial

PURPOSE

This study was conducted as a randomized controlled trial to determine the effects of e-mobile training and consultancy services on self-care agency, body image, and quality of life in patients undergoing bariatric surgery.

MATERIAL AND METHODS

This study was conducted as a randomized controlled interventional study. The sample of the study consisted of 51 patients who met the sample selection criteria and volunteered to participate in the study in the Obesity Center of a City Hospital. The patients in the experimental group received e-mobile training and consultancy services with a mobile application developed specifically for bariatric surgery that started before the operation and lasted for 3 months after the operation. CONSORT checklist was used to report the current study.

RESULTS

A statistically significant difference was found in the mean scores of Self-Care Agency Scale, Body Image Scale, Moorehead-Ardelt Quality of Life II, and BMI of the patients in the experimental and control groups according to the processes (p < 0.05). There was no statistically significant difference between the groups in terms of preoperative, 1st, 2nd, and 3rd months of Self-Care Agency, Body Image, and Quality of Life scale mean scores (p > 0.05). There was a statistically significant difference between the groups in favor of the experimental group in terms of the 1st, 2nd, and 3rd month BMI averages (p < 0.05).

CONCLUSIONS

The findings indicate that e-mobile training and consultation services given to patients undergoing bariatric surgery were effective in BMI measurements, but not on self-care agency, body image, and quality of life.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05278767.

Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review

BACKGROUND

Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking.

AIM

To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs.

METHODS

This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021.

RESULTS

A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes.

CONCLUSION

Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes.

Bariatrik Cerrahi Sonrası Öz-Etkililiğin ve Seçilmiş Faktörlerin Yaşam Kalitesine Etkisi

Giriş: Bariatrik cerrahinin kilo vermede etkili olmasının yanı sıra fizyolojik ve psikososyal sağlık üzerine de önemli etkileri vardır. Bu etkilerden biri de yaşam kalitesi üzerinedir. Amaç: Bariatrik cerrahi sonrası öz-etkililiğin ve seçilmiş faktörlerin yaşam kalitesine etkisini incelemektir. Yöntem: Araştırma kesitsel, tanımlayıcı ve kestirim tipi bir araştırmadır. Araştırma örneklemini bariatrik cerrahi yapılan 103 hasta oluşturmuştur. Veriler Eylül 2018-Temmuz 2019 tarihleri arasında sosyodemografik özellikler formu, Kilonun Yaşam Kalitesine Etkisi Ölçeği ve Öz etkililik Yeterlilik Ölçeği kullanılarak toplanmıştır. Bulgular: Hastaların yaş ortalaması 33.70±8.13 olup ameliyat sonrası geçen süre 9.64±5.22 ay olarak bulunmuştur. Hastaların tamamına sleeve gastrektomi ameliyatı yapılmıştır. Hastaların Kilonun Yaşam Kalitesine Etkisi Ölçeği toplam puan ortalaması 75.12±20.14; Öz etkililik Yeterlik Ölçeği toplam puan ortalaması 51.25±6.57 olarak bulunmuştur. Hastaların yaşam kalitesini etkileyen faktörler incelendiğinde modelin anlamlı olduğu belirlenmiştir. Modele dahil edilen değişkenler hastaların yaşam kalitesinin %52’sini açıklamaktadır. Ameliyat sonrası geçen sürenin (β: -0.653, p = 0.000) anlamlı ve negatif yönde yaşam kalitesini yordadığı saptanmıştır. Sonuç: Hastaların yaşam kalitelerinin orta düzey ve öz-etkililiklerinin düşük düzeyde olduğu bulunmuştur. Hastalarda Öz etkililiğin yaşam kalitesi üzerine etkisi olmadığı bulunmuştur. Hastalarda bariatrik cerrahi sonrası geçen süre arttıkça yaşam kalitesinin düştüğü saptanmıştır. Hastaların ameliyat sonrası yaşam kalitesinin arttırılması için hemşirelerin ve ekip üyelerinin ameliyat sonrası uzun dönem hastaları izlemesi önerilmektedir.