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Bi Y, He L, Yan F, Liu Y, Zhang Y, Gong R. Personal, external, and psychological factors influencing adherence to nutrition and diet in patients undergoing metabolic/bariatric surgery: a systematic synthesis of mixed methods research. Acta Diabetol 2024:10.1007/s00592-024-02319-9. [PMID: 38888635 DOI: 10.1007/s00592-024-02319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/06/2024] [Indexed: 06/20/2024]
Abstract
AIMS To offer a holistic view of the personal, external, and psychological factors influencing adherence to nutrition and diet in patients undergoing metabolic/bariatric surgery. METHODS This systematic synthesis of mixed methods research involved a comprehensive search for articles in English databases, including PubMed, Cochrane Library, Web of Science, EBSCO, Scopus, and Embase, as well as Chinese databases. The search encompassed articles published from the inception of the database up to June 2023. Following the evaluation of literature quality and extraction of relevant information from the selected studies, data from both quantitative and qualitative studies were integrated. The extracted data were analyzed separately, and themes were identified and summarized to elucidate the factors influencing adherence to nutritional and dietary guidelines. The methodology adhered to the guidelines recommended by the Joanna Briggs Institute (JBI) for mixed methods systematic evaluations. RESULTS Three themes and their corresponding descriptive elements were identified, including: (1) Personal factors: subjective factors (attitude, capability, awareness, behaviors), objective factors (age, sex, work status, economic level, physical activity, dietary habits, weight change); (2) External factors: medication (quantity of pills, complexity of intake times, side effects, unpleasant smell or taste), surgery factor, social influences (family members, dietitians, and peers); (3) Psychological factors: self-efficacy, attachment anxiety, and mental health problems. CONCLUSIONS The synthesis provided a comprehensive overview of the factors influencing postoperative compliance of nutrition and diet among patients undergoing metabolic and bariatric surgery. It emphasizes the necessity for clinical staff to tailor interventions based on these diverse factors, as well as to attach importance to patients' mental health, giving multidimensional dietary guidance and health care.
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Affiliation(s)
- Yaxin Bi
- Northern Jiangsu People's Hospital, Yangzhou, People's Republic of China
| | - Lijun He
- Northern Jiangsu People's Hospital, Yangzhou, People's Republic of China
| | - Fang Yan
- Northern Jiangsu People's Hospital, Yangzhou, People's Republic of China
| | - Yi Liu
- Northern Jiangsu People's Hospital, Yangzhou, People's Republic of China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, People's Republic of China
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, People's Republic of China
| | - Ronghua Gong
- Northern Jiangsu People's Hospital, Yangzhou, People's Republic of China.
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Mihalsky KP, Tran R, Moreno-Garcia F, Stenberg C, Mier Giraud F, Hare A, Quiroz LH, Fischer LE. Urinary incontinence in women who have undergone bariatric surgery. Surg Endosc 2023; 37:8791-8798. [PMID: 37587240 DOI: 10.1007/s00464-023-10299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Obesity is a known risk factor for urinary incontinence (UI). As bariatric surgery can result in significant and sustainable weight loss, many chronic diseases closely linked to obesity have likewise shown improvement after surgical weight loss. We propose that bariatric surgery may significantly improve obesity-related UI symptoms as well as improve quality of life. METHODS AND PROCEDURES This is an interim analysis of an ongoing, prospective, single-institution observational study looking at UI in women enrolled in a bariatric surgery program. Participants completed the Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), King's Health Questionnaire (KHQ), and Patient Global Impression of Improvement (PGI-I). Questionnaires were administered upon enrollment, pre-operatively, and at 3, 6, and 12 months post-operatively. Demographic data were collected at each interval and analyzed with descriptive statistics. RESULTS At analysis, 108 patients had enrolled in the study and 60% had progressed to surgery. We analyzed the following surveys: enrollment (n = 108), pre-operative (n = 43), 3-month (n = 29), 6-month (n = 26), and 1-year (n = 27). Mean BMI decreased from 49.8 to 31.1 at 1-year. All surveys showed significant improvement in UI symptoms over time. Overall, UI symptoms (PDFI-20) are correlated with BMI at time of survey and %TBWL (p = 0.03, p = 0.019). Additionally, perception of symptom improvement with surgery (PGI-I) improved over time (3-month p = 0.0289, 6-month p = 0.0024, 12-month p = 0.0035). Quality of life related to UI symptoms (KHQ) significantly improved after surgery (p = 0.0047 3-month, p = 0.0042 6-month, p = 0.0165 1-year). CONCLUSIONS Although the relationship is complex and likely depends on many factors, weight loss after bariatric surgery is associated with improvement in UI symptoms and UI-related quality of life. Bariatric surgery can play a role in the long-term treatment of UI in women with obesity that may negate the need for further invasive UI procedures.
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Affiliation(s)
- K Paige Mihalsky
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
| | - Rachel Tran
- University of Oklahoma School of Medicine, Oklahoma City, OK, USA
| | | | - Caitlin Stenberg
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Fernando Mier Giraud
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Adam Hare
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Lieschen H Quiroz
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Laura E Fischer
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
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Pfabigan DM, Hertel JK, Svanevik M, Lindberg M, Sailer U, Hjelmesæth J. Single-centre, non-randomised clinical trial at a tertiary care centre to investigate 1-year changes in social experiences and biomarkers of well-being after bariatric surgery in individuals with severe obesity: protocol for the Bariatric Surgery and Social Experiences (BaSES) study. BMJ Open 2023; 13:e071332. [PMID: 37640458 PMCID: PMC10462928 DOI: 10.1136/bmjopen-2022-071332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/13/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Obesity is linked to increased loneliness and less enjoyment of social interactions. While bariatric surgery is the most effective treatment targeting severe obesity, there is limited understanding as to whether patients experience social interactions differently after surgery. The Bariatric Surgery and Social Experiences study is designed to assess potential changes in how much patients enjoy and engage in daily social interactions 1 year after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). METHODS AND ANALYSIS Single-centre, non-randomised clinical trial carried out at the Department of Endocrinology, Obesity and Nutrition at Vestfold Hospital Trust, Norway. Eligible patients (N=113) will undergo either RYGB, SG or single anastomosis sleeve ileal (SASI) bypass. The primary outcome measure is change in the social experience score (assessed with a questionnaire) from a presurgery to a follow-up assessment 1 year after RYGB and SG. The respective changes after SASI bypass will be assessed and considered exploratory. ETHICS AND DISSEMINATION The most recent protocol version of this study was reviewed and approved by the Regional Committee for Medical Research Ethics South East Norway (REK sør-øst A) on 29 August 2022 (ref: 238406). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NCT05207917.
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Affiliation(s)
- Daniela Melitta Pfabigan
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jens Kristoffer Hertel
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
| | - Marius Svanevik
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tønsberg, Norway
| | - Morten Lindberg
- Department of Medical Biochemistry, Vestfold Hospital Trust, Tønsberg, Norway
| | - Uta Sailer
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
| | - Jøran Hjelmesæth
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, University of Oslo, Oslo, Norway
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Graham Y, Hayes C, Mahawar K, Tahrani A, López Landiribar JM, Martinez P. Social Aspects of Bariatric Surgery. OBESITY, BARIATRIC AND METABOLIC SURGERY 2023:1299-1310. [DOI: 10.1007/978-3-030-60596-4_116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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An interpretive phenomenological analysis study exploring the lived experience of personal growth in individuals who have experienced weight loss during a structured weight loss programme. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Carr P, Keighley T, Petocz P, Blumfield M, Rich GG, Cohen F, Soni A, Maimone IR, Fayet-Moore F, Isenring E, Marshall S. Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support. BMC PRIMARY CARE 2022; 23:26. [PMID: 35123409 PMCID: PMC8817771 DOI: 10.1186/s12875-022-01629-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
Abstract
Background The laparoscopic sleeve gastrectomy (LSG) and the incisionless endoscopic sleeve gastroplasty (ESG) weight loss procedures require further investigation of their efficacy, safety and patient-centered outcomes in the Australian setting. Methods The aim was to examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or LSG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support. Data were from a two-arm prospective cohort study that followed patients from baseline to 12-months postprocedure from a medical center in Queensland. Percent excess weight loss (%EWL) was the primary outcome. Secondary outcomes were body composition (fat mass, fat-free mass, android:gynoid ratio, bone mineral content) via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events. Results 16 ESG (19% attrition; 81.2% female; aged:41.4 (SD: 10.4) years; BMI: 35.5 (SD: 5.2) kg/m2) and 45 LSG (9% attrition; 84.4% female; aged:40.4 (SD: 9.0) years; BMI: 40.7 (SD: 5.6) kg/m2) participants were recruited. At 12-months postprocedure, ESG %EWL was 57% (SD: 32%; p < 0.01) and LSG %EWL was 79% (SD: 24%; p < 0.001). ESG and LSG cohorts improved QoL (19.8% in ESG [p > 0.05]; 48.1% in LSG [p < 0.05]), liver function (AST: − 4.4 U/L in ESG [p < 0.05]; − 2.7 U/L in LSG [p < 0.05]), HbA1c (− 0.5% in ESG [p < 0.05]; − 0.1% in LSG [p < 0.05]) and triglycerides (− 0.6 mmol/L in ESG [p > 0.05]; − 0.4 mmol/L in LSG [P < 0.05]) at 12-months. Both cohorts reduced fat mass (p < 0.05). The ESG maintained but LSG decreased fat-free mass at 6-months (p < 0.05); and both cohorts lost fat-free mass at 12-months (p < 0.05). There were no adverse events directly related to the procedure. The ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure. Conclusions In this setting, the ESG and LSG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at 6-months but both cohorts lost fat-free mass at 12-months postprocedure. Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings. Trial registration This study was registered prospectively at the Australia New Zealand Clinical Trials Registry on 06/03/2018, Registration Number ACTRN12618000337279. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01629-7.
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Affiliation(s)
- Prudence Carr
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Tim Keighley
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Michelle Blumfield
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Graeme G Rich
- Bariatric Gastroenterologist & Director, Bariatrics Australia, Sydney Adventist Hospital, Wahroonga, Australia
| | - Felicity Cohen
- Weightloss Solutions Australia, Varsity Lakes, Queensland, Australia
| | - Asha Soni
- Weightloss Solutions Australia, Varsity Lakes, Queensland, Australia
| | | | - Flavia Fayet-Moore
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Elizabeth Isenring
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales. .,Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.
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Zulin A, Rêgo ADS, Santos FGTD, Cardoso LCB, Santos JLGD, Salci MA, Radovanovic CAT. Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory. Rev Bras Enferm 2022; 75:e20210463. [DOI: 10.1590/0034-7167-2021-0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. Methods: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. Results: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon “Re-signifying life after bariatric surgery” was constructed. Final Considerations: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.
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Peden CJ, Ghaferi AA, Vetter TR, Kain ZN. Perioperative Health Services Research: Far Better Played as a Team Sport. Anesth Analg 2021; 133:553-557. [PMID: 34257198 DOI: 10.1213/ane.0000000000005590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Carol J Peden
- From the Department of Anesthesiology, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Anesthesiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amir A Ghaferi
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Thomas R Vetter
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Zeev N Kain
- Departments of Anesthesiology and Perioperative Care and Medicine, University of California, Irvine.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,CHOC Children's Hospital, Orange, California
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Patients' views of long-term results of bariatric surgery for super-obesity: sustained effects, but continuing struggles. Surg Obes Relat Dis 2021; 17:1152-1164. [PMID: 33785271 DOI: 10.1016/j.soard.2021.02.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/29/2021] [Accepted: 02/20/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Bariatric surgery is a standard treatment for severe obesity, but little is known about patients' perceptions about the long-term impact of such surgery. OBJECTIVE The aim of this study was to explore patients' experiences of living with a bariatric procedure for more than a decade. SETTING University hospital. METHODS At the 10-year follow-up after undergoing Roux-en-Y gastric bypass (RYGB) or biliopancreatic diversion with duodenal switch (BPD/DS), 18 consecutive patients from a previous randomized controlled trial were assessed with a semi-structured interview. Data were analyzed using thematic analysis. RESULTS When asked to reflect broadly on their experiences of living with bariatric surgery for over a decade, the participants rarely mentioned procedure-specific issues and complications. Instead, their accounts revealed 2 broad themes: sustained effects after surgery, incorporating subthemes of better health, brighter futures, and better eating and weight regulation, and continuing struggles, including difficulties with physical activity, finding support, helping their children with overweight, and self-criticism. Many positive changes were sustained, but continuing personal struggles were similar to those presurgery. CONCLUSIONS Participants expressed overall satisfaction with their bariatric surgery and related outcomes. Most participants acknowledged a continued effect on their appetite, which could be important information for patients who worry about a diminished effect after the first year postsurgery. Participants were prone to self-blame when things did not turn out the way they wanted. Therefore, healthcare providers must build a trustful relationship with their patients, so they will not hesitate to return when they face problems such as weight gain.
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Graham Y, Hayes C, Mahawar K, Tahrani A, López Landiribar JM, Martinez P. Social Aspects of Bariatric Surgery. OBESITY, BARIATRIC AND METABOLIC SURGERY 2021:1-12. [DOI: 10.1007/978-3-030-54064-7_116-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/15/2021] [Indexed: 09/01/2023]
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Abstract
PURPOSE OF REVIEW This review aims to evaluate the latest evidence on the treatment options for perceived poor responders to bariatric surgery and provide practitioners with a guide on when to consider revisional surgery and when to consider alternatives. RECENT FINDINGS The use of adjuvant pharmacotherapy has been increasingly described in the literature as an adjunct to primary bariatric surgery, in order to attain more weight loss or better control of obesity-related complications. The newer anti-obesity and anti-diabetes drugs also have cardiorenal benefits, which are shown in recent cardiovascular outcome trials. Revisional bariatric surgery has emerged as a distinctive entity and can be broadly organized into three categories: corrective, conversion, and reversal surgeries. Careful patient selection and preoperative optimization are needed to ensure long-term favorable outcomes. Newer treatment modalities involving the use of anti-obesity medications and endoscopic bariatric interventions provide patients and healthcare providers with more options, when faced with the challenge of poor response after bariatric surgery.
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Affiliation(s)
- Phong Ching Lee
- Department of Endocrinology, Singapore General Hospital, 20 College Rd, 169856, Singapore, Singapore.
| | - John B Dixon
- Clinical Obesity Research, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Pei Yin Sim
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, 20 College Rd, 169856, Singapore, Singapore
| | - Chin Hong Lim
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, 20 College Rd, 169856, Singapore, Singapore
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Varban OA. Quality of life after bariatric surgery is about weight loss…and more. Surg Obes Relat Dis 2020; 16:e59-e60. [PMID: 32753299 DOI: 10.1016/j.soard.2020.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Oliver A Varban
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Varns JA, Fish AF, Eagon JC. Testing a model of body image in the bariatric surgery patient. Appl Nurs Res 2020; 52:151228. [PMID: 31955943 DOI: 10.1016/j.apnr.2019.151228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/24/2019] [Accepted: 12/21/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose was to test a published model of body image in the bariatric surgery patient in the clinical office setting. BACKGROUND A model was created based on clinical observations during field work and the literature. It focuses on five concepts of body image: body attitude, body checking, appearance orientation, perceived body size, and perceived body space. Testing this model 3 months after surgery is important because morphology changes rapidly influencing early changes in body image, yet there is a paucity of research at this time point. METHODS For this study of 67 bariatric surgery patients, sequential sampling was used. Body image and anthropometric measures (body mass index and other weight loss indicators) were obtained at baseline and 3-months postoperatively. Established model testing criteria were used. RESULTS Over 3 months, mean body mass index was significantly reduced. Mean body image was significantly improved regarding all concepts in the model, except body checking. Body image improvement varied widely when individual responses were examined. CONCLUSIONS The model was successfully tested. Data on the five concepts in the model provided a body image profile at 3 months indicating individuals' degree of improvement. Areas of non-improvement in the early postoperative phase may signal the need for interventions, like support or psychological counseling, for patients who might be struggling with views of themselves after surgery. Preliminary recommendations are made regarding several of the instruments and their use clinically. Researchers should take into consideration the study's short 3-month time frame when designing future studies.
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Affiliation(s)
- Julie A Varns
- St. John's College of Nursing, 729 East Carpenter, Springfield, IL 62702, United States of America.
| | - Anne F Fish
- College of Nursing, University of Missouri, One University Blvd., St. Louis, MO. 63121, United States of America.
| | - J Christopher Eagon
- Washington University School of Medicine, 4921 Parkview Place, Suite C, Floor 8, St. Louis, MO 63110, United States of America.
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Katsogiannos P, Randell E, Sundbom M, Rosenblad A, Eriksson JW, Leksell J. Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients' experiences during 2 years of follow-up. Diabetol Metab Syndr 2020; 12:90. [PMID: 33062061 PMCID: PMC7552522 DOI: 10.1186/s13098-020-00597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/01/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND To examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods. METHODS Thirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed. RESULTS Significant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme "Finding a balance between the experience of the new body weight and self-confidence". CONCLUSIONS The improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness.Trial registration ClinicalTrials.gov Identifier NCT02729246. Date of registration 6 April 2016 - Retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02729246?term=bariglykos&draw=2&rank=1.
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Affiliation(s)
- Petros Katsogiannos
- Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Randell
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Andreas Rosenblad
- Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University, Uppsala, Sweden
| | - Jan W. Eriksson
- Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University, Uppsala, Sweden
| | - Janeth Leksell
- Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University, Uppsala, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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Whitehead L, Tierney S, Biggerstaff D, Perkins GD, Haywood KL. Trapped in a disrupted normality: Survivors' and partners' experiences of life after a sudden cardiac arrest. Resuscitation 2019; 147:81-87. [PMID: 31887365 DOI: 10.1016/j.resuscitation.2019.12.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/27/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022]
Abstract
AIM OF THE STUDY Advances in resuscitation science have resulted in a growing number of out-of-hospital cardiac arrest (OHCA) survivors. However, we know very little about the natural history of recovery and the unmet needs of survivors and their partners. This qualitative study sought to address this knowledge gap to improve understanding of the consequences of surviving cardiac arrest. METHODS In-depth qualitative interviews were undertaken separately with survivors and their partners between 3 and 12-months following the cardiac arrest. An interpretative phenomenological approach (IPA) to data analysis was adopted. Developing themes were discussed between members of the research team. RESULTS 8 survivors (41-79 years; 5 male; mean time 6.3 months post-hospital discharge) and 3 partners (1 male) were interviewed. The key (super-ordinate) theme of being 'trapped in a disrupted normality' was identified within the data. Five related subordinate themes included: existential impact, physical ramifications, emotional consequences, limiting participation in social activities and altered family roles. CONCLUSION Recovery for survivors is hindered by a wide range of physical, emotional, cognitive, social and spiritual challenges that disrupt perceptions of 'normality'. Survivors and their carers may benefit from focussing on establishing a 'new normal' rather than striving to achieve a pre-cardiac social and physical position. Survivor-centred assessment should support rather than undermine this goal.
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Affiliation(s)
- Laura Whitehead
- Warwick Clinical Trials Unit, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Deborah Biggerstaff
- Warwick Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry. CV4 7AL, United Kingdom
| | - Gavin D Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - Kirstie L Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, The University of Warwick, Gibbet Hill, Coventry. CV4 7AL, United Kingdom.
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