Open Access
Subscription Access
What is needed to support bariatric surgery recipients’ long-term health and wellbeing? Bariatric clinic staff’s perspectives
Abstract
Rationale and Aim: Not all bariatric surgery recipients are able to sustain long-term weight loss and weight maintenance. The purpose of this study was to explore what bariatric clinic staff perceive is needed to best support the long-term health and wellbeing of bariatric surgery recipients.
Methods: Thirteen bariatric clinic staff completed an online questionnaire, adapted from a previously created tool. The revised tool was evaluated by 3 bariatric clinic staff prior to implementation and contained 5 close-ended demographic items and 6 open-ended questions. Demographic items were analyzed using descriptive statistics and inductive content analysis was used to identify emerging themes in participants’ in-depth open ended responses. Methods were employed throughout to support data trustworthiness.
Results: All participants were female, ranged from 45-59 years old and worked in the field of bariatric surgery on average for approximately 3 years and 3 months (± 32.2 months). Bariatric clinic staff believed follow-up appointments, bariatric surgery-related education and assessing readiness to change were the most helpful aids. A lack of: ongoing counselling, financial support for excess skin removal, family physicians with expertise in bariatric surgery and access to allied health professionals were deemed needed but unavailable. Recommendations to address challenges included offering one-on-one counselling and providing education and resources for Family Health Teams and others.
Conclusions: This is the first study detailing the perspectives of bariatric care-specific providers on bariatric surgery recipients’ needs. Overall, this study provides a complementary viewpoint to the needs and perspectives of surgery recipients and develops our understanding of optimal, feasible and person-centered bariatric care.
Keywords
References
Nigro, E., Scudiero, O., Monaco, M.L., Palmieri, A., Mazzarella, G., Costagliola, C., Bianco, A. & Daniele, A. (2014). New insight into adiponectin role in obesity and obesity-related diseases. BioMed Research International doi: 10.1155/2014/658913.
World Health Organization. (2014). Global status report on noncommunicable diseases 2014. Geneva: World Health Organization. Available at: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf?ua=1. Accessed April 20, 2017.
NHLBI Obesity Education Initiative, National Heart, Lung, Blood Institute, North American Association for the Study of Obesity, Expert Panel on the Identification, Treatment of Overweight and Obesity in Adults (US). (2002). The practical guide: identification, evaluation, and treatment of overweight and obesity in adults (No. 2-4084). National Heart, Lung, and Blood Institute. Available at: https://www.nhlbi.nih.gov/files/docs/guidelines/prctgd_c.pdf. Accessed April 20, 2017.
Dixon, J.B., le Roux, C.W., Rubino, F. & Zimmet, P. (2012). Bariatric surgery for type 2 diabetes. The Lancet 379 (9833) 2300-2311.
Buchwald, H. & Oien, D.M. (2013). Metabolic/bariatric surgery worldwide 2011. Obesity Surgery 23 (4) 427-436.
Poirier, P., Cornier, M.A., Mazzone, T., Stiles, S., Cummings, S., Klein, S., McCullough, P.A., Fielding, C.R. & Franklin, B.A. (2011). Bariatric surgery and cardiovascular risk factors. Circulation 123 (15) 1683-1701.
Colquitt, J.L., Picot, J., Loveman, E. & Clegg, A.J. (2009). Surgery for obesity. Cochrane Database of Systematic Reviews CD003641.
Gloy, V.L., Briel, M., Bhatt, D.L., Kashyap, S.R., Schauer, P.R., Mingrone, G., Bucher, H.C. & Nordmann, A.J. (2013). Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. British Medical Journal 347, 5934.
Wolfe, B.M., Kvach, E. & Eckel, R.H. (2016). Treatment of Obesity. Circulation Research 118 (11) 1844-1855.
Eldar, S., Heneghan, H.M., Brethauer, S.A. & Schauer, P.R. (2011). Bariatric surgery for treatment of obesity. International Journal of Obesity 35, S16-S21.
Kaul, A. & Sharma, J. (2011). Impact of bariatric surgery on comorbidities. Surgical Clinics of North America 91 (6) 1295-1312.
Pories, W.J. (2008). Bariatric surgery: risks and rewards. Journal of Clinical Endocrinology & Metabolism 93 (11 Supplement 1) s89-s96.
Cooper, T.C., Simmons, E.B., Webb, K., Burns, J.L. & Kushner, R.F. (2015). Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery. Obesity Surgery 25 (8) 1474-1481.
Magdaleno, R., Chaim, E.A., Pareja, J.C. & Turato, E.R. (2011). The psychology of bariatric patient: what replaces obesity? A qualitative research with Brazilian women. Obesity Surgery 21 (3) 336-339.
McKenzie, J.F., Neiger, B.L. & Thackeray, R. (2017). Planning, Implementing and Evaluating Health Promotion Programs. 7th edn. Toronto: Pearson.
Liu, R.H. & Irwin, J.D. (2017). Bariatric Surgery Recipients' Needs and Perspectives on Maintaining Long-Term Health and Well-Being. Bariatric Surgical Practice and Patient Care Available at: https://doi.org/10.1089/bari.2016.0043
Gittelsohn, J., Evans, M., Story, M., Davis, S.M., Metcalfe, L., Helitzer, D.L. & Clay, T.E. (1999). Multisite formative assessment for the Pathways study to prevent obesity in American Indian schoolchildren. American Journal of Clinical Nutrition 69 (4) 767s-772s.
Gittelsohn, J., Evans, M., Helitzer, D., Anliker, J., Story, M., Metcalfe, L., Davis, S. & Cloud, P.I. (1998). Formative research in a school-based obesity prevention program for Native American school children (Pathways). Health Education Research 13 (2) 251-265.
Ferrante, J.M., Piasecki, A.K., Ohman-Strickland, P.A. & Crabtree, B.F. (2009). Family Physicians’ Practices and Attitudes Regarding Care of Extremely Obese Patients. Obesity (Silver Spring, Md.) 17 (9) 1710-1716.
Brown, I., Stride, C., Psarou, A., Brewins, L. & Thompson, J. (2007). Management of obesity in primary care: nurses’ practices, beliefs and attitudes. Journal of Advanced Nursing 59 (4) 329-341.
Balduf, L.M. & Farrell, T.M. (2008). Attitudes, beliefs, and referral patterns of PCPs to bariatric surgeons. Journal of Surgical Research 144 (1) 49-58.
Salinas, G.D., Glauser, T.A., Williamson, J.C., Rao, G. & Abdolrasulnia, M. (2011). Primary care physician attitudes and practice patterns in the management of obese adults: results from a national survey. Postgraduate Medicine 123 (5) 214-219.
Fogelman, Y., Vinker, S., Lachter, J., Biderman, A., Itzhak, B. & Kitai, E. (2002). Managing obesity: a survey of attitudes and practices among Israeli primary care physicians. International Journal of Obesity 26 (10) 1393.
Forman-Hoffman, V., Little, A. & Wahls, T. (2006). Barriers to obesity management: a pilot study of primary care clinicians. BMC Family Practice 7 (1) 35.
Sharp, L., McDonald, A., Sim, P., Knamiller, C., Sefton, C. & Wong, S. (2011). Positivism, post‐positivism and domestic water demand: interrelating science across the paradigmatic divide. Transactions of the Institute of British Geographers 36 (4) 501-515.
Glaser, B.G. (2002). Constructivist grounded theory? Forum: Qualitative Social Research Sozialforschung 3 (3) 12.
Greenfield, B.H., Greene, B. & Johanson, M.A. (2007). The use of qualitative research techniques in orthopedic and sports physical therapy: Moving toward postpositivism. Physical Therapy in Sport 8 (1) 44-54.
Ponterotto, J.G. (2005). Qualitative research in counseling psychology: A primer on research paradigms and philosophy of science. Journal of Counseling Psychology 52 (2) 126.
Neville, S., Adams, J. & Cook, C. (2016). Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field. Contemporary Nurse 52 (6) 657-668.
Robson, C. (1993). Real world research: a resource for social scientists and practitioner-researchers. 3rd edn. Oxford: Blackwell.
Mallinson, S. (2002). Listening to respondents: a qualitative assessment of the Short-Form 36 Health Status Questionnaire. Social Science & Medicine 54 (1) 11-21.
Dewey, J. (1958). Experience and nature (Vol. 1). New York: Dover Publications.
Jensen, G.M. (1989). Qualitative methods in physical therapy research: a form of disciplined inquiry. Physical Therapy 69 (6) 492-500.
Taylor, C. (1971). Interpretation and the sciences of man. The Review of Metaphysics 25 (1) 3-51.
Cresswell, J.W. & Plano Clark, V.L. (2011). Designing and conducting mixed method research. 2nd edn. Thousand Oaks, CA: Sage Publications.
Bernard, H.R. (2002). Research methods in anthropology: Qualitative and quantitative approaches. 3rd edn. Walnut Creek, CA: Alta Mira Press.
Spradley, J.P. (1979). The ethnographic interview. New York: Holt, Rinehart & Winston.
Guest, G., Bunce, A. & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods 18 (1) 59-82.
Fusch, P.I. & Ness, L.R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report 20 (9) 1408.
O’Reilly, M. & Parker, N. (2012). ‘Unsatisfactory Saturation’: a critical exploration of the notion of saturated sample sizes in qualitative research. Qualitative Research 13 (2) 190-197.
Walker, J.L. (2012). The use of saturation in qualitative research. Canadian Journal of Cardiovascular Nursing 22 (2) 37-46.
Adamson, J., Gooberman-Hill, R., Woolhead, G. & Donovan, J. (2004). 'Questerviews': using questionnaires in qualitative interviews as a method of integrating qualitative and quantitative health services research. Journal of Health Services Research & Policy 9 (3) 139-145.
Patton, M.Q. (2001). Qualitative Research and Evaluation Methods. 3rd edn. Thousands Oaks, CA: Sage Publications.
Hsieh, H.F. & Shannon, S.E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research 15 (9) 1277-1288.
Burnard, P., Gill, P., Stewart, K., Treasure, E. & Chadwick, B. (2008). Analysing and presenting qualitative data. British Dental Journal 204 (8) 429-432.
Guba, E.G. & Lincoln, Y.S. (1989). Fourth Generation Evaluation. 1st edn. Newbury Park: Sage Publications.
Irwin, J.D., He, M., Bouck, L.M.S., Tucker, P. & Pollett, G.L. (2005). Preschoolers’ physical activity behaviours: parents’ perspectives. Canadian Journal of Public Health 96 (4) 299.
Prochaska, J.O. & Velicer, W.F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion 12 (1) 38-48.
Zimmerman, G.L., Olsen, C.G. & Bosworth, M.F. (2000). A 'stages of change' approach to helping patients change behavior. American Family Physician 61 (5) 1409-1416.
Johnson, S.S., Paiva, A.L., Cummins, C.O., Johnson, J.L., Dyment, S.J., Wright, J.A., Prochaska, J.O., Prochaska, J.M. & Sherman, K. (2008). Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Preventive Medicine 46 (3) 238-246.
Prochaska, J.O., Norcross, J.C., Fowler, J.L., Follick, M.J. & Abrams, D.B. (1992). Attendance and outcome in a work site weight control program: Processes and stages of change as process and predictor variables. Addictive Behaviors 17 (1) 35-45.
Rossi, S.R., Rossi, J.S., Rossi-Delprete, L.M., Prochaska, J.O., Banspach, S.W. & Carleton, R.A. (1994). A processes of change model for weight control for participants in community-based weight loss programs. International Journal of the Addictions 29 (2) 161-177.
Lier, H.Ø., Aastrom, S. & Rørtveit, K. (2016). Patients’ daily life experiences five years after gastric bypass surgery–a qualitative study. Journal of Clinical Nursing 25 (3-4) 322-331.
Kinzl, J.F., Traweger, C., Trefalt, E. & Biebl, W. (2003). Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obesity Surgery 13 (1) 105-110.
Modarressi, A., Balague, N., Huber, O., Chilcott, M. & Pittet-Cuénod, B. (2013). Plastic surgery after gastric bypass improves long-term quality of life. Obesity Surgery 23 (1) 24-30.
Ontario Bariatric Network. (2015). Surgical program. Toronto: Ontario Bariatric Network; 2015. Available at: www.ontariobariatricnetwork.ca/our-programs/surgical-program. Accessed May 30, 2017.
DOI: http://dx.doi.org/10.5750/ejpch.v5i4.1363
Refbacks
- There are currently no refbacks.