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Patients’ Experiences, Post-operative Psychosocial and Behavioral Factors Related to Weight Change among Patients who have Undergone Sleeve Gastrectomy in China

Yu, Yang (2019) Patients’ Experiences, Post-operative Psychosocial and Behavioral Factors Related to Weight Change among Patients who have Undergone Sleeve Gastrectomy in China. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Background: Sleeve gastrectomy (SG) is the most widely used surgical treatment for morbid obesity. Post-operative weight loss is highly variable, and there has been limited research conducted to examine the various factors that contribute to weight loss outcomes following the SG procedure.
Objectives: To describe the psychosocial status and to explore factors that may contribute to weight loss variability among post-SG adults in China, including patient experiences with post-surgical lifestyle change, post-operative psychosocial (disordered eating, depression, self-efficacy, and social problem solving) and behavioral factors (diet and physical activity).
Methods: This study included two phases. First, semi-structured interviews were conducted with 15 post-SG adults in Shanghai Huashan Hospital, China. Interviews explored patient experiences of post-surgical lifestyle changes and their perceived barriers and facilitators to make the required changes. Second, in addition to the 15 participants, we further recruited 52 adults for cross-sectional measurements. Standardized questionnaires were used to measure disordered eating behaviors, depression, self-efficacy, social problem solving and physical activity. One day paper diary was used to assess dietary behavior. Weight was based on self-report.
Results: Qualitative findings revealed that SG imposed a drastic lifestyle change on participants, they viewed the changes positively and were able to use some of the core behavior change techniques (e.g., self-monitoring) to make appropriate adjustments. Both individual- and community-level barriers existed for patients to meet the required lifestyle changes. Participants reported significant post-surgical weight loss with a mean body mass index change of 12.52±6.12 kg/m2 in the quantitative phase. They demonstrated high level of self-efficacy (112.42±40.60) without obvious disordered eating disorders (43.60±25.61) and depressive symptoms (14.22±11.00). The level of social problem solving skills (89.5±12.87) was relatively low. Reported PA was far from recommended level, and the quality of dietary data was low. Self-efficacy and the subscale of disordered eating behaviors (body dissatisfaction) significantly correlated with weight loss outcome.
Conclusion: Findings suggest that participants had good psychosocial status after SG and were able to use accurate strategies for making post-surgical lifestyle adjustments. Larger longitudinal studies incorporating pre-surgical assessments were needed to further understand the psychosocial and behavioral mechanism in weight loss effect among SG population.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Yu, Yangyay60@pitt.eduyay60
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairLora,
Committee MemberKalarchian,
Committee MemberImes,
Committee MemberDainxu,
Date: 15 August 2019
Date Type: Publication
Defense Date: 27 June 2019
Approval Date: 15 August 2019
Submission Date: 14 August 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 172
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: sleeve gastrectomy; weight; psychosocial and behavioral factors
Date Deposited: 15 Aug 2019 16:37
Last Modified: 15 Aug 2019 16:37


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