Lived experiences and unique psychosocial impacts following bariatric surgery in a publicly funded Australian tertiary hospital: a qualitative study

Wright, Charlene; Kelly, Jaimon T; Healy, Rebecca; Musial, Jane; Campbell, Katrina L.; Hamilton, Kyra

doi:10.1080/00049530.2022.2046445

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Commonly utilised behaviour change techniques include ‘self‐monitoring’, ‘problem solving’, ‘social support (unspecified)’, ‘goal setting’ and ‘shaping knowledge’. In addition, individuals report experiencing several challenges after bariatric surgery due to their situation or environment 26 . Therefore, the domains ‘knowledge’, ‘behavioural regulation’, ‘goals’, ‘social influences’ and ‘environmental context and resources’ from the Theoretical Domains Framework were prioritised in the interviews (Table S4).…”

Section: Methodsmentioning

confidence: 99%

“…In addition, individuals report experiencing several challenges after bariatric surgery due to their situation or environment. 26 Therefore, the domains 'knowledge', 'behavioural regulation', 'goals', 'social influences' and 'environmental context and resources' from the Theoretical Domains Framework were prioritised in the interviews (Table S4). In addition, the findings from the survey informed one interview question related to the acceptability of eHealth and referred to the reported preference for text messaging and email approaches.…”

Section: Methodsmentioning

confidence: 99%

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A mixed‐method study to inform the development and implementation of eHealth in a bariatric surgery service in an Australian public hospital

Wright

Kelly

Campbell

et al. 2023

Nutrition & Dietetics

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AimThis study aimed to explore patient barriers to accessing services, current technology ownership/use and digital device preferences for accessing health information/health service delivery. Additionally, it aimed to explore the Theoretical Domains Framework and the acceptability of future eHealth solutions in bariatric surgery.MethodsThis mixed‐method study (survey and semi‐structured interviews) was conducted in a bariatric surgery service in an Australian public hospital. Quantitative data were analysed descriptively, and the qualitative data were deductively and inductively analysed.ResultsThis study included 117 participants (n = 102 surveyed and n = 15 interviewed). Most participants were aged ≥51 years (n = 70, 60%), and two‐thirds were female (n = 76, 65%). One in three participants reported barriers to accessing services (n = 38, 37%), including parking, travel time, and taking time off work. Most participants preferred to receive or access additional health information via email (n = 84, 82%) and were willing to engage with health professionals via email (n = 92, 90%), text messages (n = 87, 85%), and telephone (n = 85, 83%). Deductive analysis of interviews generated three themes: ‘Knowledge’, ‘Social influence’ and ‘Behavioural regulation, goals and environmental resources’. The inductive analysis generated one theme: ‘Seeing a place for eHealth in service delivery’.ConclusionThis study's findings can potentially influence the development of future eHealth solutions. Text message, email, and online approaches may be suitable for delivering further information and resources to patients, particularly regarding diet and physical activity. Online health communities are being used by patients for social support and may be worth further investigation. In addition, developing a bariatric surgery mobile application may be beneficial.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A mixed‐method study to inform the development and implementation of eHealth in a bariatric surgery service in an Australian public hospital

Wright

Kelly

Campbell

et al. 2023

Nutrition & Dietetics

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“…However, most weight loss occurs within the first 12 months postoperatively, and patients can experience weight regain and return of comorbid conditions in the medium to long term [ 45 , 46 ]. Furthermore, patients experience ongoing psychosocial challenges postoperatively, including the fear of weight regain, body image concerns, and navigating negative confrontations and perceived stigma [ 47 ]. To provide long-term psychological and lifestyle support and reduce the potential for weight regain, a follow-up care package that commences closer to when patients are susceptible to weight regain and these challenges may be beneficial.…”

Section: Discussionmentioning

confidence: 99%

A non-randomised feasibility study of a mHealth follow-up program in bariatric surgery

Wright,

Kelly,

Byrnes

et al. 2023

Pilot Feasibility Stud

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Background Behavioural support via mobile health (mHealth) is emerging. This study aimed to assess the feasibility, acceptability, cost, and potential effect on weight of a mHealth follow-up program in bariatric surgery. Methods This was a non-randomised feasibility study describing intervention development and proof in the concept of a mHealth follow-up program in bariatric surgery. The study compares a prospective cohort with a historical control group and was conducted in a tertiary bariatric surgery service in Australia. The intervention group included individuals who had bariatric surgery (2019–2021) and owned a smart device, and the historical control group received usual postoperative care (2018). The intervention involved usual care plus codesigned biweekly text messages, monthly email newsletters, and online resources/videos over a 6-month period. The primary outcome measures included feasibility (via recruitment and retention rate), acceptability (via mixed methods), marginal costs, and weight 12 months postoperatively. Quantitative analysis was performed, including descriptive statistics and inferential and regression analysis. Multivariate linear regression and mixed-effects models were undertaken to test the potential intervention effect. Qualitative analysis was performed using inductive content analysis. Results The study included 176 participants (n = 129 historical control, n = 47 intervention group; mean age 56 years). Of the 50 eligible patients, 48 consented to participate (96% recruitment rate). One participant opted out of the mHealth program entirely without disclosing their reason (98% retention rate). The survey response rate was low (n = 16/47, 34%). Participants agreed/strongly agreed that text messages supported new behaviours (n = 13/15, 87%); however, few agreed/strongly agreed that the messages motivated goal setting and self-monitoring (n = 8/15, 53%), dietary change (n = 6/15, 40%), or physical activity (n = 5/15, 33%). Interviews generated four main themes (n = 12): ‘motivators and expectations’, ‘preferences and relevance’, ‘reinforced information”, and ‘wanting social support’. The intervention reinforced information, email newsletters were lengthy/challenging to read, and text messages were favoured, yet tailoring was recommended. The intervention cost AUD 11.04 per person. The mean 12-month weight was 86 ± 16 kg and 90 ± 16 kg (intervention and historical control) with no statistically significant difference. Intervention recipients enrolled at 3 months postoperatively demonstrated a statistically significant difference in 12-month weight (p = 0.014). Conclusion Although this study observed high rates of recruitment and retention, findings should be considered with caution as mHealth may have been embraced more by the intervention cohort as a result of the 2019 coronavirus pandemic. Of the various digital strategies developed and tested, the text message approach was the most acceptable; however, future intervention iterations could be strengthened through tailoring information when possible. The use of email newsletters and online resources/videos requires further testing of effectiveness to determine their value for continued use in bariatric surgery services.

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“…[42,43] Furthermore, patients experience ongoing psychosocial challenges postoperatively, including the fear of weight regain, body image concerns, and navigating negative confrontations and perceived stigma. [44] To provide long-term psychological and lifestyle support and reduce the potential for weight regain, a follow-up care package that commences closer to when patients are susceptible to weight regain, and these challenges may be bene cial. Further research about the timing of post-operative support programs in bariatric surgery services would be bene cial.…”

Section: Discussionmentioning

confidence: 99%

Piloting a mHealth follow up program in bariatric surgery via a single-arm cohort study

Wright

Kelly

Byrnes

et al. 2022

Preprint

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Background Behavioural support via mobile health (mHealth) is emerging. This study aimed to assess the feasibility, acceptability, cost, and effect on weight of a mHealth follow up program in bariatric surgery. Methods This was a prospective single-arm cohort study with mixed methods conducted in a Tertiary bariatric surgery service in Australia. The intervention group included individuals who had bariatric surgery (2019–2021) and owned a smart device, and the historical control group received usual post-operative care (2018). The intervention involved usual care plus codesigned bi-weekly text messages, monthly email newsletters, and online resources/videos for six months. The primary outcome measures included feasibility (via recruitment and retention rate), acceptability (via mixed methods), marginal costs, and weight 12-months post-operatively. Quantitative analysis was performed, including descriptive statistics and inferential and regression analysis. Multivariate linear regression and mixed-effects models were undertaken to test the intervention effect. Qualitative analysis was performed using inductive content analysis. Results The study included 176 participants (n = 129 historical control, n = 47 intervention group; age 56 years). Intervention recruitment (n = 48/50, 96%) and retention rate (47/48, 98%) were high. The survey response rate was low (n = 16/47, 34%). Participants agreed/strongly agreed that text messages supported new behaviours (n = 13/15, 87%); however, few agreed/strongly agreed they motivated goal setting and self-monitoring (n = 8/15, 53%), dietary or physical activity behaviour change (n = 6/15, 40% and n = 5/15, 33%). Interviews generated four main themes (n = 12): ‘Motivators and expectations’, ‘Preferences and relevance’, ‘Reinforced information”, and ‘Wanting social support’. The intervention reinforced information, email newsletters were lengthy/challenging to read, and text messages were favoured, yet tailoring was recommended. The intervention cost AUD 11.04 per person. The mean 12-month weight was 86 ± 16kg and 90 ± 16 kg (intervention and historical control) with no statistically significant difference. Intervention recipients enrolled at 3-months post-operatively demonstrated a statistically significant difference in 12-month weight (p = 0.014). Conclusion A mHealth follow up program in bariatric surgery may be feasible, showing high recruitment and retention rate. Of the various digital strategies, text messages were the most acceptable and suitable for continued use. However, text messaging approaches should strive to tailor information when possible.

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Lived experiences and unique psychosocial impacts following bariatric surgery in a publicly funded Australian tertiary hospital: a qualitative study

Cited by 6 publications

References 33 publications

A mixed‐method study to inform the development and implementation of eHealth in a bariatric surgery service in an Australian public hospital

A mixed‐method study to inform the development and implementation of eHealth in a bariatric surgery service in an Australian public hospital

A non-randomised feasibility study of a mHealth follow-up program in bariatric surgery

Piloting a mHealth follow up program in bariatric surgery via a single-arm cohort study

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