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11/12/2021 | 2:45 PM to 3:45 PM
Understanding Bariatric Patients’ Experiences of Self-management Post-surgery: A Qualitative Study
Background: Although most bariatric patients achieve significant weight loss and improvements in both physical and mental health-related quality of life (HRQoL) in the short-term, there is a wide variability in weight and long-term HRQoL outcomes. The role of bariatric patients’ self-management style in explaining variability in long-term outcomes is unclear.
Objective: This qualitative study examined bariatric patients’ self-management experiences after bariatric surgery in relation to long-term outcomes.
Methods: A qualitative study was conducted using semi-structured individual interviews with post-operative bariatric patients (n=23) at a Canadian Bariatric Surgery Program. A constant comparative approach was used to systematically analyze the data and identify the overarching themes. Variation in patients’ experiences and follow-up time were the two primary units of analysis
Results: Patients were predominantly female (n=19; 82.6%) and had a mean age of (50±8.49) years. The median time post-surgery was 2 years (range: 6 months – 7 years). Three distinct phases described the process for bariatric patients to develop their self-management capacity post-surgery: 1) rediscovering self-esteem and confidence in one’s ability to self-manage (1-month to 2-years post-surgery), 2) achieving weight maintenance and addressing emotional dysregulation (1.5-3-years post-surgery); and 3) embracing a flexible balanced lifestyle (beyond 3-years).
Conclusion: Bariatric patients’ experience distinct challenges relative to their surgery time course. Facilitating access to interprofessional bariatric care post-surgery allowed patients to acquire the self-management knowledge and skills to address challenges to following the bariatric guidelines in the long-term.
Objective: This qualitative study examined bariatric patients’ self-management experiences after bariatric surgery in relation to long-term outcomes.
Methods: A qualitative study was conducted using semi-structured individual interviews with post-operative bariatric patients (n=23) at a Canadian Bariatric Surgery Program. A constant comparative approach was used to systematically analyze the data and identify the overarching themes. Variation in patients’ experiences and follow-up time were the two primary units of analysis
Results: Patients were predominantly female (n=19; 82.6%) and had a mean age of (50±8.49) years. The median time post-surgery was 2 years (range: 6 months – 7 years). Three distinct phases described the process for bariatric patients to develop their self-management capacity post-surgery: 1) rediscovering self-esteem and confidence in one’s ability to self-manage (1-month to 2-years post-surgery), 2) achieving weight maintenance and addressing emotional dysregulation (1.5-3-years post-surgery); and 3) embracing a flexible balanced lifestyle (beyond 3-years).
Conclusion: Bariatric patients’ experience distinct challenges relative to their surgery time course. Facilitating access to interprofessional bariatric care post-surgery allowed patients to acquire the self-management knowledge and skills to address challenges to following the bariatric guidelines in the long-term.
Authors
Speakers
Alaa Youssef
PhD Researcher Stanford School of Medicine
Dr. Alaa Youssef received her doctorate of philopsophy(PhD) from the Institute of Medical Science, Department of Psychiatry, from the University of Toronto in Canada. Her PhD research focused on understanding the relationship between patient experience of bariatric care and their long-term quality of life outcomes. Specfically, she idenitifed predictors of longt-term changes in physical and mental health-related quality of life outcomes in obesity. Currently, she is a postdoctoral fellow at Stanford School of Medicine, invesigating the bioethical and clinical safety challenges for using AI algorthims to improve healthcare delivery.
Robert Maunder
Psychiatrist Sinai Health
Bob Maunder is a Professor of Psychiatry at the University of Toronto. He is the Chair of Health and Behaviour at Sinai Health System, where he is also Deputy Psychiatrist-in-Chief and Head of Psychiatry Research. His research, in collaboration with Dr. Jon Hunter, focuses on how interpersonal relationships and psychological stress influence health. He was the lead author of a series of studies describing the long-term psychological impact of SARS on hospital workers and is leading a CIHR-funded study of the positive impact of Peer Resilience Champions to mitigate the psychological impact of COVID-19 on healthcare workers. He is the author of 4 books and over 100 papers and chapters describing this work.
Maria Mylopoulos
Associate Professor University of Toronto
Dr. Maria Mylopoulos holds her PhD in human development and education. She is currently Scientist and Associate Director of the Wilson Centre for Research in Education, Associate Professor in the Department of Paediatrics and Curriculum Scientist in the MD Program at the University of Toronto. Over the last 13 years she has successfully led a program of research aimed at understanding the development and performance of adaptive expertise in medicine, with a particular focus on how health professionals deal with uncertainty, novelty and complexity in their daily clinical problem solving. The aim of her research is to evolve understanding of the knowledge and capabilities that underpin this facet of expertise as it occurs in real-world contexts using theoretical frameworks of clinical reasoning and adaptive expertise. The ultimate goal of her research is to translate this understanding to educational design that promotes the development of exceptional clinicians who are able to handle the complexities and challenges of the healthcare workplace.
David Wiljer
Executive Director Univeristy of Toronto
Dr. David Wiljer is the Executive Director of Education, Technology & Innovation at the University Health Network, and an Associate Professor in the Department of Psychiatry, Faculty of Medicine and the Institute of Health Policy Management and Evaluation at the University of Toronto.
His work focuses on patient and health professions education, digitally enabled education and life-long learning. He has explored the development of large programs, infrastructure, communities, and research initiatives that involve health professionals, patients and families in new approaches to education and care delivery.
His work focuses on patient and health professions education, digitally enabled education and life-long learning. He has explored the development of large programs, infrastructure, communities, and research initiatives that involve health professionals, patients and families in new approaches to education and care delivery.
Stephanie Cassin
Associate Professor Ryerson University
Dr. Stephanie Cassin is an Associate Professor of Psychology and Director of the Healthy Eating and Lifestyle (HEAL) Lab at Ryerson University. She also holds a faculty appointment in the Department of Psychiatry at the University of Toronto. She is an expert in psychosocial interventions for binge eating and obesity. Her research focuses primarily on psychosocial predictors of bariatric (weight loss) surgery outcome, and psychosocial interventions with the potential to improve outcomes, including cognitive behavioural therapy and motivational interviewing. She also investigates health care innovations that increase treatment accessibility, such as virtual interventions.
Susan Wnuk
Psychologist Assistant Professor, University of Toronto, Department of Psychiatry
Dr. Susan Wnuk, PhD., C. Psych, is a clinical psychologist at the University Health Network Bariatric Surgery Program in Toronto and an Assistant Professor at the University of Toronto Department of Psychiatry. She provides clinical care to pre and post-bariatric surgery patients, supervises students, and conducts research. Her current areas of interest are mindfulness, pre and post-surgery psychosocial functioning and the effectiveness of behavioural interventions for bariatric surgery patients. She is involved in research projects investigating psychosocial predictors of outcome in bariatric surgery patients and the effectiveness of cognitive-behavioural and mindfulness treatments for this population that are delivered in-person and remotely. Dr. Wnuk graduated from York University in Toronto and prior to joining the Bariatric Surgery Program in 2010, she worked in hospital-based eating disorder and borderline personality disorder programs. She facilitates workshops for professionals and presents at research conferences at the local, national and international levels.
Samantha Leung
Research Analyst University Health Network
Samantha Leung is a Research Analyst working out of the University Health Network's Bariatric Centre of Excellence.
Sanjeev Sockalingam
Vice-President, Education and Professor Centre for Addiction and Mental Health, University of Toronto
Dr. Sanjeev Sockalingam is Professor and Vice-Chair, Education in the Department of Psychiatry at the University of Toronto. He is also Vice President, Education at the Centre for Addiction and Mental Health and the Psychosocial Director for the Toronto Western Hospital Bariatric Surgery Program at the University Health Network.
He is currently the Co-Chair for the Extension for Community Healthcare Outcomes (ECHO) Ontario Mental Health at the Centre for Addiction and Mental and Health and the University of Toronto, which is a provincial hub-and-spoke virtual knowledge-sharing network model building mental health and addiction capacity in rural Ontario.
Dr. Sockalingam has >190 peer-reviewed publications and is a lead investigator on several peer-reviewed clinical and medical education grants. His clinical research interests are focused on increasing access to integrated models of medical psychiatry care, including in the area of obesity and mental health. His education research interest focuses implementation of mental health capacity building using technology and data-informed lifelong learning. He has been the recipient of several national and international education awards including the 2018 Academy of Consultation-Liaison Psychiatry (ACLP) Alan Stoudemire Award for Innovation and Excellence in C-L Psychiatry Education and the Association of Chairs of Psychiatry of Canada Award for Excellence in Education.
He is currently the Co-Chair for the Extension for Community Healthcare Outcomes (ECHO) Ontario Mental Health at the Centre for Addiction and Mental and Health and the University of Toronto, which is a provincial hub-and-spoke virtual knowledge-sharing network model building mental health and addiction capacity in rural Ontario.
Dr. Sockalingam has >190 peer-reviewed publications and is a lead investigator on several peer-reviewed clinical and medical education grants. His clinical research interests are focused on increasing access to integrated models of medical psychiatry care, including in the area of obesity and mental health. His education research interest focuses implementation of mental health capacity building using technology and data-informed lifelong learning. He has been the recipient of several national and international education awards including the 2018 Academy of Consultation-Liaison Psychiatry (ACLP) Alan Stoudemire Award for Innovation and Excellence in C-L Psychiatry Education and the Association of Chairs of Psychiatry of Canada Award for Excellence in Education.
Outpatient Consultation Brief Oral Papers
Category
General Sessions
Description
CE Hours
Presenting Author
Alaa Youssef
PhD Researcher | Stanford School of Medicine
Dr. Alaa Youssef received her doctorate of philopsophy(PhD) from the Institute of Medical Science, Department of Psychiatry, from the University of Toronto in Canada. Her PhD research focused on understanding the relationship between patient experience of bariatric care and their long-term quality of life outcomes. Specfically, she idenitifed predictors of longt-term changes in physical and mental health-related quality of life outcomes in obesity. Currently, she is a postdoctoral fellow at Stanford School of Medicine, invesigating the bioethical and clinical safety challenges for using AI algorthims to improve healthcare delivery.