Self-care model and body image in adults after a bariatric surgery. / Modelo de autocuidado e imagem corporal em adultos pós cirurgia bariátrica.

OBJECTIVE: the aim of the present article was to test a self-care model explained by the relationship between self-efficacy, body image, obsessive-compulsive disorder, and depression in people with bariatric surgery in the city of Tijuana, Baja California, Mexico. METHOD: this was a correlational cross-sectional study carried out between August and December 2020. Validated instruments were administered to 102 participants to measure their self-care capacity, general self-efficacy, psychopathological symptoms, and body image perception and satisfaction. The variables of interest were analyzed using descriptive statistics and the Pearson and Spearman correlation coefficients were used to develop a model using path analysis. RESULT: a significant model was obtained with adequate goodness-of-fit indicators (chi-square χ2 (8) = 11.451, p = .177; root mean square error of approximation (RMSEA)= 0.000; goodness-of-fit index (GFI)= 0.965; comparative fit index (CFI)= 0.985; parsimonious normed fit index (PNFI)= 0.509, and Akaike information criterion (AIC)= 37.451). Self-efficacy (Zß=0.294) and body image dissatisfaction (So= -0.376) were shown to influence self-care abilities while psychopathological symptoms influenced body dissatisfaction: obsessive-compulsive disorder (Zß=0.370) and depression (Zß=0.320). CONCLUSION: adequate levels of self-efficacy and body satisfaction predict a high capacity for self-care.

Modelo de autocuidado e imagem corporal em adultos pós cirurgia bariátrica / Self-care model and body image in adults after a bariatric surgery / Modelo de autocuidado e imagen corporal en adultos post-cirugía bariátrica

Resumo Objetivo: testar um modelo de autocuidado explicado pela relação entre autoeficácia, imagem corporal, transtorno obsessivo-compulsivo e depressão em pessoas com cirurgia bariátrica na cidade de Tijuana, no México. Método: estudo transversal correlacional realizado entre agosto e dezembro de 2020. Instrumentos validados foram aplicados a 102 participantes para medir sua capacidade de autocuidado, autoeficácia geral, sintomas psicopatológicos, e percepção e satisfação com a imagem corporal. As variáveis de interesse foram analisadas utilizando estatísticas descritivas e correlações de Pearson e Spearman para finalmente desenvolver um modelo utilizando a análise de caminho (path analysis). Resultados: foi obtido um modelo significativo com bons indicadores de bondade de ajuste (qui-quadrado χ 2 (8)= 11,451, p = 0,177; raiz quadrada da média do erro de aproximação (RMSEA)= 0,000; índice de bondade de ajuste (GFI)= 0,965; índice de ajuste comparativo (CFI)= 0,985; índice de ajuste normalizado parcimonioso (PNFI)= 0,509 e critério de informação de Akaike (AIC)= 37,451). A autoeficácia (Zβ= 0,294) e a insatisfação com a imagem corporal (Zβ= -0,376) demonstraram ter um efeito sobre as capacidades de autocuidado, enquanto os sintomas psicopatológicos influenciam a insatisfação corporal: transtorno obsessivo-compulsivo (Zβ= 0,370) e depressão (Zβ= 0,320). Conclusão: níveis adequados de autoeficácia e satisfação corporal predizem uma alta capacidade de autocuidado.

Abstract Objective: the aim of the present article was to test a self-care model explained by the relationship between self-efficacy, body image, obsessive-compulsive disorder, and depression in people with bariatric surgery in the city of Tijuana, Baja California, Mexico. Method: this was a correlational cross-sectional study carried out between August and December 2020. Validated instruments were administered to 102 participants to measure their self-care capacity, general self-efficacy, psychopathological symptoms, and body image perception and satisfaction. The variables of interest were analyzed using descriptive statistics and the Pearson and Spearman correlation coefficients were used to develop a model using path analysis. Result: a significant model was obtained with adequate goodness-of-fit indicators (chi-square χ2 (8) = 11.451, p = .177; root mean square error of approximation (RMSEA)= 0.000; goodness-of-fit index (GFI)= 0.965; comparative fit index (CFI)= 0.985; parsimonious normed fit index (PNFI)= 0.509, and Akaike information criterion (AIC)= 37.451). Self-efficacy (Zβ=0.294) and body image dissatisfaction (So= -0.376) were shown to influence self-care abilities while psychopathological symptoms influenced body dissatisfaction: obsessive-compulsive disorder (Zβ=0.370) and depression (Zβ=0.320). Conclusion: adequate levels of self-efficacy and body satisfaction predict a high capacity for self-care.

Resumen Objetivo: probar un modelo de autocuidado explicado por la relación entre autoeficacia, imagen corporal, obsesión-compulsión y depresión en personas con cirugía bariátrica de la ciudad de Tijuana, B.C. Método: estudio transversal correlacional realizado entre agosto y diciembre de 2020. Se aplicaron instrumentos validados a 102 participantes para medir su capacidad de autocuidado, autoeficacia general, síntomas psicopatológicos, percepción y satisfacción de la imagen corporal. Las variables de interés fueron analizadas mediante estadística descriptiva y correlaciones de Pearson y Spearman para finalmente elaborar un modelo mediante análisis de ruta (Path Analysis). Resultados: se obtuvo un modelo significativo con buenos indicadores de bondad de ajuste (chi-cuadrado χ 2 (8)= 11.451, p = .177; error de aproximación raíz-media-cuadrada (RMSEA)= 0.000; índice de bondad de ajuste (GFI)= 0.965; índice de ajuste comparativo (CFI)= 0.985; índice de ajuste normado parsimonioso (PNFI)= 0.509 y criterio de información de Akaike (AIC)= 37.451). Se demostró que la autoeficacia (Zβ= 0.294) y la insatisfacción de la imagen corporal (Zβ= -0.376) tienen un efecto sobre las capacidades de autocuidado mientras que los síntomas psicopatológicos influyen sobre la insatisfacción corporal: obsesión-compulsión (Zβ= 0.370) y depresión (Zβ= 0.320). Conclusión: los niveles adecuados de autoeficacia y satisfacción corporal predicen una alta capacidad de autocuidado.

Efficacy of a multivitamin adherence program based on cognitive dissonance for bariatric patients: A randomized controlled trial.

BACKGROUND AND OBJECTIVES: Micronutrient deficiencies are common among bariatric patients; this study aimed to determine whether a cognitive dissonance-based virtual program improved adherence to multivitamin use in bariatric patients from northern Mexico. METHODS AND STUDY DESIGN: A randomized controlled trial of the supplementation strategy was conducted over three months. The participants were randomized to an intervention or waitlisted control group and received two psycho-educative and four cognitive dissonance virtual sessions. Multiple linear regression was used to determine standardized estimates of associations between the intervention and dependent variables. Two path analyses were evaluated considering baseline and post-test measurements. RESULTS: Intervention was associated with higher concentrations of Hb (ß=0.758, p<0.001), vitamin D (ß=0.577, p<0.001), iron (ß=0.523, p<0.001), folate (ß=0.494, p<0.01), calcium (ß=0.452, p<0.01), higher adherence (ß=0.467, p<0.001), and level of knowledge (ß=0.298, p<0.05. CONCLUSIONS: The dissonance-based intervention potentiated the level of supplementation adherence. A higher level of adherence was reflected in micronutrient concentrations, thus providing confirmation of intervention. Thus, support is found for a multidisciplinary clinical practice that enhances nutrition status after bariatric surgery for obesity.