A Qualitative Study of Young Adult Experiences in the Bariatric Healthcare System: Psychosocial Challenges and Developmental Difficulties.

OBJECTIVES: Bariatric surgery is an evidence-based treatment for severe obesity; however, the unique developmental and psychosocial needs of young adults often complicate care and, as yet, are not well understood. We sought to identify themes in young adult patients undergoing bariatric surgery regarding: 1) the psychosocial experiences of obese young adults (18 to 24) seeking bariatric surgery; 2) the experiences during the preoperative bariatric surgery process and 3) the postoperative experiences of young adult patients. METHODS: In-depth, semistructured individual interviews were conducted with 13 young adult bariatric patients who were seeking or had undergone bariatric surgery within the past 5 years. Interviews were analyzed using a qualitative methodology. RESULTS: We found the following themes in our analyses: 1) the impact of relationships (with families and healthcare providers) on the bariatric healthcare experience; 2) preoperative experiences by young adults prior to undergoing surgery and 3) postoperative reflections and challenges experienced by young adult patients. CONCLUSIONS: Results revealed that patients' experiences appear to encompass impact on familial relationships, needs sought to be fulfilled by healthcare providers, and various preoperative and postoperative psychosocial concerns. By understanding the experiences of young adults, healthcare providers might be able to provide better care for these patients.

Examining Nutrition Knowledge of Bariatric Surgery Patients: What Happens to Dietary Knowledge over Time?

BACKGROUND: Nutrition education is a standard of care in bariatric surgery clinical practice guidelines. Despite its known importance, no studies have documented the trajectory of nutrition knowledge over the course of the bariatric surgery process. Primary objectives included determining changes in bariatric surgery nutrition knowledge scores from the pre-surgical phase to 1-month post-surgical intervention and investigating the impact of time on nutrition education retention in bariatric patients. Secondary objectives focused on the relationship between patients' pre-operative anxiety and depression on nutrition knowledge retention. METHODS: Prior to data collection, patients attended a nutrition education class and met with a registered dietitian. One hundred and nineteen consented patients eligible for bariatric surgery completed a nutrition knowledge questionnaire, Eating After Bariatric Surgery (EABS) prior to and 1 month following bariatric surgery. RESULTS: Analyses revealed (1) patients' nutrition knowledge (measured by EABS) significantly increased from the pre-operative phase (M = 46.9; SD = 14.4) to the post-operative phase ((M = 56.9; SD = 14.1), t(118) = -8.01, p < .001); (2) time between the nutrition education class and patients' surgery significantly impacted knowledge retained; (3) patients with higher pre-operative levels of depression and anxiety had significantly lower post-operative nutrition knowledge; and (4) gender differences in terms of patients' nutrition knowledge. CONCLUSIONS: This study confirmed that dietary knowledge significantly improves following surgical intervention. Furthermore, increased time in between receiving nutrition knowledge and surgery resulted in less retained knowledge 1-month post-op. Future education interventions for bariatric surgery programs should focus on addressing these factors to optimize patient knowledge and information retention after surgery.

Gender, ethnocultural, and psychosocial barriers to diabetes self-management in Italian women and men with type 2 diabetes.

Although several ethnic groups experience a greater burden of diabetes, this has not been examined in first-generation Italians, who compose one of the largest ethnocultural groups in Canada. In this cross-sectional study, the authors examined the relationship among gender and ethnocultural factors, family support, depressive symptomatology, and illness perceptions on diabetes self-management (DSM) in 50 Italian women and men with type 2 diabetes. The authors first conducted a focus group to explore cultural barriers. They then assessed gender, ethnocultural, and psychosocial barriers quantitatively by an interviewer-administered questionnaire. Compared with Italian men, Italian women reported significantly greater depressive symptomatology and perceived disease seriousness. Greater depressive symptomatology was significantly associated with perceived family sabotage and DSM barriers. In univariate analyses, shorter duration of diabetes and greater perceived treatment effectiveness significantly predicted better DSM. In conclusion, certain illness perceptions and culturally relevant gender-specific barriers should be addressed by health care providers to maximize DSM in this population. Index Terms: diabetes, diet, gender, self-management