ABSTRACT
BACKGROUND: Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. METHODS: Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. RESULTS: A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. CONCLUSIONS: Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control.
Subject(s)
Allied Health Personnel , Delivery of Health Care/methods , Health Behavior , Health Promotion/methods , Mentoring/methods , Primary Health Care/methods , Self Care/methods , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Delivery of Health Care/organization & administration , Feasibility Studies , Female , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Satisfaction/statistics & numerical data , Pilot Projects , Primary Health Care/organization & administrationABSTRACT
OBJECTIVE: This study aimed to compare outcomes of laparoscopic sleeve gastrectomy (LSG) patients based on three types of staple line reinforcement (SLR): seromuscular suturing (imbrication), absorbable polymer membrane (APM), and bovine pericardial strips (BPS). BACKGROUND: LSG represented 67.3 % of bariatric procedures performed in Michigan in 2013, and its prevalence continues to rise. Multiple studies suggest that SLR can potentially reduce the incidence of complications. However, the current literature is limited secondary to a small sample size and is not conclusive on which type of reinforcement technique is best in reducing the risk of complications. METHODS: The charts of 1,526 consecutive patients who underwent an LSG from January 2005 to January 2013, by four experienced surgeons, were reviewed. Data include patient demographics, reinforcement technique utilized, length of hospitalization, complications, hospital readmission rates, and mortality. RESULTS: Of 1,502 patients who underwent an LSG and met inclusion/exclusion criteria, 373 (24.8 %) were reinforced using imbrication, 269 (17.9 %) with BPS, and 860 (57.3 %) with APM. Patient demographics and complication rates were similar between groups. A statistically significant difference occurred in length of stay, readmission, and reoperation rates (p < 0.01). Length of stay was shortest in the BPS group, but readmission and reoperation rates were statistically higher, and there was a trend towards increased leaks (p = 0.08). CONCLUSIONS: A comparison of imbrication, BPS, and APM demonstrated significantly increased readmission and reoperation rates with a trend towards increased leak rates with the use of BPS in LSG patients. Hemorrhage was not statistically different between the three reinforcement techniques.