Environmental and individual factors associated with quality of life of adults who underwent bariatric surgery: a cohort study.

INTRODUCTION: Obesity is a multifactorial chronic condition associated with genetic, behavioral and environmental factors. Understanding the role of the built and social environment in Quality of Life (QOL) is critical to reducing the negative impacts of the environment on health. OBJECTIVE: To estimate the built and social environmental and individual factors that influence the QOL of adults who underwent bariatric surgery. METHODS: A prospective cohort study conducted with adults who underwent bariatric surgery. Using longitudinal linear regression analysis, we verified the association between the domains of World Health Organization Quality of Life in version bref (WHOQOL-Bref) - General QOL and domains psychological, physical health, social relations and environment - and possible influencing factors. RESULTS: The increase in Body Mass Index (BMI) reduces on average 0.47 points in physical domain assessment score. The increase of healthy establishments within the buffer increases on average 0.52 points in the physical domain score. Being female reduces, on average, 5.35 points in the psychological domain evaluation score. Adults who practiced less than 150 min a week of leisure-time physical activity had a 3.27 point average reduction in the social relations domain assessment score. The increase in the number of Supermarkets and Hypermarkets in the buffer increases on average 2.18 points from the Social Relations domain score. CONCLUSIONS: Individual and contextual factors were associated with the QOL of adults who underwent bariatric surgery. Although the surgery yields positive results, the maintenance of same is strongly related to changes in lifestyle, the built environment and multi-professional guidance.

Fatores associados à saúde sexual em pacientes submetidos à cirurgia bariátrica / Factores asociados con la salud sexual de pacientes sometidos a cirugía bariátrica / Factors associated with sexual health in patients subjected to bariatric surgery

RESUMO Objetivo: investigar os fatores associados à saúde sexual de pacientes submetidos à cirurgia bariátrica. Métodos: trata-se de uma coorte realizada com 387 pacientes submetidos à cirurgia bariátrica entre os anos de 2012 e 2014, em um hospital geral e privado de Minas Gerais. As informações foram coletadas por meio dos prontuários eletrônicos e do telefone. Resultados: mulheres (87,60%); cor (autodeclarada) parda (49,84%); com escolaridade de 11 a 14 anos (32,57%); convivia com companheiro (69,06%); e renda média de um a três salários mínimos por domicílio (54,79%). Mediana de idade foi de 36 anos (IQ=30-43). Ao analisar a melhora no desempenho sexual após o procedimento cirúrgico, 214 (71,33%) dos pacientes ressaltaram melhora nesse aspecto. Destes, 32 (14,95%) eram do sexo masculino e 182 (85,04%) eram do sexo feminino. Fatores sociodemográficos no cenário estudado, exceto idade em sexo masculino, não mostraram diferença estatística na melhoria do desempenho sexual após a cirurgia bariátrica. Conclusão: o tratamento cirúrgico pode ter impacto positivo na vida sexual do paciente e esses resultados podem alertar as instituições de saúde para otimizar sua assistência. Assim, profissionais de saúde, especialmente os enfermeiros, exercem papel fundamental na compreensão de quais são fatores são associados à melhoria da vida sexual dos pacientes, permitindo a prevenção de queixas e medidas efetivas de intervenção.

RESUMEN Objetivo: investigar los factores asociados con la salud sexual de los pacientes sometidos a cirugía bariátrica. Métodos: estudio de cohorte realizado con 387 pacientes que sometidos a cirugía bariátrica entre 2012 y 2014, en un hospital general privado del estado de Minas Gerais. La información se recogió a través de registros médicos electrónicos y de llamadas telefónicas. Resultados: mujeres (87,60%); color de piel (autodeclarada) parda (49.84%); con escolaridad de 11 a 14 años (32.57%); en pareja (69.06%); e ingresos promedio de uno a tres salarios mínimos por domicilio (54.79%), edad promedio de 36 años (coeficiente intelectual = 30-43). Al analizar la mejora en el rendimiento sexual después del procedimiento quirúrgico, 214 (71,33%) de los pacientes confirmaron haber mejorado.Entre ellos, 32 (14.95%) eran hombres y 182 (85.04%) mujeres. Los factores sociodemográficos en el escenario estudiado, excepto la edad en los hombres, no mostraron diferencias estadísticas en la mejora del rendimiento sexual después de la cirugía bariátrica. Conclusión: el tratamiento quirúrgico puede generar un impacto positivo en la vida sexual del paciente lo cual puede hacer notar a las instituciones de salud la importancia de optimar su asistencia. Los profesionales de la salud, sobre todo los enfermeros, desempeñan un rol fundamental en la comprensión de los factores asociados con la mejora de la vida sexual de los pacientes, permitiendo la prevención de quejas y medidas de intervención efectivas.

ABSTRACT Objective: to investigate the factors associated with the sexual health of patients subjected to bariatric surgery. Methods: this is a cohort performed with 387 patients who were subjected to bariatric surgery between the years 2012 and 2014, in a general and private hospital in Minas Gerais. The information was collected through electronic medical records and the telephone. Results: women (87.60%); brown (self-declared) color (49.84%); with education from 11 to 14 years (32.57%); lived with a partner (69.06%); and average income of one to three minimum wages per household (54.79%). Median age was 36 years (IQ=30-43). When analyzing the improvement in sexual performance after the surgical procedure, 214 (71.33%) of the patients highlighted improvement in this aspect. Of these, 32 (14.95%) were male and 182 (85.04%) were female. Sociodemographic factors in the studied scenario, except for age in males, showed no statistical difference in the improvement of sexual performance after bariatric surgery. Conclusion: surgical treatment can have a positive impact on the patient's sexual life and these results can alert health institutions to optimize their assistance. Thus, health professionals, especially nurses, play a fundamental role in understanding what factors are associated with improving patients' sexual lives, allowing the prevention of complaints and effective intervention measures.