Factors influencing the bariatric surgery treatment of bariatric surgery candidates in underdeveloped areas of China
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SUBMITTER: Kong X
PROVIDER: S-EPMC10913241 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo identify barriers to and facilitators of primary care provider (PCP) referral for bariatric surgery in patients with obesity.Data sourcesMEDLINE, EMBASE, and PsycINFO databases were searched and reference lists of included articles were screened to identify additional relevant articles. Two reviewers independently reviewed citations and full-text articles, and appraised the quality of the included articles using the Critical Appraisal Skills Programme Tool Qualitative Checklist and the Appraisal Tool for Cross-Sectional Studies. They extracted data on the study characteristics and the barriers to and facilitators of PCP referral for bariatric surgery. Appraisal discrepancies were resolved through consensus among authors.Study selectionOverall, 882 citations were identified and 18 articles were then selected for this review.SynthesisBarriers included fear of surgery complications and side effects, cost, lack of availability, perception that surgery is a quick fix or a last resort, and prior negative experiences. Facilitators included direct requests from patients, patient motivation, previously failed weight-loss interventions, and obesity-related comorbidities. Those PCPs who were knowledgeable about the risks and benefits of bariatric surgery were more likely to refer their patients.ConclusionEducation and continuing professional development programs regarding bariatric surgery are needed to improve PCP knowledge and capacity to manage patients with obesity. Also, educating the general public on obesity, weight management, and available treatment options can empower patients and families to manage their weight and pursue evidence-informed treatments.
| S-EPMC9833187 | biostudies-literature
Project description:Given the worldwide increasing prevalence of severe obesity and considering the amount of scientific evidence demonstrating the beneficial effects of bariatric surgery (BS), it is surprising that only a fraction of patients with obesity undergo BS. We therefore conducted an anonymized online survey among individuals with a history of BS to understand factors influencing the deciding process leading to BS. Respondents were recruited on a voluntary basis from obesity-related social media groups between April and June 2020. The self-designed, non-validated questionnaire consisted of 20 questions and was open to any participants with a history of BS. Of 851 participants who started the survey, 665 completed the questionnaire (completion rate of 78.1%). Five years after BS, still 70% of the survey-participants were very satisfied or satisfied with the surgical result. However, the majority (73.3%) would have undergone BS earlier. The main motivation to choose BS was related to health status or quality of life. Important characteristics for a bariatric surgeon to obtain patients' trust are "taking time and listen" (74.7%), empathy (64%) and sympathy (56%). Post-operative satisfaction with the surgical outcome was high and long-lasting in this large cohort of BS patients. However, most participants would retrospectively have undergone BS earlier. The main reason to choose BS as treatment for their obesity were impaired physical health or reduced quality of life. Nearby location to patients' residence and availability of surgeons with empathy were decisive motives for bariatric centre selection.
| S-EPMC9285963 | biostudies-literature
Project description:PurposeObesity is a chronic metabolic disease with global distribution among adults and children which affects daily functioning and ultimately quality of life. Primary care physicians (PCPs) provide an important role for the treatment of severe obesity. Better understanding of obesity and its treatment options may increase patients' referral rates to the various treatment modalities, including metabolic/bariatric surgery (MBS).Materials and methodsA quantitative cross-sectional study used a self-reported questionnaire among PCPs of Clalit Health Services (CHS) in Northern Israel. The quantitative questionnaire examined the PCP's knowledge, opinions, attitude, and approaches to managing severe obesity.ResultsA total of 246 PCPs from Northern Israel filled the questionnaire (42.9%), the majority were Muslim Arabs (54.5%), who gained their medical degree outside of Israel (73.8%) and practicing for over 10 years (58.8%). 64.3% of PCPs had a high workload (over 100 appointments per week), 77.1% did not know the definition of severe obesity, and 69.17% did not attend educational meetings regarding obesity during the previous year. The referral rate for MBS was 50.4% ± 23.3. Two prognostic factors that had a statistically significant effect on the referral rate for bariatric surgery were the total appointments per week, and the number of practice years. Both had a negative association.ConclusionThe knowledge and referral rates for bariatric surgery are higher among PCPs with lower workload and relatively fewer practice years. Workshops and annual training courses may fortify knowledge and awareness for the treatment of obesity, which in turn could increase the referral rate for MBS.
| S-EPMC11217136 | biostudies-literature
Project description:BackgroundEconomic data on congenital heart disease are scarce in economically underdeveloped areas of China. Therefore, this study aimed to shed light on the level and changing trend of congenital heart disease inpatients' economic burden in underdeveloped areas.MethodThis study used a multi-stage stratified cluster sampling method to select 11,055 inpatients with congenital heart disease from 197 medical and health institutions in Gansu Province. Their medical records and expenses were obtained from the Hospital Information System. Univariate analysis was conducted using the rank sum test and Spearman rank correlation. Quantile regression and random forest were used to analyze the influencing factors.ResultsFrom 2015 to 2020, the average length of stay for congenital heart disease patients in Gansu Province was 10.09 days, with an average inpatient cost of USD 3,274.57. During this period, the average inpatient costs per time increased from USD 3,214.85 to USD 3,403.41, while the average daily inpatient costs increased from USD 330.05 to USD 376.56. The average out-of-pocket costs per time decreased from USD 2,305.96 to USD 754.77. The main factors that affected the inpatient costs included length of stay, cardiac procedure, proportion of medications, age, and hospital level.ConclusionCongenital heart disease causes a significant economic burden on both families and society. Therefore, to further reduce the patient's financial burden, the length of stay should be reasonably reduced, and the rational distribution of medical resources should be continuously promoted to ensure equitable access to healthcare services.
| S-EPMC10867958 | biostudies-literature
Project description:The prevalence of smoking habits in severe obesity is higher than in the general population. There is some evidence that smokers have different temperaments compared to non-smokers. The aim of this study is to evaluate the associations between smoking status (smokers, ex-smokers and non-smokers) and temperament characteristics in bariatric surgery candidates.We analyzed data on temperament of 420 bariatric surgery candidates, as assessed by the AFECTS scale, in an exploratory cross-sectional survey of bariatric surgery candidates who have been grouped into smokers, ex-smokers and non-smokers.We detected significant statistical differences in temperament related to the smoking status in this population after controlling the current use of psychiatric medication. Smokers had higher anxiety and lower control than non-smokers. Ex-smokers with BMI >50 kg/m(2) presented higher coping and control characteristics than smokers.Smoking in bariatric surgery candidates was associated with lower control and higher anxious temperament, when controlled by current use of psychiatric medication. Smokers with BMI >50 kg/m(2) presented lower coping and control than ex-smokers. Assessment of temperament in bariatric surgery candidates may help in decisions about smoking cessation treatment and prevention of smoking relapse after surgery.
| S-EPMC4795552 | biostudies-other
Project description:Projection of gut microbiome pre and post bariatric surgery to predict surgery outcome
| PRJEB39382 | ENA
Project description:Effect of bariatric surgery on microbiome composition and microbial metabolomics.
| PRJEB28869 | ENA
Project description:Bariatric surgery Targeted loci environmental
| PRJNA1041054 | ENA
Project description:ObjectiveTo determine whether binge eating disorder (BED) status is associated with medical comorbidities in obese adults scheduled for bariatric surgery.MethodThe study utilized Longitudinal Assessment of Bariatric Surgery-2 data obtained from six clinical centers around the United States. This is a well-phenotyped cohort of individuals who were evaluated within 30 days before their scheduled surgery using standardized protocols. In the cohort, 350 participants were classified as having BED and 1,875 as not having BED (non-BED). Multivariable logistic regression was used to determine whether BED status was independently related to medical comorbidities. As an exploratory analysis, significance was based on nominal p-values (p < .05). Holm's-adjusted p-values were also reported.ResultsAfter adjusting for age, sex, education, and body mass index, BED status was found to be independently associated with four of the 15 comorbidities (i.e., impaired glucose levels (odds ratio [OR] = 1.45 (95% confidence interval [CI]: 1.12-1.87)), high triglycerides (OR = 1.28 (95% CI: 1.002-1.63)), and urinary incontinence (OR = 1.30 (95% CI: 1.02-1.66)), all being more common among the BED sample, and severe walking limitations being less common in the BED sample (OR = 0.53 (95% CI: 0.29-0.96)). With further adjustment for psychiatric/emotional health indicators, BED status was independently associated with three comorbidities (impaired glucose levels (OR = 1.36 (95% CI: 1.04-1.79)), cardiovascular disease (OR = 0.50 (95% CI: 0.30-0.86)), and severe walking limitations (OR = 0.38 (95% CI: 0.19-0.77)). However, Holm's-adjusted p-values for all variables were greater than .05.DiscussionThe results suggest the possibility of a contribution of BED to risk of specific medical comorbidities in severely obese adults.
| S-EPMC4980070 | biostudies-literature
Project description:ObjectiveTo investigate the factors that influence the length of stay (LOS) in a neonatal intensive care unit (NICU).MethodsThis retrospective study analysed clinical data from all newborns hospitalized in the NICU of a tertiary hospital in the Western Hunan area of China over a 9-year period (2012-2020). Factors associated with the LOS were analysed using univariate analysis and Cox regression analysis.ResultsA total of 16 094 newborns were included in the study: of which 9615 were inborn and 6479 were outborn newborns. There were 9482 males and 6612 females. Over the 9-year period, the mean LOS was 11.08 days (median LOS, 9.00 days; range, 1-141 days); and the LOS first increased, then decreased and stabilized. A LOS of 8-28 days was the most common duration (8849 of 16 094; 54.98%). Cox regression analysis demonstrated that sex, patient source, delivery method, gestational age, birth weight and comorbidities were significantly associated with LOS.ConclusionBeing male, low gestational age and low birth weight increased the LOS. Reducing preterm and post-term infants, as well as eliminating comorbidities, could effectively shorten the LOS of newborns.
| S-EPMC9247289 | biostudies-literature