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Obes Surg. 2017 Jan;27(1):102-109. doi: 10.1007/s11695-016-2250-9.

Factors Leading to Self-Removal from the Bariatric Surgery Program After Attending the Orientation Session.

Author information

1
Faculty of Medicine, University of Toronto, Toronto, M5S 1A8, Canada.
2
Faculty of Engineering and Applied Science, University of Toronto, Toronto, M5S 1A4, Canada.
3
Bariatric Surgery Program, Department of General Surgery, Toronto Western Hospital, Toronto, M5T 2S8, Canada.
4
Centre for Mental Health, Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada. sanjeev.sockalingam@uhn.ca.
5
Toronto General Hospital, 200 Elizabeth St-8EN228, Toronto, ON, M5G 2C4, Canada. sanjeev.sockalingam@uhn.ca.

Abstract

BACKGROUND:

Bariatric surgery orientation sessions are often the first point of contact and a recommended component of pre-bariatric surgery assessment. Self-removal rates after bariatric program orientation are as high as 25 % despite the proven efficacy of this procedure. The objective of this study was to identify factors contributing to patient self-removal after orientation using a mixed method approach.

METHODS:

Patients who attended the Toronto Western Hospital Bariatric Surgery Program orientation between 2012 and 2013 and then self-removed from the program (N = 216) were included in the study. Subjects were interviewed via telephone using a semi-structured interview guide, generating both quantitative and qualitative data. Factors leading to discontinuation were rated on a five-point Likert scale. Qualitative data was analyzed using constant comparative methodology.

RESULTS:

The response rate was 59 % with a 40.7 % completion rate (N = 88). Concerns about potential surgical risks and complications and the ability to adapt to changes in eating and drinking post-operatively were identified as the top two factors for patients' self-removal from the program. Thematic analysis uncovered 11 major themes related to patient self-removal. Unexpected themes include perceived personal suitability for the surgery, family impact of surgery, miscommunication with the family physician, and fears related to the orientation information.

CONCLUSIONS:

This is one of the first studies examining barriers to bariatric surgery in the pre-operative setting and offers new insights into the reasons patients self-remove from bariatric surgery programs. This study may inform bariatric orientation program changes resulting in improved access to this effective surgical intervention.

KEYWORDS:

Bariatric surgery; Orientation; Self-removal

PMID:
27256014
DOI:
10.1007/s11695-016-2250-9
[Indexed for MEDLINE]

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