减重代谢术后患者饮食管理行为改变动机的质性研究

doi:10.3760/cma.j.cn441417-20250402-22032

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (22): 3854-3858.DOI: 10.3760/cma.j.cn441417-20250402-22032

减重代谢术后患者饮食管理行为改变动机的质性研究

韩红娜¹ 杨琳¹ 田明¹ 安艳新¹ 李海英² 何萍²

¹西安医学院第一附属医院肝胆及减重代谢外科，西安 710061；²西安医学院附属宝鸡医院普外一病区，宝鸡 721006

收稿日期:2025-04-02 出版日期:2025-11-01 发布日期:2025-11-21
通讯作者: 杨琳，Email：1162028061@qq.com
基金资助:
陕西省教育厅重点科学研究计划（24JR148）

Qualitative research on motivation of dietary management behavior change in patients after bariatric and metabolic surgery

Han Hongna¹, Yang Lin¹, Tian Ming¹, An Yanxin¹, Li Haiying², He Ping²

¹Department of Hepatobiliary, Metabolic, and Bariatric Surgery, The First Affiliated Hospital of Xi'an Medical College, Xi'an 7410061, China; ²First Ward, Department of General Surgery, Baoji Hospital of Xi'an Medical College, Baoji 721006, China

Received:2025-04-02 Online:2025-11-01 Published:2025-11-21
Contact: Yang Lin, Email: 1162028061@qq.com
Supported by:
Key Plan of Scientific Research of Shaanxi Provincial Department of Education (24JR148)

摘要/Abstract

摘要： 目的　探究减重代谢术后患者饮食管理行为改变动机。方法　采取目的抽样法，2024年3至4月选取在西安医学院第一附属医院和西安医学院附属宝鸡医院进行术后随访的12名患者进行深度访谈，其中男6人，女6人，年龄（32.83±6.49）岁，采用Braun＆Clarke主题分析法对资料进行分析。结果　减重代谢术后患者护理过程中饮食管理行为改变动机的4个主题，包括意识到减重代谢术后并发症的风险、意识到饮食管理不良行为的危害、意识到饮食管理健康行为的益处、意识到社会支持和积极心理水平有利于身心健康和生活。结论　通过提高减重代谢术后患者对术后并发症和不良行为危害的认知，以及社会支持水平和积极心理水平，促进患者对饮食管理健康行为的认识，从而在护理过程中转变其饮食管理行为改变的动机。针对上述因素，临床护理人员应进行有效的干预，从而提高减重代谢术后患者的饮食管理效果，改善临床结局。

关键词: 减重代谢术, 饮食管理, 改变动机, 质性研究, 外科护理学

Abstract: Objective　To explore the motivation of dietary management behavior change in patients after bariatric and metabolic surgery. Methods　Adopting the purposive sampling method, 12 patients who underwent postoperative follow-up at the First Affiliated Hospital of Xi'an Medical College and Baoji Hospital of Xi'an Medical College were selected for in-depth interviews from March to April 2024, including 6 males and 6 females who were (32.83±6.49) years old. The data were analyzed using the Braun & Clarke thematic analysis. Results　The four themes of motivation for dietary behavior change during nursing care after bariatric and metabolic surgery were as below: awareness of the risks of postoperative complications, awareness of the harms of non-compliant dietary behaviors, awareness of the benefits of healthy dietary management, and awareness that social support and positive psychological factors were conducive to mental and physical well-being and quality of life. Conclusions　By enhancing patients' awareness of postoperative complications and the risks of harmful behaviors, along with their level of social support and positive psychological well-being, we can improve their understanding of healthy dietary management practices. This, in turn, will strengthen their motivation to change dietary behaviors during nursing care. Based on these factors, clinical nursing staff should implement effective interventions to enhance the effectiveness of dietary management in patients after bariatric and metabolic surgery and to improve their clinical outcomes.

Key words: Bariatric and metabolic surgery, Dietary management, Change motivation, Qualitative research, Surgical nursing

韩红娜杨琳田明安艳新李海英何萍. 减重代谢术后患者饮食管理行为改变动机的质性研究[J]. 国际医药卫生导报, 2025, 31(22): 3854-3858.

Han Hongna, Yang Lin, Tian Ming, An Yanxin, Li Haiying, He Ping. Qualitative research on motivation of dietary management behavior change in patients after bariatric and metabolic surgery[J]. International Medicine and Health Guidance News, 2025, 31(22): 3854-3858.

参考文献

[1] News Medical Life Sciences. Alarming projection: by 2035, more than half of the global population will be obese[EB/OL].[2023-03-02].https://www.news-medical.net/news/20230302/Alarming-Projection-By-2035-more-than-half-of-the-global-population-will-be-obese.aspx.
[2] World Obesity Federation. World obesity atlas 2023 [EB/OL]. London: World Obesity Federation,[2023-03-01]. https://www.worldobesityday.org/assets/downloads/World_Obesity_Atlas_2023_Report.pdf.
[3] 中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521.
[4] 李梦伊,刘雁军,王桂琦,等. 大中华减重与代谢手术数据库2023年度报告[J]. 中国实用外科杂志,2024,44(5):552-563,570. DOI:10.19538/j.cjps.issn1005-2208.2024.05.15.
[5] 王迪,王鹏程,李雪,等. 减重代谢手术对肥胖症患者生活质量影响的Meta分析[J]. 中国全科医学,2020,23(29):3729-3734. DOI:10.12114/j.issn.1007-9572.2020.00.167.
[6] 中华医学会外科学分会甲状腺及代谢外科学组,中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国肥胖及2型糖尿病外科治疗指南(2019版)[J]. 中国实用外科杂志,2019,39(4):301-306. DOI:10.19538/j.cjps.issn1005-2208.2019.04.01.
[7] Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants[J]. Lancet, 2021, 397(10287):1830-1841. DOI: 10.1016/S0140-6736(21)00591-2.
[8] Bäuerle A, Marsall M, Niedergethmann M, et al. Adherence to dietary behavior recommendations moderates the effect between time since metabolic and bariatric surgery and percentage total weight loss[J]. Obes Surg, 2024, 34(8):2930-2939. DOI: 10.1007/s11695-024-07359-2.
[9] de Sousa Paredes SC, Mota-Garcia F. Prevalence of nutritional deficiencies in bariatric surgery candidates and its effect on metabolic status[J]. Hormones (Athens), 2020, 19(4):505-514. DOI: 10.1007/s42000-020-00234-6.
[10] 王冉,王林,刘婷,等. «减重手术围术期护理指南2021»解读[J]. 护理研究,2023,37(3):382-387. DOI:10.12102/j.issn.1009-6493.2023.03.002.
[11] Ben-Porat T, Sherf-Dagan S. Nutritional interventions for patients with severe obesity seeking bariatric surgery[J]. Nutrients, 2023, 15(3):515. DOI: 10.3390/nu15030515.
[12] Williams-Kerver GA, Steffen KJ, Mitchell JE. Eating pathology after bariatric surgery: an updated review of the recent literature[J]. Curr Psychiatry Rep, 2019, 21(9):86. DOI: 10.1007/s11920-019-1071-7.
[13] 胡雁,王志稳.护理研究[M]. 6版.北京:人民卫生出版社,2022:257-258.
[14] 花红霞,梁辉,许勤,等. 放牧饮食行为测评量表的汉化及其在减重代谢术后患者中的信效度检验[J]. 中国全科医学,2023,26(7):810-815. DOI:10.12114/j.issn.1007-9572.2022.0694.
[15] 曾雅燕,陈旭娜,林彤彤,等. 动机保护理论的健康教育模式在癌性疼痛患者疼痛全程管理中的应用[J]. 国际医药卫生导报,2025,31(5):860-864. DOI:10.3760/cma.j.cn441417-20240724-05032.
[16] Mousa AH, Alahmad KO, Alsharabi AH, et al. Assessment of motivating and demotivating factors to undergo bariatric surgery in high-risk populations with correlation to generalized anxiety disorder and influence of others: a cross-sectional study[J]. Ann Med Surg (Lond), 2023, 85(2):140-145. DOI: 10.1097/MS9.0000000000000204.
[17] 姚琳,柳清霞,郭佳,等. 减重代谢术前患者肥胖相关病耻感的质性研究[J/OL]. 中华肥胖与代谢病电子杂志,2021,7(2):86-92[2025-03-07].https://d.wanfangdata.com.cn/periodical/ChVQZXJpb2RpY2FsQ0hJMjAyNTA2MjISFHpoZnB5ZHhkenp6MjAyMTAyMDA0Ggh2NWI5ZW93cQ%3D%3D. DOI:10.3877/cma.j.issn.2095-9605.2021.02.004.
[18] Kabu Hergül F, Özbayır T. I am as normal as everyone now. . . : examination of experiences of patients undergoing bariatric surgery according to roy's adaptation model: a qualitative study[J]. Clin Nurs Res, 2021, 30(4):511-521. DOI: 10.1177/1054773819880291.
[19] Liu RH, Irwin JD. Understanding the post-surgical bariatric experiences of patients two or more years after surgery[J]. Qual Life Res, 2017,26(11):3157-3168. DOI: 10.1007/s11136-017-1652-z.
[20] Taube-Schiff M, Yufe S, Kastanias P, et al. A qualitative study of young adult experiences in the bariatric healthcare system: psychosocial challenges and developmental difficulties[J]. Can J Diabetes, 2017, 41(4):344-350. DOI: 10.1016/j.jcjd.2017.01.002.
[21] Natvik E, Gjengedal E, Moltu C, et al. Translating weight loss into agency: men's experiences 5 years after bariatric surgery[J]. Int J Qual Stud Health Well-being, 2015, 10:27729. DOI: 10.3402/qhw.v10.27729.
[22] Youssef A, Mylopoulos M, Maunder R, et al. Understanding bariatric patients' experiences of self-management post-surgery: A qualitative study[J]. Clin Obes, 2021, 11(5):e12473. DOI: 10.1111/cob.12473.
[23] van Hout GC, Boekestein P, Fortuin FA, et al. Psychosocial functioning following bariatric surgery[J]. Obes Surg, 2006, 16(6):787-794. DOI: 10.1381/096089206777346808.
[24] Mack I, Ölschläger S, Sauer H, et al. Does laparoscopic sleeve gastrectomy improve depression, stress and eating behaviour? A 4-year follow-up study[J]. Obes Surg, 2016, 26(12):2967-2973. DOI: 10.1007/s11695-016-2219-8.
[25] 郭晋仪,杨宁琍,梁辉,等. 正念饮食干预在减重代谢术后患者中应用的效果[J]. 中国普外基础与临床杂志,2025,32(5):596-602. DOI:10.7507/1007-9424.202410089.

减重代谢术后患者饮食管理行为改变动机的质性研究

Qualitative research on motivation of dietary management behavior change in patients after bariatric and metabolic surgery

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	陈春桃区秀丽李彩霞刘彩玲曾娜芬杜真萍蔡少娜米谦符霞. 维持性血液透析患者自体动静脉内瘘瘤样扩张防治不足影响因素的质性研究 [J]. 国际医药卫生导报, 2025, 31(9): 1559-1564.
[2]	汤莉姜婷俞玲娜黄霞罗凤军李岸婷童赟唐亚平高子航. 基于“互联网+护理服务”平台老年用户使用体验的质性研究[J]. 国际医药卫生导报, 2025, 31(21): 3692-3696.
[3]	徐燕妮潘燕芬程晓玲郭金玲曾秋璇. 病人专家项目干预对肺动脉高压患者自我效能与生活质量影响的质性研究 [J]. 国际医药卫生导报, 2025, 31(19): 3334-3339.
[4]	张桐高敏李翔孟晓静周立民范晶丽梅洁. 神经胶质瘤患者患病体验及需求的质性研究 [J]. 国际医药卫生导报, 2024, 30(6): 1032-1037.
[5]	刘建霞牛路野李亚楠朱小广. 伴神经损伤胸腰椎骨折患者心理体验的质性研究 [J]. 国际医药卫生导报, 2024, 30(3): 484-488.
[6]	梅兴燕吕美荣李玉荣武甜甜杨淑红贾庆运张肖. 风险管理视角下心血管疾病患者发病风险沟通体验质性研究 [J]. 国际医药卫生导报, 2024, 30(3): 519-524.
[7]	骆紫苗汪玲珍梁桂兴彭鹿胡佩欣丁美祝. 老年患者就诊医养结合门诊的影响因素质性研究 [J]. 国际医药卫生导报, 2024, 30(18): 3141-3145.
[8]	卢慧娟姜素芳万碧玉林品励唐芳汪玲珍刘旭生邓丽丽. 腹膜透析患者性生活体验的质性研究 [J]. 国际医药卫生导报, 2023, 29(8): 1095-1099.
[9]	梁倩雯马影蕊许颖佟富爽. 产妇对产后康复服务需求的质性研究 [J]. 国际医药卫生导报, 2023, 29(6): 863-867.
[10]	高敏孟晓静李翔范晶丽黄璐璐杜宇. 神经重症护士有创颅内压监测知信行的质性研究 [J]. 国际医药卫生导报, 2023, 29(19): 2811-2815.
[11]	梁燕刘楠张涵. 糖尿病患者在外就餐需求的质性研究 [J]. 国际医药卫生导报, 2023, 29(18): 2646-2649.
[12]	凌晨张云芳黄丽秋. 基于需求层次理论的初置管腹膜透析患者生活顾虑的质性研究 [J]. 国际医药卫生导报, 2023, 29(18): 2654-2658.
[13]	陈小红廖国萍罗洋洋. 低年资护士遭受工作场所暴力体验的质性研究 [J]. 国际医药卫生导报, 2023, 29(18): 2659-2663.
[14]	杭琳张洁萍项丹玉陈玉瑛孙欣鑫尹悦廖月霞. 早产儿过渡期母亲对母乳喂养社会支持需求及挑战的质性研究 [J]. 国际医药卫生导报, 2023, 29(12): 1752-1755.
[15]	王婧, 刘宇, 徐健莹, 杨丽明, 林静霞, 吴巧媚, 邓丽丽. 广州疫情封控区紧急状态下过渡隔离病区护士工作压力源的混合研究方案[J]. 国际医药卫生导报, 2022, 28(8): 1114-1118.