Sandra is a health psychologist with research interests in chronic disease management and smoking cessation. She recently completed her doctorate in health psychology at the University of the West of England in Bristol, UK. She previously worked in the National Health Service (NHS) as a primary care and mental health researcher, an assistant psychologist and in research governance. She has also delivered consultancy work developing tailored stress management interventions within organisations and group settings. Alongside her research work, Sandra also works as a general advisor for the London Research Design Service team based at Queen Mary University, which involves supporting health professionals and research teams within the North East London area to develop their research ideas into full funding applications to the NIHR and other peer reviewed funders
Statement of the problem: The superiority of bariatric surgery for improving medical outcomes in severely obese individuals when compared to other weight loss interventions remains undisputed. However, knowledge about the psychological impact of the procedure on people’s lives is limited. Recent systematic reviews have shown persisting disordered psychosocial wellbeing after surgery when compared to control groups, especially after long-term monitoring, suggesting need for psychological support and longer term postoperative research on psychological outcomes. Research literature infers limited understanding regarding the postoperative lived experience from the patient perspective. This may form a barrier in health professionals’ understanding of this patient group’s postoperative ongoing needs. This study aimed to capture patients and health professionals’ accounts of the postoperative bariatric surgery experience, exploring concordance between the two groups to gauge awareness of patients’ subsequent health needs.
Methodology and theoretical orientation: Ten individuals who had bariatric surgery two or more years ago and eight bariatric surgery practitioners were recruited within UK public hospital settings and individually interviewed by the researcher. The audio recorded interviews were transcribed and examined using thematic analysis.
Findings: Thematic analysis of the interviews elicited a key finding around ‘postsurgical cliffs in patient care’ within a heavily structured service. This permeated through three themes; (1) navigating health changes (2) contrasting perspectives and (3) perceived prejudice. Participants reported some unmet needs; namely psychological aftercare to facilitate adjustment following physical and psychological changes. Issues with excess skin, acceptance of non-obese self and perceived prejudice were prominent. Impact of differing views of success between patients and professionals on postoperative care within the service context was highlighted.
Conclusion & Significance: Bariatric surgery is a great catalyst for weight loss in severe obesity. However, lack of psychological aftercare may threaten weight loss outcomes over the longer term. Findings infer postoperative psychological support as a potential facilitator for optimising results. Recommendations from a health psychology perspective are given.