A program of nurse-led education about bariatric surgery, as well as telephone follow-up following surgery, resulted in significant improvements in patients’ overall quality of life, according to study results published in Bariatric Surgery Practice and Patient Care.

Researchers conducted the study from October 2014 to January 2016 in patients undergoing bariatric surgery at a university hospital in Istanbul, Turkey. Eligibility criteria included patients undergoing their first bariatric surgery (sleeve gastrectomy) who did not have complications during the surgery, were literate, and could speak and hear on the telephone. Patients were administered 4 questionnaires for data collection: a Patient Information Form, the Short-Form Health Survey (SF-36), a Post-Discharge Follow-up Form, and an Assessment Form of Nurse-led Educational Activities.

Interviews were conducted on the day before surgery, as well as on the first day of hospital admission. During the interview, the intervention and control groups completed the Patient Information Form and the SF-36. Patients in the intervention group (n=51) also received at least 2 face-to-face educational sessions that lasted between 30 and 60 minutes.

In the intervention group, follow-up services consisted of telephone calls every 15 days following surgery; patients also completed the Post-Discharge Follow-up Form. The researchers conducted 6 educational sessions; during the phone conversations, the patients were asked about their surgery-related health problems. The last interview, conducted 3 months after surgery, was in person; patients’ body weight and waist circumference were measured and patients completed the SF-36 and the Assessment Form for Nurse-led Educational Activities.

Patients in the control group received usual care provided by the inpatient unit during and after the surgery. Before discharge, patients received a written document from the hospital regarding postoperative nutritional guidelines as part of their standard care. The second face-to-face interviews were conducted 3 months after the surgery. Body weights and waist circumference were measured and patients completed the SF-36.

The intervention and control groups were well matched in terms of age, height, body mass index, (BMI), and waist circumference at baseline. Of the patients in the intervention group, 82.4% were female, 41.2% were between the ages of 18 and 35, and 35.3% were high school graduates. BMI of patients in the intervention group was 46.37 kg/m2 and the mean waist circumference was 137.10 cm.

 Compared with before surgery, the decrease in waist circumferences of patients in the intervention group was statistically greater than that of the control group at 3 months after surgery (17.67 cm vs 14.88; P =.001). However, the weight loss of patients 3 months after surgery was not significantly different between the 2 groups (27.63 kg vs 26.24 kg, respectively; P =.005). 

Patients in the intervention group reported that the effect of face-to-face patient education and telephone follow-up on their adaptation to nutrition, exercise, and medical treatment was higher than just reading the patient education manual.

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“The findings of this study show that patient education and follow-ups, beginning as one-on-one education before surgery and continuing by phone after surgery, resulted in significant improvements in patients’ overall quality of life,” the investigators wrote.

However, short-term follow-ups after surgery “offer limited information about patients’ ability to adapt to lifestyle changes. Therefore, long-term follow-ups, continuing for a year or more, may offer more reliable information regarding life after bariatric surgery,” the researchers added. Longer follow-up may also be “useful in maintaining the results of bariatric surgery for the long term, as well as in planning more effective health care services,” they concluded.

Reference

Güven B, Akyolcu N. Effects of nurse-led education on quality of life and weight loss in patients undergoing bariatric surgery [published online October 4, 2019]. Bariatr Surg Pract Patient Care. doi:10.1089/bari.2019.0025