Study On The Psychology And Related Factors Of Patients With Metabolic Surgery Before And After Operation

ObjectiveTo understand the preoperative and postoperative psychology of patients with metabolic surgery,and to explore the related factors and promotion strategies respectively,so as to provide reference for the intervention priorities and measures at different stages.MethodsThis study includes the following two parts:1.Mental health level of patients before metabolic surgery and its related factors:quantitative research method is adopted.A total of 272 patients who underwent metabolic surgery in the gastrointestinal hernia surgery department in a third-grade general hospital of Zhengzhou City and met the criteria for inclusion were selected.Based on the Dual Model of Mental Health,the Kessler 10 scale(K10)and Index of Well-Being(IWB)were used to evaluate the mental health of patients before surgery.The self-made general information questionnaire,Weight Bias Internalization Scale(WBIS),Connor-Davidson Resilience Scale(CD-RISC),Social Support Rating Scale(SSRS),and Medical Coping Modes Questionnaire(MCMQ)were used to analyze its influencing factors.Use SPSS21.0 and AMOS 7.0 software for analysis,that is,descriptive statistics,single factor analysis,correlation analysis,regression analysis and path analysis.2.Psychological experience of patients after metabolic surgery and their related factors:qualitative research method was adopted.A total of 18 post-metabolic patients who met the inclusion criteria were selected for review in the gastrointestinal hernia surgery department in a third-grade general hospital of Zhengzhou City.The semi-structured interview was conducted.The subjects were extracted by Colaizzi's 7-step analysis method,and the influencing factors were sorted out based on the social ecosy stem.Results1.Mental health level of patients before metabolic surgery and its related factors:(1)The K10 score of patients before metabolic surgery was(21.79±7.35)points,and 116 patients(42.6%)ranged from 22 to 50 points(poor psychological status),which were all higher than the normal model(P<0.001).The IWB score is(9.23±2.52)points,which is lower than the normal model(P<0.001).The happiness index of 111 patients(40.8%)was lower(<8.4 points).(2)The univariate analysis showed that the demographic influencing factors of patients' K10 scores before metabolic surgery were different childhood overall feelings;the demographic influencing factors of IWB scores were different self-assessed personality,education level,marital status,and family monthly income.(3)The scores of WBIS(55.46±9.81),coping response(19.79±3.07)and yield response(11.00±3.47)among the patients with poor mental status before metabolic surgery were all higher than those with good mental status(P<0.05).The total scores of CD-RISC(59.08±13.74)and the total scores of SSRS(33.79±6.64)were all lower than those with good mental status(P<0.05).The scores of WBIS(53.75±10.70)and yield coping(10.21±3.10)of patients with low-level happiness before metabolic surgery were higer than those with high-level happiness(P<0.05).The total scores of CD-RISC(58.21±12.78)and the total scores of SSRS(33.86±6.55)were lower than those with high-level happiness(P<0.05).(4)Combined with the results of univariate and correlation analysis,stepwise multiple linear regression analysis was performed on the K10 score and IWB score of patients before metabolic surgery,the results showed that WBIS,yielding response,self-strengthening,and coping response entered the K10 score model,which explained 37.4%of the total variation.Tenacity,utilization of social support,WBIS and yield response entered the IWB score model,which explained 41.6%of the total variation.(5)Path analysis shows that self-strengthening and WBIS have both direct and indirect effects on K10 scores.Tenacity,WBIS and yield response have both direct and indirect effects on IWB scores.2.Psychological experience of patients after metabolic surgery and their related factors:(1)The results of the interview showed that the psychological process of patients after metabolic surgery included excitement stage,torment stage,honeymoon stage,anxiety stage,adaptation stage and rebirth stage.A total of 21 sub-themes were identified.(2)According to the interview data and the social ecosystem,the factors that affect the psychological process of patients after metabolic surgery were summarized into three major themes,namely micro factors,meso factors and macro factors,and include 8 sub-themes.Conclusion1.The preoperative mental health level of patients undergoing metabolic surgery is poor and needs to be improved.It is recommended to pay special attention to the mental health level of patients before metabolic surgery who experience general and poor childhood experiences,introverted personality,unmarried,low income,junior high school and below and college degree.It can improve the psychology of patients before metabolic surgery by reducing the level of internalized discrimination,improving psychological resilience,especially stimulating self-strengthening and tenacity,helping to make the most of their social support,adjusting their mentality when facing stress,and reducing the yield coping style.2.The postoperative psychology of patients undergoing metabolic surgery fluctuates,which requires follow-up and timely intervention.It is suggested to improve the mental health level of patients after metabolic surgery by promoting their physical recovery after surgery,helping them adapt to dietary adjustments,improving the effect of weight loss after surgery,enriching the external support network,guiding patients to adjust their self-attitude,and popularizing the public's cognition of metabolic surgery.