After the honeymoon period; an interpretative phenomenological analysis of the experiences of bariatric surgery patients 12 months to three years post operatively
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AbstractThe role of a psychologist within bariatric services is predominately focussed on the completion of preoperative psychological assessments (NICE, 2006; Ratcliffe et al, 2014). This role requires the psychologist to determine the suitability of the patient for surgery (Bauchowitz et al., 2005; Fabricatore et al., 2006; Sogg & Mori, 2004; UK Faculty of clinical health psychology; Psychologists in weight management network meeting, 2013), however no research to date has been able to reliably determine which variables could be associated with sub optimal weight loss (Sarwer, Wadden, & Fabricatore, 2005; Van Hout, Verschure, and van Heck, 2005; Wadden, Sarwer, Fabricatore, 2007). The first part of this study examines the empirical evidence for a range of variables considered by professionals to be clear contraindications to surgery. The variables were collated from surveys conducted in America (Bauchowitz et al., 2005; Fabricatore et al., 2006). Due to conflicting evidence and various problems with the studies it is difficult for a clinician to draw any firm conclusions from the review. Therefore, an ideographic approach is suggested, which leads onto the second part of the researcher dossier. The empirical chapter presents an interpretative phenomenological analysis (IPA) of interviews with 14 bariatric participants who were 12 months to three years post-operative to explore their experience of - 21 surgery. This time frame was chosen to capture the participants after the ‘honeymoon phase’ when the participants have hit their weight plateau (Yale & Weiler, 1991; Brolin, 1992). The themes from the study were ‘pre op’ ‘phases’ weight maintenance’ ‘impact of the operation’ and an overall psychological theme of ‘locus of control’. Support was a key area for the participants, they described the lack of support they felt from professionals and means of seeking support elsewhere. The themes also highlighted the psychological struggle the participants go through post operatively with eating, however, this is balanced with the positive changes in identity and their ability to engage with life, no longer impeded by their weight. Recommendations from the study suggest the importance of psychologists being available to bariatric patients, in accordance with NICE guidance, and that all bariatric patients start their journey to surgery in a level three service (which is a weight management service with consists of a multi-disciplinary team) before being referred to the tier four surgical team. Finally weight loss prior to surgery is recommended, with an alternative method of achieving this than that presented in the recent British Obesity and Metabolic Surgery Society (2014) publication.
TypeThesis or dissertation
DescriptionA thesis submitted