الفهرس 
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Abstract
The increasing incidence of morbid obesity suggests that the quantity of bariatric surgical procedures will continue to multiply each year. Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities. The ultimate goal of bariatric surgery is not only reduced weight and reduction of co-morbidities, but also improved psychosocial functioning and quality of life (Pieracci, Pomp & Barie, 2016).
Over the past decade, bariatric surgery has grown in popularity as the most efficacious treatment for extreme obesity. During this time, there has also been increased research on the physical and psycho-social outcomes of the procedures. Unfortunately, patients appear to struggle with numerous psychological issues postoperatively. These include suboptimal weight loss, disordered eating, body image dissatisfaction, depression and low self-esteem (Sarwer et al., 2008).
There are longitudinal risks after the surgery such as weight regain, anatomic complications, and micronutrient deficiencies. Complications related to the anatomic alteration after bariatric surgery includes internal herniation, marginal ulcers and dumping syndrome. Physicians who take care of bariatric patients at any point in their post-operative care must be vigilant for these complications, as they may necessitate urgent intervention (Concors et al., 2016).
Aim of the Study:
The present study was conducted to assess physical and psychological problems among patient post bariatric surgery.
Research Question:
What are physical and psychological problems for patient post bariatric surgery?
Subject and Methods:
The study was portrayed under the four main designs as follows:
Technical design, Operational design, Administrative design and Statistical design.
1-Technical Design:
The technical design includes research design, setting, subject and tools for data collection.
Research Design:
A descriptive exploratory design was utilized to conduct this study.
Research Setting:
This study was conducted at surgical unit and obesity clinic in Eldemerdash Hospital affiliated to Ain Shams University Hospitals.
Research Subject:
Convenient sample of 177patient was obtained from surgical unit and obesity clinic in Eldemerdash Hospital affiliated to Ain Shams University Hospitals.
Inclusion criteria:
- All patients with morbid obesity post bariatric surgery.
- Agree to participate in this study.
- Male and female.
- Age (16-55) years.
Tools of Data Collection:
Tools that were used for data collection were the following:
Part (1):
Socio-demographic sheet:
The researcher developed this sheet to assess demographic data of patients such as age, sex, and level of education, marital status, previous bariatric surgery, type of bariatric surgery and medical history.
Part (2):
Physical problem questionnaire:
The researcher developed this tool to assess the physical problems among patient such as dumping syndrome, nutritional problems, wound infections, deep venous thrombosis and pulmonary embolism.
Part (3):
Psychological problem questionnaire consists of:
1. Beck depression inventory by Aaron Beck in 1996.
2. Body image-Acceptance and action questionnaire By: Emily K. Sandoz & Kelly G. Wilson in 2006.
3. Rosenberg self-esteem scale by Morris Rosenberg in 1965.
4. Eating disorder questionnaire.
The present study revealed that:
Less than three quarters of the studied patients (73.8%) were females, third of those patients (32.5%) was illiterate, more than half of them (55.0%) was married, two thirds of them (66.3%) never had previous bariatric surgery, slightly more than half of the (52.5%) were performed sleeve gastrostomy and more than half of them (56.3%) were obese.
Regarding physical complications, less than three quarter of the studied patients had dumping syndrome, majority of them had nutritional deficiency, majority of them had steatorrhea and two thirds of those patients complained from sagging skin.
Regarding psychological complications, it was found that, depressive symptoms appeared on two fifth of the studied patients, less than three quarter of those patients not accept their body image, less than half of them had low self-esteem and less than three quarter of the studied patients weren’t restraining their eating. In addition, there was statistically significant correlation between physical and psychological complications and patients demographic characteristics.
Conclusions:
Based on this study finding, it can be concluded that:
Physical problems less than three quarter of the studied patients had dumping syndrome, majority of those patients had nutritional deficiency, majority of them had steatorrhea and more than half of them complained from excess skin.
Psychological problems, it was found that, depressive symptoms presented on two fifth of the studied patients , less than three quarter of them not accept their body image, less than half of them had low self-esteem and less than three quarter of them weren’t restraining their eating. In addition, there was statistically significant correlation between physical and psychological complications and patients demographic characteristics.
Recommendation:
In research:
- Replication of the current study on large sample and different hospitals settings to be able to generalize the results.
- Further study is recommended about lifestyle modification and cognitive behavioral therapy to patients post bariatric surgery.
- Assessment of life style and eating habits on morbid obese patients.
In services:
- Educational Training program for nurses to improve their practice regarding management of patient undergoing bariatric surgery.
In community:
- Psychological supportive clinics to help patient manage their psychological problems pre and post bariatric surgery.