RESUMO
Objective To investigate the status of depression/anxiety in obese patients seeking metabolic surgery and analyze the effects of depression/anxiety on different aspects of quality of life. Methods Convenient sampling was used and 117 metabolic surgery were recruited from the Department of Bariatric and Metabolic Surgery in the First Affiliated Hospital of Nanjing Medical University from March to July,2017. Patient Health Questionnaire(PHQ-9),Generalized Anxiety Disorder 7-item scale (GAD-7),12 item Short-Form Health Survey(SF-12)and the general information and disease characteristics questionnaire were used to collect data. Results Nearly 25.6%(30/117) of the patients suffered from moderate, moderately severe and severe depression symptoms and the median and interquartile range of PHQ-9 was 6 and 7 points.16.2%(19/117)of the patients had moderate and severe anxiety symptoms and the median and interquartile range of GAD-7 was 3 and 6 points. Multiple linear regression analysis showed that scores in the physical component of the SF-12 were associated with the body mass index,the presence of comorbidities and depression,which could explain 20.0% of the total variance;the symptoms of depression and anxiety were negatively related to the mental component summary of SF-12,which could explain 49.6% of the total variance. Conclusions The present findings suggests that there is a high occurrence of depression and anxiety in metabolic surgery patients, which severely impair the patients′quality of life. As for the obese patients seeking metabolic surgery for treatment, routine screening of depression and anxiety incorporating the diagnosis of the problems are warranted.Then intervention based on the assessment can be exerted to maximize the benefit of patients undergoing the surgery in the long term.
RESUMO
Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice. As for the postoperative diet strategy, current literature remains non-unified to identify the duration and the content of the nutrition managements. Domestic clinical reports about the postoperative nutrition managements after metabolic surgery are rare and lack of unified and good reference standard. Meanwhile, divergence still existed in current literature regarding to the content of the postoperative nutrition managements. Therefore, it is necessary to develop the standardized protocol for nutrition managements which is offering basis and reference for the clinical application of perioperative nutrition managements after metabolic surgery.