ABSTRACT
PURPOSE: To explore barriers, facilitators, and motivators to adopting and maintaining regular physical activity among women with obesity who have undergone bariatric surgery. APPROACH: Individual interviews with women 3 to 24 months post-bariatric surgery. SETTING: Participants were recruited from a bariatric clinic in Montreal, Canada. PARTICIPANTS: Twelve women were recruited (mean age = 47 ± 9 years) using poster advertisements and word of mouth. Participants were on average 15 months postsurgery. METHOD: Each woman was interviewed once using a semistructured interview protocol. Recruitment was conducted until data saturation (i.e., no new information emerged). The interviews were transcribed, coded, and analyzed using inductive thematic analysis. RESULTS: Three interrelated themes emerged: the physical body, appraisal of the physical and social self, and the exercise environment. Barriers included weight-restricted mobility, side effects of surgery, body dissatisfaction, compromised psychological health, competing responsibilities, a lack of exercise self-efficacy and social support, reduced access to accommodating facilities, lack of exercise knowledge, and northern climate. Participants reported postsurgical weight loss, weight and health maintenance, enjoyment, body image, and supportive active relationships, as well as access to accommodating facilities and exercise knowledge, as facilitators and motivators. CONCLUSION: Suggested physical activity programming strategies for health care professionals working with this unique population are discussed. Physical activity and health promotion initiatives can also benefit from a cultural paradigm shift away from weight-based representations of health.
Subject(s)
Bariatric Surgery/psychology , Exercise/psychology , Health Promotion/methods , Motivation , Obesity/prevention & control , Adult , Attitude to Health , Canada , Female , Humans , Middle Aged , Qualitative ResearchABSTRACT
The share of seroso-papillary endometrial carcinoma (SPEC) for the past 4 years has been 6.4%--101 out of 1,567 endometrial cancers. There has been lower incidence of obesity, diabetes mellitus and infertility in cases of SPEC than endometrioid carcinoma (EEC)--18.8 and 53.7; 12.9 and 23.3; 8.8 and 20.6%, respectively, (p < 0.05). Only 60.4% of SPEC patients had locally-advanced tumors (stage I--35.6; stage II--24.8%) while tumor dissemination was reported in 39.6% (stage III--27.7 and stage IV--11.9%). Among EEC patients, locally-advanced tumors were detected in 89.6% (stage I--62.9 and stage II--26.7%) and disseminated tumor incidence was 3 times lower than in SPEC--10.4% (stage III--8.1 and stage IV--2.3%). Deep invasion into the stroma (more than 10 mm) was registered in 27.7% (SPEC) while in EEC--6.0% (p(0.05). Lymphogenous metastasis was much more common in SPEC (13.9%) as compared with less than 4.1% in EEC patients. There was no correlation between its presence and depth of invasion in the myometrium (p(0.05). High incidence of association of metastasis and superficial or deep invasion was reported for SPEC. This tumor should be classified as pathogenetic variant II of clinico-morphological changes.
