“If you're offered help, take it”: A qualitative study examining bariatric patients' experience of telephone‐based cognitive behavioural therapy

Abstract

Summary The increased recognition of patients' mental health needs after bariatric surgery has resulted in the emergence of accessible psychosocial interventions; however, there is a dearth of literature on patient experience and satisfaction with these interventions. We explored patients' perceptions and experiences of telephone‐based cognitive behavioural therapy (Tele‐CBT) in this qualitative study. Ten participants from the Toronto Western Hospital Bariatric Surgery Program in Toronto, Canada who completed the Tele‐CBT (http://clinicaltrials.gov Identifier: NCT02920112) were individually interviewed from November 2014 to June 2016 until thematic saturation occurred (ie, no more new coding groups emerged). Interviews were transcribed, independently coded, checked for discrepancies, and analysed using grounded theory. Four themes emerged: (1) participants were generally satisfied with Tele‐CBT (eg, therapeutic alliance, resources provided, relevance of therapy to their own bariatric journey), (2) participants noticed emotional, cognitive, and behavioural changes following therapy, (3) the optimal time to deliver the Tele‐CBT was when weight loss plateaued, generally at one‐year post‐surgery, and (4) participants found the telephone modality convenient. CBT was generally found to be helpful and the telephone format increased convenience and accessibility. Patients reported learning skills and receiving resources that could help them improve their well‐being following bariatric surgery.

Understanding bariatric patients' experiences of self‐management post‐surgery: A qualitative study

“…Having access to interprofessional bariatric support post‐surgery allowed patients to cultivate their self‐awareness capacity and learn specific coping strategies that helped them self‐manage emotional dysregulation and problematic eating behaviours associated with weight regain. Thus, findings from this study support previous work underscoring the importance of attending to the psychological changes following bariatric surgery 8,11,25,29,40 …”

“…For example, close to 1‐year post‐surgery, participants described the slow‐down in weight loss to be associated with increased grazing habits and specific food cravings impacting their ability to adhere to the bariatric guidelines. Whilst some were able to self‐manage, majority of bariatric patients recognized the value of accessing post‐operative inter‐professional care to help them “normalize setbacks,” address emotional dysregulations may be linked to grazing habits, and cultivate positive coping strategies 40 . Having access to interprofessional bariatric support post‐surgery allowed patients to cultivate their self‐awareness capacity and learn specific coping strategies that helped them self‐manage emotional dysregulation and problematic eating behaviours associated with weight regain.…”

“…Whilst some were able to self-manage, majority of bariatric patients recognized the value of accessing post-operative inter-professional care to help them "normalize setbacks," address emotional dysregulations may be linked to grazing habits, and cultivate positive coping strategies. 40 Having access to interprofessional bariatric support postsurgery allowed patients to cultivate their self-awareness capacity and learn specific coping strategies that helped them self-manage emotional dysregulation and problematic eating behaviours associated with weight regain. Thus, findings from this study support previous work underscoring the importance of attending to the psychological changes following bariatric surgery.…”

“…Thus, findings from this study support previous work underscoring the importance of attending to the psychological changes following bariatric surgery. 8,11,25,29,40 A major strength of this qualitative study is the iterative data collection and analysis approach to develop a mechanistic understanding of bariatric patients' self-management experiences. Recruiting participants from a diverse sample of bariatric patients with distinct postoperative care experiences allowed for exploring variation in patients'…”