Pasienterfaringar med bruk av klinisk tilbakemeldingssystem i oppfølging etter fedmekirurgi: Ein kvalitativ studie
DOI:
https://doi.org/10.7557/14.7821Nyckelord:
Fedmepoliklinikk, brukarmedverknad, psykisk helse, kvalitativ metode, klinisk tilbakemeldingssystemAbstract
Etter fedmekirurgi opplever ein del pasientar helseutfordringar. For å auke brukarmedverknaden til pasientane og legge til rette for meir individuell oppfølging, blei eit nytt klinisk tilbakemeldingssystem (KTS) innført ved ein fedmepoliklinikk i Norge i januar 2018. Studien utforskar pasientane si innsikt i formålet med KTS, korleis spørsmål om psykisk helse blei erfart, og den samla nytteverdien av systemet i behandlingsoppfølginga. Studien har eit kvalitativt design. To fokusgruppeintervju og eit individuelt intervju blei gjennomført med pasienter som har brukt KTS etter fedmeoperasjon og systematisk tekstkondensering blei brukt som analysemetode. Resultata syner at formålet med KTS var uklart for informantane, noko som påverka kor grundig og ærleg dei var i svara sine. Spørsmål om psykisk helse blei opplevd som sensitive og lite relevante, og den erfarte nytteverdien var avhengig av i kva grad behandlar tok utgangspunkt i tema pasienten sjølv opplevde som viktige.
Referenser
Boswell, J. F., Kraus, D. R., Miller, S. D., & Lambert, M. J. (2015). Implementing routine outcome monitoring in clinical practice: benefits, challenges, and solutions. Psychother Res, 25(1), 6–19. https://doi.org/10.1080/10503307.2013.817696
Busetto, L., Dicker, D., Azran, C., Batterham, R. L., Farpour-Lambert, N., Fried, M., Hjelmesæth, J., Kinzl, D. R. L., Makaronidis, K. S., Schindler, K., Topalak, H., … Yumuk, V. (2017). Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management. Obesty Facts, 10(6), 597–632. https://doi.org/10.1159/000481825
Börjesson, S., & Boström, P. K. (2019). "I want to know what it is used for": Clients’ perspectives on completing a routine outcome measure (ROM) while undergoing psychotherapy. Psychother Res, 30(3), 337–347. https://doi.org/10.1080/10503307.2019.1630780
Carlier, I. V., Meuldijk, D., Van Vliet, I. M., Van Fenema, E., Van der Wee, N. J., & Zitman, F. G. (2010). Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. J Eval Clin Pract, 18(1), 104-110. https://doi.org/10.1111/j.1365-2753.2010.01543.x
Castaneda, D., Popov, V. B., Wander, P., & Thompson, C. C. (2018). Risk of Suicide and Self-harm Is Increased After Bariatric Surgery-a Systematic Review and Meta-analysis. Obes Surg, 29(1), 322–333. https://doi.org/10.1007/s11695-018-3493-4
Corrigan, P., Druss, B., & Perlick, D. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in the Public Interest, 15(2), 37–70. https://doi.org/10.1177/1529100614531398
Den nasjonale forskningsetiske komite for samfunnsvitenskap og humaniora (NESH). (2021). Forskningsetiske retningslinjer for samfunnsvitenskap og humaniora. https://www.forskningsetikk.no/retningslinjer/hum-sam/forskningsetiske-retningslinjer-for-samfunnsvitenskap-og-humaniora/
Ekeland, T.-J., & Heggen, K. (2007). Meistring og myndiggjering-Reform eller retorikk. Gyldendal Akademiske.
Enden, T., Bernklev, T., Jelsness-Jørgensen, L.-P., & Amdal, C. D. (2018). Pasientene kjenner best egen helse. Tidsskrift for den Norske Lægeforening, 138(8). https://doi.org/10.4045/tidsskr.17.1054
Eriksen, C. B. (2017). Det er ikke slut, før den fede dame taber sig. Tidsskrift for kjønnsforskning, 41(2), 106–123. https://doi.org/10.18261/issn.1891-1781-2017-02-02
Field, J., Holmes, M. M., & Newell, D. (2019). PROMs data: can it be used to make decisions for individual patients? A narrative review. Patient related outcome measures, 10, 233–241. https://doi.org/10.2147/PROM.S156291
Gibbons, C., Porter, I., Gonçalves-Bradley, D. C., Stoilov, S., Ricci-Cabello, I., Tsangaris, E., Gangannagaripalli, J., Davey, A., Gibbons, E. J., Kotzeva, A., Evans, J., van der Wees, P. J., Kontopantelis, E., Greenhalgh, J., Bower, P., Alonso, J., & Valderas, J. M. (2021). Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice. Cochrane Database Syst Rev, 10(10), Cd011589. https://doi.org/10.1002/14651858.CD011589.pub2
Goldenshluger, A., Elazary, R., Cohen, M. J., Goldenshluger, M., Ben-Porat, T., Nowotni, J., Geraisi, H., Amun, M., Pikarsky, A. J., & Keinan-Boker, L. (2018). Predictors for Adherence to Multidisciplinary Follow-Up Care after Sleeve Gastrectomy. Obes Surg, 28(10), 3054–3061. https://doi.org/10.1007/s11695-018-3296-7
Helse Bergen (2016). Nordiske retninglinjer for kontroll og tilskudd av vitaminer/mineraler samt oppfølging etter fedmekirurgi kontroll-og-tilskudd-av-vitaminer. https://www.helse-bergen.no/49c469/siteassets/seksjon/soreg/documents/nordiske-retningslinjer-for-kontroll-og-tilskudd-av-vitaminer---norsk-versjon-pdf-26.5.17.pdf
Hegland, P. A., Aasprang, A., Hjelle Øygard, S., Nordberg, S., Kolotkin, R., Moltu, C., Tell, G. S., & Andersen, J. R. (2018). A review of systematic reviews on the effects of patient-reported outcome monitoring with clinical feedback systems on health-related quality of life-implications for a novel technology in obesity treatment. Clin Obes, 8(6), 452–464. https://doi.org/10.1111/cob.12277
Hegland, P. A., Aasprang, A., Kolotkin, R. L., Moltu, C., Tell, G. S., & Andersen, J. R. (2020). A novel patient-reported outcome monitoring with clinical feedback system in bariatric surgery care: study protocol, design and plan for evaluation. BMJ Open, 10(6), e037685. https://doi.org/10.1136/bmjopen-2020-037685
Hovland, R.T. (2020). Kliniske tilbakemeldingssystemer i psykiske helsevern -implementering og praktisering. [Doktorgradsavhandling]. Universitetet i Bergen.
Hovland, R. T., Ytrehus, S., Mellor-Clark, J., & Moltu, C. (2020). How patients and clinicians experience the utility of a personalized clinical feedback system in routine practice. Jounal of Clinical Psychology, 79, 711–728. https://doi.org/10.1002/jclp.22992
Malterud, K. (2018a). Fokusgrupper som forskningsmetode for medisin og helsefag (2 ed.). Universitetsforlaget As.
Malterud, K. (2018b). Kvalitative forsknings-metoder for medisin og helsefag. Universitetsforlaget As.
Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res, 26(13), 1753–1760. https://doi.org/10.1177/1049732315617444
McAleavey, A. A., de Jong, K., Nissen-Lie, H. A., Boswell, J. F., Moltu, C. & Lutz, W. (2024). Routine outcome monitoring and clinical feedback in psychotherapy: Recent advances and future directions. Adm Policy Ment Health, 51, 291–302. https://doi.org/10.1007/s10488-024-01351-9
Mechanick, J. I., Apovian, C., Brethauer, S., Garvey, W. T., Joffe, A. M., Kim, J., Kushner, R. F., Lindquist, R., Pessah-Pollack, R., Seger, J., Urman, R. D., Adams, S., Cleek, J. B., Correa, R., Figaro, M. K., Flanders, K., Grams, J., Hurley, D. L., Kothari, S., ... Still, C. D. (2019). Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: Cosponsored by American association of clinical endocrinologists/American college off endocrinology, The obesity society, American society for metabolic & Bariatric surgery, Obesity medicine association, and American society of anesthesiologists - executive summary. Endocr Pract, 25(12), 1346–1359. https://doi.org/10.4158/gl-2019-0406
Müller, A., Hase, C., Pommnitz, M. & de Zwaan, M. (2019). Depression and Suicide After Bariatric Surgery. Curr Psychiatry Rep, 21(9), 84. https://doi.org/10.1007/s11920-019-1069-1
Natvik, E., Lavik, K. O., Ogden, J., Strømmen, M. & Moltu, C. (2022). The patient-practitioner interaction in post bariatric surgery consultations: an interpersonal process recall study. Disability and Rehabilitation, 1–10. https://doi.org/10.1080/09638288.2022.2152876
Natvik, E., Råheim, M. & Sviland, R. (2021). The hamster wheel: a case study on embodied narrative identity and overcoming severe obesity. Med Health Care Philos, 24(2), 255–267. https://doi.org/10.1007/s11019-021-10002-x
Nielsen, A. S., Kidholm, K. & Kayser, L. (2020). Patients' reasons for non-use of digital patient-reported outcome concepts: A scoping review. Health Informatics J, 26(4), 2811–2833. https://doi.org/10.1177/1460458220942649
Robstad, A. N., Westergren, T., Siebler, F., Søderhamn, U., Fegran, L. (2019). Intensive care nurses`implicit an explicit attitudes and their behavioural intension towards obese intensive care patients. J Adv Nurs, 75, 3631–3642. https://doi.org/10.1111/jan.14205
Sarwer, D. & Heinberg, L. (2020). A review of the psychosocial aspects of clinically severe obesity and bariatric surgery. Am Psychol, 75(2), 252–264. https://doi.org/10.1037/amp0000550
Simpson, E., Brown, R., Sillence, E., Coventry, L., Lloyd, K., Gibbs, J., Tariq, S. & Durrant, A. C. (2021). Understanding the Barriers and Facilitators to Sharing Patient-Generated Health Data Using Digital Technology for People Living With Long-Term Health Conditions: A Narrative Review. Front Public Health, 9, 641424. https://doi.org/10.3389/fpubh.2021.641424
Solstad, S. M., Castonguay, L. G. & Moltu, C. (2017). Patients' experiences with routine outcome monitoring and clinical feedback systems: A systematic review and synthesis of qualitative empirical literature. Psychother Res, 29(2), 157–170. https://doi.org/10.1080/10503307.2017.1326645
Solstad, S. M., Kleiven, G. S. & Moltu, C. (2020). Complexity and potentials of clinical feedback in mental health: an in-depth study of patient processes. Quality of life research, 30, 3117–3125. https://doi.org/10.1007/s11136-020-02550-1
Spirou, D., Raman, J. & Smith, E. (2020). Psychological outcomes following surgical and endoscopic bariatric procedures: A systematic review. Obes Rev, 21(6), e12998. https://doi.org/10.1111/obr.12998
Swager, L. C., Pratt, K. J., Kiser, H. M. & Pona, A. A. (2024). Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes. Obes Sci Pract.10(6), e70030. https://doi.org/10.1002/osp4.70030
Szmulewicz, A., Wanis, K. N., Gripper, A., Angriman, F., Hawel, J., Elnahas, A., Alkhamesi, N. A. & Schlachta, C. M. (2019). Mental health quality of life after bariatric surgery: A systematic review and meta‐analysis of randomized clinical trials. Clinical obesity, 9(1), e12290. https://doi.org/10.1111/cob.12290
Tanneberger, A. & Ciupitu-Plath, C. (2018). Nurses’ Weight Bias in Caring for Obese Patients: Do Weight Controllability Beliefs Influence the Provision of Care to Obese Patients? Clin Nurs Res, 27(4), 414–432. https://doi.org/10.1177/1054773816687443
Thagaard, T. (2013). Systematikk og innlevelse. En innføring i kvalitativ metode. Fagbokforlaget.
Thornquist, E. (2016). Kommunikasjon: Teoretiske perspektiver på praksis i helsetjenesten. Fagbokforlaget.
Ueland, V. (2019). Stigmatisering og skam – en kvalitativ studie om å leve med fedme. Sykepleien forskning, 14(77012), e-77012. https://doi.org/10.4220/Sykepleienf.2019.77012
Våge, V., Lyyjynen H. & Hanson, S. (2023). Norsk kvalitetsregister for fedmekirugi (Årsrapport 2023). Scandinavian obesity surgery registry Norway https://www.helse-bergen.no/49daff/contentassets/2444c1e8cc95404fa3529d8af4a0602f/arsrapport-soregn-2023_final.pdf
Nedladdningar
Publicerad
Nummer
Sektion
Licens
Copyright (c) 2026 May Ina Kjøsnes Jarning, Eli Natvik, Pål Andre Hegland
Det här verket är licensierat under en Creative Commons Erkännande 4.0 Internationell-licens.
