The Relationship among Health Beliefs, Social Support, and Health-Promoting Behaviors in Obese Patients after Bariatric Surgery
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Abstract
Obesity is a risk factor for various diseases affecting health, quality of life, economy, and society in a wide range. According to the effects on health, patients with obesity try to seek various ways to lose weight by themselves, resulting in both good and undesirable effects on health and well-being. Bariatric surgery is another option for patients with obesity who have attempted weight loss through many methods but have not succeeded. The benefits of bariatric surgery do not only provide weight loss but also reduce the long-term comorbidity rates. It is found that maintaining stable body weight after bariatric surgery is extremely challenging. An important factor is changes in physical and psychological behaviors that lead to successful long-term maintenance of body weight. This descriptive correlational research aimed to examine the relationships among health belief factors, social support, and health-promoting behaviors and to compare those variables in successful and unsuccessful groups in bariatric surgery. Purposive sampling was performed to recruit 57 obese patients after bariatric surgery with continuous follow-up at the outpatient department. Data were collected using four questionnaires, including a personal information form, the Health Belief Questionnaire, the Social Support Questionnaire, and the Health-Promoting Behaviors Questionnaire. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation, and an independent t-test.
The results of the study found that the sample had a high level of perceived susceptibility (mean = 24.98, SD =1.69) and perceived severity (mean = 26.91, SD = 3.32) and a moderate level of perceived benefit (mean = 23.10, SD = 1.94), perceived barriers (mean = 24.00, SD = 2.79), and health motivation (mean = 25.21, SD = 2.66). The social support scores were high (mean = 52, SD = 11.34) and health-promoting behaviors were moderate (mean = 2.73, SD = 17.86). Perceived severity, perceived benefit, and social support were positively correlated with health-promoting behaviors with statistical significance (r = 0.47, p < .01, r = 0.38, p <.01 and r = 0.12, p < .05, respectively). However, perceived susceptibility, perceived barriers, and health motivation were not significantly associated with health-promoting behaviors (r = 0.05, p > .05; r = 0.15, p > .05; and r = 0.20, p > .05, respectively).
Furthermore, a comparison of the studied factors between the successful and unsuccessful surgery groups revealed no statistically significant differences in perceived susceptibility, perceived severity, perceived benefit, perceived barriers, health motivation, social support, and health-promoting behaviors. The successful group scored slightly higher than the unsuccessful group. Upon further examination of health-promoting behaviors, no significant differences were found between the two groups in physical activity and exercise, nutrition, spiritual development, interpersonal relationships, and stress management. However, there was a statistically significant difference in health responsibility, with the successful surgery group scoring slightly higher than the unsuccessful group (t = -2.48, p < .05). Overall, the successful group had slightly higher scores in all areas except stress management, with the unsuccessful group had slightly higher scores in stress management, but there was no significant difference.
The study findings can be applied to assess social support and to organize activities that encourage participation from family members, friends, and healthcare teams in promoting health behaviors. The results also serve as a basis for developing programs that enhance family involvement in self-care before and after surgery, increase confidence in performing health-promoting behaviors, emphasize supervision, care, and continue follow-up to maintain a stable body weight after surgery.
Keywords: Bariatric surgery, Health beliefs, Health promoting behavior, Obesity, Social support
Author contributions:
NS: Conceptualization, method and design, tool validation, data collection and analysis, and writing and revising the manuscript
SC: Conceptualization, method and design, data analysis, writing, revising, and editing the manuscript, and corresponding with the editor-in-chief
PS: Conceptualization, method and design, data analysis, revising the manuscript
Article Details
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บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
References
World Health Organization. Obesity and overweight. [Internet]. Geneva: WHO; 2024 [ cited 2024 Feb 17]. Available from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Kumfum A, Jaitae S, Rattanapunya S, Numboonjit S, Sukseetong N. Nutritional status, attitudes and policy recommendation on surveillance of obesity among personnel at Chiangmai Rajabhat University. Disease Control Journal. 2023;49(3):541-50. (in Thai)
Aekplakorn W, Puckcharern H, Satheannoppakao W. Survey of Thai people’s health by physical examination, No.6 (2019-2020) Bangkok: Mahidol University, Faculty of Medicine Ramathibodi Hospital; 2023.
Sukkum S. Nurses’ roles in caring for obese patients undergoing laparoscopic sleeve gastrectomy. Thai Journal of Nursing. 2021;70(3):29–38. (in Thai)
Taptaemtut M. A Health literacy lifestyle program for working age people with metabolic syndrome, Lamae district, Chumphon province. Journal of Boromarjonani College of Nursing, Suphanburi. 2023; 6(1):145-59. (in Thai)
Limprasert S. Obesity and cardiovascular diseases. J Med Health Sci. 2024;31(1):107-12.
Ayanan P, Chomchuen T, Tangkawanich T. Factors related obesity behavior of senior high school students in Muang district, Chiang Rai Province. Journal of Health Research and Development Nakhon Ratchasima Provincial Pubic Health Office. 2021;7(1):75-89. (in Thai)
Mo-suwan L, Puwanant M, Phosuwattanakul J, Suthutvoravut U, Jongpipatwanich S, Chongviriyaphan N, et al. Clinical practice guidelines for the pediatric inpatient treatment of severe acute malnutrition. Thai Journal of Parenteral and Enteral Nutrition. 2019;28 (1):10-39. (in Thai)
Juárez-Fernández M, Román-Sagüillo S, Porras D, Garcia-Mediavilla MV, Linares P, Ballesteros-Pomar MD, et al. Long-term effects of bariatric surgery on gut microbiota composition and faecal metabolome related to obesity remission. Nutrients. 2021;13(8):2519. doi: 10.3390/nu13082519.
Lam BCC, Lim AYL, Chan SL, Yum MPS, Koh NSY, Finkelstein EA. The impact of obesity: a narrative review. Singapore Med J. 2023;64(3):163-71. doi: 10.4103/singaporemedj.SMJ-2022-232
Van de Laar AW, van Rijswijk AS, Kakar H, Bruin SC. Sensitivity and specificity of 50% excess weight loss (50%EWL) and twelve other bariatric criteria for weight loss success. Obes Surg. 2018;28(8):2297-304. doi: 10.1007/s11695-018-3173-4.
Alfadda AA, Al Qarni A, Alamri K, Ahamed SS, Abo’ouf SM, Shams M, et al. Perceptions, attitudes, and barriers toward obesity management in Saudi Arabia: data from the ACTION-IO study. Saudi J Gastroenterol. 2021;27(3):166-72. doi: 10.4103/sjg.sjg_500_20.
Moriconi D, Masi S, Rebelos E, Virdis A, Manca ML, De Marco S, et al. Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding.Obes Res Clin Pract. 2020;14(3):205-9. doi: 10.1016/j.orcp.2020.05.009.
Ullah A, Jamil M, Jamil J. The role of dietary interventions in the management of obesity [Internet]. In: I. McFarlane S, editor. Obesity-recent insights and therapeutic options. IntechOpen; 2023. p. 1-22. doi: 10.5772/intechopen. 111529
Becker, Marshall H. The health belief model and sick role behavior.Health Educ. Monogr. 1974; 2(4):409-19.
Phasuk, P. The relation between health beliefs and self health care behaviors of elders in Nongkae subdistrict, Rasisalai district, Sisaket Province. Journal of Department of Health Service Support. 2020; 16(1):44–55. (in Thai)
Jaiyod N, Manoton A. Effectiveness of applying the concept of health belief model in modifying obesity reduction behavior of Sukhothai personnel, Muang district, Sukhothai province. Journal of Community Public Health. 2023; 9(1):54-68. (in Thai)
Hongsakornprasert K. Effects of social support on elderly patients with depressive disorders. Multidisciplinary Journal for Health. 2022;4(2):15-26. (in Thai)
Jintanapanya P. Effect of behavior modification program on the health behavior and nutritional status of overweight and obese healthcare worker in Thung Song Hospital, Nakhon Si Thammarat Province. Maharaj Nakhon Si Thammarat Medical Journal. 2023;7(1):28-41. (in Thai)
Athanasiadis DI, Martin A, Kapsampelis P, Monfared S, Stefanidis D. Factors associated with weight regain post-bariatric surgery: a systematic review.Surg Endosc. 2021;35(8):4069-84.
Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 4th ed. Upper Saddle River, NJ: Pearson; 2002.
Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res. 1987;36(2):76-81.
Cadena-Obando D, Ramírez-Rentería C, Ferreira-Hermosillo A, Albarrán-Sanchez A, Sosa-Eroza E, Molina-Ayala M, Espinosa-Cárdenas E. Are there really any predictive factors for a successful weight loss afterbariatric surgery? BMC Endocr Disord. 2020;20(1): 20. doi: 10.1186/s12902-020-0499-4.
Liao J, Yin Y, Zhong J, Chen Y, Chen Y, Wen Y, et al. Bariatric surgery and health outcomes: an umbrella analysis. Front Endocrinol (Lausanne). 2022;13: 1016613. doi: 10.3389/fendo.2022.1016613.
Maiman LA, Becker MH. The health belief model: origins and correlates in psychological theory. Health Educ Monogr. 1974;2(4):336-53.
Gregory D. Zimet, Nancy W. Dahlem, Sara G.Zimet, Gordon K. Farley. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1998;(52):30-41.
Narmkul P, Ua-Kit N. Predicting factors of weight control behaviors among overweight female adolescents. [Master’s dissertation]. Bangkok: Chulalongkorn University; 2013. doi.org/10.58837/CHULA.THE.2010.655.
Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. doi: 10.3758/BF03193146.
Sararuk M. Health beliefs and obesity prevention behaviors of over-nourished high school students: a case study of Matthayom Trakan Phuetphon school, Ubon Ratchathani province. Humanities and Social Sciences Journal, Ubon Ratchathani Rajabhat University. 2013;4(2):65-85. (in Thai)
Wongpakaran T, Wongpakaran N, Sirirak T, Arunpongpaisal S, Zimet G. Confirmatory factor analysis of the revised version of the Thai multidimensional scale of perceived social support among the elderly with depression. Aging Ment Health. 2018;22(9):1143-48.
Wannalai U. Factors influencing health status of late adolescents in Muang district, Lampang province. Journal of Health Sciences Scholarship. 2021;8(2):197-18. (in Thai)
Yaemmen P, Duangsong R. The effects of health promotion program by application of health belief model and social support on behavioral modification for weight control among overweight students at Level 5 of primary school, Muang district, Phitsanulok province. KKU Research Journal (Graduate Studies). 2012;12(1):57-67. (in Thai)
