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Publications

Journal Article Epublish

PubMed: 40790737 DOI: 10.1186/s12889-025-24035-x

Bariatric surgery decision-making of adults with obesity: a grounded theory study.

BMC Public Health 25(1):2725

Authors: Yihong Xu, Wen Li, Liping Zhu, Yunxia Li, Jianan Wang, Xiaoxiao Zhang, Shanni Ding, Mizhi Wu, Hongying Pan, Weihua Yu, Jionghuang Chen

Affiliations

  • Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
  • School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
  • Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
  • Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Abstract

OBJECTIVE

The retention rate of Bariatric Surgery (BS) remains a critical concern, yet the decision-making mechanism among obese individuals considering BS is still unclear. This study aims to identify key stages and core mechanisms in the BS decision-making process.

DESIGN

Qualitative, one-on-one, and focus group in-depth interviews were conducted.

METHODS

Semi-structured interviews were conducted in China from September 2022 to February 2023. Using the Straussian Grounded Theory (SGT) approach, an iterative analysis of the BS decision-making process was performed, ultimately constructing a decision-making mechanism for obese patients opting for BS. Reporting followed the SRQR checklist.

RESULTS

Interviews were conducted with 21 obese individuals scheduled for BS one day before surgery. A theoretical model was developed to describe and explain the BS decision-making process. The study identified five key stages in the decision-making process: Initial Attention, Proactive Information-Seeking, Decision-Making Process, Definitive Surgical Decision, Preparation Phase, and Abandonment, with the Decision-Making Process being the most critical. The study examined the influence of External Environment on Cognitive Decision-Making, focusing on social pressure, social support, and peer support. Additionally, the Cognitive Trade-off Theory for Bariatric Surgery (CTT-BS) was established, incorporating five cognitive-level factors.

CONCLUSION

The identified decision-making stages and cognitive theory provide evidence to clarify the facilitators and barriers to BS motivation retention, offering insights for developing strategies to improve BS retention rates.

MeSH

Decision Making, Public Health, Bariatric Surgery, Obesity, Retention, Psychology, Grounded Theory