4.4 Article

The Patient-Practitioner interaction in post bariatric surgery consultations: an interpersonal process recall study

期刊

DISABILITY AND REHABILITATION
卷 45, 期 26, 页码 4440-4449

出版社

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2022.2152876

关键词

Bariatrics; communication; dyadic analysis; intersubjectivity; obesity treatment; patient-provider interaction; qualitative research; relationship building

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The study found that patients who have had bariatric surgery and healthcare practitioners experienced relational states and shifts in clinical encounters post-surgery, but discussions did not address the psychosocial burdens of living with obesity. Patients and practitioners avoided conflict, leading to distance rather than connection, limiting the benefits for both parties.
PurposeThe patient-practitioner relationship is fundamental to rehabilitation practice and patients' health and wellbeing. Dissonance between patients who have had bariatric surgery and health care practitioners about what supportive care and good outcomes are can undermine care. To address the mechanisms of this process, we conducted an Interpersonal Process Recall study.Materials and MethodsWe interviewed patients (11), video recorded consultations (10), conducted video-assisted individual interviews with patients (10) and practitioners (11) and a dyadic data analysis.ResultsWe identified relational states and shifts in the clinical encounter 2-3 years post-surgery, described in themes: a) Playing by the Book - Making it Easier for Each Other, b) Down the Blind Alley - Giving up on Each Other, and c) Opposite Poles - Towards and Away from Each Other.ConclusionsThe post-surgery consultations facilitated responsibility for health and self-care but did not invite dialogues about the psychosocial burdens of living with obesity and undergoing bariatric surgery. Patients and practitioners tried to avoid creating conflict, which in turn seemed to foster distance, rather than human connection. This limits the encounter's benefit to both parties, leaving them frustrated and less willing to either meet again or take any gains into their future lives.

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