Cassie Brode1, Megan Ratcliff2, Jennifer Reiter-Purtill3, Sanita Hunsaker3, Michael Helmrath4, Meg Zeller3. 1. Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV, 26505, USA. cassie.brode@hsc.wvu.edu. 2. , Atlanta, GA, USA. 3. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers"). SETTING: Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital. METHODS: A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions. RESULTS: Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p < .05), and there was a trend towards non-completion for older adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion. CONCLUSIONS: These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers"). SETTING: Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital. METHODS: A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions. RESULTS: Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p < .05), and there was a trend towards non-completion for older adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion. CONCLUSIONS: These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.
Entities:
Keywords:
Adolescent bariatric surgery; Attrition; Caregiver weight loss surgery; Predictors of surgery non-completion
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