Abstract:

Objective To systematically evaluate the diet experience of patients with obesity after metabolic bariatric surgery（MBS）,and comprehensively understand the diet problems and management needs,so as to provide bases for better clinical medical work. Methods Cochrane Library,JBI library,PubMed,Embase,Web of science,CINAHL,PsychINFO,CNKI,CBM were searched by computer. Qualitative research on diet experience of patients after metabolism bariatric surgery was retrieved and collected. The retrieval period was from the establishment of the databases to January 2021. The quality of the literature was evaluated by the quality evaluation standard of JBI evidence-based health care center in Australia,and the results were integrated by the method of aggregation. Results 18 studies were included. Researchers distilled 39 results into 7 sub-themes,which were combined into 4 themes,namely ①changes in the eating state after metabolic bariatric surgery:changes in dietary patterns in patients,changes in postoperative diet management stage;②positive eating strategies after metabolic bariatric surgery;③negative eating experience and bad eating behavior after metabolic bariatric surgery:negative eating experience,bad eating behavior and reasons;④after metabolic bariatric surgery,patients seek multi-faceted diet management support:support from health care providers, support from family and friends,and support from social organizations. Conclusion Medical staff should pay attention to the patients’ diet problems after metabolic bariatric surgery,provide targeted support and help according to the causes of the problems,guide the patients to establish positive diet behavior,achieve and maintain the best weight loss effect,and improve the quality of life.

Key words: Obesity, Bariatric Surgery, Feeding Behavior, Surgical Nursing, Qualitative, Systematic Review

摘要：

目的 系统评价肥胖症患者减重代谢术后的饮食体验的研究,全面了解其存在的饮食问题与管理需求,为更好地开展临床医疗工作提供依据。 方法 计算机检索Cochrane Library、乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Embase、Web of Science、CINAHL、PsycINFO、中国知网、万方数据库、中国生物医学文献数据库。搜集有关肥胖症患者减重代谢术后饮食体验的质性研究,检索年限为建库至2021年1月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法进行结果整合。 结果 共纳入18项研究,提炼39个结果,归纳为7个类别,综合为4个整合结果。①减重代谢术后患者进食状态的变化:饮食方式的变化、饮食管理阶段的变化;②减重代谢术后积极的进食策略;③减重代谢术后消极的进食体验和不良饮食行为:消极的进食体验、不良饮食行为及原因;④减重代谢术后患者寻求多方面的饮食管理支持:医护人员的饮食管理支持、家人和朋友的饮食管理支持、社会组织的饮食管理支持。 结论 医护人员应重视患者在减重代谢术后已出现的或可能会出现的饮食问题,根据相关原因,有针对性的提供支持与帮助以应对术后饮食挑战,指导患者建立正确的饮食行为,实现并维持最佳的减重效果,提高生活质量。

关键词: 肥胖症, 减重代谢手术, 摄食行为, 外科护理学, 质性研究, 系统评价