Changes in health-related quality of life in people with morbid obesity attending a learning and mastery course. A longitudinal study with 12-months follow-up

Randi Andenæs, May S Fagermoen, Hilde Eide, Anners Lerdal, Randi Andenæs, May S Fagermoen, Hilde Eide, Anners Lerdal

Abstract

Background: Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual's overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up.

Methods: A single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery.

Results: At the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL.

Conclusions: Participation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course.

Trial registration: The study is registered in Clinical Trials: NCT01336725.

Figures

Figure 1
Figure 1
Scoring (in proportions) of the EQ-5 sub-domains at baseline and 12-month follow-up (n = 69). Differences between the two time points are analyzed using chi-square and Fisher’s exact tests.

References

    1. Jeffery RW, Sherwood NE. Is the obesity epidemic exaggerated? No. BMJ. 2008;336:245.
    1. World Health Organization. Global Database on Body Mass Index. http://apps. who. int/bmi/index. jsp.
    1. Holmen J, Midthjell K, Krokstad S, Lingaas Holmen T. Obesity and Type 2 Diabetes in Norway: New Data from the HUNT Study [abstract] Obes Facts. 2009;2:256.
    1. Bray GA, Wilson JF. Obesity. Ann Intern Med. 2008;149:4.
    1. Kolotkin RL, Meter K, Williams GR. Quality of life and obesity. Obes Rev. 2001;2:219–229.
    1. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vliegen E, Micic D, Maislos M, Roman G, Schutz Y, Toplak H, Zahorska-Markiewicz B. Management of obesity in adults: European clinical practice guidelines. Obes Facts. 2008;1:106–116.
    1. Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009;CD003641:2.
    1. Victorzon M, Tolonen P, Sintonen H. Health-related quality of life in severely and morbidly obese patients waiting for bariatric surgery in Finland. Scand J Surg. 2010;99:122–126.
    1. Sendi P, Brunotte R, Potoczna N, Branson R, Horber FF. Health-related quality of life in patients with class II and class III obesity. Obes Surg. 2005;15:1070–1076.
    1. Andersen JR, Aasprang A, Bergsholm P, Sletteskog N, Våge V, Natvig GK. Predictors for health-related quality of life in patients accepted for bariatric surgery. Surg Obes Relat Dis. 2009;5:329–333.
    1. Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–1917.
    1. Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)–an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord. 1998;22:113–126.
    1. Fabricatore AN, Wadden TA, Sarwer DB, Faith MS. Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg. 2005;15:304–309.
    1. Stout AL, Applegate KL, Friedman KE, Grant JP, Musante GJ. Psychological correlates of obese patients seeking surgical or residential behavioral weight loss treatment. Surg Obes Relat Dis. 2007;3:369–375.
    1. Bentley TGK, Palta M, Paulsen AJ, Cherepanov D, Dunham NC, Feeny D, Kaplan RM, Fryback DG. Race and gender associations between obesity and nine health-related quality-of-life measures. Qual Life Res. 2011;20:665–674.
    1. Jakicic JM, Davis KK. Obesity and physical activity. Psychiatr Clin North. 2011;34:829–840.
    1. Andersen JR, Aasprang A, Bergsholm P, Sletteskog N, Våge V, Natvig GK. Health-related quality of life and paid work participation after duodenal switch. Obesity Surgery. 2010;20:340–345.
    1. Lund RS, Karlsen TI, Hofsø D, Fredheim JM, Røislien J, Sandbu R, Hjelmesæth J. Employment is associated with the health-related quality of life of morbidly obese persons. Obes Surg. 2011;21:1704–1709.
    1. Zeller MH, Modi AC. Predictors of health-related quality of life in obese youth. Obesity. 2006;14:122–130.
    1. Wiczinski E, Döring A, John J, von Lengerke T. Obesity and health-related quality of life: Does social support moderate existing associations? Br J Health Psychol. 2009;14:717–734.
    1. von Gruenigen VE, Gibbons HE, Kavanagh MB, Janata JW, Lerner E, Courneya KS. A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change. Health Qual Life Outcomes. 2009;7:17.
    1. Adams TD, Pendleton RC, Strong MB, Kolotkin RL, Walker JM, Litwin SE, Berjaoui WK, LaMonte MJ, Cloward TV, Avelar E, Owan TE, Nuttall RT, Gress RE, Crosby RD, Hopkins PN, Brinton EA, Rosamond WD, Wiebke GA, Yanowitz FG, Farney RJ, Halverson RC, Simper SC, Smith SC, Hunt SC. Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese. Obesity. 2010;18:121–130.
    1. Kral JG. Surgical Treatment of Obesity. John Wiley, Chichester; 2001. pp. 511–517. (In International Textbook of Obesity).
    1. Bandura A. Self-efficacy : the exercise of control. Freeman, New York; 1997.
    1. World Health Organization. International Classification of Functioning, Disability and Health (ICF) .
    1. Huber JG, Sillick J, Skarakis-Doyle E. Personal perception and personal factors: incorporating health-related quality of life into the International Classification of Functioning, Disability and Health. Disabil Rehabil. 2010;32:1955–1965.
    1. Brooks R. EuroQol: the current state of play. Health Policy. 1996;37:53–72.
    1. Fayers PM, Machin D. Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. John Wiley, Chichester; 2007.
    1. Lerdal A, Andenæs R, Bjørnsborg E, Bonsaksen T, Borge L, Christiansen B, Eide H, Hvinden K, Fagermoen MS. Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway. Qual Life Res. 2011;20:1189–1196.
    1. Schwarzer R, Jerusalem M. In: In Measures in health psychology: a user's portfolio. Weinman S, Wright S, Winsor JM, editor. Nfer-Nelson, UK; 1995. Generalized self-efficacy scale; pp. 35–37.
    1. Cohen J. A power primer. Psychol Bull. 1992;112:155–159.
    1. Neovius K, Johansson K, Kark M, Neovius M. Obesity status and sick leave: a systematic review. Obes Rev. 2009;10:17–27.
    1. Johansson E, Böckerman P, Kiiskinen U, Heliövaara M. Obesity and labour market success in Finland: the difference between having a high BMI and being fat. Econ Hum Biol. 2009;7:36–45.
    1. Sobal J. In: In International Textbook of Obesity. Björntorp P, editor. John Wiley, Chichester; 2001. Social and Cultural Influences on Obesity; pp. 305–322.
    1. Uchino BN. Social support and physical health: understanding the health consequences of relationships. Yale University Press, New Haven; 2004.
    1. Goffman E. Stigma: notes on the management of spoiled identity. Prentice-Hall, Englewood Cliffs, NY; 1963.
    1. Fraser SN, Spink KS. Examining the Role of Social Support and Group Cohesion in Exercise Compliance. J Behav Med. 2002;25:233.
    1. Armstrong SN, Anderson M, Le ET, Nguyen LH. Application of the Health Belief Model to bariatric surgery. Gastroenterol Nurs. 2009;32:171–178.
    1. Greenberg I, Perna F, Kaplan M, Sullivan MA. Behavioral and psychological factors in the assessment and treatment of obesity surgery patients. Obes Res. 2005;13:244–249.
    1. Doll HA, Petersen SE, Stewart-Brown SL. Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res. 2000;8:160–170.
    1. de Zwaan M, Petersen I, Kaerber M, Burgmer R, Nolting B, Legenbauer T, Benecke A, Herpertz S. Obesity and quality of life: a controlled study of normal-weight and obese individuals. Psychosomatics. 2009;50:474–482.
    1. Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, Wonderlich SA, Gosnell BA. Long-term follow-up of patients' status after gastric bypass. Obes Surg. 2001;11:464–468.
    1. Kolotkin RL, Crosby RD, Gress RE, Hunt SC, Engel SG, Adams TD. Health and health-related quality of life: differences between men and women who seek gastric bypass surgery. Surg Obes Relat Dis. 2008;4:651–658.

Source: PubMed

3
S'abonner