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L'éducation thérapeutique du patient en amont d'une chirurgie bariatrique : identification des déterminants psychosociaux de la participation et de la qualité de vie du patient opéré

Abstract : Study 1: Few studies to our knowledge concentrate on understanding the reasons for acceptation or refusal of a program, they are often limited to a qualitative approach and in number of participants. The first part of our results shows there is a profile of patients ‘adhering’ to TPE with differences in terms of weight excess; psychological suffering; behavioral tendencies; and confirms the predictive role of the affective dependence schematic in TPE adhesion. However, the second part of the results shows that behavioral tendencies do not suffice by themselves in explaining the factors that push patients to participate in a program and brings to light the influence of patient perception on TPE adhesion. Indeed, an internalizing profile would be more active in the research of solutions and complementary information concerning surgery or in participating in groups.Study 2: Studies show the effectiveness of TPE on the biopsychosocial, educational (acquiring information & skills) levels and on the quality of life of the obese patient. However, no study investigates the evolution of biopsychosocial variables after a TPE preparing to bariatric surgery. Results show that surgery contributes to numerous benefits for the patient including weight loss, anxiety reduction, behavioral inhibition and quality of life improvement. However, participation impacts anxiety and avoidance variables. The qualitative analysis exploring the way transformations are lived throughout the first year corroborates the results of the quantitative analysis. As a matter of fact, TPE patients acquire emotional and social skills allowing them to verbalize the changes linked to the surgery that may impact the quality of psychosocial and dietary well-being.Study 3: No studies explore the influence of a TPE-adhering patient’s profile on post operatory quality of life. Our results bring forth the influence of specific variables such as positive affect, reward dependence, young age, and a weight loss, satisfactory on quality of life. This study validates our research hypothesis: quality of life depends on psychopathological moderators which are anxiety, depression, personal factors such as age, reward dependency ; but also on biomedical factors such as post operatory BMI.
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Submitted on : Friday, March 15, 2019 - 3:35:14 PM
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Aurélie Croiset. L'éducation thérapeutique du patient en amont d'une chirurgie bariatrique : identification des déterminants psychosociaux de la participation et de la qualité de vie du patient opéré. Psychologie. Université Toulouse le Mirail - Toulouse II, 2017. Français. ⟨NNT : 2017TOU20043⟩. ⟨tel-02069217⟩

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