Future Goals for
Bariatric Care
The program that is utilized at Mayo Clinic is not easily accessible to replicate at other facilities; therefore, structure to support the inclusion of occupational therapy by other programs is needed (Mayo Clinic, 2019).
By increasing awareness of the benefits that skilled occupational therapy services can provide to this population, future developments regarding bariatric care can overturn past cycles of failure and improve overall weight loss and quality of life for clients (Vallis, 2016).
Many occupational challenges are present for individuals seeking or undergoing bariatric surgery, such as socialization, self-care, eating, meal preparation, leisure engagement, education, and work (Ellison, Keesing, & Harris, 2020; Faccio, Nardin, & Cipolletta, 2016; Vallis, 2016). The current standard of care for this population is addressed through an interprofessional team to provide care prior to and following surgery; however, this team does not consistently involve occupational therapy or clearly define the role of occupational therapy. It is essential to provide comprehensive treatment that addresses the functional impacts of surgery and reintegration into daily life in addition to the surgical complications and nutritional restrictions (Mata, Mikkola, Loveland, & Hallowell, 2015). With the influence of psychosocial, physical, environmental, cultural, and spiritual factors on functional performance, occupational therapy is a professional qualified to assist people in creating and implementing unique and orderly approaches to major lifestyle changes. Greater clarity, structured programs, and advocacy are necessary to effectively integrate occupational therapy into the interprofessional team to improve outcomes of bariatric surgery care.
Evaluation
Using assessment tools that indicate changes in lifestyle and health behavior are relevant for occupational therapy as they would open the door for more comprehensive descriptions of occupational therapy and its impact in future interventions for individuals seeking bariatric care (Nielsen & Christensen, 2018).
Intervention
OT can contribute effectively to interventions due to their holistic approach for therapy, individualized care for each client, knowledge on the roles and tasks necessary and desired by humans, supporting changes in health behavior with technology, and promoting the enjoyment of being active and engaged (Nielsen & Christensen, 2018).
Utilizing the EHP model to collaborate between disciplines and view patient care through a shared lens can enhance outcomes for patients, enhance understanding between disciplines, and provide a continuum of care that ensures consistency in quality.
Leading The Way
Occupational therapists in Canada participated in a workshop that was created to increase understanding of bariatric care and highlight the potential for OT interventions for clients seeking bariatric care (Forhan & Law, 2009). The authors found that this workshop formed positive changes in practitioners’ beliefs about this population, such as viewing weight gain as a multifactorial challenge (Forhan & Law, 2009). Forhan and Law (2009) stated that creating a collaborative network can raise the profile of OT contributions to this population and better define the role of OT.
This collaborative network may include an international network between Canada and the U.S. so that knowledge of assessment and intervention for people with bariatric needs can be disseminated between one another efficiently (Forhan & Gill, 2013; Forhan & Law, 2009). Effective knowledge exchange and translation activities are appropriate for the development and evaluation of continuing professional education and advancing evidence-based practice (Forhan & Law, 2009).
Virtual Care
Utilizing virtual intervention methods was found to have positive results for participants following bariatric surgery (Sherf-Dagan et al., 2018).
Digital communication methods, such as online education programs, is a method used to increase patient engagement and minimize barriers (Sherf-Dagan et al., 2018).
Smartphone apps with encouraging messages were also found to have positive behavior changes and increased weight loss for participants following bariatric surgery (Sherf-Dagan et al., 2018).
Educational video-based aids had a greater impact than educational booklets on patients’ decisional conflicts and outcome expectancies (Sherf-Dagan et al., 2018).
The utilization of technology and virtual contexts can be applied through OT and an interprofessional healthcare team to best meet the needs of each client.
References
Ellison, N., Keesing, S., & Harris, C. (2020). Understanding occupational engagement for individuals with bariatric needs: The perspectives of Australian occupational therapists. Australian Occupational Therapy Journal. doi:10.1111/1440-1630.12657
Faccio, E., Nardin, A., & Cipolletta, S. (2016). Becoming ex-obese: Narrations about identity changes before and after the experience of the bariatric surgery. Journal of Clinical Nursing, 25(11-12), 1713-1720. doi:10.1111/jocn.13222
Forhan, M., & Gill, S. (2013). Cross-border contributions to obesity research and interventions: A review of Canadian and American occupational therapy contributions. Occupational Therapy in Health Care, 27(2), 129–141. doi:10.3109/07380577.2013.785642
Mata, H., Mikkola, A., Loveland, J., & Hallowell, P. T. (2015). Occupational therapy and bariatric surgery: Discovering occupation after weight-loss surgery. OT Practice, 20(1), 11–15. Retrieved from https://www.aota.org/Publications-News/otp/Archive/2015 /01-19-15/Bariatric-Surgery.aspx
Mayo Clinic. (2019). Overview - Bariatric Center in Florida - Mayo Clinic. Retrieved from https://www.mayoclinic.org/departments-centers/general-surgery/florida/bariatric-center/overview
Nielsen, S. S., & Christensen, J. R. (2018). Occupational therapy for adults with overweight and obesity: Mapping interventions involving occupational therapists. Occupational Therapy International, 2018, 1–17. doi:10.1155/2018/741268
Sherf-Dagan, S., Hod, K., Mardy-Tilbor, L., Gliksman, S., Ben-Porat, T., Sakran, N., . . . Raziel, (2018). The effect of pre-surgery information online lecture on nutrition knowledge and anxiety among bariatric surgery candidates. Obesity Surgery, 28(7), 1876-1885. doi:10.1007/s11695-018-3134-y
Vallis, M. (2016). Quality of life and psychological well‐being in obesity management: improving the odds of success by managing distress. Int J Clin Pract, 70, 196-205. doi:10.1111/ijcp.12765