Wishing for deburdening through a sustainable control after bariatric surgery

The aim of this study was an in-depth investigation of the change process experienced by patients undergoing bariatric surgery. A prospective interview study was performed prior to as well as 1 and 2 years after surgery. Data analyses of the transcribed interviews were performed by means of the Grounded Theory method. A core category was identified: Wishing for deburdening through a sustainable control over eating and weight, comprising three related categories: hoping for deburdening and control through surgery, feeling deburdened and practising control through physical restriction, and feeling deburdened and trying to maintain control by own willpower. Before surgery, the participants experienced little or no control in relation to food and eating and hoped that the bariatric procedure would be the first brick in the building of a foundation that would lead to control in this area. The control thus achieved in turn affected the participants' relationship to themselves, their roles in society, and the family as well as to health care. One year after surgery they reported established routines regarding eating as well as higher self-esteem due to weight loss. In family and society they set limits and in relation to health care staff they felt their concern and reported satisfaction with the surgery. After 2 years, fear of weight gain resurfaced and their self-image was modified to be more realistic. They were no longer totally self-confident about their condition, but realised that maintaining control was a matter of struggle to obtaining a foundation of sustainable control. Between 1 and 2 years after surgery, the physical control mechanism over eating habits started to more or less fade for all participants. An implication is that when this occurs, health care professionals need to provide interventions that help to maintain the weight loss in order to achieve a good long-term outcome

The Adult Life After Childhood Cancer in Scandinavia (ALiCCS) Study: Design and Characteristics

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageBackground. During the last five decades, survival of childhood cancer has increased from 25% to 80%. At the same time, however, it has become evident that survivors experience a broad range of therapy-related late adverse health effects. The aim of the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study is to investigate long-term health consequences of past and current therapies in order to improve follow-up care of survivors and to reduce treatment-related morbidity of future patients. Procedure. Childhood cancer survivors were identified through the five Nordic cancer registries and a comparison cohort was established through random selection of cancer-free individuals from the civil registration systems. A unique personal identification number was used to link between different health registries. Abstraction of treatment information for a subset of survivors allows investigation of the association between the various components of cancer therapy and late occurring comorbidity. Results. The childhood cancer survivor cohort comprises 33,160 1-year survivors and the comparison cohort comprises 212,892 cancer free individuals from the general population. In the childhood cancer survivor cohort, all types of childhood cancer are represented including leukemia (21%), lymphoma (14%), central nervous system tumors (24%), sarcomas (5%), retinoblastoma (3%), and neuroblastoma (4%). Among the survivors, 22% have been followed beyond the age of 40 years. Conclusion. The ALiCCS study constitutes a new large resource for research on late effects of childhood cancers that include all types of childhood malignancies and has followed a large proportion of the survivors well into late adulthood.Danish Council for Strategic Research/09-06689

Number of bed days at hospital and associated standardised bed day ratios (SBDRs) for diseases in each of the 12 main diagnostic groups.

<p>Note that the diagnostic group “Recurrence and new primary cancers” is beyond the scale, with a standardised hospitalisation rate ratio (RR) of 24.2. 95% CI, 95% confidence interval; Obs., observed.</p

Observed and expected numbers of hospitalisations by sex and attained age in 21,297 5-year survivors of childhood cancer in the Nordic countries.

<p>Observed and expected numbers of hospitalisations by sex and attained age in 21,297 5-year survivors of childhood cancer in the Nordic countries.</p

Standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and the percentage (%) of total AER for main diagnostic groups and selected disease categories distinguished by AER ≥ 20.

<p>Standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and the percentage (%) of total AER for main diagnostic groups and selected disease categories distinguished by AER ≥ 20.</p

Risk of hospitalisation for somatic diseases in each of 12 main diagnostic groups.

<p>95% CI, 95% confidence interval; Obs., observed; RR, standardised hospitalisation rate ratio.</p

Flow diagram of exclusions of study participants and final study cohort size.

<p>Note: the index date is the date of cancer diagnosis and the corresponding date for population comparisons.</p