摘要： 背景 減重代謝術(shù)后不良飲食行為是導(dǎo)致術(shù)后復(fù)胖的重要原因，但其概念尚未統(tǒng)一，且用詞混亂，較大程度地限制了該領(lǐng)域的深入研究及研究結(jié)論的可靠程度。 目的 界定減重代謝術(shù)后不良飲食行為的概念。 方法 于2022年5月，系統(tǒng)檢索中國知網(wǎng)、萬方數(shù)據(jù)知識服務(wù)平臺、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、PubMed、Web of Science、CINAHL數(shù)據(jù)庫，獲取以"減重代謝術(shù)后不良飲食行為"為主要研究內(nèi)容且涉及相關(guān)概念、定義屬性、先決條件、結(jié)局指標(biāo)的文獻(xiàn)，檢索時限為建庫至2022-05-10，語種限定為中、英文。根據(jù)納入的文獻(xiàn)，按照Rodgers演化概念分析的步驟，從概念演化、屬性特征、先決條件、后果、相關(guān)概念、典型案例、為概念的進(jìn)一步發(fā)展提出假設(shè)和啟示7個方面對減重代謝術(shù)后不良飲食行為的相關(guān)內(nèi)容進(jìn)行分析與整合。 結(jié)果 共納入符合要求的文獻(xiàn)36篇，包括英文文獻(xiàn)33篇、中文文獻(xiàn)3篇。Rodgers演化概念分析結(jié)果顯示：減重代謝術(shù)后不良飲食行為包括失控性進(jìn)食、放牧飲食、情緒性進(jìn)食、食物渴求、食物成癮、補(bǔ)償行為6個屬性特征；先決條件包括主觀和客觀因素，主觀因素包括自我效能、飲食態(tài)度、心理狀況、工作壓力等，客觀因素包括年齡、性別、文化程度、肥胖病史等；后果包括進(jìn)食障礙和精神心理疾病、減重效果、營養(yǎng)狀況、生活質(zhì)量。 結(jié)論 減重代謝術(shù)后不良飲食行為的概念尚未統(tǒng)一，未來還需結(jié)合我國國情深入剖析減重代謝術(shù)后不良飲食行為的內(nèi)涵，在此基礎(chǔ)上對相關(guān)理論、評估工具、影響因素和干預(yù)措施等內(nèi)容進(jìn)行深入研究，從而維持患者術(shù)后減重效果，提高患者生活質(zhì)量。

關(guān)鍵詞: 減重代謝術(shù), 不良飲食行為, Rodgers演化概念分析法, 減重結(jié)局, 生活質(zhì)量

Abstract:

Background

Maladaptive eating behavior after bariatric surgery is an im-portant cause of postoperative weight regain. However, the depth and reliability of its related research has been greatly hindered partially by non-unification of its concept and inappro-priate words used to explain the concept.

Objective

To clarify the concept of maladaptive eating behavior after bariatric surgery.

Methods

In May 2022, database of CNKI, WanFang Data, SinoMed, PubMed, Web of Science and CINAHL were systematically searched for studies in Chinese or English mainly about maladaptive eating behavior after bariatric surgery from inception to May 10, 2022, involving related concepts, definition attributes, antecedents and consequences. The contents of included literature were analyzed using the Rodgers' process of concept analysis, involving the evolution, attributes, antecedents, consequences, related concepts, typical case, assumptions and enlightenment for further development.

Results

Altogether, 36 studies were included, 33 of which in English, and the other three were in Chinese. The conceptual attributes of maladaptive eating behavior after bariatric surgery were composed of six aspects: uncontrolled eating, grazing, emotional eating, food craving, food addiction and compensatory behaviors. The antecedents include subjective factors (containing self-efficacy, dietary attitude, psychological status, work pressure and so on) , and objective factors (containing age, gender, education level, obesity history and others) . Eating disorders, mental illness, weight-loss outcome, nutritional status and quality of life compose the consequences.

Conclusion

The concept of maladaptive eating behavior after bariatric surgery is still non-unified. Its meanings in China should be discussed according to the national condition, and in-depth research on relevant theories, assessment tools, influencing factors and intervention should be conducted on this foundation, so as to maintain the effect of bariatric surgery and improve the quality of life in these patients.

Key words: Bariatric surgery, Maladaptive eating behavior, Rodgers' evolutionary concept analysis, Weight-loss outcomes, Quality of life

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