Some positive personality correlates of adherence to treatment among post-bariatric surgery patients

Pages:51-54
Kaehalee Ghorpade and Shobhana Abhyankar (Department of Psychology, Fergusson College, Pune, Maharashtra)

Obesity was recently deemed a disease by the American Medical Association. This chronic disease has established its roots in India and the incidence and prevalence of Obesity and its related diseases is at an all-time high. As per the Times of India Report in 2009, nearly 55 million of the Indian population is obese. Bariatric Surgery, evaluated as the best treatment option for morbid obesity is growing in popularity. Bariatric surgery involves an anatomical modification of the gastro-intestinal tracts; as a result the post-surgery treatment is chronic involving the patient to incorporate several behavioural modifications. The long-term follow-up makes adherence a vital issue in the bariatric patient population. The researchers sought to identify certain positive personality correlates of good treatment adherence in post-surgery bariatric patients. Thirty one patients scheduled for surgery at different times, were given a pre-operative test packet during which they were assessed on their levels of Perceived Competence for adhering to the treatment, Dispositional Optimism regarding a general expectancy of future outcomes, Internal Reasons of Motivation for choosing the treatment program, and Autonomous Self Regulation of Health Behaviours. At the 15 day follow up when the first diet change would be made, the patients were assessed for the level of treatment adherence as rated by the doctor. It was found that Perceived Competence was positively correlated with Treatment Adherence (r = 0.56, p < 0.01). However, Optimism (r = 0. 25, p > .05), Internal Reasons of Motivation for choosing the treatment (r = 0.12, p > .05), and Autonomous Regulation of health behaviour (r = 0.24, p > .05) showed an insignificant correlation with Treatment Adherence. Relative Autonomy Index (RAI) was calculated by subtracting controlled regulation from autonomous self-regulation. RAI was positively correlated with Treatment Adherence (r = 0.42 p < 0.05). This implies that autonomous regulation rather than controlled regulation is strongly implicated in post-surgery bariatric surgery treatment adherence. The results also show that being optimistic and having internal reasons for motivation are not implicated in adherence; perceived competence in one's ability to follow treatment and autonomous self-regulation of one's own health behaviours also needs to be cultivated in a chronic treatment regimen such as this. This gives us a guideline for pre and post-surgery psychological assessment and counselling of bariatric patients to increase adherence and in-turn reduce complications in order eventually to give desired results of the surgical treatment.