Page 104 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 6
Patients
Patients were selected from a prospective database if they had undergone a primary bariatric procedure between October 2011 and October 2012. When body weight measures before and/ or one year after bariatric surgery were not available patients were excluded. Patients who could be included were invited to participate through an electronic mail request via the Qualtrics platform (Qualtrics, Provo, UT). Before they could start the questionnaires, patients gave electronic informed consent. A total of 1,334 patients were eligible for inclusion; 1,024 patients were successfully contacted and asked to participate. The response rate was 67% (689/1024) and 590 patients (58% of the contacted population) agreed to participate and were included.
Questionnaires
General information
Patients were asked to report their current body weight, educational level, employ- ment, and income. Educational level was subdivided into ‘low’ (no schooling, sec- ondary school, or intermediate vocational education), ‘medium’ (secondary vocational education or high school) and ‘high’ (higher professional education or university de- gree). Employment was subdivided into ‘working’, ‘unemployed’, ‘retired’ or ‘student’. An annual income of €34,085 was considered a median income in the Netherlands at the time of the study.
Body contouring surgery and skin surplus
Our self-developed questionnaire inquired whether patients had undergone BCS or whether there was a desire for BCS. Patients were asked to indicate their reasons for not undergoing BCS. Patients estimated the amount of overhanging skin by compar- ing their body to pictures of the PRS, ranging from ‘0’ (appearance in normal range) to ‘3’ (most sever deformity) 17. Pictures of arms, breasts (for women), abdomen and flanks were used. In addition, patients indicated in which of the following body parts they had overhanging skin: arms, inside thighs, outside thighs, abdomen, breasts/ chest, buttocks, back, flanks and other body parts. They were also asked to indicate their top three of body parts for which they would like to have BCS.
Body Satisfaction
A short version of an unpublished questionnaire developed by the authors (AJ) was used to assess satisfaction with their body (Appendix 1). Patients rated their total body and 16 body parts on a scale from ‘1’ (not satisfied with body) to ‘10’ (extremely satisfied with body). Subsequently, patients were asked about the importance of all these body parts on a 4-point Likert scale 20. In a Likert scale responses are scored along a range, in this case ranging from ‘1’ (not important) to ‘4’ (very important). Pa- tients could also indicate how satisfied they were with the proportions of their body.
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