Cognitive structures of obese patients undergoing bariatric surgery: a concept mapping analysis.

Background: The preparation of patients for bariatric surgery includes education concerning the intervention and its after-effects, and training on the health behaviors that they must put into practice after surgery. In this descriptive study, we have analyzed the cognitive structures of obese patients who have participated in a series of education sessions given by a medical team.

Methods: 30 severely obese patients participated in an interview during which a concept map was drawn up. The concept maps were analyzed to describe the nature and organization of the patient's knowledge.

Results: 10 knowledge domains have been identified concerning the intervention (principles, risks, follow-up care) and its consequences (weight, health, diet, social and psychological well-being, self-image, physical activity). Height domains were brought up by more than two-thirds of the patients. The knowledge organization is quite variable, as shown by the connections drawn between domains. Knowledge is mingled with other mental states in the cognitive structures of the patients. One-third of them expressed erroneous knowledge, especially concerning the surgical intervention and diet. The patients expressed numerous and positive perspectives on the expected change (81% of the mental states). Most concerned their quality of life. Nonetheless, 17 out of 30 patients also expressed themselves in a more negative fashion (12% of the mental states).

Conclusion: This study shows the richness and diversity of the knowledge acquired by patients before a bariatric operation. It confirms the importance of education before surgery and the necessity of pursuing it as part of their long-term care.