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Individual's Experience of Living With Roux‐en‐Y Gastric Bypass Surgery: An Interpretative Phenomenological Analysis

ABSTRACT

Aim

To explore the lived experience following Roux-en-Y gastric bypass surgery of eight men and women in the South of England who had undergone surgery a minimum of 12 months prior.

Design

This phenomenologically based qualitative study utilised Interpretative Phenomenological Analysis (IPA) as a framework for the analysis and exploration of participants' lived experiences.

Method

Semi-structured individual interviews were conducted with eight men and women in the South of England in 2017.

Results

Interpretative Phenomenological Analysis revealed four superordinate themes: Managing change and uncertainty; The affective experience of change; The post-operative body within its relational context; and The presence and absence of appropriate support.

Conclusion

Participants described the complex nature of the post-operative experience and highlighted the deeply personal nature of the adjustment required following surgery. The process of change and adjustment does not represent a smooth transition from pre- to post-operative life, and the experience of weight loss is intertwined with relationships that require patients to renegotiate the ways in which they understand themselves within social encounters.

Implications and Contribution

The clinical significance of this study lies in its support for the contribution that an existential phenomenological approach can offer in supporting individuals who choose to have bariatric surgery through its acknowledgment of the body as a site of experience which is situated within a person's wider social, cultural and historical world. These findings contribute an in-depth appreciation of the biopsychosocial experiences of individuals following Roux-en-Y gastric bypass surgery that can be applied in nursing practice to better inform the development of appropriate ways in which to support the overall wellbeing of individuals who made the decision to undergo bariatric surgery.

Patient and Public Contribution

Limited patient involvement was incorporated, focusing on feedback on the interview process.

Enhancing dyadic outcomes of stroke survivors and caregivers: protocol for a randomised controlled trial

Por: Lin · Y.-N. · Hsu · S.-P. · Kang · J.-H. · Liou · T.-H. · Han · D.-S. · Ni · P. · Chiu · V. · Rodakowski · J. · Chang · F.-H.
Introduction

Stroke is a leading cause of death and disability worldwide. Stroke survivors and their caregivers often face profound social isolation and various participation restrictions, resulting in frustration and adverse health outcomes. Dyad-focused interventions, which address both survivor and caregiver needs, are essential during the transition process. However, few interventions equally prioritise the outcomes of both survivors and caregivers. This study aims to evaluate the efficacy of a newly developed dyad-focused strategy training intervention in enhancing participation among stroke survivors and their caregivers.

Methods and analysis

This study employs a single-blind, parallel-group randomised controlled trial with allocation concealment and assessor blinding. We aim to enrol 138 stroke survivor-caregiver dyads, randomly assigned in a 1:1 ratio to either the experimental intervention group or the control group. Both groups will receive their usual rehabilitation plus 45–60 min sessions of the intervention twice weekly for a total of 12 sessions. Outcome measures, including the Participation Measure-3 Domains, 4 Dimensions, General Self-Efficacy Scale and Activity Measure for Post-Acute Care, will be collected at baseline, post-intervention and at 3-month, 6-month and 12-month follow-ups. Data will be analysed using multiple linear regression and mixed-effects regression models. Qualitative indepth interviews with participants, caregivers and therapists will be conducted post intervention, transcribed and thematically analysed.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of Taipei Medical University (approval number: N202203083), National Taiwan University Hospital (approval number: 202207096RINA) and Taipei Tzu Chi Hospital (approval number: 11 M-107). Findings will be disseminated through presentations at scientific conferences and publications in peer-reviewed journals.

Trial registration number

NCT05571150; Preresults.

Mesenchymal intravenous stromal cell infusions in children with recessive dystrophic epidermolysis bullosa: MissionEB protocol for a randomised, double-blinded, placebo-controlled, two-centre, crossover trial with an internal phase I dose de-escalation ph

Por: Bageta · M. L. · Lopez-Balboa · P. · Dimairo · M. · Glover · R. · Hutchence · K. · Papaioannou · D. · Cooper · C. · Biggs · K. · Tappenden · P. · Ennis · K. · Ogboli · M. · Lovgren · M.-L. · Poudel · P. · Nadeem · M. · McGrath · J. A. · Julious · S. A. · Petrof · G. · Martinez · A. E.
Introduction

Recessive dystrophic epidermolysis bullosa (RDEB) is a severe genetic mucocutaneous fragility disorder characterised by chronic blistering, slow wound healing and increased risk of squamous cell carcinoma. Current management options are very limited.

Methods

This is a randomised (1:1), placebo-controlled, double-blinded crossover (A/B) trial with an internal phase I dose de-escalation (4+5 design) in the first 3 months and a 12-month continued treatment follow-on open-label study if 3-month outcome data from the crossover trial indicate safe and beneficial effects. RDEB is a rare condition, so we expect to recruit a maximum of 36 participants based on feasibility and not formal power considerations. Participants aged>6 months and x106 cells/kg intravenous infusion of umbilical cord-derived mesenchymal stem cells or placebo at the start of each crossover period (day 0) and 14 days later. The dose will be de-escalated to 1–1.5x106 cells/kg depending on observed toxicity. For the main crossover trial, the primary outcome is the change in disease severity as measured by the Epidermolysis Bullosa Disease Activity and Scarring Index at 3 months from day 0 infusion. Secondary outcomes measured at 3 and 6 months from day 0 infusion include changes in general clinical appearance of skin disease, pain and itch, and quality of life. Adverse events and serious adverse events will be monitored throughout the trial.

Ethics and dissemination

North East—York Research Ethics Committee approved the protocol (ref: 21/NE/0016) on 16 March 2021. Findings will be published in peer-reviewed scientific journals, presented at relevant national and international conferences, and an open-access final report submitted to the funder.

Trial registration number

ISRCTN14409785. Protocol V. 8.0, 14 November 2022.

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