title: Predictors of post-bariatric surgery appointment attendance: the role of relationship style.
abstract: BACKGROUND
  Attendance at bariatric surgery follow-up appointments has been associated with bariatric surgery outcomes. In this prospective study, we sought to examine psychosocial predictors of attendance at post-operative follow-up appointments.
  
  
  METHODS
  Consecutive bariatric surgery patients (n = 132) were assessed pre-surgery for demographic variables, depressive symptoms, and relationship style. Patients were followed for 12 months post-surgery and, based on their attendance at follow-up appointments, were classified as post-surgery appointment attenders (attenders--attended at least one appointment after post-operative month 6) or post-surgery appointment non-attenders (non-attenders--did not attend at least one appointment after post-operative month 6). Psychosocial and demographic variables were compared between the attender and non-attender groups. Multivariate logistic regression was used to identify significant predictors of attendance at post-bariatric surgery follow-up appointments.
  
  
  RESULTS
  At 12 months post-surgery, 68.2 % of patients were classified as attenders. The non-attender group was significantly older (p = 0.04) and had significantly higher avoidant relationship style scores (p = 0.02). There was a trend towards patients in the non-attender group living a greater distance from the bariatric center (p = 0.05). Avoidant relationship style was identified as the only significant predictor of post-operative appointment non-attendance in the logistic regression analysis.
  
  
  CONCLUSIONS
  These findings suggest that avoidant relationship style is an important predictor of post-bariatric surgery appointment non-attendance. Recognition of patients' relationship style by bariatric surgery psychosocial team members may guide the delivery of interventions aimed at engaging this patient group post-surgery.
authors.affiliation: Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON, Canada, sanjeev.sockalingam@uhn.on.ca.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sockalingam
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cassin
authors.forename: Raed
authors.initials: R
authors.lastname: Hawa
authors.forename: Attia
authors.initials: A
authors.lastname: Khan
authors.forename: Susan
authors.initials: S
authors.lastname: Wnuk
authors.forename: Timothy
authors.initials: T
authors.lastname: Jackson
authors.forename: Allan
authors.initials: A
authors.lastname: Okrainec
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010349:Patient Compliance; D011184:Postoperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors