title: Patients' perspectives on laparoscopic adjustable gastric banding (LAGB) aftercare attendance: qualitative assessment.
abstract: BACKGROUND
  Despite recognition of the importance of laparoscopic adjustable gastric banding (LAGB) aftercare for optimal surgical outcomes and the failure of some patients to attend regularly, factors influencing LAGB aftercare attrition have not been thoroughly examined in the literature.
  
  
  METHODS
  Patients' perspectives on LAGB aftercare attendance were explored using a qualitative research methodology. Twenty-four LAGB patients who either (1) did not attend aftercare (n = 12) or (2) attended aftercare regularly (n = 12) were interviewed. Data were analysed using grounded theory methods.
  
  
  RESULTS
  Four common processes emerged from patients' descriptions: (1) barriers to attendance, (2) purely medical service, (3) non-patient centred approach, and (4) behavioural and psychological aspects of behavioural changes. Regular attendees typically reported (1) a commitment to aftercare, (2) a need to make the band work, (3) regular monitoring motivated attendance, and (4) happiness with the improved health. Non-regular attendees perceived (1) that aftercare is more relevant early on after the surgery, (2) insufficient follow-up from the centre, (3) failure and shame, (4) not comfortable to be vulnerable, and (5) an intention to reconnect.
  
  
  CONCLUSIONS
  Patients perceive LAGB post-operative medical management to be professional, effective, and valuable. Patients' difficulty to actively participate during aftercare visits contributes to reduced satisfaction and a range of compromised outcomes. Management of LAGB post-operative patients may be improved with the use of patient-centred strategies that encourage patients' active participation. Further research is required to evaluate the emerged themes and determine whether interventions targeting identified barriers enhance attendance and improve outcomes.
authors.forename: Irina
authors.initials: I
authors.lastname: Moroshko
authors.forename: Leah
authors.initials: L
authors.lastname: Brennan
authors.forename: Narelle
authors.initials: N
authors.lastname: Warren
authors.forename: Wendy
authors.initials: W
authors.lastname: Brown
authors.forename: Paul
authors.initials: P
authors.lastname: O'Brien
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D015438:Health Behavior; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology*; D036301:Qualitative Research; D016896:Treatment Outcome; D015431:Weight Loss