title: The potential for cross-addiction in post-bariatric surgery patients: Considerations for primary care nurse practitioners.
abstract: OBJECTIVE
  Possible mental health issues for post-bariatric surgery patients include the development of cross-addictions after the rapid weight loss period. No validated screening tool to assess for possible cross-addictions exists. The main purpose of this study was to develop recommendations for modifying an existing addiction screening tool (the Shorter PROMIS Questionnaire) for use by primary care providers.
  
  
  METHODS
  A qualitative descriptive design was used with triangulation of input from the scholarly literature, content experts (CEs), and post-bariatric surgery patients. Three focus groups were conducted with post-bariatric surgery patients (n = 12) with the same questions asked of the CEs (n = 3). Content analysis was used to analyze the transcripts.
  
  
  CONCLUSIONS
  The following themes regarding addictions after bariatric surgery were identified through consensus: alcohol, gambling, shopping, exercise, food starving/bingeing, and sexuality/relationships. Dissonant themes included caffeine and tobacco by the post-bariatric surgery patients and prescription/illicit medications by the CEs.
  
  
  CONCLUSIONS
  Targeted screening for early identification of problem behaviors by primary care providers may result in appropriate referral to and management by mental health providers, assisting ongoing success of bariatric surgery.
authors.affiliation: Our Lady of Lourdes Hospital, Binghamton, New York.
authors.forename: Melissa
authors.initials: M
authors.lastname: Bak
authors.affiliation: Decker School of Nursing, Binghamton University/SUNY, Binghamton, New York.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Seibold-Simpson
authors.affiliation: Decker School of Nursing, Binghamton University/SUNY, Binghamton, New York.
authors.forename: Rosa
authors.initials: R
authors.lastname: Darling
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology; D050110:Bariatric Surgery / Q000523:psychology*; D016739:Behavior, Addictive / Q000175:diagnosis / Q000523:psychology*; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology; D017144:Focus Groups; D005715:Gambling / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D036301:Qualitative Research; D012725:Sexual Behavior / Q000523:psychology
keywords: Obesity; addiction; screening; weight management