The Patient-Practitioner interaction in post bariatric surgery consultations: an interpersonal process recall study

Abstract

Purpose: The patient-practitioner relationship is fundamental to rehabilitation practice and patients’ health and wellbeing. Dissonance between patients who have had bariatric surgery and health care practitioners about what supportive care and good outcomes are can undermine care. To address the mechanisms of this process, we conducted an Interpersonal Process Recall study. Materials and Methods: We interviewed patients (11), video recorded consultations (10), conducted video-assisted individual interviews with patients (10) and practitioners (11) and a dyadic data analysis. Results: We identified relational states and shifts in the clinical encounter 2-3 years post-surgery, described in themes: a) Playing by the Book – Making it Easier for Each Other, b) Down the Blind Alley – Giving up on Each Other, and c) Opposite Poles – Towards and Away from Each Other. Conclusions: The post-surgery consultations facilitated responsibility for health and self-care but did not invite dialogues about the psychosocial burdens of living with obesity and undergoing bariatric surgery. Patients and practitioners tried to avoid creating conflict, which in turn seemed to foster distance, rather than human connection. This limits the encounter’s benefit to both parties, leaving them frustrated and less willing to either meet again or take any gains into their future lives.