A nurse-led perioperative intervention enhances self-care and supports long-term weight loss after bariatric surgery: a randomized controlled trial.
The NURLIFE intervention significantly improved pre-operative weight loss and self-care behaviors in bariatric patients, suggesting a potential role for nurse-led management in enhancing surgical outcomes.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This study evaluated the impact of a nurse-led case management intervention (NURLIFE) on weight loss and self-care behaviors in bariatric patients. Forty patients were randomized to either the intervention group or a control group receiving standard care. The intervention group exhibited significant pre-operative weight loss and maintained improvements post-surgery.
Abstract
<h4>Background</h4>Bariatric surgery is an effective intervention for severe obesity, but long-term success relies on sustained self-care behaviors, self-efficacy for exercise, and weight management. Nurse-led case management has shown promise in enhancing patient outcomes, yet robust evidence from randomized controlled trials remains limited.<h4>Objective</h4>This study evaluated the impact of a nurse-led case management intervention (NURLIFE) on pre- and post-operative weight loss and self-care behaviors in bariatric patients.<h4>Methods</h4>A single-centre randomized controlled trial was conducted from January 2024 to August 2025 in a public hospital in southern Portugal. Forty patients were randomized to an intervention group (IG, n=20) receiving NURLIFE (personalized counselling, goal setting, and follow-up) or a control group (CG, n=20) receiving standard care. Outcomes, including weight, Self-Care of Chronic Illness Inventory (SCII), Self-Efficacy for Exercise (SEE), and Social Appearance Anxiety Scale (SAAS), were assessed at baseline, pre-surgery, and 12 months post-surgery. Data were analysed using mixed-model ANOVA and post-hoc tests with Bonferroni correction.<h4>Results</h4>The IG exhibited significant pre-operative weight loss (7.36 ± 7.09 kg vs. -0.10 ± 7.33 kg in CG, p = 0.001), corresponding to a % total weight loss (TWL) of 5.88% in the intervention group versus -0.62% in the control group. At 12 months, the intervention group achieved a %TWL of 42.29% compared with 34.97% in the control group. Significant improvements were observed pre-operatively in SCII Monitoring (p = 0.001), Management (p= 0.001), and in SEE (p < 0.001) and in SCII Maintenance (p = 0.050) and SEE (p < 0.011) at 12 months. These results suggest a potential additional contribution of the nursing intervention in relation to surgery. In addition, sustained improvements in self-efficacy (SEE) and maintenance of self-care behaviors were observed.<h4>Conclusion</h4>The NURLIFE intervention significantly enhanced pre-operative weight loss, which was maintained post-surgery, alongside improvements in self-care and exercise self-efficacy. These findings suggest a potential role of nurse-led case management into perioperative care to optimize bariatric outcomes.
Background
This paper addresses the challenge of achieving long-term weight loss after bariatric surgery, which is often dependent on sustained self-care behaviors and self-efficacy. Previous studies have indicated that nurse-led case management may improve patient outcomes, but robust evidence from randomized controlled trials is limited. This study aims to fill that gap by evaluating the effectiveness of a nurse-led intervention on weight loss and self-care in bariatric patients.
Methods
A single-centre randomized controlled trial was conducted with 40 patients, randomized into an intervention group (IG, n=20) receiving the NURLIFE intervention and a control group (CG, n=20) receiving standard care. The intervention included personalized counselling, goal setting, and follow-up. Outcomes were assessed at baseline, pre-surgery, and 12 months post-surgery, using mixed-model ANOVA and post-hoc tests with Bonferroni correction.
Results
The intervention group exhibited a significant pre-operative weight loss of 7.36 ± 7.09 kg compared to -0.10 ± 7.33 kg in the control group, with a p-value of 0.001. The total weight loss at 12 months was 42.29% in the intervention group compared to 34.97% in the control group. Significant improvements were also noted in self-care behaviors and self-efficacy, with p-values of 0.001 for SCII Monitoring and Management pre-operatively, and p < 0.011 for SEE at 12 months.
Interpretation
The findings suggest that the nurse-led intervention may enhance both pre-operative weight loss and self-care behaviors, which aligns with previous literature indicating the benefits of case management. However, while the statistical significance is clear, the clinical significance of the weight loss achieved should be considered, especially given the small sample size and the single-site nature of the study. These factors may limit the broader applicability of the results.
Key findings
- 7.36 ± 7.09 kg pre-operative weight loss in IG vs -0.10 ± 7.33 kg in CG, p = 0.001
- 5.88% total weight loss (TWL) in IG vs -0.62% in CG pre-operatively
- 42.29% TWL in IG at 12 months vs 34.97% in CG
- Significant improvement in SCII Monitoring (p = 0.001) and Management (p = 0.001) pre-operatively
- Significant improvement in SEE at 12 months (p < 0.011)
Limitations
- small sample size (n=40)
- single-center study limits generalizability
- short follow-up duration of 12 months