首页 > 资讯 > 认知因素视角下减重代谢术后饮食与体力活动行为促进策略的整合性综述

认知因素视角下减重代谢术后饮食与体力活动行为促进策略的整合性综述

泰然健康网
2025-08-10 23:48

摘要： 背景随着肥胖问题日益严重，减重代谢术需求量也逐年增加，患者术后仍须维持良好生活习惯以巩固减重效果。但在相应行为指南已较为成熟的同时，患者行为依从性并不理想，导致术后较高的复胖率。可考虑从认知因素这一核心视角出发采取策略促进患者的饮食与体力活动行为。目的系统编码整合认知因素视角下的减重代谢术后饮食、体力活动行为促进策略。方法 2022年6月，采用WHITTEMORE和KNAFL的整合性综述方法，在PubMed、Web of Science、the Cochrane Library、CINAHL英文数据库和中国知网（CNKI）、万方数据知识服务平台中文数据库中与减重代谢术后饮食与体力活动行为促进策略有关研究，检索时限为1994年1月至2022年6月。采用2016版"关键评估清单"（CASP）进行文献质量评价，纳入符合标准的研究，根据"体力活动与饮食行为改变技术分类法"（CALO-RE分类法）对策略统一编码并加以合并。结果共纳入25篇文献，包括17篇随机对照试验、4篇观察性研究、4篇综述。通过编码，所有策略均被CALO-RE分类法覆盖，涉及其中的25类策略，主要包括行为情况监测、社会支持、目标设定、障碍识别解决等。整合得到的"减重代谢术后饮食与体力活动行为促进策略集"共46条策略。结论本研究通过整合性综述和CALO-RE分类法，系统编码了适用于减重代谢术后患者的认知因素视角下饮食与体力活动行为促进策略，为术后行为管理提供了技术储备。减重代谢外科医护可在评估患者行为水平和认知因素状况后，结合实际情况选取合适策略，有效提升患者的行为依从性。未来可在实证研究中进一步验证并优化本策略集。

关键词: 减重代谢术, 体质量保持, 减体质量饮食, 体力活动, 认知因素, 促进策略, 整合性综述

Abstract:

Background

With the growing problem of obesity, the demand for bariatric surgery has increased these years. Patients still need to maintain good living habits after surgery to consolidate the weight loss effects. While the behavioral guidelines are relatively mature, patient's behavioral compliance is not ideal, resulting in a high rate of postoperative weight regain. In that case, we can depend on strategies to promote dietary and physical activity behaviors in patients from the cognitive perspective.

Objective

To systematically code and merge the dietary and physical activity behavior promotion strategies after bariatric surgery from the cognitive perspective.

Methods

In June 2022, the WHITTEMORE and KNAFL's integrative review methodology was used. Studies written in English related to dietary and physical activity behavior promotion strategies after bariatric surgery were searched in databases of PubMed, Web of Science, the Cochrane Library and CINAHL, and those in Chinese were searched in databases of CNKI and Wanfang Data from January 1994 to June 2022. The 2016 version of the Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the literature. Studies meeting the inclusion criteria were included, and the strategies extracted from which were uniformly coded and merged according to the CALO-RE taxonomy.

Results

A total of 25 studies were included, including 17 randomized controlled trials, 4 observational studies, and 4 reviews. After coding, all strategies were covered by CALO-RE taxonomy, involving 25 kinds, mainly including self-monitoring of behavior, social support, goal setting, identifying barriers/problem resolution, etc. A total of 46 strategies were obtained and used to create a strategy set named "promotion strategies of dietary and physical activity behaviors after bariatric surgery".

Conclusion

Through the application of the integrative review methodology and the guidance of CALO-RE taxonomy, this study systematically coded and merge the dietary and physical activity behavior promotion strategies from the cognitive perspective for applicable to patients after bariatric surgery, providing a reservoir of techniques for postoperative behavioural management. After assessing patients' behavioural levels and cognitive factors, bariatric surgery providers can select appropriate strategies to improve patients' behavioural compliance. This strategy set can be further validated and optimised in future empirical studies.

Key words: Bariatric surgery, Body weight maintenance, Weight reduction diets, Physical activity, Cognitive factors, Promotion stratigies, Integrative review