Abstract
BACKGROUND:
Laparoscopic sleeve gastrectomy is the most common bariatric surgical and a life changing surgery which used for helping patients who are suffering from obesity for losing weight and enhance their health weight loss.
MATERIALS AND METHODS:
A descriptive, cross sectional study design was conducted in Holy Karbala from 1 December 2023 until 2 February 2024 in Surgical Unit at Al-imam Hussein Medical City, 25 nurses working in surgical unit was selected purposively according to inclusion and exclusion criteria. The data was collected through the use of constructive questions as a structured interviewer. The data was investigated with statistical processes and using the SPSS version 25 application statistical analysis coordination.
RESULTS:
Showed that the majority of studied sample were single female nurse at the age group ranging between (21 and 27) years old at the Mean = 27.12, standard deviation = +5.375, and about 88% from them lived in urban area and 48% of studied sampled graduated from Faculty of Nursing.
CONCLUSION:
Nurses’ knowledge about sleeve gastrostomy was ranging between poor to moderate, and as general the total score of nurses’ knowledges was poor in all domains. There was no significant association between nurses’ knowledge and their demographic data. The study recommended enhancing nurses’ opportunity in the surgical ward to provide updating their education to demand knowledge and skills regarding sleeve gastrectomy.
Keywords: Assessment, gastrectomy, knowledge, nurses, sleeve
Introduction
Laparoscopic sleeve gastrectomy (LSG) is a restrictive, nonreversible bariatric procedure for managing obesity. It involves removing 85% of the stomach and stabling back the remaining portions together.[1] LSG is a relatively safe surgical option for weight loss, some complications have been reported, such complications include, leakage, clots, infections, strictures, and hemorrhage, with gastric sleeve dilatations and staple-line leaks being the most common.[2] Nurses’ knowledge in caring for gastric surgery patients is critical for ensuring optimal patient outcomes and recovery. This involves understanding preoperative and postoperative care, recognizing complications, and providing patient education. Here are key areas of knowledge and skills required for nurses caring for gastric surgery patients: Preoperative Care, Postoperative Care, Complication Management, Nutritional Support, Patient, Education and Discharge Planning.[3]
Gastric leaking, by definition, is the leak of luminal contents from a surgical join between two hollow viscera.[4] In the vast majority of patients, the duration of gastric leak development is usually less than 14 days after bariatric surgery.[5] Patients may be asymptomatic or present with signs and symptoms of septic shock. Patients usually present with a sudden abdominal pain, accompanied by fever and tachycardia.[6]
Considering the rarity of gastro pleural fistulas, this case report outlines the clinical presentation, radiological findings, and outcome of a 24-year-old male who was diagnosed with a gastro pleural fistula that is communicating with a per splenic collection after gastric sleeve surgery.[7,8]
A complication to both laparoscopic and open surgery is incisional hernia, and obesity is a risk factor.[9] After a midline incision, up to 10–20% of patients can develop a hernia,[10,11] and approximately 20% of these hernias need surgery.[12,13] The reported incidence of trocar site hernia has been low at up to 5%,[8,14] but in recent years’ papers reporting up to 39% have been published.[15,16] The reported rates vary with study design and follow-up time,[14,17] but—importantly—also the focus on hernia repair in contrast to focus on patients with a history of laparoscopy.[15,18] Nursing managers play a crucial role in healthcare settings, and their leadership style can significantly impact nurses’ knowledge, performance, and overall job satisfaction. Here are some common leadership styles and their potential effects on nurses’ knowledge, While clear expectations and rewards can improve performance, this style might not strongly encourage ongoing learning and professional growth.[19]
Importance of the study laparoscopic sleeve gastrectomy LSG has become the most common accomplished bariatric operation in recent years.[20,21] However, usually becoming the second most common conducted bariatric operation after gastric bypass, with more than 1.9 billion obese and over 600 million overweight international in 2014.[22,23] Obesity is rightly categorized as a disease WHO bariatric operation can successfully treat obesity and enhance or even help solve a number of related comorbidities, providing patients with a better life based on recent research findings.[24,25] Laparoscopic sleeve gastrectomy is not only safety but efficient bariatric surgery with long-lasting consequences.[26,27] The aim of the present study, to assess nurse’s knowledge toward sleeve gastrectomy in surgical unit at Al-imam Hussein Medical City and identify the relationship between nurses’ knowledge about sleeve gastrectomy and their sociodemographic data.
Materials and Methods
Study design and setting
A descriptive study was conducted in Holy Karbala from 1 December 2023 until 2 February 2024 to Assessment of Nurses’ Knowledge toward Sleeve Gastrectomy in Surgical Unit at Al-imam Hussein Medical City.
Study participants and sampling
A Non-Probability (Purposive Sample) of (25) nurses working in surgical unit. was selected to be a sample of this study, according to inclusion and exclusion criteria.
The inclusion criteria
The researcher used the following criteria for specifying the study sample included in the study: The nurses have one year more experience in the surgical word. The nurse’s agreement to participate in the research. Both gender male and female.
The study instrument
The study instrument (questionnaire) constructed according to previous review and developed by researcher and experts in surgical and nursing felid. Finlay instrument composed from two parts.
Part 1: Socio-demographic data
The Present part is comprised of (8) items, include: (gender, age, marital status, residency, monthly income, level of educational, experience years in nursing field, number of years’ experience within the surgical unit).
Part 2: Clinical data
Part two: nurses’ knowledge includes general information about gastric sleeve comprises of (11) items, nursing care before gastric sleeve (9) items, nursing care after gastric sleeve (15) items.
The study instrument validity
The study instrument validity is used to determine that study tool will measure the data that is needed to measure the face validity using determined by the expert’s panel to test relevance, clarity, and competence of the questions to measure the interesting concept. A draft of questionnaire of tool study is intended and presented to (5) experts, who have experience in field of nursing and medicine.
Pilot study
The pilot study applied on 5 nurse’s general of sample is excluded from of the present study, it is a mini-study that we do so to know the time required to collect the sample, are the questions and information clear or not, and how much time does it take to interview with the nurse, the aims of pilot study:
To identify whether respondents comprehend the study tool’s questions and their directions throughout the data collection process. To ensure the reliability and increase the dependability of questionnaires. To determine the time needed to gather the data for every subject. The findings are obtained from the pilot study show the following: The content of the questions is clear and comprehensible for the nurses. The study instrument reliability was determined. The questionnaire can be completed with (10–15 minutes). All these purposes are accomplished.
The study reliability
Reliability deals with the dependability and consistency of the research instrument to check the variable of interest by use test retest. The reliability of the present study personal correlation coefficient r = 0.87, determination of reliability of the questionnaire. The study findings of the questions are displayed, the study instrument is reliable to study a phenomenon on a similar population and in any time of study in the future.
Data collection
The data were collected through the use of constructive questions as a structured interviewer.
Statistical analysis
The data was investigated with statistical processes and using the SPSS version 25 application statistical analysis coordination. The statistical information analysis data method was used to test and assess the findings of the present study:
Descriptive analysis (Frequency (F), Percentage (%), Mean of scores (MS) and Standard deviation).
Inferential data Analysis (Testing of Chi-Square χ2 and Person- correlation coefficient). Mean of score (MS): is equal to (1.5–2.5), which it considers a moderate mean of score, more than (2.5) was considered a high mean of score, less 1.5 was measured poor MS.
Ethical consideration
The study approval was obtained from the Surgical Unit at Al-imam Hussein Medical City. Finally, a voluntary verbal agreement was gained from the participants after explaining the purpose of the study in order to participate in the study.
Result
Table 1, shows that the majority of the nurse’s subgroup are: nurses with ages between (21–27) years old (28%), female nurses (68%), single nurses (60%), those who live urban residents (88%), nurses graduated from Faculty of Nursing (48%), those with a monthly income of sufficient to some extent (48%), those with (1–10) years of experience in nursing (76%), those with (1–9) years of experience in surgery (80%).
Table 1.
Distribution of the study samples according to socio-demographic data
| Items | Sub-groups | Study sample No.=25 |
||||
|---|---|---|---|---|---|---|
| F | % | |||||
| Age/Years | 21–27 | 7 | 28 | |||
| 28–34 | 5 | 20 | ||||
| 35–41 | 5 | 20 | ||||
| 42–48 | 4 | 16 | ||||
| 49–55 | 4 | 16 | ||||
| Mean=27.12 standard deviation=+ 5.375 | ||||||
| Gender | Female | 17 | 68 | |||
| Male | 8 | 32 | ||||
| Marital Status | Single | 15 | 60 | |||
| Married | 10 | 40 | ||||
| Residency | Urban | 22 | 88 | |||
| Rural | 3 | 12 | ||||
| Levels of Education | Nursing School | 3 | 12 | |||
| Nursing Institute | 10 | 40 | ||||
| Faculty of Nursing | 12 | 48 | ||||
| Monthly Income (IQD) | Sufficient | 12 | 48 | |||
| Sufficient to some extent | 12 | 48 | ||||
| Insufficient | 1 | 4 | ||||
| Year of Experience in Nursing | 1–10 | 19 | 76 | |||
| 11–20 | 6 | 24 | ||||
| 21–30 | 2 | 5.0 | ||||
| Year of Experience in Surgery Ward | 1–9 | 20 | 80 | |||
| 10–18 | 5 | 20 | ||||
Table 2 It Shows that assessment and mean of scores for items regarding nurses’ general knowledge about sleeve gastrostomy show that the assessment of nurses’ knowledge is (Poor) for the following questions (1,7,9,11), at the same time, it is considered (moderate) for the questions numbered (2,3,4,5,6,8,10). This Assessment is based on the statistical scoring system that indicated a cutoff point at (0.66), with a minimum score (1), so that total score between (1 and 1.66) as poor knowledge; moderate is between (1.67 and 2.3); while good knowledge is above (2.33–3).
Table 2.
Descriptive statistics and mean of scores for items regarding nurses’ general nurses’ knowledge about sleeve gastrectomy
| Knowledge question | F | % | Mean | Assessment | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1-sleeve gastrectomy is about 80% of the stomach removed for weight loss. | I know | 11 | 44.0 | 1.48 | Poor | |||||
| Not sure | 10 | 40.0 | ||||||||
| I don’t know | 4 | 16.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 2-sleeve gastrectomy is performed for people if their body mass index (BMI) is from 35_39.5. | I know | 8 | 32.0 | 1.72 | Moderate | |||||
| Not sure | 11 | 44.0 | ||||||||
| I don’t know | 6 | 24.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 3 Laparoscopic sleeve gastrectomy is an optional surgical procedure only. | I know | 16 | 64.0 | 1.92 | Moderate | |||||
| Not sure | 6 | 24.0 | ||||||||
| I don’t know | 3 | 12.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 4-Abdominal adhesions | I know | 10 | 40.0 | 1.68 | Moderate | |||||
| Not sure | 12 | 48.0 | ||||||||
| I don’t know | 3 | 12.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 5-The operation is performed for those suffering from serious obesity-related diseases such as (diabetes, cardiovascular disease, high blood pressure and obstructive sleep apnea). | I know | 13 | 52.0 | 2.20 | Moderate | |||||
| Not sure | 7 | 28.0 | ||||||||
| I don’t know | 5 | 20.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 6-The sleeve gastrectomy operation is performed for people if the BMI is 40 or more | I know | 10 | 40.0 | 1.88 | Moderate | |||||
| Not sure | 8 | 32.0 | ||||||||
| I don’t know | 7 | 28.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 7-when performing an sleeve gastrectomy are removed the ghrelin hormone responsible for hunger | I know | 9 | 36.0 | 1.08 | Poor | |||||
| Not sure | 10 | 40.0 | ||||||||
| I don’t know | 6 | 24.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 8-The doctor can perform an laparoscopic sleeve gastrectomy | I know | 23 | 92.0 | 2.16 | Moderate | |||||
| Not sure | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 9-Gastrectomy is performed for patients from 14 to 65 years of age | I know | 11 | 44.0 | 1.60 | Poor | |||||
| Not sure | 7 | 28.0 | ||||||||
| I don’t know | 7 | 28.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 10-The percentage of excess weight loss weight loss during the first three months by 33% | I know | 13 | 52.0 | 1.68 | Moderate | |||||
| Not sure | 9 | 36.0 | ||||||||
| I don’t know | 3 | 12.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 11-Weight loss within 6 months of 50% | I know | 10 | 40.0 | 1.64 | Poor | |||||
| Not sure | 13 | 52.0 | ||||||||
| I don’t know | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
F.=frequency. %=percentage. Mean of score (poor=1–1.66 moderate=1.67 –2.32 high=2.33– 3)
Table 3 shows descriptive statistics for items regarding health care before sleeve gastrectomy; it shows that the assessment of nurses’ knowledge is (poor) for the following questions (13,14,15,16,18,19,20), At the same time, it is considered (moderate) for the question numbered (12,17). The nurse or nurse educates the patient before the procedure on how to do the following things (leg movement exercises, foot movement exercises).
Table 3.
Descriptive statistics and mean of scores for items regarding nurses’ general nurses’ knowledge about health care before sleeve gastrectomy
| 2- Before Sleeve Gastrectomy Knowledge question | F | % | Mean | Assessment | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12-Weight loss during 12 months by 65% | I know | 11 | 44.0 | 1.68 | Moderate | |||||
| Not sure | 12 | 48.0 | ||||||||
| I don’t know | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 13-Pre-operative examinations (complete blood count, liver function, kidney function, thyroid function, electrocardiogram, chest x-ray, fluoroscopy on the abdomen to diagnose gallstones and liver size) | I know | 23 | 92.0 | 1.64 | Poor | |||||
| Not sure | 1 | 4.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 14-Stop smoking 12 weeks before surgery | I know | 19 | 76.0 | 1.12 | Poor | |||||
| Not sure | 5 | 20.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 15-The doctor and nurse took the patient’s medical history and the medicines he used previously | I know | 25 | 100.0 | 1.28 | Poor | |||||
| 16-Stop eating a day before stomach the sleeve | I know | 22 | 88.0 | 1.00 | Poor | |||||
| Not sure | 3 | 12.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 17-The patient’s pre-operative diet program started by the doctor | I know | 19 | 76.0 | 1.12 | Moderate | |||||
| Not sure | 5 | 20.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 18-The nurse educates the patient before the procedure on how to do the following things (diaphragm breathing exercises, how to do a therapeutic cough, deep breathing exercises) | I know | 22 | 88.0 | 1.28 | Poor | |||||
| Not sure | 3 | 12.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 19-The nurse or nurse educates the patient before the procedure on how to do the following things (leg movement exercises, foot movement exercises) | I know | 21 | 84.0 | 1.12 | Poor | |||||
| Not sure | 3 | 12.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 20-The nurse or the nurse prepares the location of the operation (Clean place of operation, shave place of operation). | I know | 23 | 92.0 | 1.20 | Poor | |||||
| Not sure | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
F.=frequency. %=percentage. Mean of score (poor=1–1.66 moderate=1.67 –2.32 high=2.33– 3)
Table 4 Shows the assessment and mean of a score for items regarding nurse’s knowledge about nursing care after sleeve gastrectomy, it shows that the assessment of nurses’ knowledge of most of the questions poor. At the same time, it is considered (moderate) for the question numbered (20,25,26.27). This Assessment is based on the statistical scoring system that indicated the total score between (1 and 1.66) as poor knowledge; moderate is between (1.67 and 2.3), while good knowledge is above (2.33).
Table 4.
Descriptive statistics and mean of scores for items regarding nurses’ general knowledge about health care after sleeve gastrectomy
| After Sleeve Gastrectomy knowledge question | F | % | Mean | Assessment | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 21-Fluids and food may be given immediately after the operation. | I know | 5 | 20.0 | 2.20 | Moderate | |||||
| Not sure | 10 | 40.0 | ||||||||
| I don’t know | 10 | 40.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 22-In the first week, the patient takes only clear fluids | I know | 21 | 84.0 | 1.24 | Poor | |||||
| Not sure | 2 | 8.0 | ||||||||
| I don’t know | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 23-The patient’s diet in the second and third week is a protein rich liquid | I know | 13 | 52.0 | 1.56 | Poor | |||||
| Not sure | 11 | 44.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 24-The second and third week, the patient avoids eating sugar and fat | I know | 18 | 72.0 | 1.28 | Poor | |||||
| Not sure | 7 | 28.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 25-After the third week, the patient turns to thicker and crushed foods | I know | 17 | 68.0 | 1.36 | Poor | |||||
| Not sure | 7 | 28.0 | ||||||||
| I don’t sure | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 26-After the fourth week, the patient turns to solid foods | I know | 5 | 20.0 | 1.88 | Moderate | |||||
| Not sure | 18 | 72.0 | ||||||||
| I don’t know | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 27-The patient consumes three meals a day containing protein and fiber in addition to two snacks | I know | 7 | 28.0 | 1.76 | Moderate | |||||
| Not sure | 17 | 68.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 28-The patient drinks a lot of water from 90 minutes after each meal to 15 minutes before the next meal | I know | 9 | 36.0 | 1.80 | Moderate | |||||
| Not sure | 12 | 48.0 | ||||||||
| I don’t know | 4 | 16.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 29-The patient should not combine eating and drinking at the same time | I know | 18 | 72.0 | 1.32 | Poor | |||||
| Not sure | 6 | 24.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 30-One serving size is less than one cup | I know | 13 | 52.0 | 1.56 | Poor | |||||
| Not sure | 10 | 40.0 | ||||||||
| I don’t know | 2 | 8.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 31-The patient walks at least 30 minutes a day | I know | 19 | 76.0 | 1.28 | Poor | |||||
| Not sure | 5 | 20.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 32-The patient takes medications and vitamins determined by the doctor | I know | 23 | 92.0 | 1.12 | Poor | |||||
| Not sure | 1 | 4.0 | ||||||||
| I don’t know | 1 | 4.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 33-The patient made regular visits to the doctor to follow up on his condition | I know | 21 | 84.0 | 1.16 | Poor | |||||
| Not sure | 4 | 16.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 34-Nursing diagnosis after the quantization process is subject to the patient’s imbalance in nutrition (food is less than the body needs). | I know | 15 | 60.0 | 1.56 | Poor | |||||
| Not sure | 6 | 24.0 | ||||||||
| I don’t know | 4 | 16.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
| 35-Nursing diagnosis after the quantization process, the patient suffers from a lack of information about the quantization process. | I know | 18 | 72.0 | 1.28 | Poor | |||||
| Not sure | 7 | 28.0 | ||||||||
| Total | 25 | 100.0 | ||||||||
F.=frequency. %=percentage. Mean of score (poor=1–1.66 moderate=1.67 –2.32 high=2.33– 3)
Table 5 is about Assessment and mean of scores for the domain of nurses’ knowledge about sleeve gastrectomy; it shows that the Assessment of nurses’ knowledge is (poor) for the all three domains and overall Assessment for nurses’ knowledge about sleeve gastrectomy, it shows that the overall Assessment for nurses’ knowledge is (poor) with a mean of the score (1.35).
Table 5.
Overall assessment for nurses’ knowledge about sleeve gastrectomy
| Domains | Mean of Score | Assessment | ||
|---|---|---|---|---|
| General Knowledge | 1.40 | Poor | ||
| Nursing Care before Sleeve Gastrectomy | 1.30 | Poor | ||
| Nursing Care after Sleeve Gastrectomy | 1.37 | Poor | ||
| Total Score | 1.35 | Poor |
F.=frequency. %=percentage. Mean of score (poor=1–1.66 moderate=1.67 –2.32 high=2.33– 3)
According to Table 6, there is no significant correlation between the overall Assessment of nurses’ knowledge about sleeve gastrectomy and their demographic data (P ≤ 0.05).
Table 6.
The relationship between overall assessment of nurses’ knowledge and socio-demographic characteristics
| Items | Sub-groups | Study sample N0.=25 |
Significance P | |||||
|---|---|---|---|---|---|---|---|---|
| F | % | |||||||
| Age/Years | 21–27 | 7 | 28 | 0.68 | ||||
| 28–34 | 5 | 20 | N.S | |||||
| 35–41 | 5 | 20 | ||||||
| 42–48 | 4 | 16 | ||||||
| 49–55 | 4 | 16 | ||||||
| Mean=27.12 standard deviation=+ 5.375 | ||||||||
| Gender | Female | 17 | 68 | 0.79 N.S |
||||
| Male | 8 | 32 | ||||||
| Marital Status | Single | 15 | 60 | 0.97 | ||||
| Married | 10 | 40 | ||||||
| Residency | Urban | 22 | 88 | 0.77 N.S |
||||
| Rural | 3 | 12 | ||||||
| Levels of Education | Nursing School | 3 | 12 | 0.23 N.S |
||||
| Nursing Institute | 10 | 40 | ||||||
| Faculty of Nursing | 12 | 48 | ||||||
| Monthly Income (IQD) | Sufficient | 12 | 48 | 0.33 N.S |
||||
| Sufficient to some extent | 12 | 48 | ||||||
| Insufficient | 1 | 4 | ||||||
| Year of Experience in Nursing | 1–10 | 19 | 76 | 0.85 N.S |
||||
| 11–20 | 6 | 24 | ||||||
| 21–30 | 2 | 5.0 | ||||||
| Year of Experience in Surgery Ward | 1–9 | 20 | 80 | 0.56 N.S |
||||
| 10–18 | 5 | 20 | ||||||
Discussion
The findings of the current research showed that the majority of the studied sample with ages between (21 and 27) years old, and that corresponding with study done by (Kelley et al., 2016)[28] whose found that the nurse’s age was (range = 23–32) is the dominant age group of the study sample and this study result is similar to the present study. Regarding to gender, the present study found that the 68% of studied sample were female’s nurses, this result similar with (Wang et al., 2016)[29] who conducted study in China which showed 60% of nurses was single. While findings of the current research disagree with (Griauzde et al., 2018)[30] whose found in the United Kingdom and (Twells et al., 2017)[31] in Canada that study demonstrated that 50% of nurses is married. Concerning residency, the current study results show that most of the nurses live at urban residents (88%). Also show 80% of the studied sample had 1–9 years’ working experience in a surgery ward and this result was similar to a study conducted in Egypt by (Younus et al., 2018),[32] also similar to the study conducted in India by (Petcu, 2017).[33] The result of the present study shows that assessment and mean scores for items regarding nurses’ general knowledge about sleeves is poor for almost all questions and that corresponding with a previous study done by (Steyer et al., 2016)[25] showed that poorly nursing knowledge regarding general sleeve gastrectomy information. Also, come to be an agreement with previous study conducted in Iraq by (Wadi Al-Azawi and Hameed 2021)[34] regarding to assessment the of nursing knowledge about health care before sleeve gastrectomy; it shows that the assessment of nurses’ knowledge is poor for the almost questions. While the study conducted by (Barros et al., 2020)[21] showed that was moderately response mean score. But there are completely harmonized with result of previous study done by (Sharma et al., 2018).[35] Also that completely agree with result of study done by (Steyer et al., 2016).[25]
According to the result there was no significant correlation between overall assessment of nurses knowledge about sleeve gastrectomy and their demographic data (P ≤ 0.05). This study is agrees with results obtained in India by (Sharma et al., 2018),[35] but disagrees with study in America by (Gill et al., 2016),[36] (Mansour et al., 2019),[16] most of nurses do not have good knowledge about gastrectomy because this operation is considered new method in the world and also Iraq to decrease the weight and most of nurses don’t read about this operation in there study program, that is mean all of nurses equal to have bad knowledge, for this reason association cannot be found between overall assessment of nurses knowledge about sleeve gastrectomy and their demographic data between overall assessment of nurses knowledge about sleeve gastrostomy and their demographic data.
Limitation and recommendations
Based on the results of the study, the researcher recommended that: Training and education programs in their specialty must be designed and created for nurses in this surgical ward for development their knowledge. Enhancing nurses’ opportunity in the surgical ward to provide updating their education to demand knowledge and skills regarding sleeve gastrectomy. Publishing booklets for nurses related to pre and post sleeve gastrectomy.
Conclusion
In agreement with the findings of the present study, the researcher may conclude the following: Nurses with ages between 21–27 years old (28%), female nurses (68%), single nurses (60%), those who live urban residents (88%), nurses graduated from Faculty of Nursing (48%), those with a monthly income of sufficient to some extent (48%), those with (1–10) years of experience in nursing (76%), those with (1–9) years of experience in surgery (80%). Nurses’ knowledge about sleeve gastrostomy was ranging between poor to moderate, and as general the total score of nurses’ knowledges was poor in all domains (general knowledge, pre-sleeve gastrectomy, post sleeve gastrectomy, and complications related sleeve gastrectomy). There is no significant association between nurses’ knowledge and their demographic characteristics.
Ethical considerations
This essay consider all ethical concepts. The participants were made aware of the study’s goals and the progression of its execution. They also received assurance. The research findings were made available to them if they so choose, and they were allowed to exit the study whenever they pleased. The subjects have provided their written consent.
Conflicts of interest
There are no conflicts of interest.
Acknowledgments
We thank the assistance of Al-Mustaqbal University Colleges who helped us conducting this study.
Funding Statement
According to the researcher, no organization has provided them with direct or indirect financing
References
- 1.Franco JV, Ruiz PA, Palermo M, Gagner M. A review of studies comparing three laparoscopic procedures in bariatric surgery: Sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21:1458–68. doi: 10.1007/s11695-011-0390-5. [DOI] [PubMed] [Google Scholar]
- 2.Lalor PF, Tucker ON, Szomstein S, Rosenthal RJ. Complications after laparoscopic sleeve gastrectomy. SOARD. 2008;4:33–8. doi: 10.1016/j.soard.2007.08.015. [DOI] [PubMed] [Google Scholar]
- 3.Mansour, Ahmed, Dalia Abellatif, Sahar Yassien. “Nurses’ Performance for Patient Undergoing Bariatric Surgery”. EBNR. 2019;1(1):12–12. [Google Scholar]
- 4.Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: Review of its prevention and management. World J Gastroenterol. 2014;20:13904. doi: 10.3748/wjg.v20.i38.13904. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Csendes A, Braghetto I, León P, Burgos AM. Management of leaks after laparoscopic sleeve gastrectomy in patients with obesity. J Gastrointes Surg. 2010;14:1343–8. doi: 10.1007/s11605-010-1249-0. [DOI] [PubMed] [Google Scholar]
- 6.Baker RS, Foote J, Kemmeter P, Brady R, Vroegop T, Serveld M. The science of stapling and leaks. Obes Surg. 2004;14:1290–8. doi: 10.1381/0960892042583888. [DOI] [PubMed] [Google Scholar]
- 7.Sakran N, Goitein D, Raziel A, Keidar A, Beglaibter N, Grinbaum R, et al. Gastric leaks after sleeve gastrectomy: A multicenter experience with 2,834 patients. Surg. 2013;27:240–5. doi: 10.1007/s00464-012-2426-x. [DOI] [PubMed] [Google Scholar]
- 8.Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18:1083–8. doi: 10.1007/s11695-008-9576-x. [DOI] [PubMed] [Google Scholar]
- 9.Erdas E, Dazzi C, Secchi F, Aresu S, Pitzalis A, Barbarossa M, et al. Incidence and risk factors for trocar site hernia following laparoscopic cholecystectomy: A long-term follow-up study. Hernia. 2012;16:431–7. doi: 10.1007/s10029-012-0929-y. [DOI] [PubMed] [Google Scholar]
- 10.MK D. Elective midline laparotomy closure. Ann Surg. 2020;251:843–53. doi: 10.1097/SLA.0b013e3181d973e4. [DOI] [PubMed] [Google Scholar]
- 11.Baucom RB, Beck WC, Holzman MD, Sharp KW, Nealon WH, Poulose BK. Prospective evaluation of surgeon physical examination for detection of incisional hernias. J Am Coll Surg. 2014;218:363–6. doi: 10.1016/j.jamcollsurg.2013.12.007. [DOI] [PubMed] [Google Scholar]
- 12.Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: Making the case for hernia research. Hernia. 2012;16:179–83. doi: 10.1007/s10029-011-0879-9. [DOI] [PubMed] [Google Scholar]
- 13.Gruberg L, Weissman NJ, Waksman R, Fuchs S, Deible R, Pinnow EE, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: The obesity paradox? J Am Coll Cardiol. 2002;39:578–84. doi: 10.1016/s0735-1097(01)01802-2. [DOI] [PubMed] [Google Scholar]
- 14.Helgstrand F, Rosenberg J, Bisgaard T. Trocar site hernia after laparoscopic surgery: A qualitative systematic review. Hernia. 2011;15:113–21. doi: 10.1007/s10029-010-0757-x. [DOI] [PubMed] [Google Scholar]
- 15.Scozzari G, Zanini M, Cravero F, Passera R, Rebecchi F, Morino M. High incidence of trocar site hernia after laparoscopic or robotic Roux-en-Y gastric bypass. SurgEndosc. 2014;28:2890–8. doi: 10.1007/s00464-014-3543-5. [DOI] [PubMed] [Google Scholar]
- 16.Mansour, Ahmed, Dalia Abellatif, Sahar Yassien. “Nurses’ Performance for Patient Undergoing Bariatric Surgery”. EBNR. 2019;1(1):12–12. [Google Scholar]
- 17.Ahlqvist S, Björk D, Weisby L, Israelsson LA, Cengiz Y. Trocar site hernia after gastric bypass. Surg Technol Int. 2017;30:170–4. [PubMed] [Google Scholar]
- 18.Karampinis I, Lion E, Grilli M, Hetjens S, Weiss C, Vassilev G, et al. Trocar site hernias in bariatric surgery—an underestimated issue: A qualitative systematic review and meta-analysis. ObesSurg. 2019;29:1049–57. doi: 10.1007/s11695-018-03687-2. [DOI] [PubMed] [Google Scholar]
- 19.Comajuncosas J, Hermoso J, Gris P, Jimeno J, Orbeal R, Vallverdú H, et al. Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: A prospective 3-year follow-up study. AmJ Surg. 2014;207:1–6. doi: 10.1016/j.amjsurg.2013.05.010. [DOI] [PubMed] [Google Scholar]
- 20.Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int. 2003;63:793–808. doi: 10.1046/j.1523-1755.2003.00803.x. [DOI] [PubMed] [Google Scholar]
- 21.Barros LM, Gomes FA, Carneiro FN, Galindo NM, Frota NM, Caetano JÁ. Knowledge and attitude of candidates to gastroplasty about perioperative: Randomized clinical trial. Rev Bras Enferm. 2020;73:e20180869. doi: 10.1590/0034-7167-2018-0869. [DOI] [PubMed] [Google Scholar]
- 22.Kalantar-Zadeh K, Block G, Horwich T, Fonarow GC. Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. J Am Coll Cardiol. 2004;43:1439–44. doi: 10.1016/j.jacc.2003.11.039. [DOI] [PubMed] [Google Scholar]
- 23.Veronese N, Cereda E, Solmi M, Fowler SA, Manzato E, Maggi S, et al. Inverse relationship between body mass index and mortality in older nursing home residents: A meta-analysis of 19,538 elderly subjects. Obes Rev. 2015;16:1001–15. doi: 10.1111/obr.12309. [DOI] [PubMed] [Google Scholar]
- 24.Smama’h Y, Eshah NF, Al Oweidat IA, Rayan A, Nashwan AJ. The impact of leadership styles of nurse managers on nurses’ motivation and turnover intention among Jordanian nurses. J Healthc Leadersh. 2023;15:19–29. doi: 10.2147/JHL.S394601. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Steyer NH, Oliveira MC, Gouvêa MR, Echer IC, Lucena AD. Clinical profile, nursing diagnoses and nursing care for postoperative bariatric surgery patients. Rev Gaúcha Enferm. 2016;37:e5017. doi: 10.1590/1983-1447.2016.01.50170. [DOI] [PubMed] [Google Scholar]
- 26.Cao C, Wang R, Wang J, Bunjhoo H, Xu Y, Xiong W. Body mass index and mortality in chronic obstructive pulmonary disease: A meta-analysis. 2012;7:e43892. doi: 10.1371/journal.pone.0043892. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Drager LF, McEvoy RD, Barbe F, Lorenzi-Filho G, Redline S. Sleep apnea and cardiovascular disease: Lessons from recent trials and need for team science. Circulation. 2017;136:1840–50. doi: 10.1161/CIRCULATIONAHA.117.029400. doi: 10.1161/CIRCULATIONAHA.117.029400. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Kelley T, Docherty S, Brandon D. Information needed to support knowing the patient. Adv Nurs Sci. 2013;36:351–63. doi: 10.1097/ANS.0000000000000006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Wang L, Liu W, He X, Chen Y, Lu J, Liu K, et al. Association of overweight and obesity with patient mortality after acute myocardial infarction: A meta-analysis of prospective studies. Int J Obes. 2016;40:220–8. doi: 10.1038/ijo.2015.176. [DOI] [PubMed] [Google Scholar]
- 30.Griauzde DH, Ibrahim AM, Fisher N, Stricklen A, Ross R, Ghaferi AA. Understanding the psychosocial impact of weight loss following bariatric surgery: A qualitative study. BMC Obes. 2018;5:1–9. doi: 10.1186/s40608-018-0215-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Twells LK, Driscoll S, Gregory DM, Lester K, Fardy JM, Pace D. Morbidity and health-related quality of life of patients accessing laparoscopic sleeve gastrectomy: A single-centre cross-sectional study in one province of Canada. BMC Obes. 2017;4:1–0. doi: 10.1186/s40608-017-0176-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Younus H, Chakravartty S, Sarma DR, Patel AG. Endobarrier as a pre bariatric surgical intervention in high-risk patients: A feasibility study. Obes Surg. 2018;28:3020–7. doi: 10.1007/s11695-018-3322-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Petcu A. Comprehensive care for bariatric surgery patients. AACN Adv Crit Care. 2017;28:263–74. doi: 10.4037/aacnacc2017410. [DOI] [PubMed] [Google Scholar]
- 34.Wadi Al-Azawi HA, Hameed DM. Assessment of nurses’ knowledge toward sleeve gastrectomy in surgical unit at Al-Najaf Al-Ashraf Governorate. Indian J Forensic Med Toxicol. 2021;15(2):2430. [Google Scholar]
- 35.Sharma N, Lee J, Youssef I, Salifu MO, McFarlane SI. Obesity, cardiovascular disease and sleep disorders: Insights into the rising epidemic. J Sleep Disord Ther. 2017;6(1):260. doi: 10.4172/2167-0277.1000260. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Gill RS, Majumdar SR, Rueda-Clausen CF, Apte S, Birch DW, Karmali S, et al. Comparative effectiveness and safety of gastric bypass, sleeve gastrectomy and adjustable gastric banding in a population-based bariatric program: Prospective cohort study. Can J Surg. 2016;59:233. doi: 10.1503/cjs.013315. [DOI] [PMC free article] [PubMed] [Google Scholar]