Bariatrik Cerrahi Hastalarında Farkındalık Temelli Eğitim Programı: Bir Eylem Araştırması Çalışma Protokolü

Yıl 2026, Cilt: 28 Sayı: 1 , 61 - 72 , 28.04.2026

Defne Dizlek Bayraktar , Emine Çatal , Hüseyin Çiyiltepe

https://doi.org/10.69487/hemarge.1779207

https://izlik.org/JA53JT78LN

Öz

Amaç: Bariatrik cerrahi, obezitenin yönetiminde en etkili müdahalelerden biridir. Ancak bireylerin kilo verme ve verdiği kiloyu koruma konusundaki başarısının büyük ölçüde bireylerin cerrahi sürece ve buna eşlik eden yaşam tarzı değişikliklerine uyum sağlamasına bağlı olduğu bilinmektedir. Farkındalık uygulamaları, beyni yeniden şekillendirmede ve daha sağlıklı yeme davranışlarını teşvik etmede değerli araçlar olarak ortaya çıkmıştır. Farkındalık üzerine yapılan çalışmalar, yeme farkındalığı tekniklerinin obezitenin önlenmesi ve tedavisinde önemli bir rol oynayabileceğini sürekli olarak göstermektedir. Bu çalışma protokolünde, bireylerin yeme farkındalığını geliştirmeye yönelik Bariatrik Cerrahi Hastalarında Farkındalık Temelli Eğitim Programı’nın (MBTP-BS) oluşturulması amaçlanmıştır. Yöntem: Bu makale, bir eylem araştırmasının çalışma protokolünü sunmaktadır. Bariatrik cerrahi öncesinde cerrahi kararı verilmiş hastalar çalışmaya dahil edilmiş olup, 15 katılımcı eylem grubuna, 15 katılımcı ise kontrol grubuna alınmıştır. Araştırmada, eylem grubuna ameliyat öncesi dönemde dört hafta sürecek farkındalık temelli egzersiz ve yeme farkındalığı uygulamaları müdahale olarak uygulanmıştır. Eğitimin etkinliği, eğitimden önce ve cerrahiden sonraki 3. ve 6. aylarda toplanan nicel ve nitel verilerin analiziyle değerlendirilmiştir. Çalışma protokolünde SPIRIT raporlama kontrol listesi izlenmiştir. Sonuç: Bu çalışma protokolü, bariatrik cerrahi hasta grubundaki bireylerin cerrahi süreçte uyumunu artırmak ve farkındalık temelli eğitim yoluyla yaşam tarzı değişikliklerine yönelmelerini sağlamak açısından önem taşımaktadır. Klinik Araştırma Kaydı: Çalışma 16 Ağustos 2023 tarihinde ClinicalTrials.gov’da (NCT05992662) kaydedilmiştir.

Anahtar Kelimeler

Farkındalık , Yeme Farkındalığı , Bariatrik Cerrahi , Eylem Araştırması , Araştırma Protokolü

Etik Beyan

Akdeniz Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’ndan izin alınmıştır (No:7090404/452).

Destekleyen Kurum

Yazarlar bu çalışmanın herhangi bir finansal destek almadığını beyan etmişlerdir.

Mindfulness-Based Training Program in Bariatric Surgery Patients: An Action Research Study Protocol

https://izlik.org/JA53JT78LN

Öz

Aim: Bariatric surgery is one of the most effective interventions in the management of obesity. However, it is known that individuals’ success in losing weight and maintaining that weight loss largely depends on their adherence to the surgical process and the accompanying lifestyle changes. Mindfulness practices have emerged as valuable tools in reshaping the brain and promoting healthier eating behaviors. Studies on mindfulness consistently show that mindful eating techniques can play a significant role in the prevention and treatment of obesity. This study protocol aims to develop a Mindfulness-Based Training Program in Bariatric Surgery Patients (MBTP-BS) to enhance individuals’ mindful eating. Methods: This article presents the study protocol of an action research. Patients who have been decided for surgery prior to bariatric surgery were included in the study, with 15 participants assigned to the action group and 15 participants to the control group. In the research, mindfulness-based exercises and eating awareness practices were implemented as an intervention for the action group during a preoperative period lasting four weeks. The effectiveness of the training was evaluated through the analysis of quantitative and qualitative data collected before the training and at the 3rd and 6th months after the surgery. The study protocol followed the SPIRIT reporting checklist. Conclusion: This study protocol is important for increasing the adherence of individuals in the bariatric surgery patient group to the surgical process and facilitating their engagement in lifestyle changes through mindfulness-based training. Clinical Trial Registration: The study was registered on ClinicalTrials.gov (NCT05992662) on August 16, 2023.

Anahtar Kelimeler

Mindfulness , Bariatric Surgery , Action Research , Eating Behavior , Research Protocol.

Etik Beyan

Permission was obtained from the Clinical Research Ethics Committee of the Akdeniz University, Faculty of Medicine (No:7090404/452).

Destekleyen Kurum

The authors declared that this study had received no financial support.

Kaynakça

• Adelman, C. (1993). Kurt Lewin and the origins of action research. Educational Action Research, 1, 7-24.
• Ames, G. E., Koball, A. M., & Clark, M. M. (2022). Behavioral interventions to attenuate driven overeating and weight regain after bariatric surgery. Frontiers in Endocrinology, 13, 934680.
• Almuhtadi, Y., & Alageel, S. (2023). Systematic review of mindfulness-based interventions for weight management among pre-and post-bariatric surgery patients. Advances in Mind–Body Medicine, 37(3), 15–22.
• Athanasiadis, D. I., Martin, A., Kapsampelis, P., Monfared, S., & Stefanidis, D. (2021). Factors associated with weight regain post-bariatric surgery: A systematic review. Surgical Endoscopy, 35, 4069–4084.
• Baig, S. J., Priya, P., Mahawar, K. K., Shah, S., & Indian Bariatric Surgery Outcome Reporting Group. (2019). Weight regain after bariatric surgery: A multicentre study of 9617 patients. Obesity Surgery, 29, 1583–1592.
• Bradbury, H. (Ed.). (2015). The Sage handbook of action research. Sage.
• Brode, C. S., & Mitchell, J. E. (2019). Problematic eating behaviors and eating disorders associated with bariatric surgery. Psychiatric Clinics, 42(2), 287–297.
• Caldwell, A. E., Purcell, S. A., Gray, B., Smieja, H., & Catenacci, V. A. (2022). The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review. Obesity Science & Practice, 8(2), 219–232.
• Chan, A.-W., Boutron, I., Hopewell, S., Moher, D., Schulz, K. F., ..., Hróbjartsson, A. (2025). SPIRIT 2025 statement: Updated guideline for protocols of randomised trials. BMJ, 389, e081477.
• Chacko, S. A., Yeh, G. Y., Davis, R. B., & Wee, C. C. (2016). A mindfulness-based intervention to control weight after bariatric surgery. Complementary Therapies in Medicine, 28, 13–21.
• Craig, H. C., Alsaeed, D., Norris, S., Holian, J., Kennedy, C., Feldman, A., & Le Roux, C. (2024). Patient perspectives about treatment preferences for obesity with complications. Obesity Science & Practice, 10(1), e720.
• Creswell, J. W., & Plano Clark, V. L. (2017). Designing and conducting mixed methods research (3rd ed.). Sage.
• Czepczor-Bernat, K., Brytek-Matera, A., Gramaglia, C., & Zeppegno, P. (2020). The moderating effects of mindful eating on emotional functioning and eating styles. Eating and Weight Disorders, 25, 841–849.
• Dao, M. C., Messer, E., Conigliaro, T., Sakaida, K., Ouellette, A. F., Himaras, V., ..., & Roberts, S. B. (2019). Factors influencing energy intake in adults with overweight and obesity. Nutrients, 11(6), 1365.
• Dizlek, D., & Çatal, E. (2018). Morbid obezitede bariatrik cerrahi sonrası hasta sonuçları. Düzce Üniversitesi Bilim ve Teknoloji Dergisi, 6, 501–512.
• El Ansari, W., & Elhag, W. (2021). Weight regain and insufficient weight loss after bariatric surgery. Obesity Surgery, 31, 1755–1766.
• Felske, A. N., Williamson, T. M., Rash, J. A., Telfer, J. A., Toivonen, K. I., & Campbell, T. (2022). Mindfulness-informed intervention for bariatric surgery candidates. Behavioral Medicine, 48, 216–229.
• Finch, J. (1987). The vignette technique in survey research. Sociology, 21, 105–114.
• Framson, C., Kristal, A. R., Schenk, J. M., Littman, A. J., Zeliadt, S., & Benitez, D. (2009). Development and validation of the MEQ. Journal of the American Dietetic Association, 109(8), 1439–1444.
• Groene, P., Eisenlohr, J., Zeuzem, C., Dudok, S., Karcz, K., & Hofmann-Kiefer, K. (2019). Postoperative nausea and vomiting in bariatric surgery. Videosurgery and Other Miniinvasive Techniques, 14(1), 90–95.
• Guarderas, X., Cadena-Semanate, R., Herrera, G., & Guerron, A. D. (2020). Surgical approach of weight regain after bariatric surgery.
• Guimarães, M., Osório, C., Silva, D., Almeida, R. F., Reis, A., Cardoso, S., ... & Nora, M. (2021). Long-term efficacy of Roux-en-Y gastric bypass. Obesity Surgery, 31, 3623–3629.
• Günbayı, İ., & Karadağ, E. (2022). Eylem araştırmasında karma yöntem uygulamaları: Yöntemden topluluk eylemine.
• Ivankova, N. V. (2015). Mixed methods applications in action research. Sage.
• Işık, E., & Semerci, Ç. (2019). Veri üçgenlemesi: Odak grup, görüşme ve gözlem. Turkish Journal of Educational Studies, 6, 53–66.
• Jacobs, A., Monpellier, V. M., Torensma, B., Antoniou, E. E., Janssen, I. M., Tollenaar, R. A., & Jansen, A. T. (2024). Mental and behavioral predictors of weight loss after bariatric surgery. Obesity Reviews, 25(6), e13729.
• King, W. C., Hinerman, A. S., Belle, S. H., Wahed, A. S., & Courcoulas, A. P. (2018). Comparison of weight-regain measures after bariatric surgery. JAMA, 320, 1560–1569.
• Koffman, L., Levis, A. W., Haneuse, S., Johnson, E., Bock, S., McSperitt, D., .. & Anterburn, D. (2022). Telephonic nutritional counseling in bariatric surgery. Obesity Surgery, 32(1), 133–141.
• Köse, G., Tayfur, M., Birincioğlu, İ., & Dönmez, A. (2016). Turkish adaptation of MEQ. Journal of Cognitive Behavioral Psychotherapy and Research, 3(1), 125–134.
• Lauti, M., Kularatna, M., Hill, A. G., & MacCormick, A. D. (2016). Weight regain following sleeve gastrectomy. Obesity Surgery, 26, 1326–1334.
• Lewin, K., & Lippitt, R. (1938). Autocracy and democracy: A preliminary experimental report. Sociometry, 1, 292–300.
• Lopes, K. G., Romagna, E. C., Mattos, D. M. F., & Kraemer-Aguiar, L. G. (2024). Disordered eating and weight regain. Nutrients, 16(23), 4250.
• Lopez-de-Andres, A., Jimenez-Garcia, R., Cuadrado-Corrales, N., Carabantes-Alarcon, D., Hernandez-Barrera, V., de Miguel-Diez, J., ... & Zamorano-Leon, J. J. (2024). Bariatric surgery outcomes in Spain. BMJ Open Diabetes Research and Care, 12(4), e004351.
• Lourensz, K., Himantoko, I., Shaw, K., Laurie, C., Becroft, L., Forrest, E., .... & Brown, W. (2022). Revisional malabsorptive surgery outcomes. Obesity Surgery, 32(6), 1822–1830.
• Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2019). Mindfulness app for weight and stress. JMIR mHealth and uHealth, 7(4), e12210.
• Mantzios, M., Bahia, H., Hussain, M., Keyte, R., Egan, H., Strachan, R., et al. (2024). Mindful eating reflective practice: IPA study. Nutrition and Health.
• Marrow, A. J. (1977). The practical theorist: The life and work of Kurt Lewin. Teachers College Press.
• Mason, A. E., Jhaveri, K., Cohn, M., & Brewer, J. A. (2018). Mobile mindful eating intervention. Journal of Behavioral Medicine, 41, 160–173.
• May, M., Furtado, M., & Ornstein, L. (2014). The mindful eating cycle. Bariatric Times, 11(2), 8–12.
• Mercado, D., Robinson, L., Gordon, G., Werthmann, J., Campbell, I. C., & Schmidt, U. (2021). Mindfulness-based interventions for obesity and binge eating. Appetite, 166, 105464.
• Morgan, D. L., Krueger, R. A., & King, J. A. (1998). Involving community members in focus groups. Sage.
• Palacio, A., Luna, C., Maíz, C., & Blanco, E. (2021). Nutritional and behavioral factors in weight gain after bariatric surgery. Revista Médica de Chile, 149(1).
• Rogowitz, E., Patti, M.-E., & Lawler, H. M. (2019). Time to dump “late dumping syndrome.” Obesity Surgery, 29, 2985–2986.
• Sala, M., Shankar Ram, S., Vanzhula, I. A., & Levinson, C. A. (2020). Mindfulness and eating disorder psychopathology. International Journal of Eating Disorders, 53, 834–851.
• Sarkhel, S., Singh, O. P., & Arora, M. (2020). Psychoeducation guidelines. Indian Journal of Psychiatry, 62(Suppl 2), S319–S323.
• Siu, P. M., Yu, A. P., Chin, E. C., Yu, D. S., Hui, S. S., Woo, J., Fong, D. Y., Wei, G. X., & Irwin, M. R. (2021). Tai Chi and central obesity. Annals of Internal Medicine, 174(8), 1050–1057.
• Story, N. M., Lumby, J., Fethney, J., & Waters, D. (2021). Eating behaviours in metabolic surgery. Journal of Clinical Nursing, 30, 3342–3354.
• Tripoli, G., Vinci, S., La Cascia, C., Buscemi, S., Maniaci, G., Sartorio, C., et al. (2024). Behavioural predictors of weight loss maintenance. Journal of Clinical & Developmental Psychology, 6(1).
• Tuncer, M., & Kamçı, F. (2024). Odak grup görüşmeleri. Euroasia Journal of Social Sciences & Humanities, 11, 12–25.
• Uslu, F., & Demir, E. (2023). Derinlemesine görüşme tekniği. Hacettepe Üniversitesi Edebiyat Fakültesi Dergisi, 40, 289–299.
• Van Veldhuisen, S. L., Gorter, T. M., van Woerden, G., de Boer, R. A., Rienstra, M., Hazebroek, E. J., et al. (2022). Bariatric surgery and cardiovascular disease. European Heart Journal, 43, 1955–1969.
• Viftrup, D. T., Laursen, K., & Hvidt, N. C. (2021). Spiritual care education: An action research study. Religions, 12(10), 827.
• Velapati, S. R., Shah, M., Kuchkuntla, A. R., Abu-Dayyeh, B., Grothe, K., Hurt, R. T., & Mundi, M. S. (2018). Weight regain after bariatric surgery. Current Nutrition Reports, 7, 329–334.
• Voroshilov, A. P., Volinsky, A. A., Wang, Z., & Marchenko, E. V. (2017). Qigong breathing and hunger. Journal of Evidence-Based Complementary & Alternative Medicine, 22(4), 687–695.
• Wong, L. Y., Zafari, N., Churilov, L., Stammers, L., Price, S., Ekinci, E. I., & Sumithran, P. (2020). Emotional eating change after bariatric surgery. BJS Open, 4(6), 995–1014.
• Yıldırım, A., & Şimşek, H. (2021). Sosyal bilimlerde nitel araştırma yöntemleri (12. baskı). Seçkin Yayıncılık.