Wouter Leclercq

Chapter 5 80 The interviews consisted of three main parts; 1) education in the specific informed consent domains; 2) perioperative expectations and experiences and 3) personal (un)certainties in undergoing bariatric surgery. The focus of this manuscript is solely on part 1 and part 3, regarding the preoperative education and the SIC process. Although in semi-structured interviewing the sequencing of questions is not the same for each participant, an interview guide [see Appendix 5.1] was used to ensure that the researcher would collect similar types of data from all participants. None of the interviews were recorded. The researcher made notes in the form of keywords during the performance of the interviews. If the researcher was of opinion that the participant made an interesting quote or statement, the whole quote/statement was literally noted. Directly after the interview all notes were transcribed. Setting This study was performed between October 2017 and April 2018 at a large teaching hospital with a bariatric surgery department certified as European Centre of Excellence. Patients were contacted by letter and telephone to participate in the study. Before the start of the semi-structured interviews, all patients had to sign a written informed consent form to participate in this study. Data Besides the gathering of information through semi-structured interviewing, preoperative and postoperative data (anthropometrics up to five years, postoperative complications and pre-operative comorbidities) were retrospectively collected from the electronic patient files. Primary responder (i.e. weight loss success) was defined as the achievement of a percentage Excess Weight Loss (%EWL) >50% and primary non-responder (i.e. weight loss failure) was defined as the inability to achieve a %EWL >50% at eighteen months post-surgery. 18 Analysis and statistics All the gathered knowledge from the semi-structured interviews and the data from the electronic patient files were processed. The information gathered from the closed- ended questions was processed as quantitative data (comparable to a survey). The open conversations of part 1 and part 3 were of qualitative nature and were therefore addressed in a qualitative manner. Coding on the keywords was applied, including the identification of relevant “themes”, to organize and group the information into “categories” (creating a single code to describe a large amount of text, for example: “missed information”, “improvements“). Relevant information of these “categories” were then paralleled between the semi-structured interviews. Data processing and analysis in semi-structured interviews were on-going processes. As such, the data was collected until a point of data saturation was reached, namely when no new or relevant information emerged.