A nurse-led perioperative intervention enhances self-care and supports long-term weight loss after bariatric surgery: a randomized controlled trial.

Authors

Cláudia Mendes, Manuel Carvalho, Catarina Martins, Maria Marques, Otília Zangão, João Gregório

Published in

International journal of nursing studies advances. Volume 11. Pages 100633. Epub Jul 18, 2026.

Abstract

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.
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.
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.
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.
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.

PMID:
42529786
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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