{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:07:05Z","timestamp":1785769625045,"version":"3.56.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro Universitet","doi-asserted-by":"publisher","award":["ORU 2018\/00376"],"award-info":[{"award-number":["ORU 2018\/00376"]}],"id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003509","name":"\u00d6rebro Universitet","doi-asserted-by":"publisher","award":["ORU 2018\/2019"],"award-info":[{"award-number":["ORU 2018\/2019"]}],"id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>After bariatric surgery, adherence to lifestyle recommendations is crucial. Health literacy and self\u2010efficacy may impact recovery after surgery. In this multicentre study performed in three hospitals in Sweden, we evaluated any relation between preoperative health literacy and general self\u2010efficacy on the one side and weight loss, health\u2010related quality of life, length of stay, and complications up to 2\u2009years after bariatric surgery on the other. Of 686 included patients, 56% (<jats:italic>n<\/jats:italic>\u2009=\u2009382) had limited functional health literacy, 42% (<jats:italic>n<\/jats:italic>\u2009=\u2009278) had limited communicative and critical health literacy, and 40% (<jats:italic>n<\/jats:italic>\u2009=\u2009266) reported low general self\u2010efficacy. Preoperative functional, communicative and critical health literacy, and general self\u2010efficacy were not associated with the degree of weight loss at 1 or 2\u2009years after surgery. However, limited health literacy and low general self\u2010efficacy scores were associated with both reduced quality of life and obesity\u2010related problems postoperatively. Further, a higher proportion of those with inadequate health literacy had a prolonged length of stay. Although patients with limited health literacy and self\u2010efficacy may experience similar maximum weight loss after bariatric surgery as other patients, they still might have reduced health\u2010related quality of life in terms of obesity\u2010related problems. Increased awareness of this association as well as patient\u2010centered support before and after bariatric surgery may be of benefit.<\/jats:p>","DOI":"10.1111\/cob.70009","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T20:59:56Z","timestamp":1741726796000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of health literacy and general self\u2010efficacy on surgical outcomes 2\u2009years after bariatric surgery"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-6745","authenticated-orcid":false,"given":"Maria","family":"Jaensson","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, School of Health Sciences \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karuna","family":"Dahlberg","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, School of Health Sciences \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Unit of Integrative Epidemiology Institute of Environmental Medicine, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Thorell","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Danderyd Hospital Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Surgery and Anesthesiology Ersta Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"\u00d6sterberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Mora Hospital  Mora Sweden"},{"name":"Department of Clinical Science and Education S\u00f6dersjukhuset, Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrica","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences, and Society Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Stenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12203"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaa011"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004369"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046407"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-020-0637-0"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06394-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10081739"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-80"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.06.044"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/day062"},{"issue":"1","key":"e_1_2_11_12_1","first-page":"e46","article-title":"Health literacy in surgery","volume":"4","author":"Chang ME","year":"2020","journal-title":"Health Lit Res Pract"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-019-04060-7"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0093"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2020.09.021"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505837"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.37.2.122"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2016.08.017"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2022.2050458"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-019-04028-7"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-027272"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-002033"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12125"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494813500592"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1027\/\/1015-5759.18.3.242"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2020.10.017"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1757975918788300"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056592"},{"key":"e_1_2_11_29_1","unstructured":"M\u00e5rtenssonL W\u00e5ngdahlJ.Scale for functional health literacy. Swedish version. Guidelines for use of the scale. Version 3.1 January 2017. 2017:2\u20138. 08\u201002\u20102021.2017https:\/\/uploads.staticjw.com\/ha\/halsolitteracitet\/guidelines-sfhl-swedish-version-3-1-january-2017.pdf"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-061509"},{"key":"e_1_2_11_31_1","unstructured":"SchwarzerR.Everything you wanted to know about the General Self\u2010Efficacy Scale but were afraid to ask.2018Accessed January 22 2018.http:\/\/userpage.fu-berlin.de\/~health\/faq_gse.pdf"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0802272"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277\u20109536(95)00125\u2010q"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0895\u20104356(98)00102\u20104"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-022-01992-0"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i04"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780100410"},{"key":"e_1_2_11_39_1","unstructured":"Organization WHO.WHO European Regional Obesity Report 2022.2022https:\/\/www.who.int\/europe\/publications\/i\/item\/9789289057738"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-090419-102529"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2022.10.028"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.0672"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010023\u201015519\u20109"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.3832"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.15171\/hpp.2019.22"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2024.02.004"},{"issue":"6","key":"e_1_2_11_47_1","first-page":"284","article-title":"Use and effectiveness of the teach\u2010back method in patient education and health outcomes","volume":"36","author":"Yen PH","year":"2019","journal-title":"Federal Practitioner"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-024-07379-y"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2022.03.010"}],"container-title":["Clinical Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cob.70009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:25:08Z","timestamp":1760487908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cob.70009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/cob.70009"],"URL":"https:\/\/doi.org\/10.1111\/cob.70009","archive":["Portico"],"relation":{},"ISSN":["1758-8103","1758-8111"],"issn-type":[{"value":"1758-8103","type":"print"},{"value":"1758-8111","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"assertion":[{"value":"2024-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70009"}}