Digital Follow-Up and Nursing Education in Bariatric Surgery Patients

Obesity is a chronic, multifactorial disease associated with increased morbidity, mortality, and reduced quality of life. Bariatric surgery is considered the most effective long-term treatment for morbid obesity; however, sustainable outcomes depend on adherence to postoperative lifestyle modifications, including regular physical activity, nutritional regulation, and behavioral adaptation. Despite the effectiveness of surgery in achieving initial weight loss, some patients experience insufficient weight reduction or weight regain due to poor adherence to recommended lifestyle changes.

Digital health technologies have emerged as promising tools for improving patient monitoring, self-management, and behavioral compliance. Mobile and web-based follow-up systems may enhance communication between patients and healthcare professionals, facilitate structured exercise adherence, and promote sustained behavioral change. Additionally, structured nursing education plays a critical role in empowering patients, increasing health literacy, and improving postoperative adaptation.

This randomized controlled trial aims to evaluate the effectiveness of a PHP-MySQL database-based digital follow-up system combined with structured nursing education in patients undergoing bariatric surgery. Eligible participants will be randomly assigned to intervention and control groups using a simple randomization method. The intervention group will receive structured nursing education and participate in an 8-week digitally monitored exercise program beginning at postoperative month four. The control group will receive standard postoperative care without structured digital follow-up.

Primary outcome measures include changes in quality of life assessed by the Moorehead-Ardelt Quality of Life Questionnaire II (MA-II). Secondary outcomes include changes in body mass index (BMI), physical activity levels measured by the International Physical Activity Questionnaire (IPAQ), and exercise adherence rates recorded through the digital platform.

The findings of this study are expected to contribute to the development of evidence-based postoperative follow-up models integrating digital health systems and nursing-led behavioral interventions in bariatric care.

Inclusion criteria

• Adults aged 18-65 years Undergoing bariatric surgery Eligible for physical activity participation according to the International Physical Activity Questionnaire (IPAQ) Able to use the PHP-MySQL based digital follow-up system Willing to participate and provide written informed consent

Exclusion criteria

• Severe cardiopulmonary disease or any medical condition that contraindicates exercise Uncontrolled hypertension or uncontrolled diabetes Severe musculoskeletal limitations preventing participation in the exercise program Severe psychiatric disorder impairing compliance or follow-up Participation in another interventional study during the study period Refusal or inability to provide informed consent