The success of many surgical procedures depends not only on the skill of the surgeon and the use of state-of-the-art technology, but also on the actions and characteristics of the patient. Patients' emotional and psychosocial concerns, health-related behaviours, outcome expectations, and compliance with treatment regimen can all strongly influence the ultimate effectiveness of surgery. Thus, mental health professionals are increasingly called upon to perform presurgical psychological screening (PPS) to ensure that patients are given the treatments most likely to be effective, while reducing the chances of worsening their conditions. This book presents PPS procedures for a wide range of surgery types, such as spinal surgery, organ transplantation, bariatric surgery, and plastic surgery. Drawing on both research and clinical experience, the authors explain how to conduct PPS, communicate results to patients and surgeons, and identify possible pre- or post-surgery interventions to mitigate risk factors and maximise the likelihood of surgical success. Case studies and a discussion of bioethics are included
Pain is an unfortunate daily experience for many individuals. Chronic pain -- lasting six or more months -- is suffered by approximately 30% of the population in the United States. These individuals wake up, function during the day and go to sleep, trying to keep pain at a minimum while, at the same time, maintaining some quality of life. They may make frequent visits to the doctor and the pharmacy. When they find relief, it is usually short-lived and comes at a cost such as dependence on narcotic medications or complete limitation of activity. Pain often becomes the central point of their existence. This practice guide describes an approach to psychological evaluation of the chronic pain patient who is being considered for surgery. A large body of research is accumulating which demonstrates that the outcome of surgical procedures aimed at chronic pain relief can be strongly influenced by psychological and emotional factors. This approach, termed "presurgical psychological screening" (PPS) uses interview and testing techniques to identify emotional, behavioral, and psychosocial difficulties which have been demonstrated to negatively impact surgical outcome. Studies show that even patients with clearly identifiable pathophysiology may respond poorly to surgery, due to issues such as pain sensitivity, medication dependence, rewards for pain behavior and personality style. Thus, some insurance carriers, rehabilitation nurses and state worker's compensation systems are encouraging, or even requiring, presurgical psychological screening in cases of surgery designed to relieve chronic pain. The first to present a comprehensive, unified approach to PPS in chronic pain syndromes, this text is designed to provide the behavioral health practitioner, as well as the trainee, with all the tools and information necessary to conduct PPS evaluations. It identifies a multitude of risk factors for poor surgical outcome and reviews research associated with each risk factor. Hands-on techniques for eliciting information from the patient about risk factors is also detailed. Toward this end, the practice guide also contains a number of forms and session outlines which can be directly utilized, or which can be altered to fit readers' needs. Models for weighing and combining surgical outcome risk factors are also provided. Thus, practitioners are able to reach valid and reliable predictions of surgical results. Finally, the text provides outlines of psychological interventions which can facilitate surgical outcome as well as surgical treatment alternatives. Upon completion of this practice guide, readers should be able to begin providing PPS evaluations which are scientifically valid, clinically sound, and which result in significant overall improvement in the treatment of chronic pain syndromes.
Bariatric surgery plays an important role in the treatment of obesity; in this comprehensive resource the worldwide leaders of the field provide the most up-to-date information on the psychosocial issues that affect their patients. Included is an overview and history of surgical procedures, complete with illustrations, practical advice on topics such as physical activity and nutritional care after surgery, and essential information that allows clinicians to assist their clients as much as possible; for example, how pre-weight loss surgery psychosocial evaluations can serve as clinical interventions in their own right, and how structured interviews and questionnaires can be used in multiple contexts such as screening, treatment planning, and prognostic assessment. A distinctive chapter includes an overview of the special issues present in treating adolescents, who increasingly are the target of bariatric surgery procedures. This book is an essential reference for clinicians from the evaluation through the follow-up and aftercare of bariatric surgery patients.
Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
Annotation Written by three psychologists and one orthopedic spine surgeon, this book demonstrates that surgery to relieve chronic back pain can be greatly augmented by the inclusion of psychological components in the assessment and preparation of patients for spine surgery, as well as in post-operative rehabilitation. It offers specific techniques for screening out patients who will not benefit from surgery, preparing patients to undergo surgery, and improving rehabilitation outcomes. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com).
This book fills the gap between the increasing demand for epilepsy surgical experience and limited training facilities in this area. It comprehensively describes surgical techniques, including tricks and pitfalls, based on the author’s 30 years of experience, providing optimal and effective training for young neurosurgeons by avoiding learning by trial and error. Moreover, it also includes useful information for epileptologists and other professionals involved in the epilepsy surgical program to allow them to gain a better understanding of possibilities and limitations of epilepsy surgery.
Since the original publication of this landmark volume, tremendous advances have been made in understanding and managing psychological factors in pain. This revised and greatly expanded second edition now brings the field fully up to date. Designed for maximum clinical utility, the text shows how to tailor psychological treatment programs to patients suffering from a wide range of pain problems. Conceptual and diagnostic issues are discussed, widely used clinical models reviewed, and a framework presented for integrating psychological treatment with medical and surgical interventions. The second edition has been augmented with detailed case material and the latest treatment outcomes data. Thirteen entirely new chapters provide coverage of specific pain syndromes and disorders, as well as interventions for pain-related fear and preparing patients for implantable technologies.
This definitive clinical reference comprehensively reviews the most advanced methods for assessing the person in pain. The field's leading authorities present essential information and tools for evaluating psychosocial, behavioral, situational, and medical factors in patients' subjective experience, functional impairment, and response to treatment. Empirically supported instruments and procedures are detailed, including self-report measures, observational techniques, psychophysiological measures, and more. Best-practice recommendations are provided for assessing the most prevalent pain syndromes and for working with children, older adults, and people with communication difficulties. The book also weighs in on the limitations of existing methods and identifies key directions for future research.
Spinal disorders, especially neck and back pain, are frequent yet challenging for physicians to manage. While most texts are highly subspecialized or focus on only a specific area of management, The Spine Handbook provides a thorough overview of the entire spine and interdisciplinary treatment of common spinal conditions. Sections build from the foundations of history and examination, radiological imaging, and behavioral assessment through the core topics of both interventional and surgical options, as well as exploring emerging and special conditions, and neuromodulation. Chapters are written by experts from a wide array of fields, including physical therapists, radiologists, psychologists, physiatrists, anesthesiologists, orthopedic spine surgeons, and neurosurgeons. Each chapter contains key points to summarize content and discussions of anatomy, pathophysiology, presentation, imaging, and treatment options. This comprehensive handbook provides the fundamental diagnostic and therapeutic information needed to effectively deliver 'best practice' care for spinal disorders, making it a must-read for physicians of any training level that may encounter or treat spinal disorders.
Pain syndromes involve a complex interaction of medical and psychological factors. In each syndrome unique physiological mechanisms are mediated by emotional states, personality traits, and environmental pressures to determine the nature and extent of pain complaints and pain-related disability. The Handbook addresses the complexities of chronic pain in three ways. Section I describes general concerns that cross-cut the different syndromes, such as the use of narcotic pain medications, the detection of deception and malingering, and the epidemiology of pain. Section II presents comprehensive reviews of a wide range of pain syndromes. Each covers basic pathophysiology, psychological factors found to influence the course of the syndrome, and syndrome-specific multidisciplinary treatment approaches. Most of the Section II chapters are coauthored by psychologists and physicians. Section III discusses pain in special populations, including the elderly and children. The Handbook is the most up-to-date, comprehensive, and integrated single-volume resource for all those professionally concerned with pain.
