Factors that Predict Preoperative Psychological Evaluation Recommendations for Bariatric Surgery Candidates PDF Download
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Author: Kimberly A. Wisotzke
Publisher:
ISBN:
Category :
Languages : en
Pages : 178
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Book Description
Approximately 36% of adults in the United States population are obese. Obese patients have an increased risk of mortality and morbidity, particularly related to hypertension, dyslipidemia, Type 2 diabetes, asthma, sleep apnea, and impaired psychosocial functioning. The popularity of bariatric surgery has seen significant increases in recent years as a cost-effective way to manage weight. Determining candidates' psychological suitability for bariatric surgery is complicated by the fact that research on psychosocial predictors of success and/or poor outcomes is lacking and results are inconsistent. Psychologists often develop their own guidelines to assist in deciding whether a candidate should be cleared for surgery; thus evaluation procedures and cited contraindications to surgery vary greatly among programs. This study investigated predictors of psychological evaluation recommendation status in a sample of 100 bariatric surgery candidates. The variables that were examined included demographics, Axis I and Axis II psychopathology, and data from the Millon Behavioral Medicine Diagnostic (MBMD) (i.e., coping styles, stress moderators such as social isolation, and treatment prognostics such as interventional fragility, utilization excess, and problematic compliance). Number of Axis I diagnoses, social isolation, and educational level emerged as the strongest predictors of recommendation status. Multivariate logistic regression results suggest that for every additional Axis I diagnosis, the odds of being in the delayed group are approximately 5 times higher after controlling for the other factors in the model. Participants who reported greater social isolation on the MBMD have the odds of being delayed 6% times higher than those with higher social support. For those participants whose highest level of education is grade school, the odds of being delayed were 55 times higher than those participants who completed college or beyond. Additional research into predictors of success following bariatric surgery using large-scale, prospective, longitudinal studies is needed to better inform psychological evaluations. Efforts should also be made to review one's own bariatric psychological evaluation procedure to uncover which factors are most influential in the decision-making process.
Author: Kimberly A. Wisotzke
Publisher:
ISBN:
Category :
Languages : en
Pages : 178
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Book Description
Approximately 36% of adults in the United States population are obese. Obese patients have an increased risk of mortality and morbidity, particularly related to hypertension, dyslipidemia, Type 2 diabetes, asthma, sleep apnea, and impaired psychosocial functioning. The popularity of bariatric surgery has seen significant increases in recent years as a cost-effective way to manage weight. Determining candidates' psychological suitability for bariatric surgery is complicated by the fact that research on psychosocial predictors of success and/or poor outcomes is lacking and results are inconsistent. Psychologists often develop their own guidelines to assist in deciding whether a candidate should be cleared for surgery; thus evaluation procedures and cited contraindications to surgery vary greatly among programs. This study investigated predictors of psychological evaluation recommendation status in a sample of 100 bariatric surgery candidates. The variables that were examined included demographics, Axis I and Axis II psychopathology, and data from the Millon Behavioral Medicine Diagnostic (MBMD) (i.e., coping styles, stress moderators such as social isolation, and treatment prognostics such as interventional fragility, utilization excess, and problematic compliance). Number of Axis I diagnoses, social isolation, and educational level emerged as the strongest predictors of recommendation status. Multivariate logistic regression results suggest that for every additional Axis I diagnosis, the odds of being in the delayed group are approximately 5 times higher after controlling for the other factors in the model. Participants who reported greater social isolation on the MBMD have the odds of being delayed 6% times higher than those with higher social support. For those participants whose highest level of education is grade school, the odds of being delayed were 55 times higher than those participants who completed college or beyond. Additional research into predictors of success following bariatric surgery using large-scale, prospective, longitudinal studies is needed to better inform psychological evaluations. Efforts should also be made to review one's own bariatric psychological evaluation procedure to uncover which factors are most influential in the decision-making process.
Author: James E. Mitchell
Publisher: Taylor & Francis
ISBN: 113662273X
Category : Psychology
Languages : en
Pages : 288
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Book Description
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.
Author: Ryan Joseph Marek
Publisher:
ISBN:
Category : Mental illness
Languages : en
Pages : 50
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Book Description
Introduction: Psychological comorbidity is common in bariatric surgery candidates. Many multidisciplinary teams incorporate psychometric testing to screen for psychological factors that, if left unattended, may negatively impact surgical results. Purpose: Report descriptive findings and empirical correlates of Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) scales among bariatric surgery candidates undergoing a pre-surgical psychological evaluation. Materials and Methods: The sample consisted of male (n = 324) and female (n = 658) patients seeking bariatric surgery who were administered the MMPI-2-RF at their psychological evaluation. Psychosocial and medical variables were retrospectively coded from the patients medical records. These criteria included history/current mental health diagnoses and treatments, maladaptive eating behaviors/diagnoses, past/current substance use, abuse history, sleep apnea, and denial of surgery. Results: Descriptive analyses demonstrated similar findings for male and female candidates and replicated previous reports. MMPI-2-RF scales measuring emotional dysfunction were associated with maladaptive eating patterns, a history of Major Depressive Disorder, and previous suicide attempts. Scale scores measuring behavioral dysfunction were associated with current/past substance use and previous physical abuse. MMPI-2-RF scale scores measuring somatic problems were associated with a higher BMI at the time of surgery, sleep apnea diagnosis/adherence, physical/sexual abuse history, active mood disorder, previous mental health diagnoses, and maladaptive eating patterns. Conclusions: The MMPI-2-RF can aid in identifying a broad range of psychological co-morbidity among bariatric surgery candidates. When used in conjunction with a pre-surgical psychological interview, it can aid in the assessment of psychological factors relevant to pre-surgical psychological assessment of bariatric surgery candidates.
Author: James E. Mitchell
Publisher: Taylor & Francis
ISBN: 0415949661
Category : Medical
Languages : en
Pages : 184
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Book Description
First Published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.
Author: Christopher Still
Publisher: Springer
ISBN: 149391197X
Category : Medical
Languages : en
Pages : 234
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Book Description
Developed by the American Society for Metabolic and Bariatric Surgery (ASMBS), The ASMBS Textbook of Bariatric Surgery provides a comprehensive guide of information dealing with the ever evolving field of bariatric surgery. Volume II: Integrated Health is divided into 3 sections: bariatric medicine, psychosocial and nutritional aspects of bariatric surgery. The first section deals with the psychosocial issues associated with morbid obesity. The second section deals with the role of bariatric physicians in preoperative and postoperative support of the bariatric patients. The nutritional section discusses the preoperative and postoperative nutritional support for the bariatric patient. The ASMBS Textbook of Bariatric Surgery will be of great value to surgeons, residents and fellows, bariatric physicians, psychologists, psychiatrists and integrated health members that manage the morbidly obese.
Author: Haley Marie Kiser
Publisher:
ISBN:
Category : Obesity
Languages : en
Pages : 0
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Book Description
According to the American Society of Metabolic and Bariatric Surgery (ASMBS) clinical practice guidelines, all patients seeking bariatric surgery are required to have a preoperative psychological evaluation. The purpose of the psychological evaluation is to assess current and untreated mental health diagnoses, disordered eating, substance use and psychosocial history prior to surgery (Mechanick et al., 2020). However, there is no clear guidance on how these areas should be assessed within the evaluation. These guidelines also do not provide guidance on how providers should assess family/relational contexts that may also influence the patients’ ability to modify and maintain health behaviors. This is critical information that is needed to establish consistency of the preoperative psychological evaluation process between centers to ensure equity for bariatric patients in the evaluation process between centers. This current dissertation presents the results of three studies which investigated associations between psychological evaluation pass/delay rates, demographics, current diagnoses (mental health, disordered eating, substance use), postoperative outcomes, impairment/no impairment on that piloted relational screener, and whether a patient completed the behavioral health consultation once screening as impaired. It also explored the preliminary feasibility of piloting a brief relational screener alongside the standard psychological evaluation and referral pathways. The first study provides evidence about which mental health, disordered eating, and substance use diagnoses associate with patient pass and delay rates from the bariatric surgery preoperative psychological evaluation. It also investigated reasons, recommendations, and referrals for delay and denial after the postoperative psychological evaluation. Significant associations between pass/delay rates and demographics, current mental health treatment, and having a current mental health, disordered eating, or substance use diagnosis were found. The second study sought to determine if there were differences between patients who received a pass or delay from their initial preoperative psychological evaluation and postoperative outcomes following bariatric surgery. It also sought to detect how the combination of pass/delay and select mental health diagnoses and patient demographics associate with postoperative weight- related outcomes. Significant associations between pass/delay rates with demographics and mental health, disordered eating, and substance use were found. No significant differences were found between pass/delay and postoperative complications, readmissions, and ER visits. Patients who received a delay from their initial preoperative psychological evaluation had higher weights over 12-months. The third study piloted a voluntary brief family relational screener, delivered at the same time as the standard psychological evaluation, to identify impaired family factors (i.e., family functioning, family support, relationship security, and family life events) and their associations with self-efficacy for making health behavior change and psychological evaluation pass/delay clinical decisions, and ensuing referral to a behavioral health consultation. The study interest rate was 51.1%, and the response/completion rate after determining interest was 85.1%. The majority (75.4%) of patients in the study screened as impaired on at least one assessment within the screener and were eligible for the behavioral health consultation. Forty-eight percent of patients with noted impairment) completed the behavioral health consultation. Multiple assessments within the relational screener were also significantly associated with self-efficacy scores.
Author: Andrew Block
Publisher: Amer Psychological Assn
ISBN: 9781433812422
Category : Medical
Languages : en
Pages : 296
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Book Description
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
Author: Tiffany Milligan
Publisher:
ISBN:
Category : Obesity
Languages : en
Pages : 79
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Book Description
According to the World Health Organization and National Institutes of Health, obesity is a global health problem. Worldwide, obesity is the fifth-leading cause of death. Weight loss surgeries such as gastric banding, sleeve gastrectomy, and gastric bypass surgery have become increasingly popular methods to manage intractable obesity in the United States. Such surgeries have inherent risks, both medical and psychosocial, and as a result, candidates for weight loss surgery routinely undergo pre-surgical evaluations to determine their suitability for weight loss procedures. The current study was done in partnership with Kettering Bariatrics in Kettering, Ohio, and is an analysis of the ability of their pre-surgical psychological evaluation to predict post-surgical success. In this study, success was defined as percentage of weight lost. Regression analyses examined the predictive ability of six psychological constructs and four demographic variables on weight loss at three post-surgical time points. Different predictor variables were demonstrated to predict weight loss at different post-surgical intervals. The results of this study were interpreted using Prochaska & DiClemente’s Stages of Change as a theoretical framework. The clinical implications for mental health providers working with the weight loss surgery population are discussed, and suggestions for future research are made.
Author:
Publisher: ScholarlyEditions
ISBN: 1464964203
Category : Medical
Languages : en
Pages : 2983
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Book Description
Issues in Eating Disorders, Nutrition, and Digestive Medicine: 2011 Edition is a ScholarlyEditions™ eBook that delivers timely, authoritative, and comprehensive information about Eating Disorders, Nutrition, and Digestive Medicine. The editors have built Issues in Eating Disorders, Nutrition, and Digestive Medicine: 2011 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Eating Disorders, Nutrition, and Digestive Medicine in this eBook to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Issues in Eating Disorders, Nutrition, and Digestive Medicine: 2011 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.
Author: Stephanie A. Zaleski
Publisher:
ISBN:
Category : Gastric bypass
Languages : en
Pages : 93
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Book Description
Obesity has become an epidemic in the United States, especially in the past 30 years, with the rate of obesity more than doubling. Bariatric surgery has become a more common method to deal with obesity and its associated sequelae. Before being approved for surgery, one must engage in a psychological evaluation to determine whether one has the psychological and emotional resources necessary to proceed with gastric bypass surgery. The objective of the current study was to determine whether specific psychological variables obtained during the psychological evaluation for gastric bypass surgery, specifically, the validity and clinical scales of the MMPI-2 and the SCL-90-R, and psychological variables obtained during the clinical interview, could be used to predict success post-surgery in terms of percent excess weight lost (%EWL). It was expected that clinical elevations on these scales would predict lower weight loss. Results indicated that the only significant predictor of outcome, in terms of a higher %EWL, was a lower score on subscale Pd2 (Psychopathic Deviate: Authority Problems) of the MMPI-2 at six months post-surgery. However, higher scores on scale 2 (Depression) and F (Infrequency), as well as a greater number of Axis I diagnoses, approached significance as predictors of %EWL at 6 months post-surgery. In addition, a greater number of self-reported coping mechanisms and a higher score on scale 1 (Hypochondriasis) of the MMPI-2 also demonstrated a trend towards significance for being considered significant predictors at 1 and 2 years post-surgery, respectively. None of the hypothesized predictor variables were found to be significant predictors of %EWL at 3 months, 1 year, or 2 years post-surgery, or for maintenance of weight loss from 1 to 2 years post-surgery. Limitations, strategies to overcome these limitations, and directions for future research are discussed.
