TY - JOUR
T1 - Presurgical behavioral medicine evaluation (PBME) for implantable devices for pain management
T2 - A 1-year prospective study
AU - Heckler, David R.
AU - Gatchel, Robert J.
AU - Lou, Leland
AU - Whitworth, Tony
AU - Bernstein, Dana
AU - Stowell, Anna W.
PY - 2007/6
Y1 - 2007/6
N2 - To reduce poor surgical outcomes, presurgical psychological evaluations are used to better predict prognosis. The current study investigated the utility of a revised Presurgical Behavioral Medicine Evaluation (PBME) algorithm, developed specifically for patients who were candidates for implantable devices. Patients were categorized into a Green, Yellow I, Yellow II, or Red prognosis group, with Green having the best, and Red having the worst, prognosis for good surgical outcomes. Variables, including gender, disability payment status, and involvement in pending litigation, were found to be significantly different among the groups in a sample of 95 consecutive patients. Analysis of data at the initial evaluation indicated that patients within the Red group endorsed significantly more physical/functional limitations, depressive symptomatology, and psychosocial distress than the Green group. In a 12-month follow-up analysis, significant differences among the four groups on various psychosocial measures were found. In addition, post-hoc tests revealed specific significant differences among the groups. A repeated measures analysis of the initial evaluation, 6-month, and 12-month follow-up data revealed that these measures were also significantly affected by the prognostic group. Lastly, nonparametric analysis indicated that there were significant differences among the groups on total risk factor scores as determined by the PBME algorithm.
AB - To reduce poor surgical outcomes, presurgical psychological evaluations are used to better predict prognosis. The current study investigated the utility of a revised Presurgical Behavioral Medicine Evaluation (PBME) algorithm, developed specifically for patients who were candidates for implantable devices. Patients were categorized into a Green, Yellow I, Yellow II, or Red prognosis group, with Green having the best, and Red having the worst, prognosis for good surgical outcomes. Variables, including gender, disability payment status, and involvement in pending litigation, were found to be significantly different among the groups in a sample of 95 consecutive patients. Analysis of data at the initial evaluation indicated that patients within the Red group endorsed significantly more physical/functional limitations, depressive symptomatology, and psychosocial distress than the Green group. In a 12-month follow-up analysis, significant differences among the four groups on various psychosocial measures were found. In addition, post-hoc tests revealed specific significant differences among the groups. A repeated measures analysis of the initial evaluation, 6-month, and 12-month follow-up data revealed that these measures were also significantly affected by the prognostic group. Lastly, nonparametric analysis indicated that there were significant differences among the groups on total risk factor scores as determined by the PBME algorithm.
KW - Implantable devices
KW - Presurgical screening algorithm
KW - Psychosocial risk factors
KW - Surgical outcomes
UR - http://www.scopus.com/inward/record.url?scp=34250203883&partnerID=8YFLogxK
U2 - 10.1111/j.1533-2500.2007.00118.x
DO - 10.1111/j.1533-2500.2007.00118.x
M3 - Article
C2 - 17559480
AN - SCOPUS:34250203883
SN - 1530-7085
VL - 7
SP - 110
EP - 122
JO - Pain Practice
JF - Pain Practice
IS - 2
ER -