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Presurgical Psychological Screening in Chronic Pain Syndromes - A Guide for the Behavioral Health Practitioner (Paperback)
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Presurgical Psychological Screening in Chronic Pain Syndromes - A Guide for the Behavioral Health Practitioner (Paperback)
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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.
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