How can presurgical psychological screening be helpful for medical practitioners?
Emotional, behavioral, cognitive, and social factors contribute considerably to treatment outcomes, and the pain experience varies greatly among individuals with even the same pain conditions. Presurgical psychological evaluations can optimize treatment outcomes and are an essential component of the medical decision when determining patient eligibility for surgery. Poor surgical outcomes are not only costly and time-consuming for patients and providers but can be tragic for the patient. Not uncommonly, patients report having their hopes dashed when they experience limited benefit from yet another treatment that they believed would be providing substantial pain relief. Presurgical psychological evaluation, which relies on an empirical approach to make recommendations based on psychodiagnostic assessment and medical information, will help ensure that patients possess the basic knowledge and cognitive capacity necessary to understand the mechanisms involved in the proposed procedure, including the risks and benefits, and are able to provide consent for surgery. The evaluation and delivery of psychoeducation can also prepare patients psychologically for the surgery, assess motivation, and help develop feasible and realistic expectations for pain reduction with the outcome of the intervention. In addition to the psychoeducation component, presurgical psychological evaluation can assess and quantify the extent to which psychological, social, cultural, and behavioral factors may contribute to surgical outcomes. For example, it can identify patients at heightened probability to experience poor outcomes, overutilize health care and prescription medications, adhere to postsurgical recommendations, decompensate or improve psychologically, and engage in litigation or make extreme requests to the medical treatment team. Moreover, the patient’s psychosocial and behavioral strengths and vulnerabilities can be identified and considered in treatment planning to optimize outcomes. The information obtained from the presurgical psychological evaluation can inform individualized treatment planning for each patient and provide information to determine if the patient is suitable for the surgery or if a decision should be made to delay the surgery until after the provision of psychological treatment and reduction of psychiatric distress. This approach has been found to improve surgical outcomes.