Next Article in Journal
Acknowledgement to Reviewers of Healthcare in 2015
Next Article in Special Issue
A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain
Previous Article in Journal
Developing a Complex Educational–Behavioural Intervention: The TREAT Intervention for Patients with Atrial Fibrillation
Previous Article in Special Issue
Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion
Article Menu

Export Article

Open AccessReview
Healthcare 2016, 4(1), 11; doi:10.3390/healthcare4010011

Demoralization, Patient Activation, and the Outcome of Spine Surgery

Texas Back Institute, Plano, TX 75093, USA
Academic Editor: Robert J. Gatchel
Received: 25 November 2015 / Revised: 6 January 2016 / Accepted: 12 January 2016 / Published: 19 January 2016
(This article belongs to the Special Issue Low Back Pain: Recent Advances And Perspectives)
View Full-Text   |   Download PDF [178 KB, uploaded 19 January 2016]

Abstract

It is now well established that psychosocial factors can adversely impact the outcome of spine surgery. This article discusses in detail one such recently-identified “risk” factor: demoralization. Several studies conducted by the author indicate that demoralization, an emotional construct distinct from depression, is associated with poorer pain reduction, less functional improvement and decreased satisfaction among spine surgery patients. However, there are indications that the adverse impact of risk factors such as demoralization can be mitigated by psychosocial “maximizing” factors—characteristics that propel the patient towards positive surgical results. One of these maximizing factors, patient activation, is discussed in depth. The patient activation measure (PAM), an inventory assessing the extent to which patients are active and engaged in their health care, is associated not only with improved spine surgery results, but with better outcomes across a broad range of medical conditions. Other maximizing factors are discussed in this article. The author concludes that the past research focus on psychosocial risk factors has limited the value of presurgical psychological screening, and that future research, as well as clinical assessment, should recognize that the importance of evaluating patients’ strengths as well as their vulnerabilities. View Full-Text
Keywords: presurgical psychological screening; spine surgery; demoralization; patient activation; MMPI-2-RF; maximizing factors presurgical psychological screening; spine surgery; demoralization; patient activation; MMPI-2-RF; maximizing factors
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Block, A.R. Demoralization, Patient Activation, and the Outcome of Spine Surgery. Healthcare 2016, 4, 11.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Healthcare EISSN 2227-9032 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top