title: Presurgical Behavioral Medicine Evaluation (PBME) for implantable devices for pain management: a 1-year prospective study.
abstract: 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.
authors.affiliation: Department of Psychology, Texas Tech University, Lubbock, Texas, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Heckler
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gatchel
authors.forename: Leland
authors.initials: L
authors.lastname: Lou
authors.forename: Tony
authors.initials: T
authors.lastname: Whitworth
authors.forename: Dana
authors.initials: D
authors.lastname: Bernstein
authors.forename: Anna W
authors.initials: AW
authors.lastname: Stowell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001524:Behavioral Medicine / Q000379:methods*; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000523:psychology* / Q000601:surgery; D010147:Pain Measurement / Q000379:methods; D011300:Preoperative Care / Q000523:psychology*; D011446:Prospective Studies; D011584:Psychology; D012189:Retrospective Studies; D013997:Time Factors