How do mental health professionals evaluate candidates for bariatric surgery? Survey results
How do mental health professionals evaluate candidates for bariatric surgery? Survey results
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DOI：
10.1381/096089206776944986
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发表时间：
2006-05-01
期刊：
影响因子：
2.9
通讯作者：
Krasucki, JL
中科院分区：
文献类型：
--
作者：
Fabricatore, AN;Crerand, CE;Krasucki, JL
背景：近年来，极度肥胖的患病率和减肥手术的普及率急剧增加。许多手术程序要求候选人进行术前心理评估，但没有共识存在指导心理健康专业人员在这些evaluations.Method的行为：一项调查被送往减肥外科医生，谁被要求分发调查的心理健康专业人员，他们指的是手术候选人进行术前评估。194名受访者提供了他们使用的评估方法的信息，哪些心理社会领域是他们评估的重点，以及他们认为哪些是手术禁忌症。开放式问题的回答被编码为content.Results：大多数受访者报告使用临床访谈（98.5%），症状清单（68.6%），和客观的个性/精神病理学测试（63.4%）。少数人使用认知功能测试（38.1%）和投射人格测试（3.6%）。超过90%的受访者将心理健康问题列为最重要的评估领域。同样，92.3%的受访者将精神问题列为手术的“明确禁忌症”，但大多数受访者没有列出特定的疾病。知情同意和治疗依从性相关的问题是非精神领域最常列为重要领域的评估和禁忌症surgery. Conclusion：评估减肥手术候选人的心理健康专业人士的评估做法有很大的不同。在大型长期研究确定术后不良结局的一致心理社会预测因素之前，不太可能达成共识。
Background: The prevalence of extreme obesity and the popularity of bariatric surgery have increased dramatically in recent years. Many surgery programs require that candidates undergo a preoperative psychological evaluation, but no consensus exists for guiding mental health professionals in the conduct of these evaluations.Method: A survey was sent to bariatric surgeons, who were asked to distribute the surveys to the mental health professionals to whom they refer surgery candidates for preoperative evaluations. 194 respondents provided information on the assessment methods they use, which psychosocial domains are the focus of their evaluations, and what they consider to be contraindications to surgery. Responses to open-ended questions were coded for content.Results: Most respondents reported using clinical interviews (98.5%), symptom inventories (68.6%), and objective personality/psychopathology tests (63.4%). A minority used tests of cognitive function (38.1%) and projective personality tests (3.6%). Over 90% of respondents listed mental health issues among the most important areas to assess. Similarly, 92.3% listed psychiatric issues as "clear contraindications" to surgery, but no specific disorder was listed by a majority of respondents. Issues related to informed consent and treatment adherence were the non-psychiatric domains most frequently listed as important areas to assess and as contraindications to surgery.Conclusion: The assessment practices of mental health professionals who evaluate bariatric surgery candidates vary widely. No consensus is likely to emerge until large long-term studies identify consistent psychosocial predictors of poor postoperative outcomes.