ReviewHealthcare (Basel, Switzerland)2016
Demoralization, Patient Activation, and the Outcome of Spine Surgery.
Review in Healthcare (Basel, Switzerland), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- A comprehensive analysis of the association of psychological profiling and sagittal balance parameters with neck pain in a non-deformity cervical spondylosis population: A prospective two-centers cross-sectional study.Neurosurgical review · 2026Article
- Does grit and self-control impact outcomes following spine surgery? Early findings from a prospective study evaluating the association between grit and self-control following minimally invasive laminectomy/microdiscectomy and anterior cervical surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Observational
- Application and advances of patient activation in surgical patients.World journal of surgical oncology · 2025Review
- The Role of Psychosocial Screening in Patient Selection for Spine Surgery: A Review.International journal of spine surgery · 2023Article
- Demoralization and Suicidal Ideation in Chronic Pain Patients.Psychology research and behavior management · 2023Article
- The Role of Demoralization and Meaning in Life (DEMIL) in Influencing Suicidal Ideation Among Patients Affected by Chronic Pain: Protocol of a Single-Center, Observational, Case-Control Study.JMIR research protocols · 2020Article
- Preoperative patient activation is predictive of improvements in patient-reported outcomes following minimally invasive lumbar decompression.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
- Increased Patient Activation Is Associated with Fewer Emergency Room Visits and Hospitalizations for Pain in Adults with Sickle Cell Disease.Pain medicine (Malden, Mass.) · 2019Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
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.
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