Identifying and optimizing psychosocial frailty in surgical practice

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery Pub Date : 2024-11-06 DOI:10.1016/j.scrs.2024.101061

Kurt S. Schultz MD, Caroline E. Richburg MD, Emily Y. Park MD, Ira L. Leeds MD MBA ScM

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引用次数: 0

Abstract

Psychosocial frailty is under-screened for and under-treated in patients undergoing surgery, even though patients with psychosocial frailty are at increased risk for postoperative complications. Numerous approaches exist to identifying psychosocial frailty in the preoperative period, ranging from neighborhood-level indices to patient-level, patient-reported data. Presurgical optimization of psychosocial frailty has returned mixed results, focusing primarily on psychological well-being with limited attention paid to addressing a patient's social risk profile. Mediators and moderators of psychosocial frailty in surgical outcomes must be further elucidated before investigators can appropriately trial psychosocial optimization programs that benefit patients. In recent years, new policies and system-level changes have incentivized screening for psychosocial frailty, and additional reimbursement strategies should be formulated to address frailty in the preoperative period in a feasible, sustainable, and cost-effective manner.

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在外科实践中识别和优化社会心理脆弱性

尽管心理社会功能虚弱的患者术后出现并发症的风险会增加，但对手术患者的心理社会功能虚弱筛查和治疗却不足。目前有许多方法可用于识别术前的心理社会脆弱性，从邻里层面的指数到患者层面的患者报告数据，不一而足。手术前优化心理社会脆弱性的结果不一，主要集中在心理健康方面，而对患者的社会风险概况关注有限。必须进一步阐明社会心理脆弱对手术结果的中介和调节因素，研究人员才能适当地试用有益于患者的社会心理优化方案。近年来，新政策和系统层面的变化激励了社会心理虚弱的筛查，应制定更多的报销策略，以可行、可持续和具有成本效益的方式解决术前阶段的虚弱问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Colon and Rectal Surgery SURGERY-

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： Seminars in Colon and Rectal Surgery offers a comprehensive and coordinated review of a single, timely topic related to the diagnosis and treatment of proctologic diseases. Each issue is an organized compendium of practical information that serves as a lasting reference for colorectal surgeons, general surgeons, surgeons in training and their colleagues in medicine with an interest in colorectal disorders.