Table 6 - uploaded by David Mahony
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Bariatric surgery patients are required to receive psychological clearance before they are eligible for surgery. In spite of this, there are no standard assessment practices or tests designed specifically for these evaluations.
The objective of this study is to determine the reliability and construct validity of the PsyBari, a psychological test de...
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Citations
... 5 Mahony Psychological Assessment for Bariatric Surgery (MPABS) was developed by David Mahony in 2011. 6 Mahony Psychological Assessment for Bariatric Surgery is a 5-point Likert-type self-report questionnaire consisting of 115 items in total. The original questionnaire in English has a high level of internal consistency (Cronbach's α = 0.930; 0.940 for men and 0.927 for women). ...
... The subscale of awareness of dietary restrictions that will be necessary after surgery has a low-reliability level in both sexes (<0.60). 6 The present study has aimed to translate MPABS into Turkish and to examine its validity and reliability. We assumed that the questionnaire would correlate with the eating disorder questionnaires and have subscales similar to those found in the original study and that the Turkish version will be generally valid and reliable. ...
... We also took into account the suggestions put forth in the original study and checked for items with common factor variance <0.500 and factor loadings <0.400 to remove. 6 As a result of these procedures, Table 3. ...
Background
The aim of this study was to determine the validity and reliability of the Turkish version of Mahony Psychological Assessment for Bariatric Surgery which can be easily administered and used as a guide by health professionals who will be included in the treatment of patients who are potential candidates for bariatric surgery.
Methods
A total of 310 patients who were admitted to health institutions for bariatric surgery in 3 different provinces of Turkey answered these questions in the Turkish translation of Mahony Psychological Assessment for Bariatric Surgery. Eating disorder examination questionnaire was also administered to the patients in addition to Mahony Psychological Assessment for Bariatric Surgery.
Results
Early life problems due to weight scores of women were significantly higher than men (P = .001). Among the age groups, both the early life problems due to weight scores (P = .008) and dysphoric feelings about weight scores (P < .001) of the 18-44 age group were significantly higher than the participants who are over the age of 45. There is a weak-to-medium and positive correlation between the total Mahony Psychological Assessment for Bariatric Surgery total scores and all the subscale and total scores of the Eating Disorder Examination Questionnaire (P < .05 for all). These correlation results support the co-validity of Mahony Psychological Assessment for Bariatric Surgery and Eating Disorder Examination Questionnaire. Internal consistency of the Mahony Psychological Assessment for Bariatric Surgery was at a high level except for the subscale of positive treatment attitude and supportive environment. Cronbach’s ɑ values were calculated to be 0.902 for the subscale of emotional and binge eating, 0.820 for the early life problems due to weight, 0.856 for the dysphoric feelings about weight, 0.539 for the positive treatment attitude and supportive environment, and 0.919 for the whole scale.
Conclusion
The analyses have shown that the Turkish version of Mahony Psychological Assessment for Bariatric Surgery may be used in clinical interviews and psychiatric evaluation of bariatric surgery patients in Turkey.
... I realize that I eat more at night. 27 I have difficulty in distinguishing between hunger and the desire to eat. ...
BACKGROUND
It is recommended that bariatric surgery candidates undergo psychological assessment. However, no specific instrument exists to assess the psychological well-being of bariatric patients, before and after surgery, and for which all constructs are valid for both genders.
AIMS
This study aimed to develop and validate a new psychometric instrument to be used before and after bariatric surgery in order to assess psychological outcomes of patients.
METHODS
This is a cross-sectional study that composed of 660 individuals from the community and bariatric patients. BariTest was developed on a Likert scale consisting of 59 items, distributed in 6 constructs, which assess the psychological well-being that influences bariatric surgery: emotional state, eating behavior, quality of life, relationship with body weight, alcohol consumption, and social support. Validation of BariTest was developed by the confirmatory factor analysis to check the content, criteria, and construct. The R statistical software version 3.5.0 was used in all analyses, and a significance level of 5% was used.
RESULTS
Adjusted indices of the confirmatory factor analysis model indicate adequate adjustment. Cronbach’s alpha of BariTest was 0.93, which indicates good internal consistency. The scores of the emotional state, eating behavior, and quality of life constructs were similar between the results obtained in the community and in the postoperative group, being higher than in the preoperative group. Alcohol consumption was similar in the preoperative and postoperative groups and was lower than the community group.
CONCLUSIONS
BariTest is a reliable scale measuring the psychological well-being of patients either before or after bariatric surgery.
HEADINGS:
Bariatric Surgery; Psychometrics; Psychological Tests; Obesity
... There are specific interview schedules, that could be modified as per the cultural and institutional requirements (Boston Interview and the PsyBari) [ Table 2]. [12,13] If the psychologist or MHP deems that the person lack capacity (to understand the risks, benefits, and results of the surgical procedure; a reluctance to adhere to the postoperative recommendations) or has certain psychiatric illnesses (active psychosis, mood disorder, multiple suicide attempts or a recent suicide attempt, addiction, dementia, severe mental retardation, severe life stressors) surgery should be postponed or rescinded. ...
... drug or alcohol abuse, nonstabilized psychotic disorders, severe depression, personality, and eating disorders, unless specifically advised by a psychiatrist experienced in obesity). [106][107][108][109] Nowadays, in fact, psychiatric conditions should be diagnosed and treated before addressing the patient to any bariatric surgical treatment. 5,106,110 If guidelines counseling the right procedure for bariatric surgical treatments are widely available, 107 endoscopic procedure still miss of uniform recommendations. ...
Obesity is a leading cause of preventable death in developed countries, with a rising incidence over time. Lifestyle modification, pharmacotherapy, and bariatric surgery are the mainstays of bariatric therapy, even though burdened by several limitations in terms of efficacy or safety. Bariatric endoscopy has been developed in the last decades as a minimally invasive alternative, aimed to bridge the gap between conservative and interventional conventional therapies. This review aims to provide an updated overview of the bariatric and metabolic available endoscopic procedures and to drive the choice of the right procedure for the right patient.
... Importantly, while there are published recommendations regarding the structure and content of psychosocial evaluations, consensus guidelines have not been established. [10][11][12] The 2013 clinical practice guidelines provide vague recommendations, including assessment of "environmental, familial, and behavioral factors of all patients before surgery" and of patients' "ability to incorporate nutritional and behavioral changes before and after surgery". 4 The lack of clear, published guidelines has led to significant diversity in the depth and breadth of psychosocial assessment across centers. ...
Preoperative psychosocial assessment is the standard of care for patients seeking weight-loss surgery (WLS). However, the assessment procedure varies widely by surgery site. Comprehensive assessments can provide a wealth of information that assists both the patient and the treatment team, anticipate and prepare for challenges associated with extensive behavioral and lifestyle changes that are required postsurgery. In this review, we provide an overview of the purpose of the preoperative psychosocial assessment and domains to be included. Challenges commonly identified in the assessment are discussed, including maladaptive eating behaviors, psychiatric comorbidities, and alcohol use. Potential solutions and approaches to these challenges are provided. Additionally, patient populations requiring special consideration are presented to include adolescents, those with cognitive vulnerabilities, and aging adults.
... Six of these tools, plus their revised and alternate versions, were determined to be broad in nature. Several tools in this group purported to assess a variety of eating behavior constructs or were designed to screen for multiple eating disorders and were thus categorized as Bmulti-construct^ [15][16][17][18][19][20][21][22][23][24][25][26][27][28], while the others contained subscales relevant to eating behavior alongside other subscales or items that that were not germane to eating and thus were categorized as being Bbroad^ [29][30][31][32]. The other 14 tools were more specifically focused, such as the Night Eating Questionnaire [59] and the Dutch Sweet Eating Questionnaire [62]. ...
... Females were disproportionately represented, ranging from 65.6 to 100 % of study participants. Two studies reported demographic data separately for males and females [31,65], but only the study of the PsyBari analyzed the data according to these categories [31]. Just under half of the studies (n=6) included information regarding the education level of participants, and the description of this information was inconsistent. ...
... Females were disproportionately represented, ranging from 65.6 to 100 % of study participants. Two studies reported demographic data separately for males and females [31,65], but only the study of the PsyBari analyzed the data according to these categories [31]. Just under half of the studies (n=6) included information regarding the education level of participants, and the description of this information was inconsistent. ...
The present study aims to identify the range of eating behavior self-assessment tools reported in the adult bariat-ric surgery literature and evaluate the measurement properties of these tools using pre-established criteria. This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This review revealed the use of 20 distinct tools; however, evidence for measurement properties specific to bariatric surgery populations was limited to only ten of these tools, as reported in 14 papers. Validity varied extensively and there was a widespread lack of information regarding measurement of change over time and patient burden. According to the evaluation criteria, there was adequate support for two tools. Several other tools show potential but would benefit from additional investigation of their measurement properties prior to continued use with bariatric surgery patients.
... Amongst Brazilian publications, some allusions regarding the duration of preoperative psychological evaluation were found, suggesting great variability as to the number of sessions, with some authors even mentioning that psychological assessments have been conducted in a single session, or according to the "best judgment" of each professional 13,15,19 . Another reference to time was found in a study showing that 67.4% of patients (after surgery) wanted to be better prepared, psychologically, before the surgery, with more than one session 15 . ...
... Amongst Brazilian publications, some allusions regarding the duration of preoperative psychological evaluation were found, suggesting great variability as to the number of sessions, with some authors even mentioning that psychological assessments have been conducted in a single session, or according to the "best judgment" of each professional 13,15,19 . Another reference to time was found in a study showing that 67.4% of patients (after surgery) wanted to be better prepared, psychologically, before the surgery, with more than one session 15 . ...
The prevalence of obesity on a global scale has alarmed health institutions, the general population and professionals involved in its treatment. Bariatric surgery has emerged as an effective and lasting alternative for weight reduction and improved general health. In this context and as part of a multidisciplinary team, psychologists are responsible for the preoperative psychological assessment of bariatric candidates.
To investigate how psychological assessments are occurring, including the identification of utilized resources; factors that are addressed; the duration of the process; existing protocols; and to evaluate the importance of this practice.
A systematic review of national and international literature, through PubMed and Scielo's databases, using "psychological assessment", "obesity" and "surgery", as keywords.
There is an agreement about the main factors that should be investigated during the preoperative assessment, as well as the main contraindications for the surgical procedure. The importance of the psychological assessment is well established in the field of bariatric surgery. However, this area needs a standard protocol to guide the mental health professionals that deal with bariatric patients.
... Pre-Operative Phase Psychological assessment of behavioural, nutritional, familial and personality factors should be an integral part of the patient´s pre-operative evaluation (EL C [93][94][95][96][97][98][99] ). ...
In 2012, an expert panel composed of presidents of each of the societies, the European Chapter of the International Federation for the Surgery of Obesity (IFSO-EC), and of the European Association for the Study of Obesity (EASO), as well as of the chair of EASO Obesity Management Task Force (EASO OMTF) and other key representatives from IFSO-EC and EASO, devoted the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery in advance of the 2013 European Congress on Obesity held in Liverpool. This meeting was prompted by the extraordinary advancement made in the field of metabolic and bariatric surgery during the past decade. It was agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced by focusing in particular on the evidence gathered in relation to the effects on diabetes and the changes in the recommendations of patient eligibility criteria. The expert panel allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.
... Não está bem esclarecido se esse comportamento na esfera psicológica é mais afetado pelas condições prévias à cirurgia ou pelo desconforto que as sobras de pele passam a representar com o emagrecimento acentuado. Muitos estudos têm procurado estabele cer paralelos, identificando as variáveis envolvidas nesse processo 21,22 . ...
Atualmente, a cirurgia plástica vem se firmando cada vez mais como parte integrante do tratamento cirúrgico da obesidade mórbida, na medida em que visa a devolver as melhores condições de contorno corporal ao enorme contingente de pacientes submetidos a grandes perdas ponderais. Os aspectos peculiares que acompanham essa nova trajetória do paciente obeso exigem abordagem interdisciplinar, com cuidadoso acompanhamento psicológico, antes e depois da cirurgia bariátrica, que deverá prepará-lo continuamente para as grandes transformações impostas a sua imagem corporal. Com a popularização das gastroplastias e a crescente demanda por procedimentos de contorno corporal após grandes emagrecimentos, é cada vez mais comum a presença desses pacientes nos consultórios de cirurgiões que não estão ligados aos serviços multidisciplinares, e que, portanto, precisam conhecer, avaliar e lidar também com os aspectos psicológicos envolvendo candidatos a cirurgia plástica pós-bariátrica. Este trabalho estabelece uma revisão da literatura acerca do complexo ambiente psicológico na obesidade, voltada para o cirurgião plástico, com ênfase na identificação e no controle das condições psíquicas desfavoráveis, possibilitando o melhor planejamento operatório em pacientes com perda significativa de peso após cirurgia bariátrica.
... The current study seeks to determine the sexual abuse/attack prevalence rate in BSPs using the PsyBari, a psychological test designed specifically for bariatric surgery evaluations (Mahony, 2010a). The attained rates were compared to previously reported studies that used BSPs as well as to studies using obese, non-BSPs and studies using the general population. ...
... The PsyBari is a psychological test designed specifically for bariatric surgery evaluations (Mahony, 2010a). It measures psychological and behavioral variables considered to be important in identifying patients at risk for postsurgical psychosocial problems. ...
... female patients were not included because they did not answer the sexual abuse/attack item. The reason that these patients did not answer this item is difficult to determine although it is not necessarily indicative of sexual abuse/attack status (Mahony, 2010b ...
This study assessed sexual abuse/attack histories in 573 [corrected] bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who disclosed sexual abuse/attack were more likely to disclose physical abuse, psychological problems, psychological treatment, psychiatric medication, and psychiatric hospitalization. Among bariatric surgery patients who disclosed sexual abuse/attack, females were more likely to disclose suicidal ideation. A logistic regression found that for females, physical abuse and suicidal ideation reliably predicted abuse/attack status. For males, psychological problems, psychiatric medications, hospitalization, and suicidal ideation, reliably predicted abuse/attack status.
