The Post Covidl-19 world- Psychological impact and the need for Refractive based procedure screening – The Eyesenck Personality Questionnaire
The pandemic that is raging around the world has been largely recognized to cause not only a massive economic hardship on people, but also is fast turning out to have a telling effect on the mental well being of millions around the world. It is now very certain, the post covid-19 world will no longer be the same, not at least for the next year or two. The World Economic Forum predicts a secondary epidemic of burnouts and stress related absenteeism in the latter half of 2020. Low mood , insomnia, stress, depression and emotional fatigue and exhaustion may be symptoms that people in general, and patients in particular exhibit particularly, when they walk into the practice to check their eyes.
Against this background, patient’s psychological well being screening is all the more important, especially for those who are a candidate for refractive based procedures, from Lasik, ICL, to multifocal or extended depth of focus, based lenses. Many of these patients were already scheduled for surgery, when the lockdown in many countries came into effect. Screening for candidacy of patients for refractive outcomes is important, irrespective of the fact that these patients were already counselled before for refractive procedure or not. Such psychological screening should also be extended as a standard counselling tool for all refractive based procedures.
One such screening tool, or set of questions could be the application of the Eysenck Personality Questionnaire. The three broad criteria, that qualify a patient for refractive based procedures are Candidacy, Calculations and Counselling. A personality set of questions to establish candidacy and as an adjunct tool for counselling is more important in a changed world.
Personality is the aspect of a patient’s behaviour across several situations. The Eyesenck personality is based on the premise that an individual personality can be classified into Introvert/Extrovert and Stable or Neurotic. You can plot the Introvert/Extrovert on the Y axis ( Y+ and Y-) and the Stable/Neurotic on the X axis. A patient who is Introvert and Stable is classified as Phlegmatic; a patient who is classified as Extrovert and Stable is classified as Sanguine; Introvert but Neurotic is classified as Melancholic; and an Extrovert but Neurotic is Choleric. This is often referred to as the temperament theory. However, often the individual temperament may be a mix of types wherein an individual personality types may overlap. A conscious decision may have to be made in these cases, with regards to the election of patient for premium procedure.
In the context of Refractive patient screening, the Melancholic and Choleric patients are the ones that would generally be excluded from the elective procedure, irrespective of the fact that these personality types may often be shared with Phlegmatic and Sanguine nature.
A full analysis of personality traits of each of these quadrants are beyond the scope of this article. However, in the context of refractive screening of patients, the Choleric nature patients are often restless, inflexible, dominating, impatient, and irritable. The Melancholic are more analytical and may be patients with high demand and expectation. Obsession and discontentment are often words associated with such patients.
As a rejoinder, I must say that each of these personality traits have their own strengths, but from the point of view of refractive screening of patients, the choleric and melancholic personality types may not be suitable candidates for elective procedures.
As said earlier, the post Covid world would be extremely challenging and more patients will show up with high expectation, restless, demand for value of money spent, and possibly a medium to vent their pent up social and economic frustration. Centres providing refractive procedures, need to screen patients more effectively, in order to ascertain their candidature. In the post Covid world, Candidacy, Calculation and Counselling , the three Cs of the Refractive world are going to be ever important.