676
|
Cohen C. On the quality of life: some philosophical reflections. Circulation 1982; 66:III29-33. [PMID: 6982121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Quality of life, as a concept pertaining to patients undergoing coronary artery bypass graft surgery, is explored. A theory of life quality, based on the capacity of the patient to realize his own life plans, is proposed, explaining the role of differing factors, general and individualized. Using the proposed theory, three avenues of investigation are suggested, each aimed at the more effective use of surgery in improving life quality.
Collapse
|
677
|
Raskind M, Veith R, Barnes R, Gumbrecht G. Cardiovascular and antidepressant effects of imipramine in the treatment of secondary depression in patients with ischemic heart disease. Am J Psychiatry 1982; 139:1114-7. [PMID: 6180649 DOI: 10.1176/ajp.139.9.1114] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The authors report on 12 men with ischemic heart disease who developed secondary depression following myocardial infarction or coronary artery bypass-graft surgery and were treated with imipramine hydrochloride for 4 weeks. Imipramine had an antiarrhythmic effect, manifested by reduction in premature ventricular contractions during treatment. This drug did not produce clinically significant disturbances in cardiac conduction, but orthostatic hypotension led to early termination of the drug treatment in 1 subject. Imipramine treatment was associated with significant improvement in both observer-rated and patient-rated depression scales.
Collapse
|
678
|
Budabin M. Neurologic complications of open heart surgery. THE MOUNT SINAI JOURNAL OF MEDICINE, NEW YORK 1982; 49:311-3. [PMID: 6982405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
679
|
Krantz DS, Arabian JM, Davia JE, Parker JS. Type A behavior and coronary artery bypass surgery: intraoperative blood pressure and perioperative complications. Psychosom Med 1982; 44:273-84. [PMID: 6982484 DOI: 10.1097/00006842-198207000-00005] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Previous research has suggested that Type A, compared to Type B patients undergoing coronary artery bypass surgery evidence greater intraoperative increases over hospital admission systolic blood pressure, even though patients are under general anesthesia. The present study sought to examine whether such blood pressure increases are accounted for by elevations occurring entirely during surgery (with conscious mediation minimized), or by increases occurring prior to surgery. A second purpose of the study was to examine the relationship between Type A behavior and complications occurring during and after surgery. Twenty-seven male patients given a structured interview to measure Type A behavior in advance of surgery comprised the present sample. Results indicated that interview Type A intensity was reliably related to magnitude of systolic, but not diastolic blood pressure increases during, but not prior to surgery. The 12 patients with complications (largely arrhythmias), were reliably higher in rated intensity of Type A behavior (p less than 0.01) than those without complications (n = 14). None of the Type B or Type X patients showed evidence of complications during or after surgery. Results of this study support a body of data linking Type A behavior to cardiovascular reactivity and clinical complications of coronary disease. Since this reactivity is evident under general anesthesia, these data further suggest that conscious mediation may not always be necessary in order to elicit these responses.
Collapse
|
680
|
Abstract
Research indicates that patients do not hold delusions with as fixed a certainty as has been believed. Confrontation with reality may have an important role in the evaluation and treatment of delusional patients. The authors suggest four factors that may help predict the value of reality confrontation in a given clinical situation: 1) how understandable the delusion is in the context of the patient's life, 2) the degree of conviction with which the patient holds the delusion, 3) the phase in development of the delusional beliefs, and 4) the diagnosis of the patient.
Collapse
|
681
|
Dubois C. [Rehabilitation of aortocoronary bypass patients: social reinsertion and preventive counseling. Psychological aspects]. SOINS. CHIRURGIE GENERALE ET SPECIALISEE 1982:37-9. [PMID: 6981210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
682
|
Abstract
What is thought to be the first case of coronary artery bypass in a patient on lithium carbonate prophylaxis is presented. A postcardiotomy delirium developed on day 2 and appeared unrelated to the underlying manic-depressive illness. A 2-year follow-up indicated apparent resolution of pre-existing psychological difficulties and no recurrence of somatic symptoms. It is suggested that lithium carbonate prophylaxis be continued with appropriate monitoring during coronary artery bypass procedures.
Collapse
|
683
|
Zyzanski SJ, Rouse BA, Stanton BA, Jenkins CD. Employment changes among patients following coronary bypass surgery: social, medical, and psychological correlates. Public Health Rep 1982; 97:558-65. [PMID: 6983084 PMCID: PMC1424376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The relations of socioeconomic and psychological factors to resumption of employment following coronary artery bypass surgery were studied using a questionnaire returned by a sample of 426 men and 70 women. The sample was drawn from the membership of Mended Hearts, Inc., a nationwide voluntary organization of persons who have had heart surgery. Preoperatively, more men (92 percent) than women (59 percent) were employed. Return to work rates were high for men (81 percent) and much lower for women (58 percent). The 395 men tended to return to work an average of 3.7 months after surgery whereas the 41 women took an average of 4.8 months. Return to work following surgery was most clearly related to socioeconomic level for both sexes. In addition, for men, those most likely to return had less postoperative morbidity and held jobs requiring little physical exertion. Patients who reported that they were forced into an early retirement represent a particularly vulnerable group in that they were more likely to experience the most postoperative morbidity. As a group, they believed that their physicians had least prepared them to return to work, and they experienced the poorest emotional adjustment. Thus, women and those forced into early retirement represent two potentially high-risk groups of patients who would seem to require additional clinical and psychological management following surgery.
Collapse
|
684
|
David P, Boulay F, Bourassa MG. [Return to work can be improved following aortocoronary bypass]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1982; 166:85-93. [PMID: 6756570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
685
|
Wilson-Barnett J. Assessment of recovery: with special reference to a study with post-operative cardiac patients. J Adv Nurs 1981; 6:435-45. [PMID: 6976363 DOI: 10.1111/j.1365-2648.1981.tb03247.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The recovery process is dependent on many psychological and physical factors. In this paper recovery refers to major, short-term illness often treated by surgery, which is not expected to result in permanent disability or handicap. Research reviewed which attempts to identify influences on recovery also shows how many patients are left with a degree of disability, usually for psychological reasons. It is suggested that the stress and impact of severe illness and surgery may have a long lasting, previously unrecognized effect. Nursing which studies the interaction of physical and psychological aspects of illness and care is seen as the most suitable discipline from which to assess recovery and identify risk factors. A study reported here with patients after coronary artery grafting, provides information on recovery and illustrates how many aspects of a patients' experience may help or hinder this process. Data is obtained from patients' interviews to give a wider, more humanistic evaluation of outcome than is usually employed for this type of surgery.
Collapse
|
686
|
Neale A. Patient-physician dialogue improves medical decisions. HOSPITAL PROGRESS 1981; 62:45-7. [PMID: 10295135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
687
|
Salinger R, Bond CA. Bipolar affective disorder following coronary bypass surgery. J Clin Psychiatry 1981; 42:354-5. [PMID: 6792189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Bipolar affective disorders characterized by mania and depression have not previously been reported as a complication of coronary bypass surgery, although pure depressive symptoms are well known. This case describes a 46 year old male, with a negative psychiatric history, who developed mania as well as depression after having two vessel bypass surgery on his right coronary artery. The patient's history and symptoms of mania and depression met research criteria for the diagnosis of a bipolar affective disorder, and he responded well to lithium carbonate.
Collapse
|
688
|
Burns-Stewart S. Professional sharing. 1. Bedside report: a critical issue. Crit Care Nurse 1981; 1:6-7. [PMID: 6975700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
689
|
Hansen M, Lavandero R. A multidisciplinary education program for patients undergoing cardiovascular surgery. QRB. QUALITY REVIEW BULLETIN 1981; 7:19-24. [PMID: 6789271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
690
|
Ramshaw JE, Stanley G. Individual differences in life-style response to coronary artery bypass surgery. THE BRITISH JOURNAL OF MEDICAL PSYCHOLOGY 1981; 54:83-9. [PMID: 6972780 DOI: 10.1111/j.2044-8341.1981.tb01473.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Fifty-three patients who had undergone coronary artery bypass surgery 12 to 27 months previously were given four standard personality questionnaires and asked to write about the main effects the operation had on their life-styles. These responses were then content analysed. Although hierarchical grouping analysis indicated that the responses could best be classified into four groups, only three distinct response profiles emerged. The first group described mainly adverse consequences of surgery; the other three groups described the effects of surgery as beneficial. Personality test data suggested that individual personality and coping style considerably influence a patient's perception of surgical outcome, and that this perception is largely independent of cardiac symptoms.
Collapse
|
691
|
Pliskin JS, Stason WB, Weinstein MC, Johnson RA, Cohn PF, McEnany MT, Braun P. Coronary artery bypass graft surgery: clinical decision making and cost-effectiveness analysis. Med Decis Making 1981; 1:10-28. [PMID: 6820456 DOI: 10.1177/0272989x8100100104] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Decision-analytic techniques were used to evaluate the choice between an aortocoronary bypass operation and medical management in a set of hypothetical patients with coronary artery disease. The decision framework incorporates variables believed to have an important bearing on the choice of treatment. Probability estimates were obtained from two cardiologists and one cardiac surgeon. Patient preferences for the trade-off between years of survival and the quality of life as reflected by the severity of angina pectoris were made explicit by assigning utility values to alternative health outcomes. The results are expressed in terms of quality-adjusted years of life expectancy. Decision analysis favored operation for 13 of the 14 hypothetical patients, including patients with one- and two-vessel disease. The one patient for whom medical treatment was preferred had mild angina pectoris, severe left ventricular dysfunction, and a poor prognosis regardless of therapeutic modality. The results are sensitive to changes in the probability of long-term survival, but not to changes in operative mortality rates. In five patients, the physicians' clinical judgments favored medical treatment, whereas their decision-analysis-derived estimates of survival favored operation. Possible explanations for these discrepancies are discussed. A simplified cost-effectiveness analysis for patients in whom surgery was the optimal treatment indicated costs ranging from $1,500 to $250,000 per year of life gained and from $1,500 to $32,000 per quality-adjusted year of life gained.
Collapse
|
692
|
Zyzanski SJ, Stanton BA, Jenkins CD, Klein MD. Medical and psychosocial outcomes in survivors of major heart surgery. J Psychosom Res 1981; 25:213-21. [PMID: 6973628 DOI: 10.1016/0022-3999(81)90035-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
693
|
Abstract
To describe psychosocial adaptation after coronary artery surgery and to identify preoperative factors associated with good outcome, the authors interviewed 30 patients before and 1--2 years after surgery. Despite good physiologic outcome (as measured by treadmill and cardiac function) this sample was found to be functioning poorly. Eighty-three percent were unemployed, and 57% were sexually impaired. A preoperative duration of symptoms of eight months or more was associated with significantly worse postoperative overall adaptation. Most patients who had suffered angina eight months or longer evidenced a damaged self-concept, which was reinforced rather than repaired by the experience of surgery.
Collapse
|
694
|
Contini L. Hymn to life. SUPERVISOR NURSE 1980; 11:39-42. [PMID: 6969455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
695
|
Hélie F. [An opinion survey of surgical patients provided with useful anti-anxiety measures]. L' INFIRMIERE CANADIENNE 1980; 22:14-7. [PMID: 6966617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
696
|
Jamail D. Open heart surgery and All That Jazz! BIOMEDICAL COMMUNICATIONS 1980; 8:10-1. [PMID: 10294992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
697
|
Romirowsky S. Psychological adaptation patterns in response to cardiac surgery. JOURNAL OF REHABILITATION 1980; 46:50-2. [PMID: 6967116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
|
698
|
Reznick SM. A case of depressive neurosis following aortocoronary artery bypass surgery. MARYLAND STATE MEDICAL JOURNAL 1980; 29:75-7. [PMID: 6966724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
699
|
Cromwell V, Huey R, Korn R, Weiss J, Woodley R. Understanding the needs of your coronary bypass patient. Nursing 1980; 10:34-41. [PMID: 6965775 DOI: 10.1097/00152193-198003000-00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
700
|
Nursing grand rounds. Meeting the needs of your coronary bypass patients. Nursing 1980; 10:40-5. [PMID: 6965776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|