PubMed Health⌕ Search

Biomedical subjects

Debra K Moser

Publications and source records attributed to Debra K Moser.

At least 55 records · Page 3Linked to original sources
PubMed2003

Predictors of NCLEX-RN success in a baccalaureate nursing program as a foundation for remediation.

This study evaluated students' demographic and nursing program variables and standardized test scores to determine whether significant differences existed between students who successfully completed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and those who were unsuccessful. In addition, the predictive accuracy of two standardized examinations, the Mosby AssessTest and the Health Education Systems, Incorporated (HESI) Exit Examination were compared. Two cohorts of graduating senior nursing students were studied (1999 cohort N = 121; 2000 cohort N = 103). Demographic and nursing program variables were obtained from student records. The Undergraduate Studies Committee provided standardized test scores (Mosby AssessTest in 1999; HESI Exit Examination in 2000). Only two program variables were consistently associated with success on the NCLEX-RN--final course grade for a didactic, senior-level medical-surgical nursing course and cumulative program grade point average. Scores on both standardized tests were significantly different in students who were successful on the NCLEX-RN and those who were not. The HESI Exit Examination demonstrated greater sensitivity, specificity, positive and negative predictive value, and test efficiency, compared with the Mosby AssessTest. Use of program variables and students' standardized test scores may allow faculty to identify students at risk for failing the NCLEX-RN and to provide structured remediation so these students may be successful on the licensing examination and begin their nursing careers.

Adult↗
PubMed2003

Critical care nurses' beliefs about and reported management of anxiety.

BACKGROUND: Anxiety is associated with increased morbidity and mortality. Critical care nurses are uniquely positioned to reduce anxiety in their patients. Critical care nurses' beliefs about and frequency of use of strategies to reduce anxiety have not been studied. OBJECTIVES: To explore critical care nurses' beliefs about the importance of anxiety management and to describe nurses' reported use of strategies to manage anxiety in their patients. METHODS: A random sample (N = 2500) of members of the American Association of Critical-Care Nurses was asked to complete the Critical Care Nurse Anxiety Identification and Management Survey. RESULTS: Respondents (n = 783) were primarily female (92%), white (88.5%) staff nurses (74.1%) who thought that anxiety is potentially harmful (mean, 4.1; SD, 0.8; range, 1 = no harm to 5 = life-threatening harm), that anxiety management is important (mean, 4.8; SD, 0.6; range, 1 = not important to 5 = very important), and that effective anxiety management is beneficial (mean, 4.6; SD, 0.6; range, 1 = no benefit to 5 = profound benefit). A majority commonly used pharmacological management; most also used information and communication interventions. Fewer subjects used the presence of patients' family members to alleviate patients' anxiety; few reported using stress-reduction techniques. CONCLUSION: Most respondents thought that treating anxiety is important and beneficial. Commonly used strategies included pharmacological relief of anxiety and pain and information and communication interventions. Although these strategies are useful, they may not effectively reduce anxiety in all patients.

Anxiety↗
PubMed2002

Normal fluctuations in pulmonary artery pressures and cardiac output in patients with severe left ventricular dysfunction.

BACKGROUND: One barrier to accurate interpretation of changes in hemodynamic pressures and cardiac output is lack of data about what constitutes a normal fluctuation. Few investigators have examined normal fluctuations in these parameters and none have done so in patients with left ventricular dysfunction. AIMS: To describe normal fluctuations in pulmonary artery pressures and cardiac output in patients with left ventricular dysfunction. METHODS: Hemodynamically stable advanced heart failure patients (N=39; 55+/-6 years old; 62% male) with left ventricular dysfunction (mean ejection fraction 22+/-5%) were studied. Cardiac output and pulmonary artery pressures were measured every 15 min for 2 h. RESULTS: Mean+/-standard deviation fluctuations were as follows: pulmonary artery systolic pressure=7+/-4 mmHg; pulmonary artery diastolic pressure=6+/-3 mmHg; pulmonary capillary wedge pressure=5+/-3 mmHg; cardiac output=0.7+/-0.3 l/min. The coefficient of variation for fluctuations in pulmonary artery systolic pressure was 6.7%, in pulmonary artery diastolic pressure was 9.3%, in pulmonary capillary wedge pressure was 9.2%, and in cardiac output was 7.2%. CONCLUSIONS: Values that vary <8% for pulmonary artery systolic pressure, <11% for pulmonary artery diastolic pressure, <12% for pulmonary capillary wedge pressure, and <9% for cardiac output from baseline represent normal fluctuations in these parameters in patients with left ventricular dysfunction.

Blood Pressure↗
PubMed2002

Psychosocial factors and their association with clinical outcomes in patients with heart failure: why clinicians do not seem to care.

Poor quality of life, social isolation, depression and anxiety all have been linked to increased risk of rehospitalization and mortality in patients with heart failure. Yet, despite evidence of their importance to outcomes in heart failure patients, psychosocial factors are assessed and treated infrequently in clinical practice. Potential reasons for this include: (1) inadequate dissemination of research about the link between psychosocial factors and outcomes; (2) insufficient training in heart-mind interactions that precludes clinicians from taking advantage of what is known; (3) perceived problems with interventions or with the science of heart-mind interactions that interfere with acceptance of what is known; (4) concerns about how to measure psychosocial factors in clinical practice; and (5) lack of curiosity from clinicians about the role of psychosocial factors in their patients. In this article, each of these possible explanations is explored and recommendations suggested.

Anxiety↗
PubMed2002

The physiological response in patients with acute myocardial infarction to the administration of psychological instruments.

The administration of psychologically provocative research instruments could serve as a transient source of stress and spuriously affect results. To determine whether the administration of selected psychosocial instruments activates the stress response, we examined the physiological stress response of stable patients post-myocardial infarction (MI) to completing the Beck Depression Inventory, the Illness Perception Questionnaire, and the Spielberger State Anxiety Inventory 24 to 48 hours post-acute event. Salivary cortisol, heart rate variability (HRV), heart rate, and mean arterial pressure (MAP) were measured prior to instrument administration and 30 minutes after as indicators of the stress response. Twenty-four subjects (16 men) completed the study. Mean baseline measures of salivary cortisol (0.558 mcg/dL), heart rate (86 bpm), and MAP (86 mm Hg) were within normal ranges. A repeated-measures analysis of variance demonstrated no significant difference in salivary cortisol, F(1, 23) = 2.59, NS; HRV, F(1, 18) = 0.27, NS; heart rate, F(1, 23) = 4.29, NS; or MAP, F(1, 22) = 0.859, NS, from preinterview to postinterview. These results suggest that completing these selected psychological instruments in thefirst 24 to 48 hoursfollowing MI was not a stressful event, at least for those who were stable post-percutaneous transluminal coronary angioplasty.

Adult↗
PubMed2002

Critical care nurses' assessment of patients' anxiety: reliance on physiological and behavioral parameters.

BACKGROUND: Anxiety activates the sympathetic nervous system and hypothalamic-pituitary-adrenal axis and may increase morbidity and mortality in vulnerable critical care patients. Despite the adverse effects of anxiety, little is known about critical care nurses 'practices for assessing anxiety. OBJECTIVE: To determine the importance that critical care nurses place on evaluating anxiety and to describe clinical indicators used to assess anxiety. METHODS: Twenty-five hundred members of the American Association of Critical-Care Nurses received the Critical Care Nurse Anxiety Identification and Management Survey and were asked to rate the importance of anxiety assessment, to rate the importance of 61 anxiety indicators, and to select and rank the 5 most important anxiety indicators. RESULTS: Seven hundred eighty-three completed surveys (31.6%) were returned by female (92.0%), white (88.6%) staff nurses (74.2%) who practiced critical care nursing 32.5 hours (SD, 12.3 hours) weekly. Nearly three quarters (71.3%) of respondents thought that anxiety assessment is very important. Only 2 indicators, agitation and patients' verbalization of anxiety, were rated as very important to anxiety assessment. Thirty-nine indicators rated as important primarily included measurable physiological changes and observable behaviors. The top 5 anxiety indicators were agitation, increased blood pressure, increased heart rate, patients' verbalization of anxiety, and restlessness. CONCLUSION: Important indicators of anxiety included observable behaviors and measurable physiological changes. Reliance on these criteria may produce an inaccurate and incomplete anxiety evaluation in vulnerable patients and lead to poorer outcomes. A comprehensive, systematic anxiety assessment tool for valid and reproducible evaluation of patients' anxiety is needed.

Adult↗
PubMedDate not supplied

A cross-sectional examination of changes in anxiety early after acute myocardial infarction.

BACKGROUND: Anxiety is common after acute myocardial infarction (AMI). The assessment and treatment of anxiety early after AMI is important, because anxiety is associated with increased morbidity and mortality. Few data exist about anxiety early after AMI, the time when anxiety likely peaks. Furthermore, no researchers have evaluated potential gender differences in the evolution of anxiety after AMI. OBJECTIVES: The purpose of this study was to investigate the evolution of anxiety during the first 72 hours of hospitalization for AMI and to examine whether there is a gender difference in the pattern of anxiety early after AMI, from cross-sectional data. METHODS: In this cross-sectional study, 486 patients with AMI were recruited from 4 urban university medical centers and 2 private hospitals in the United States and 1 large university teaching hospital in Australia. The Spielberger State-Trait Anxiety Inventory was used to measure anxiety once in each patient within 72 hours of the patient's admission to the hospital. Patients were divided into 6 groups based on the time interval in which they were interviewed. RESULTS: The mean score of state anxiety was 39 +/- 13. Peak anxiety occurred within the first 12 hours after AMI (P<.05) and anxiety level differed among the time intervals (F [5, 474]=4.55, P<.001). There was a main effect of gender on anxiety (F [1, 474]=11.86, P<.001). Women reported higher anxiety than men at all time points except the time interval of 24.1 to 36 hours after AMI. CONCLUSION: Prospective, longitudinal, repeated measures research is needed to confirm the trajectory of anxiety in AMI patients, but data from this study suggest that anxiety should be assessed and treated in the early stages of AMI to prevent potential complications that may be exacerbated by anxiety and to provide comfort to AMI patients.

Academic Medical Centers↗
PubMedDate not supplied

Emotional well-being in spouses of patients with advanced heart failure.

BACKGROUND: The physical demands and psychological stressors of caregiving negatively impact the emotional well-being of spouses in many chronically ill populations such as patients with Alzheimer's disease and end-stage renal failure. Heart failure (HF) is a chronic illness with a poor prognosis that is increasing in prevalence and incidence, yet little is know about its effect on the family, particularly the spouse. OBJECTIVE: We conducted this study to describe the emotional well-being of spouses of patients with HF, to identify factors associated with spouses' decreased emotional well-being, and to compare emotional well-being between spouses with higher and lower levels of perceived control. We proposed a model that included age, sex, employment status, perceived control, and caregiver burden to explain the emotional well-being of spouses. METHODS: Data were collected from 69 spouses of patients with advanced HF (mean age 54 years and predominantly female) using 2 subscales of the SF-36, control attitudes scale-family version and caregiver appraisal tool. Descriptive statistics, Pearson correlations, and stepwise multiple regression were used to analyze data. RESULTS: The model explained 40% of the variance in the emotional well-being of spouses (P = 0.001). Perceived control (P = 0.001) and age (P = 0.046) were associated with emotional well-being. In spouses with higher levels of control, emotional well-being was significantly higher than in spouses with lower levels of control (P = 0.003). Older spouses had higher levels of emotional well-being compared with younger spouses (P = 0.01). CONCLUSIONS: Health care professionals must assess the level of control perceived by spouses of patients with advanced HF and provide information and counseling directed toward increasing their sense of control. Younger spouses are particularly at risk for decreased emotional well-being and may require special intervention.

Adult↗
PubMedDate not supplied

Two-year follow-up of quality of life in patients referred for heart transplant.

BACKGROUND: Assessment of physical and mental health has become one of the ultimate tests of health-related quality of life (HRQOL) for patients with advanced heart failure. Little is known, however, about the comparative effects of surgical or medical treatment on the HRQOL of these chronically ill patients over time. METHODS: We examined 77 patients (74% of whom were male), aged 56.1 +/- 12.7 years who were referred for heart transplant evaluation at a single heart failure center to describe the effects of time and treatment status on changes in HRQOL scores (physical and mental health and depression) using the Short Form-12 and the Beck Depression Inventory at 2 time points during their illness trajectory. The 2 evaluations on average were 2 years apart (mean 24.5 +/- 2.8 months). All patients were evaluated at baseline, and 3 groups were identified at the time of the 2-year follow-up: transplant recipients (n = 17), transplant candidates (n = 13), and medically stable patients considered too well to receive a transplant (n = 47). Nonparametric statistics were used to analyze group differences in HRQOL scores. The significance level was set at a P value less than .05. RESULTS: Demographic and HRQOL scores were not significantly different among the 3 groups at baseline. During follow-up, physical health and depression scores significantly improved over time in all patients, but changes in mental health were minimal. Group comparisons showed that although all patients continued to have low HRQOL scores at the time of follow-up evaluation, medically stable patients had higher mental health scores and less depressive symptoms than their counterparts. CONCLUSION: Our results support the need for ongoing HRQOL assessment with an emphasis on timely recognition and treatment of psychologic distress throughout the heart failure illness trajectory. Heart transplant recipients and candidates equally need special attention and follow-up because they both seem to have emotional and psychologic repercussions.

Adult↗
PubMedDate not supplied

Prevalence of myocardial ischemia during mechanical ventilation and weaning and its effects on weaning success.

BACKGROUND: Myocardial ischemia may be considered both a consequence of weaning from ventilation and a potential cause of weaning failure. A limited number of investigations have evaluated myocardial ischemia during mechanical ventilation and weaning and its effect on weaning success. The purpose of this pilot investigation was to determine the prevalence of myocardial ischemia in a diverse group of medical intensive care unit (MICU) patients during baseline mechanical ventilation, during weaning using continuous positive airway pressure, and up to 24 hours after extubation and to evaluate the relationship between ischemia and weaning failure. METHODS: This study was a prospective, repeated-measure, descriptive investigation that studied 43 ventilated MICU patients. Slightly more than half of participants were male (53%), and participants had a mean age of 51.1 +/- 14.6 years and were ventilated an average of 11.7 +/- 11.3 days. Myocardial ischemia was evaluated by examination of plasma cardiac troponin I, creatine phosphokinase-myocardial band (CK-MB), and ST-segment changes on electrocardiogram. Continuous electrocardiographic data were obtained by a calibrated, frequency-modulated, continuous 3-channel electrocardiographic recorder using leads I, II, and V2. RESULTS: Seventy percent of these participants (n = 30) exhibited ST-segment deviation at some point during data collection (baseline mechanical ventilation, during weaning, after extubation). Twenty-four participants exhibited ST-segment deviation at baseline, 7 during weaning, and 8 after extubation. Nine participants exhibited ST-segment deviation at >1 data collection time point. None had ST-segment deviation at all 3 time points. Cardiac enzyme concentrations were highly variable; five participants demonstrated clinically important increases in either CK-MB and/or troponin I. Thirty-five percent of participants required >1 weaning trial. Participants who exhibited ST-segment deviation during baseline ventilation were 60% more likely to fail their initial weaning trial. There were no significant differences in CK-MB or troponin I levels between those participants who were successfully weaned with 1 trial and those who failed to wean during that first trial. CONCLUSIONS: Silent myocardial ischemia was a common occurrence in this diverse group of MICU patients, although only 21% had previously diagnosed coronary disease. Clinicians must be aware of the potential for silent ischemia, monitor and evaluate their patients for such, and intervene to promote optimal cardiovascular function, particularly during the stress of ventilator weaning.

Adult↗
PubMedDate not supplied

Management of anxiety after acute myocardial infarction.

BACKGROUND: Anxiety is common after acute myocardial infarction (AMI) and may induce complications and poorer outcome because of activation of the sympathetic nervous system and the hypothalamic pituitary adrenal axis. Little is known about critical care nurses' management of anxiety in the initial days after AMI. OBJECTIVE: The purpose of this study was to describe pharmacological and nonpharmacological anxiety management practices in a sample of patients with AMI and to determine the association between patient self-reported anxiety level, clinician anxiety assessment, and subsequent anxiety management by clinicians. METHODS: In this descriptive, correlational investigation, subjects (n = 101) were requested to complete the Spielberger State Anxiety Inventory (SAI) within 48 hours of hospital admission for AMI. After hospital discharge, the investigators performed a thorough medical records review to evaluate the use of pharmacological and nonpharmacological anxiety management strategies for the period that encompassed 12 hours before and 12 hours after administration of the SAI. RESULTS: Subjects were primarily white (93%), married (72%) individuals with a hospital admission Killip classification of I (71%). Documentation of subjective anxiety assessment was found for only 45 subjects (44.6%). Subject rating of anxiety with SAI ranged from 20 (no anxiety) to 77 (extreme anxiety; mean, 37.2 +/- 12.4). Seventy-two subjects had documentation of anxiety management (pharmacological, 25.7%; nonpharmacological, 45.6%). No significant relationship was seen between the subject SAI score and the clinician assessment of anxiety (lambda = 0.03; P < .05). Although documentation was seen that 72 subjects received anxiety management, no association was found between the clinician evaluation of anxiety and the use of anxiety management strategies (pharmacological: lambda = 0.11; P = .65; nonpharmacological: lambda = 0.07; P = .08). A small but significant relationship was found between the subject SAI score and the use of pharmacological anxiety management (lambda = 0.10; P = .03) but no association was found between SAI score and the use of nonpharmacological anxiety management (lambda = 0.6; P = .50). Evaluation of efficacy was not routinely documented (pharmacological, 58%; nonpharmacological, 2%). Only 2 subjects (2%) received consultation to social work for management of anxiety. CONCLUSION: Anxiety was not systematically and accurately assessed or logically managed in this sample of patients with AMI. Critical care clinicians need a comprehensive understanding about the importance of anxiety to patient outcome in addition to objective, reliable, and valid anxiety measures and a useful repertoire of evidence-based management strategies to effectively manage anxiety. Effective management of anxiety positively influences patient outcome and should be a goal for all critical care patients.

Analgesics↗
PubMedDate not supplied

Using a 0-10 scale for assessment of anxiety in patients with acute myocardial infarction.

Patients with acute myocardial infarction (AMI) often experience anxiety, an emotion that predicts adverse physiologic outcomes. The purpose of this study was to determine whether a single-item anxiety assessment instrument, the Anxiety Level Index (ALI), is a valid alternative to the State Anxiety Index (SAI) or the anxiety subscale of the Brief Symptom Inventory (BSI) for assessing state anxiety for patients with AMI. In this prospective multicenter study, 243 inpatients with AMI rated their anxiety using the SAI, the anxiety subscale of the BSI, and the ALI. Anxiety Level Index scores were compared to SAI and BSI anxiety subscale scores. There were moderate, positive correlations between the SAI and the ALI (rs = 0.52, P < .001), and between the ALI and the anxiety subscale of the BSI (rs = 0.45, P < .001). Although ALI scores were moderately and significantly correlated with scores on the SAI and the BSI anxiety subscales, the results of the Bland-Altman method indicate a lack of construct validity of the single-item measure. The quest continues to construct a simple self-report measure of anxiety that is appropriate for critically ill patients with AMI.

Adult↗
PubMedDate not supplied

Physical activity patterns in heart transplant women.

Maintaining regular, long-term physical activity is critical to achieve favorable effects of heart transplantation. Yet, at present, little is known about the physical activity patterns of transplant recipients, especially women. The study was conducted to (1) describe levels and types of physical activity using actigraphy and self-report, (2) determine the association between physical activity and sociodemographic variables, and (3) assess the relationship between physical activity, quality of life (QOL), and relevant health indicators (hypertension, hyperlipidemia, and obesity) among female heart transplant recipients. Twenty-seven women (average age, 57 +/- 13 years, primarily Caucasian [82%], retired [89%], married [67%], average time since transplant 2.1 +/- 1.3 years) from a single heart transplant facility were asked to report amount and types of physical activity and overall QOL and wear an actigraph for 1 week to measure physical activity level. Physical activity levels by actigraphy averaged 280,320 +/- 52,416 counts for the week (range, 206,784-354,144); self-reported physical activity level on a 0 to 10 scale was 4.3 +/- 0.37 (range, 0-7). The actigraph and self-reported measures were significantly correlated (r = 0.661, P = .000). It was found that women were more likely to engage in household tasks and family activities than occupational activities or sports. Significant differences in physical activity (F = 6.319, P = .006) were observed in participants who reported fair (n = 13), good (n = 9), and very good (n = 5) overall QOL. The only demographic factor associated with physical activity was age; younger women were more active than older women (r = -0.472, P = .013). A negative correlation was found between levels of physical activity and presence of hypertension, hyperlipidemia, and obesity. It was found that a majority of female transplant recipients remains sedentary. Given the association between physical activity and overall QOL and relevant health indicators, measures to enhance physical activity need to be developed and tested; these strategies may be beneficial in improving overall outcomes.

Activities of Daily Living↗
PubMedDate not supplied

Factors influencing food intake in patients with heart failure: a comparison with healthy elders.

BACKGROUND AND RESEARCH OBJECTIVE: Promoting adequate nutritional intake of patients with heart failure (HF) is an essential component of comprehensive management. This goal can be hampered by decreased appetite, as well as psychological, social, and HF-related factors that can affect food intake. Factors related to aging may also affect food intake in older patients. The purpose of this study was to compare patients with HF to healthy elders regarding the extent to which they perceived how appetite and hunger, emotional and social, and illness factors affected the amount of food they ate in the previous week. SUBJECTS AND METHODS: Sixty-seven patients with HF were recruited from 3 Midwestern HF clinics. As part of a larger study examining nutrition in HF, patients filled out the Food Eating Experiences and Diet (FEED) questionnaire, an instrument designed to assess factors affecting appetite and hunger. Patients were asked to rate their hunger and appetite on a visual analog scale. On Likert-type scales, they rated the extent to which appetite/hunger, emotional/social, and illness factors affected the amount of food intake. Sixty-eight healthy elders were recruited from 2 Midwestern senior citizen centers. As part of a study collecting a large data set for comparison with HF patients, healthy elders provided demographic and health information and filled out the FEED questionnaire. RESULTS AND CONCLUSIONS: Factors rated as affecting food intake most often by patients with HF were decreased hunger sensations, diet restrictions, fatigue, shortness of breath, nausea, anxiety, and sadness. Factors rated most often by healthy elders as affecting food intake were diminished hunger sensations, early satiety, eating alone, and decreased senses of taste and smell. Among patients with HF, many factors unique from those present due to age were reported to affect food intake.

Aged↗
PubMedDate not supplied

A nursing intervention to reduce prehospital delay in acute coronary syndrome: a randomized clinical trial.

Prehospital delay in patients experiencing symptoms of acute coronary syndrome (ACS) has proved to be a significant and intractable public health problem, with minimal change in delay time over the past 2 decades despite numerous community education programs designed to reduce delay. With each 30-minute increment of delay, 1-year mortality increases by 7.5%, thus reinforcing the importance of helping patients label symptoms correctly and take appropriate action steps to seek definitive treatment. We therefore are conducting a multicenter, international clinical trial in 3,500 patients with documented coronary heart disease to determine whether a brief education and counseling intervention delivered by a nurse can reduce prehospital delay in the face of symptoms of ACS. The main outcome being studied is time from ACS symptom onset to arrival at the emergency department. Secondary outcomes include use of the emergency medical system; aspirin use; and knowledge, attitudes, and beliefs about heart attack symptoms. Patients are being followed for 2 years from the time of enrollment. The purpose of this article is to describe the intervention and its theoretical framework, and to outline the design of this randomized controlled trial.

Acute Disease↗
PubMedDate not supplied

The Minnesota Living With Heart Failure Questionnaire: sensitivity to differences and responsiveness to intervention intensity in a clinical population.

BACKGROUND: The Minnesota Living With Heart Failure Questionnaire (LHFQ) is a commonly used measure of health-related quality of life in persons with heart failure. Researchers have questioned whether LHFQ is sensitive to subtle differences and sufficiently responsive to clinical interventions because the instrument has demonstrated variable performance in clinical trials. OBJECTIVES: A secondary analysis was conducted to assess the LHFQ for sensitivity to different clinical states and responsiveness to varying intensities of clinical intervention. METHODS: A convenience sample of nine experimental or quasi-experimental studies from eight clinical sites in the United States yielded data from 1,136 patients with heart failure. Data in the studies had been collected at enrollment and one, three, and/or six months later. Data were analyzed using descriptive, univariate, and multivariate techniques. RESULTS: Total and subscale scores on LHFQ were poorer in those with worse New York Heart Association functional class, although there was no difference in LHFQ scores between classes III and IV. No difference in LHFQ scores was found when patients were classified by ejection fraction. Scores improved significantly following hospital discharge, even in those in the control group. Changes in LHFQ scores were greatest in those receiving high intensity interventions. CONCLUSIONS: The LHFQ is sensitive to major differences in symptom severity but may not be sensitive to subtle differences. It is responsive to high intensity interventions. Investigators are cautioned against using this instrument without first maximizing intervention power or without a control group for comparison.

Aged↗
PubMedDate not supplied

Effects of gender and preference for information and control on anxiety early after myocardial infarction.

BACKGROUND: Men and women differ in anxiety, which is one of the most stressful outcomes of an acute myocardial infarction (AMI). This anxiety may be moderated by coping styles of preference for information and control. OBJECTIVE: This study aimed to examine the relation of gender and preference for information and control to anxiety during the critical care period after AMI. METHODS: As part of a larger study on complications after AMI, a descriptive cross-sectional multicenter one-group investigation designed with a convenience sample of AMI patients admitted to acute care units was conducted. Within the first 48 hours after the patients were admitted to the hospital, anxiety was assessed using the State Anxiety Inventory, and preference for information and control was measured using the Krantz Health Opinion Survey. RESULTS: The sample of AMI patients (N = 410) was 68% male, 87% White, 68% married. The women were significantly older than the men (p <.05) and significantly more anxious (p <.05). Multiple stepwise regression analysis with a control for age demonstrated that neither preference for information nor preference for control moderated the relation of gender and anxiety. CONCLUSIONS: The women expressed greater anxiety than the men. However, the men and women were similar at all levels of anxiety in their preference for information and control. The search for other factors related to the stress of AMI will help healthcare providers design effective interventions to reduce anxiety among men and women.

Aged↗