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Biomedical subjects

Elizabeth Broadbent

Publications and source records attributed to Elizabeth Broadbent.

8 recordsLinked to original sources
PubMed2006

Changes in patient drawings of the heart identify slow recovery after myocardial infarction.

OBJECTIVE: The objective of this study was to investigate how changes in heart attack patients' drawings of their heart over the recovery period relate to psychological and functional recovery. METHODS: Sixty-nine inpatients admitted for acute myocardial infarction at the coronary care unit at a metropolitan hospital completed questionnaires at discharge, including a drawing of what they thought had happened to their heart after their heart attack. Fifty-six patients returned follow-up questionnaires at 3 and 6 months, including heart drawings, cardiac anxiety, time to return to work, changes in exercise frequency, and healthcare use. RESULTS: Increases in the size of the heart drawn at the 3-month follow-up relative to discharge were related to slower return to work (r = 0.48, p < .01), higher cardiac anxiety (r = 0.35, p < .05), and more phone calls to health services (r = 0.37, p < .05) as well as increases in worry about another myocardial infarction (r = 0.39, p < .01), increased activity restriction (r = 0.34, p < .05), higher use of alternative medicines (r = 0.40, p < .05), and less frequent exercise (r = -0.39, p < .05) relative to before the myocardial infarction. CONCLUSIONS: Drawings of the heart may be useful in identifying patients who have experienced heart attacks who are likely to develop greater heart-focused anxiety, complaints of ill health, and higher use of health care. Increases in the size of the patient's drawing of the heart may reflect increases in the extent to which their heart condition plays on their mind and directs their daily activities.

Activities of Daily Living↗
PubMed2006

The brief illness perception questionnaire.

OBJECTIVE: This study evaluates the Brief Illness Perception Questionnaire (Brief IPQ), a nine-item scale designed to rapidly assess the cognitive and emotional representations of illness. METHODS: We assessed the test-retest reliability of the scale in 132 renal outpatients. We assessed concurrent validity by comparing the Brief IPQ with the Illness Perception Questionnaire-Revised (IPQ-R) and other relevant measures in 309 asthma, 132 renal, and 119 diabetes outpatients. Predictive validity was established by examining the relationship of Brief IPQ scores to outcomes in a sample of 103 myocardial infarction (MI) patients. Discriminant validity was examined by comparing scores on the Brief IPQ between five different illness groups. RESULTS: The Brief IPQ showed good test-retest reliability and concurrent validity with relevant measures. The scale also demonstrated good predictive validity in patients recovering from MI with individual items being related to mental and physical functioning at 3 months' follow-up, cardiac rehabilitation class attendance, and speed of return to work. The discriminant validity of the Brief IPQ was supported by its ability to distinguish between different illnesses. CONCLUSION: The Brief IPQ provides a rapid assessment of illness perceptions, which could be particularly helpful in ill populations, large-scale studies, and in repeated measures research designs.

Adaptation, Psychological↗
PubMed2005

Avoiding involuntary sleep during civil air operations: validation of a wrist-worn alertness device.

BACKGROUND: Fatigue and sleepiness may rise to unacceptably high levels during civil air operations as a result of relatively long duty periods that may coincide with the circadian low of alertness, and disruption of the circadian rhythm due to time zone shift. Previous studies investigated various measures to detect the presence of sleep. Of these, wrist inactivity was able to identify sleep lasting longer than 5 min, and an alertness device based on wrist inactivity was subsequently developed. The aim of the present study was to assess the effectiveness and utility of the device. METHODS: The alertness device was worn by 21 Air New Zealand pilots during flights between Auckland and Perth. The presence of sleepiness and sleep was determined using brain electrical activity (electroencephalogram - EEG) and eye movements (via the electrooculogram - EOG). The EEG and EOG were recorded over the entire flight and were used to validate the effectiveness of the alertness device by determining whether sleep was detected correctly. Also, the pilots assessed the effectiveness and utility of the device subjectively. RESULTS: Of the 21 pilots, 10 showed sleepiness or sleep during the flights based on the EEG and EOG. The study demonstrated that the alertness device provides an effective method for preventing or inhibiting accidental sleep. Although some sleep episodes in excess of 5 min occurred due to brief movements resetting the alarm delay timer, the efficacy of the device can be increased by modifying the alarm software to ignore brief movements within a period of sleep. The majority of the aircrew found the device acceptable to use. CONCLUSIONS: The study has shown that the alertness device can awaken pilots effectively during flight. Its anticipated use is to prevent accidental sleep during flight, and as part of cockpit napping procedures to ensure that the non-napping pilot remains awake. However, use of such a device is not intended to replace the development of rosters that minimize fatigue or to extend current duty times.

Adult↗
PubMed2004

Fatigue self-management strategies and reported fatigue in international pilots.

The use of strategies to manage fatigue associated with work was investigated in a sample of 253 pilots operating Air New Zealand regional and international routes. Overall, 13% of pilots responded that they experienced fatigue from their job as a pilot three times a week or more but no differences in overall fatigue levels were found by age, rank or fleet. The use of napping by pilots prior to an overnight duty was variable and 25% of pilots responded that they napped only a little of the time or not at all before such a duty. Pilots who routinely used daytime napping prior to overnight duties reported significantly lower levels of general fatigue. The use of the cockpit napping procedure was evenly split, with 52.5% of pilots reporting the use of cockpit napping over the previous 12 months. The use of the cockpit napping procedure was associated with lower levels of reported fatigue. Hypnotic medication use in the previous 2 months was reported by 19% of pilots mostly on an occasional basis. Melatonin and alternative medicine were used less frequently than hypnotics. This study highlights fatigue as a major problem for many pilots operating regional and international routes. The strategies used by international aircrew to manage fatigue are variable and provide support for the association between napping and lower reported fatigue.

Adult↗
PubMed2004

A picture of health--myocardial infarction patients' drawings of their hearts and subsequent disability: a longitudinal study.

OBJECTIVE: The aim of this study was to examine whether myocardial infarction (MI) patients' drawings of their hearts predict subsequent return to work, exercise, distress about symptoms and perceptions of recovery at 3 months. METHODS: Just prior to hospital discharge, 74 consecutive patients aged under 70 admitted with an acute MI drew pictures of their hearts. Patients' recovery was assessed at 3 months by postal questionnaire. RESULTS: Patients who drew damage on their heart while in the hospital perceived that their heart had recovered less at 3 months (P = .005), that their heart condition would last longer (P = .01) and had lower perceived control over their heart condition (P = .05) than did patients who drew no damage. The amount of damage drawn on the heart was also associated with a slower return to work (r = .37, P < .05). While patients' peak troponin-T in the hospital was associated with the amount of damage drawn (r = .41, P < .001), it was not associated with the speed of return to work or other 3-month outcomes, apart from perceived duration of heart condition (r = .26, P < .05). CONCLUSION: Patients drawings of damage on their hearts after a MI predict recovery better than do medical indicators of damage. Drawings offer a simple starting point for doctors to assess patients' ideas when discussing their heart condition and an opportunity to counter illness negative beliefs.

Art↗
PubMed2003

Symptom complaints following aerial spraying with biological insecticide Foray 48B.

AIM: To investigate the effect of aerial Bacillus thuringiensis (Foray 48B) spraying on self-reported symptom complaints, health perceptions, and visits to healthcare providers. METHODS: Two hundred and ninety two residents within the Ministry of Agriculture and Forestry (MAF) West Auckland spray zone were recruited by a door-to-door survey of homes within the most intensively sprayed area ten weeks prior to the first aerial spraying. Participants completed a symptom checklist and a questionnaire measuring health perceptions. Three months after the start of spraying, 181 (62%) of the original participants responded to a similar postal questionnaire. Symptom reports, health perceptions and visits to healthcare providers were compared between the baseline and the follow-up questionnaire. Rates of symptom complaints in respondents with previously diagnosed asthma, hay fever, or other allergies were compared to those in respondents without these prior health conditions. RESULTS: Symptom complaints increased significantly following the aerial spraying, in particular: sleep problems, dizziness, difficulty concentrating, irritated throat, itchy nose, diarrhoea, stomach discomfort, and gas discomfort. Analyses showed a significant increase in symptoms in those participants with a previous history of hay fever. While overall self-ratings of health decreased following the spraying, most residents saw their health as unaffected by the spray programme, and there was no significant increase in visits to general practitioners or alternative healthcare providers. CONCLUSIONS: Aerial spraying with Foray 48B is associated with some adverse health consequences in terms of significant increases in upper airway, gastrointestinal, and neuropsychiatric symptoms, as well as a reduction in overall perception of health in the exposed population./

Adolescent↗
PubMedDate not supplied

Psychological stress impairs early wound repair following surgery.

OBJECTIVE: Laboratory studies have demonstrated that psychological stress is associated with slower healing of small superficial wounds. The application of this finding to the clinical environment has not yet been undertaken. In order to do this, we investigated the relationship between psychological stress and wound repair in patients following routine surgery. METHODS: Forty-seven adults with an inguinal hernia were given a standardized questionnaire assessing psychological stress and worry about the operation before undergoing open incision repair. Wound fluid was collected from 36 participants over the first 20-hour postoperative period. Wound healing was assessed by levels of interleukin-1, interleukin-6, and matrix metalloproteinase-9 in the fluid. Other outcome measures included patient self-reports of recovery, as well as cytokine response to lipopolysaccharide stimulation of peripheral blood. RESULTS: Greater preoperative perceived stress significantly predicted lower levels of interleukin-1 in the wound fluid (beta = -0.44, p = 0.03). Greater worry about the operation predicted lower levels of matrix metalloproteinase-9 in the wound fluid (beta = -0.38, p = 0.03) as well as a more painful (beta = 0.51, p = 0.002), poorer (beta = -0.36, p = 0.04), and slower recovery (beta = 0.43, p = 0.01). CONCLUSIONS: Psychological stress impairs the inflammatory response and matrix degradation processes in the wound immediately following surgery. This finding generalizes previous laboratory research to surgical patients and expands the known influence of stress to connective tissue matrix remodelling processes. These results suggest that in clinical practice, interventions to reduce the patient's psychological stress level may improve wound repair and recovery following surgery.

Adolescent↗