Biomedical subjects

J D Putzke

Publications and source records attributed to J D Putzke.

16 recordsLinked to original sources

PubMed2002

Pain classification following spinal cord injury: the utility of verbal descriptors.

OBJECTIVES: To determine the predictive utility of verbal descriptors to distinguish between pain types following spinal cord injury (SCI). DESIGN: Cross-sectional. SETTING: USA. METHODS: Participants (n=29) completed the Short Form - McGill Pain Questionnaire (SF-MPQ) for each pain site reported. A total of 64 pain sites were reported with 80% of the sample reporting multiple pain sites. Each pain site was categorized using three different SCI pain classification schemes. The predictive utility of verbal descriptors to distinguish between pain types was examined statistically using (1) each word separately, (2) a combination of words (ie, the SF-MPQ total subscales, the number of words chosen on each scale), and (3) discriminant function analysis. RESULTS: There was a substantial overlap in the use of verbal descriptors across pain types. Few differences across pain types were found for endorsement of individual words, and differences across pain types were not found for any of the word combination scores. The majority of the verbal descriptors did not enter the step-wise discriminant functions for each SCI pain classification scheme, however, 'tingling' and 'aching' showed modest predictive utility for neuropathic and musculoskeletal pain, respectively. Correct classification was in the low range (ie, 39% to 82%, average=60%, with a 33% chance level). All three pain classification schemes showed the same general pattern of results. CONCLUSION: In general, verbal descriptors alone offered marginal utility with regard to identifying specific pain types following SCI. Future directions alone and implications are discussed.

Adult↗

PubMed2001

Quality of life after spinal cord injury caused by gunshot.

OBJECTIVE: To determine what effect gunshot-caused spinal cord injury (SCI) has on self-reported quality of life (QOL) and on the frequency of pain sufficient to interfere with day-to-day activities. DESIGN: Follow-up, case-control design. SETTING: Analysis of data obtained from the (US) National Spinal Cord Injury Statistical Center from 18 funded Spinal Cord Injury Model Systems. PARTICIPANTS: Individuals with traumatic onset SCI (n = 1901). From these, 111 persons with gunshot-caused SCI were matched to persons with nongunshot SCI. MAIN OUTCOME MEASURES: Satisfaction with Life Scale (SWLS), the Craig Handicap Assessment and Reporting Technique (CHART), Medical Outcomes Study Short-Form Health Survey (SF-12), and an individual pain item from the SF-12. RESULTS: No between-group differences were found on any of the QOL outcome measures. In contrast, those with SCI caused by gunshot reported that pain more frequently interfered with day-to-day activities than the matched comparison group. CONCLUSIONS: SCI caused by gunshot appears largely unrelated to QOL, after controlling for demographic and medical characteristics associated with this group. Gunshot as a mechanism of SCI may place individuals at an increased risk of subsequent development of pain that interferes with activities of daily living.

Adult↗

PubMed2001

Developmental memory performance: inter-task consistency and base-rate variability on the WRAML.

Two studies examined developmental memory test consistency and base-rate variability on the Wide Range Assessment of Memory and Learning (WRAML) using three age cohorts from the standardization sample. Study 1 examined inter-subtest correlation coefficients across the nine subtests of the WRAML and compared across three age cohorts (5, 11, 16 to 17 year olds). An age-related increase in inter-task consistency was found (mean r = .26 and .42 for the youngest and oldest age groups, respectively). However, correlation coefficients were generally in the low to moderate range (rs = .2 to .5) for all three cohorts suggesting considerable performance variability across memory subtests. Study 2 examined base-rate variability in the WRAML standardization sample using several different methods. More specifically, base-rate information is provided for the maximum discrepancy between subtests, profile strengths and weakness (i.e., discrepancies from the mean scaled score), and the prevalence of individuals within the "deficient" performance range (i.e., < = 2 SD below normative means). In addition, performance variability across the four WRAML index scores was examined by determining the prevalence rates for the maximum discrepancy (1) between index scores, and (2) from the General Memory Index compared to the other three index scores. Performance discrepancies tended to be higher among the youngest group. Again, however, considerable performance variability was observed across all three age cohorts. Implications for clinical practice are discussed.

Adolescent↗

PubMed2001

Predictors of pain 1 year post-spinal cord injury.

OBJECTIVE: To determine the predictive validity of demographic and medical characteristics to the subsequent development of pain 1 year post-spinal cord injury (SCI). DESIGN: Prospective longitudinal design using data from 18 Model Spinal Cord Injury Systems of Care. PARTICIPANTS: Adults 18 years or older with traumatic-onset SCI (n = 540) evaluated at 1 year postinjury. OUTCOME MEASURES: A single item from the Short Form-12 that assessed pain interference in day-to-day activities using a 5-point Likert scale. PREDICTOR VARIABLES: Demographic and medical characteristics, individual and total medical complications during rehabilitation, and insurance provider. RESULTS: Univariate analyses showed age, education, marital status, primary occupation at the time of injury, American Spinal Injury Association motor score, and sponsor of care to be related to pain interference 1 year post-SCI. Polychotomous logistic regression indicated that age and occupational status at the time of injury were the only significant unique predictors of pain interference. The youngest (aged 18-29 years) and oldest (aged 60 years and older) age groups reported the least amount of pain interference, whereas individuals unemployed at the time of injury were significantly more likely to report pain interference. None of the other predictor variables was significant. CONCLUSION: Age and occupational status appear to be important predictors of pain interference 1 year post-SCI. Future directions of study and limitations are discussed.

Adult↗

PubMed2001

Impact of demographic and medical factors on satisfaction with life after spinal cord injury: a normative study.

OBJECTIVE: The aim of this study was (1) to examine demographic and medical predictors of the Satisfaction With Life Scale (SWLS) among individuals with spinal cord injury (SCI) and (2) to provide a normative table for the SWLS that includes appropriate adjustments for the most important predictors of life satisfaction. STUDY DESIGN: We examined predictors of the SWLS including age, education, sex, race, injury duration, number of rehospitalizations, marital status, employment status, SCI etiology, and level of neurological impairment. PARTICIPANTS: Individuals in the National Spinal Cord Injury Statistical Center database [from 18 SCI model systems (1995-1999)] undergoing follow-up assessment were included for study. OUTCOME MEASURE: Satisfaction With Life Scale. RESULTS: Univariate analyses indicated that marital and employment status, race, sex, education, and injury duration were significant factors associated with scores on the SWLS. In general, individuals who were female, white, married, and currently employed and had a higher education and longer injury duration reported significantly higher scores on the SWLS (P < .01). Effect-size estimates for these factors ranged from 0.16 to 0.41. Regression analyses showed that education, employment status, and injury duration were the strongest unique predictors of satisfaction with life but accounted for only 10% of the variance. CONCLUSION: The SWLS is a global measure of life satisfaction and is relatively unrelated to demographic and medical characteristics. Normative tables are provided for epidemiologic comparison.

Adolescent↗

PubMed2001

Gunshot versus nongunshot spinal cord injury: acute care and rehabilitation outcomes.

OBJECTIVE: To examine the impact of gunshot-caused spinal cord injury on acute and rehabilitative care outcome using a case control design. DESIGN: Two groups (i.e., gunshot- vs. nongunshot-caused spinal cord injury) of 212 individuals were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, primary occupation, impairment level, and Model System region. Outcome measures included length of hospital stay, functional status (FIM), treatment charges, and home discharge rates. RESULTS: The two groups did not differ in the length of stay during acute and rehabilitative care, charges during rehabilitative care, or postrehabilitation discharge placement. Several significant between-group differences in treatment procedures were noted (e.g., prevalence of spinal surgery), which may, in part, account for the higher acute-care charges among those persons with nongunshot-caused spinal cord injury. CONCLUSION: Once an individual is stabilized and admitted for rehabilitative care, gunshot etiology of spinal cord injury seems largely unrelated to the initial rehabilitation outcome.

Adult↗

PubMed2001

Nursing home residence: quality of life among individuals with spinal cord injury.

OBJECTIVE: To examine the quality of life among individuals with spinal cord injury currently living in a nursing home vs. community residence. DESIGN: A case-control design matched nursing home and community residents on numerous demographic and medical characteristics. Two groups of 37 individuals (nursing home vs. community residents) were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, and impairment level. Etiology of spinal cord injury, American Spinal Injury Association Impairment Index at the time of rehabilitation discharge, and injury duration, although not specifically matched, were not significantly different between groups (P > 0.05). Outcome measures included the Satisfaction With Life Scale, and the Craig Handicap Assessment and Reporting Technique (CHART). RESULTS: Results indicated that overall self-reported quality of life was significantly lower among nursing home residents compared with matched community-dwelling residents (mean = 18 and 14, respectively). Similarly, self-reported handicap was significantly higher among the nursing home residents compared with community residents (mean = 337 and 181, respectively), particularly in the areas of physical independence, mobility, occupational functioning, and economic self-sufficiency (P < 0.05). In contrast, the score on the CHART social integration subscale was similar across groups (P > 0.05). CONCLUSION: Despite matching numerous variables, the nursing home residents demonstrated significantly lower quality of life across multiple domains as compared with their community-dwelling counterparts. Additional research is needed to examine the specific mechanisms associated with these differences.

Adult↗

PubMed2001

Bladder management and quality of life after spinal cord injury.

OBJECTIVE: This study examines the quality of life among individuals with spinal cord injury requiring assistance for bowel and bladder management vs. those with independent control of bowel and bladder. DESIGN: Two groups of 53 individuals each were matched case for case on age, education, sex, race, and lesion level. Outcome measures included the Satisfaction With Life Scale, the Craig Handicap Assessment and Reporting Technique (CHART), and the SF-12. RESULTS: Satisfaction with life was significantly lower among dependent individuals with impaired bowel and bladder functioning as compared with individuals with independent bowel and bladder control. Similarly, dependent individuals reported greater self-reported handicap (CHART) than independent individuals in the areas of physical independence, mobility, and occupational functioning. However, dependent and independent individuals did not differ in the areas of social integration and economic self-sufficiency. Item analysis on the CHART item assessing number of social contacts initiated in the previous month suggested that dependent individuals may have difficulty initiating new social contacts. Independent individuals reported better overall physical health (SF-12) than dependent individuals. Mental health (SF-12), however, did not differ across groups. CONCLUSIONS: Individuals with impaired bowel and bladder control reported lower quality of life on several domains compared with those with independent control of bowel and bladder. Though the two groups did not differ in self-reported social integration, dependent individuals may have greater difficulty creating new social relationships.

Adult↗

PubMed2001

Self-report measures among transplant candidates: the impact of evaluative situations.

Experiment 1 was a between-subjects design comparing transplant candidates completing self-report measures under an evaluative versus an anonymous research condition. A cardiac disease group and a healthy community group served as controls. Transplant candidates in the anonymous research condition reported significantly more depression, anxiety, and negative affectivity as compared with transplant candidates in the evaluative condition and community controls. In contrast, the evaluative transplant group (a) did not differ from the community controls on any of the self-report measures, and (b) reported significantly less depression than cardiac disease controls. Experiment 2 was a within-subjects design with transplant candidates completing self-report measures under both an evaluative and an anonymous research condition. Significantly greater anxiety was reported under the anonymous research condition. Social desirability was significantly related to change in self-reported anxiety and depression across conditions, but was unrelated to change in endorsement of personality characteristics.

Affect↗

PubMed2000

Activities of daily living among heart transplant candidates: neuropsychological and cardiac function predictors.

BACKGROUND: The ability of patients to perform day-to-day tasks (e.g., medication management, dietary regulation) is an important concern of transplant teams. METHODS: We studied a clinical series of 75 heart transplant candidates and 38 controls to examine the predictive validity of demographic, neuropsychologic, and cardiac function variables to a performance-based measure of instrumental activities of daily living (IADL) capacity (i.e., Everyday Problems Test, EPT). RESULTS: Multiple regression analyses, controlling for education and race, indicated that neuropsychologic tests accounted for between 34% and 67% of the variance across IADL domains (e.g., cooking, household chores, medication management). The IADL capacity was most consistently predicted by long-standing verbal ability (Shipley Institute of Living Scale-Vocabulary, SILS-VOC) and psychomotor speed and mental flexibility (Trail Making Test-Part B, TMT-B). Similarly, SILS-VOC and TMT-B also tended to show the best operating characteristics (i.e., sensitivity, specificity, positive predictive power, negative predictive power) for detection of dependence across IADL domains. In contrast, cardiac function measures (e.g., cardiac output, mean atrial pressure) were largely unrelated to the patient's performance on the paper-and-pencil EPT task. CONCLUSIONS: Long-standing intellectual ability, and a measure of speeded information processing and mental flexibility are the best predictors of IADL capacity.

Activities of Daily Living↗

PubMed2000

Neuropsychological functioning among heart transplant candidates: a case control study.

Neuropsychological performance was examined among a group of patients with end-stage heart disease undergoing routine evaluation for transplantation using a matched case-control design. Heart transplant candidates and controls were matched case by case for gender, race, education and age range. In order to match all 44 controls, a clinical series of 303 heart transplant candidates evaluated between October 1995 through March 1998 were considered. Although not specifically matched on variables of estimated IQ and socioeconomic status, statistical analysis showed no group differences on these variables. A separate analysis of variance on each neuropsychological test indicated that the heart transplant candidates performed significantly worse than controls on tasks of fine motor speed and dexterity (i.e., Grooved Peg Board), psychomotor speed and mental flexibility (i.e., Trail Making Test, Part B), and abstract reasoning and problem solving ability (i.e., Shipley Institute of Living Scale-Abstraction subtest). Implications of the results and future directions are discussed.

Adult↗

PubMed2000

Neuropsychological performance as a function of cardiac status among heart transplant candidates: a replication.

This study examined the relationship between cardiac function and cognitive test performance among candidates for heart transplant. Participants were 26 individuals undergoing heart catheterization within one day of completing a battery of cognitive tests. Partial correlation analyses controlling for age and education were used to examine the relationship between cardiac function and cognitive performance. Results replicate previous findings in that increasing hemodynamic pressure variables, e.g., pulmonary artery systolic pressure, were associated with decreased cognitive performance on a measure of psychomotor speed and attention (Trail Making Test-Part A: r=.53). In contrast, cardiac output and cardiac index appeared to be not significantly related to cognitive performance. Taken together, poor performance on cognitive tests among heart transplant candidates appears to be attentionally mediated.

Attention↗

PubMed1999

The utility of K-correction to adjust for a defensive response set on the MMPI.

This study examined the utility of the K-correction procedure to adjust for a defensive response set on the MMPI. The sample consisted of 61 patients with end-stage lung disease undergoing psychosocial evaluation for transplantation. Participants were separated into defensive and non-defensive groups using a median split on the K scale (defensive group T score 59) as the cutoff score. The MMPI was scored once in the standard manner and then rescored omitting all K-scale items from the clinical scales. As hypothesized, raw score analysis after omitting K-scale items showed the defensive group endorsed significantly fewer items on all five scales involving K-correction (Scales Hs, Pd, Pt, Sc, Ma). Analysis of K-corrected T scores on Scales Hs, Pd, Pt, and Sc using standard procedures showed a significant group difference only on Scale Hs with a higher T score found among the defensive group. The defensive and nondefensive groups were not significantly different in demographic, medical, or psychiatric characteristics suggesting that the tendency to respond in a defensive manner is the major characteristic that distinguishes the two groups. Taken together, these results provide support for the use of the K-correction procedure when examining MMPI clinical profiles among patients with end-stage pulmonary disease undergoing evaluation for transplantation.

Adaptation, Psychological↗

PubMed1998

The relationship between cardiac function and neuropsychological status among heart transplant candidates.

BACKGROUND: Cognitive deficits among heart transplant candidates have been well documented. This study was designed to examine the hypothesis that impaired cognitive test performance among heart transplant candidates may be attributed, in part, to decreased cerebral perfusion secondary to poor cardiac function. METHODS AND RESULTS: Sixty-two patients participated in the study who underwent heart catheterization within 1 day of completing a battery of cognitive tests. Multiple demographic and patient characteristics were examined for their potential moderating role in the relationship between measures of cardiac function and cognitive performance including age, education, race, gender, psychiatric history, medication usage, cardiac surgical history, and self-reported symptoms of depression and anxiety. Only age and education were significantly related to cognitive performance (P < .01). Thus, partial correlation analyses controlling for age and education were used to examine the relationship between cardiac function and cognitive performance. In general, increasing hemodynamic pressure variables (ie, pulmonary artery pressure and right atrial pressure), and to a lesser extent cardiac output and cardiac index, were related (r = - .32 to - .43; P < .01) to decreased performance on cognitive tasks that assessed simple attention, speed of mental processing, and mental flexibility (Digit Span-Forward, Trail Making Test-Part B, Symbol Digits Modalities Test, and Stroop Neuropsychological Screening Test). Left ventricular ejection fraction, systemic and pulmonary vascular resistance, and mean arterial pressure were largely unrelated to cognitive performance in this sample of patients with end stage cardiac disease. CONCLUSIONS: Hemodynamic pressure variables seem to be most consistently related (ie, inversely) to cognitive functioning among heart transplant candidates.

Cognition Disorders↗

PubMed1998

Does memory test performance in children become more consistent with age? Cross-sectional comparisons using the WRAML. Wide Range Assessment of Memory and Learning.

This study examined intertask consistency on the Wide Range Assessment of Memory and Learning (WRAML), using two age cohorts of children. Eighty-one neurologically impaired children and 76 matched (i.e., age, gender, race) controls were separated into two age groups, 5- to 9- and 10- to 14-year-olds. Performance on four subtests from the WRAML Memory Screening Index were examined. For the older neurologic sample, all six intertask correlations were significant (mean r = .58) while only three of the six correlation coefficients were significant among the younger neurologic group (mean r = .26). In contrast, only three of the six intertask coefficients were statistically significant in both the younger and older controls. A possible explanation for these divergent findings and clinical implications of intertask variability on memory measures are discussed.

Adolescent↗

PubMed1998

A defensive response set and the relation between cognitive and emotional functioning: a replication.

This study was designed to examine the hypothesis that a defensive self-report response set tends to attenuate the strength of the relationship between self-reported emotional functioning and cognitive tests, particularly the functioning of verbal memory. 75 patients with end-stage lung disease were administered the MMPI and a cognitive test battery as part of a psychosocial evaluation for transplantation. Patients were separated into defensive and nondefensive groups using the MMPI F - K Gough Dissimulation index (raw score F minus K < or = -15). Cognitive factor scores were generated and correlated with non-K-corrected raw scores of MMPI Scales 2, 7, and 8. Correlation coefficients were compared across groups. As predicted, increases on Scales 2 and 7 were significantly associated with decreased functioning of verbal memory (r = -.35 and -.34, respectively) among the nondefensive group but were unrelated in the defensive group. It is argued that the attenuation of the relationship between self-reported emotional status and verbal memory functioning is, in part, due to a restricted range of symptom endorsement on the MMPI among the defensive group. These findings replicate those previously reported using a sample of patients with cardiac disease.

Cognition↗