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Biomedical subjects

J K Austin

Publications and source records attributed to J K Austin.

At least 19 recordsLinked to original sources
PubMed2001

Stressors, coping and depression in haemodialysis patients.

BACKGROUND: Depression is common in persons receiving outpatient haemodialysis, but little work has been done to explore the variables associated with depression. AIMS: The primary purposes of this study were to (i) examine relationships among stressors, coping and depression and (ii) test the mediating role of coping. DESIGN/METHODS: Data were collected at two points in time, three months apart in 1995/1996. The final convenience sample at Time 2 was 86 participants from two United States midwestern, inner-city dialysis units. Structured interviews were conducted using the Centre for Epidemiologic Studies Depression Scale, the haemodialysis stressor scale (HSS) and the coping strategy indicator. RESULTS: At Time 1 more psychosocial stressors were associated with greater use of problem-solving, social-support and avoidance coping. Both avoidance coping and more psychosocial stressors at Time 1 were related to depression at Time 2. Finally, avoidance coping was found to explain much of the relationship between psychosocial stressors and depression. CONCLUSIONS: Research is now needed that explicates the causal relationships among stress, coping and depression in haemodialysis patients.

Adaptation, Psychological↗
PubMed2001

Camp experiences and attitudes toward epilepsy: a pilot study.

Most healthcare providers report anecdotally that a camping experience helps children and adolescents with chronic health conditions to develop more positive attitudes toward their condition. However, children's and adolescents' perceptions have rarely been studied systematically. This pilot study of 20 campers with epilepsy who were 8-16 years of age was undertaken to examine the effect of a camp experience on their attitudes toward epilepsy. Attitudes, measured by the 13-item Child Attitude Toward Illness Scale (CATIS), were assessed before and after the camp experience. No pretest or posttest difference in attitude toward epilepsy was found in the total group. However, when attitudes were examined by seizure frequency, there was a trend for those with more frequent seizures to report a more positive attitude after the camp experience. Issues in evaluating camp experiences for youth with chronic conditions are reviewed, and recommendations are made for a comprehensive camp evaluation. Nurses are encouraged to assist families whose child is challenged by more frequent seizures to consider a camp experience.

Adolescent↗
PubMed2001

Behavior problems in children before first recognized seizures.

OBJECTIVE: It is not known when behavior problems begin in children with epilepsy. The purposes of this study were to: 1) describe the rates of behavior problems in children before their first recognized seizure, 2) determine the differences in behavior problems between children with a first recognized seizure and their healthy siblings, and 3) identify the seizure variables early in the course of the condition that are associated with behavior problems before the first recognized seizure. METHODS: The sample was 224 children (4-14 years old) with a first recognized seizure and their 135 healthy siblings. As part of a larger study, computer-assisted structured telephone interviews were conducted with mothers to measure child and sibling behavior problems. Behavior problems were measured using the Child Behavior Checklist. Frequencies, t tests, correlational analysis, and multiple regression were used to analyze data. RESULTS: Higher than expected rates of behavior problems in the 6 months before the first recognized seizure were found in the total seizure sample, with 32.1% being in the clinical or at-risk range. Rates were highest in children who had previous events that were probably seizures, with 39.5% in the clinical or at-risk range. Children with seizures had significantly higher Total, Internalizing, Attention, Thought, and Somatic Complaints problem scores than their nearest-in-age healthy siblings. Within the seizure sample, variables significantly associated with behavior problems after adjusting for research site, child sex, child age, and socioeconomic status (as represented by primary caregiver's education) were interactions of previously unrecognized seizures with gender and epilepsy syndrome/type of seizures. CONCLUSIONS: Children with previously unrecognized seizures are already at increased risk for behavior problems at the time of their first recognized seizure. These findings are consistent with the hypothesis that in some children, epilepsy is a pervasive condition that includes both seizures and behavioral problems.

Adolescent↗
PubMed2000

Behavioral aspects of epilepsy in children with mental retardation.

Epilepsy and mental retardation, two relatively common childhood conditions, are both associated with a wide range of behavioral disorders. This article reviews the behavioral disturbances found in children with epilepsy, mental retardation, and both conditions. The behavioral disturbances found in children with epilepsy are associated with seizure-related, cognitive, developmental, and psychosocial factors. Although children with mental retardation also demonstrate a broad spectrum of behavioral disturbances, children with specific mental retardation syndromes have better-defined patterns of psychopathology. The presence of epilepsy and mental retardation seems to increase the severity of psychopathology. Further studies are needed, however, to define better the interaction of these two conditions and how they impact the behavior of children.

Autistic Disorder↗
PubMed2000

Childhood epilepsy and asthma: changes in behavior problems related to gender and change in condition severity.

PURPOSE: We conducted a 4-year follow-up study of behavior problems in children with either epilepsy (n = 115) or asthma (n = 105) to identify changes in behavior problems as they were related to gender and change in condition severity. All children were between ages 8 and 13 years and had been diagnosed with their respective conditions for >/=1 year at entry into the study. METHODS: Behavior problems were measured by using the mother's rating on the Child Behavior Checklist. Baseline and follow-up behavior problem scores were examined to see if significant changes occurred over the observation period of the study. To explore change in behavior based on condition severity, each child was placed into "low" and "high" condition severity groups at each time, resulting in four groups: low/low, low/high, high/low, or high/high. There were too few cases in the low/high group to be included in some analyses. Data were analyzed by using analysis of covariance with adjustment for baseline behaviors, age, and age of onset. RESULTS: Within both samples, there was a significant improvement over time for the Total Behavior Problems and Internalizing Problems scores (p </= 0.006). Improvement in Internalizing Problems was greater for the asthma sample than for the epilepsy sample (p </= 0.007). Within the epilepsy sample, there was a significant gender-by-change in seizure condition interaction for Total Behavior Problems, Internalizing Problems, and Externalizing Problems. The interaction effect indicated that behavior problems in girls with high seizure severity at both baseline and follow-up became substantially worse over the 4-year period. CONCLUSIONS: It was concluded that adolescent girls, particularly those with high-severity epilepsy during the transition to adolescence, merit closer clinical supervision for behavior problems.

Adolescent↗
PubMed2000

Children with epilepsy: quality of life and psychosocial needs.

In this chapter, research related to quality of life in children with epilepsy and their psychosocial needs is reviewed. Nursing and nonnursing research reports and descriptions of instruments developed between January 1994 and February 1999 are included. Most research reports described quality-of-life problems, especially psychological functioning in school-age children. Less attention was devoted to psychosocial needs. Major gaps included intervention studies and research on infants and young children. Conclusions include recommendations for future research.

Age Factors↗
PubMed1999

Quality of life in black hemodialysis patients.

The objectives of this study were to describe quality of life in a sample of black in-center hemodialysis patients, to identify relationships between quality of life (QOL) and selected demographic and illness variables, and to identify changes in quality of life over time. Data were collected at two points in time, 3 months apart. The data were obtained from 79 patients in two inner-city dialysis units and included persons new to dialysis. Structured interviews were conducted using the Quality of Life Index. On the average, these patients were satisfied with their QOL, although there was a large range of scores. Psychological/spiritual QOL (M = 4.27) was higher than health and functioning quality of life (M = 3.77) at both time periods. Younger age (M = 4.07) and more education (M = 4.00) were associated with poorer psychological/spiritual QOL at Time 1, whereas lower hematocrits (M = 3.55) and being new to dialysis (M = 3.41) were associated with poorer health and functioning QOL. The QOL of these black hemodialysis patients was fairly high and similar to the QOL previously reported for whites, suggesting that interventions to improve QOL in hemodialysis patients do not need to be tailored by race. In addition, findings suggest that nursing support may be the most needed during the early stages of dialysis.

Adaptation, Psychological↗
PubMed1999

Symptoms of depression in adolescents with epilepsy.

OBJECTIVE: To identify factors related to symptoms of depression in a sample of adolescents with epilepsy. METHOD: Cross-sectional data were collected on 115 adolescents aged 12 to 16 years who had epilepsy. Demographic (age, gender), seizure (severity, age of onset), family (stress, resources, relationships), mother (perceptions of stigma, depression), and child (attitude toward epilepsy, satisfaction with family relationships, coping, perceptions of control) variables were assessed by questionnaire and standardized scales. Depression was measured by the Children's Depression Inventory and the Anxiety/Depression subscale of the Youth Self-Report. Data were analyzed by using multiple regression with depression as the dependent variable. RESULTS: In this sample, 23% of subjects had symptoms of depression. Significant predictors of depression as measured by the Children's Depression Inventory (R2 = 0.53) were youth's attitude toward epilepsy, youth satisfaction with family relationships, and unknown locus of control or external locus of control for socially powerful others. CONCLUSIONS: Adolescents' attitudes, attributions, and satisfaction with family relationships are related to depression and should be assessed in the clinical setting. The relationship between locus of control and depression fits the learned helplessness model of depression and suggests the need for interventions to promote an internal locus of control in adolescents with epilepsy.

Adolescent↗
PubMed1999

Does academic achievement in children with epilepsy change over time?

A 4-year follow-up study of academic achievement in children aged between 11 and 17 years with epilepsy or asthma was carried out to identify differences between the two samples and to identify change in achievement over time. Differences based on sex and seizure severity also were explored. There were 98 subjects in the group with epilepsy and 96 subjects in the group with asthma. Academic achievement in five areas (Composite, Reading, Mathematics, Language, and Vocabulary) was measured using school-administered group test scores. To explore change over time in condition severity, each child was categorized as having a low or high condition severity at baseline (time I) and again 4 years later, resulting in four groups: low-low, low-high, high-low, and high-high. There were too few cases in the low-high group to be included in the analyses. Data were processed using analysis of covariance (ANCOVA), intraclass correlation coefficients, and paired t tests. At follow-up the children with epilepsy continued to perform significantly worse in all five achievement areas than the children with asthma. Children with either inactive or low-severity epilepsy had mean scores comparable to national norms; those with high seizure severity had mean scores ranging from 3 to 5 points below national norms. No changes were found in academic achievement over time for either sample, even among those whose conditions improved. Although boys with high-severity epilepsy continued to have the lowest achievement scores, there was no trend for them to decline in achievement over time.

Adolescent↗
PubMed1999

Behavioral issues in pediatric epilepsy.

Children with epilepsy have more behavioral and cognitive problems than children with other chronic illnesses and children in the general population. Risk factors are multiple, probably involving a combination of neurological, seizure, family, and child variables. Problems with attention and symptoms of depression occur frequently but may be unrecognized. Anxiety disorders and psychoses are less common. There are very few studies defining most effective therapies for behavioral problems in children with epilepsy. Education, group psychotherapy, and psychopharmacology have been used with success.

Child↗
PubMed1999

Factors associated with treatment-related stressors in hemodialysis patients.

The objectives of this study were to describe the treatment-related stressors of incenter hemodialysis patients, to identify relationships between stressors and selected demographic and illness variables, and to identify changes in stressors over time. Data were collected at two points in time, 3 months apart. The data were obtained from 86 patients in 2 inner-city midwest dialysis units. Structured interviews were conducted using one open-ended question and the Hemodialysis Stressor Scale. The greatest stressors were fluid limitations, the length of dialysis, and vacation limitations. There was a consistent trend for almost all stressors to become more intense over time, with some specific stressors increasing significantly. Patients new to dialysis and those with more education had relatively more stressors. An important serendipitous finding was that some treatment-related stressors were not troublesome because subjects chose not to follow certain treatment recommendations. In-depth evaluation in relation to individual stressors is required before adequate individual intervention strategies can be developed. Nurses need to be educated about the factors that are stressful to patients, so they can support them appropriately.

Activities of Daily Living↗
PubMed1998

Wife caregivers' and supportive others' perceptions of the caregivers' health and social support.

Perceptions of health and social support held by 75 wives caring for their mentally impaired husbands at home were compared with those of 75 supportive others, that is, secondary caregivers. Ratings by the two groups were significantly correlated, suggesting that the reports of wife caregivers may be considered valid. Supportive others rated physical help received by wife caregivers significantly higher than did the caregivers. Nondepressed caregivers perceived themselves to be significantly healthier than their supportive others perceived them. Depressed caregivers reported larger social networks than did their supportive others. Findings point to the importance of gaining the perspectives of both primary and secondary caregivers in order to understand the total reality of the caregiving situation.

Adult↗
PubMed1998

Academic achievement in children with epilepsy or asthma.

The purposes of the study were to compare academic achievement between children with epilepsy and those with asthma and to identify child perception, school adaptive functioning, and condition severity factors related to academic achievement. Subjects were 225 children (117 with epilepsy and 108 with asthma) aged between 8 and 12 years. Academic achievement was measured using school-administered group tests. Self-report questionnaires were used to measure child attitudes and school self-concept. Teachers rated school adaptive functioning. Data were analyzed using ANCOVA and multiple regression. Children with epilepsy had significantly lower achievement scores than children with asthma. Boys with severe epilepsy were most at risk for underachievement. Factors related to poor academic achievement in both samples were: high condition severity, negative attitudes, and lower school adaptive functioning scores. Less variance was accounted for in the model for epilepsy (R2=0.25) than for asthma (R2=0.36). Boys with high seizure severity were most at risk for achievement-related problems. Future research in epilepsy should consider additional factors in the model predicting academic achievement.

Asthma↗
PubMed1997

Application of an attribution-affect-action model of caregiving behavior.

An attribution model was used to examine how staff perceptions of behavior of a resident with Alzheimer's disease influenced the way the behavior was managed. A sample of 54 female nursing staff members responded to a vignette describing a caregiving situation of a demented resident who was not feeding himself or herself. Caregiver attribution of resident behavior to reversible causes significantly predicted expectations for improved self-feeding in the future, and future expectations for self-feeding were significantly related to caregiving behavior to encourage self-feeding. Caregivers expected greater participation in self-feeding by female residents than by male residents.

Adult↗
PubMed1997

Behaviour problems in children with new-onset epilepsy.

Behaviour problems are common in children with epilepsy and it is not known when these problems begin. Some suggest that behaviour problems are caused by a neurological condition that also causes the seizures. Behaviour problems were investigated in 42 youths (23 girls and 19 boys) over a 4-month period beginning at the time of the initial seizure. Subjects were aged 4-15 years (mean, M = 8.4). Approximately 57% had partial seizure(s) and 43% had generalized seizure(s). The large majority (71%) were diagnosed with epilepsy. As a part of a larger study, parents rated their children's behaviour on the Child Behaviour Checklist immediately prior to the first seizure (time 1), and at 4 months after the first seizure (time 2). Seizure severity was rated as follows: high = 20%, moderate = 39%, and low = 41%. At time 1, 24% already had behaviour problems. Behaviour problems significantly decreased from time 1 to time 2 (P < 0.001) for the whole group. Within the epilepsy group (n = 40), differences were found in behaviour problems based on seizure severity from time 1 to time 2 as follows: low, time 1: M = 55, time 2: M = 45; moderate, time 1: M = 55, time 2: M = 51; and high, time 1: M = 61, time 2: M = 55. Results indicate that children should be assessed for behaviour problems at the time of the first seizure.

Adaptation, Psychological↗
PubMed1996

Synergism of the polyamine analogue, N1,N11-bisethylnorspermine with cis-diaminedichloroplatinum (II) against murine neoplastic cell lines in vitro and in vivo.

The activities of naturally occurring polyamines are exploited to enhance the antitumor activity of cisplatin. The polyamine analogue, N1,N11-bis-ethylnorspermine (BE-3-3-3) is used at subtherapeutic levels in L1210 leukemia suspension cultures and plating efficiency assays of B16 F1 melanoma cells to increase the cytotoxic effect of cisplatin seven- and ten-fold, respectively. Similar experiments in mice reveal additive effects for DBA/2J mice bearing L1210 and synergistic effects in C57/B6 mice bearing B16 F1 tumor after optimizing combination ratios. In the latter model, at a BE-3-3-3/cisplatin molar ratio of 250:1, an increased lifespan (ILS) of 56% is recorded during a 9-day dosing schedule, whereas BE-3-3-3 at the same dose caused a 21% ILS, and cisplatin only exhibited a 7% ILS. Possible reasons for differences between in vitro and in vivo activity are discussed.

Animals↗
PubMed1996

A model of family adaptation to new-onset childhood epilepsy.

The onset of a chronic health condition such as epilepsy can interfere with the successful accomplishment of important psychosocial developmental tasks. Children with epilepsy are especially at risk for problems and often exhibit poor self-esteem, social withdrawal, and behavior problems. The purposes of this paper are first, to review the relevant literature on factors related to psychosocial adaptation in childhood epilepsy, and second, to present a model based on this literature to guide psychosocial nursing practice. Implications for psychosocial nursing care are discussed. Moreover, instruments for use in assessment of children and families are described, and instruments to assess need for psychosocial nursing care are presented.

Adaptation, Psychological↗