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Biomedical subjects

K B King

Publications and source records attributed to K B King.

35 records · Page 2Linked to original sources
PubMed1992

Coronary artery bypass graft surgery in older women and men.

OBJECTIVE: To compare women and men younger than 70 years of age and 70 years or older undergoing coronary artery bypass surgery. DESIGN: Retrospective chart review, case-control series. SETTING: University medical center. PATIENTS: All women (n = 465) having first-time isolated coronary artery bypass surgery between 1983 and 1988, and 465 men matched for age and year of surgery. Predominantly white; 33% were 70 years or older. MEASURES: Medical record data: demographics, preoperative comorbidities, perioperative and postoperative complications, mortality, length of stay. RESULTS: Preoperatively, women 70 years of age or older had a higher incidence of congestive heart failure, renal disease and hypertension, and a lower incidence of smoking history compared with women less than 70 years old. Men 70 years or older had a higher incidence of congestive heart failure and renal disease, and a lower incidence of smoking history compared with men less than 70 years old. There was no difference in mortality between older and younger women, whereas the mortality rate for older men was higher than that for younger men. There were fewer differences between women younger than 70 and those 70 years or older in incidence of postoperative complications than between men of those same age groups. Among patients 70 years or older, incidence of postoperative congestive heart failure was greater in women than in men. There were no other differences between women and men younger than 70 and those 70 years or older in incidence of postoperative complications. Controlling for the influence of postoperative complications, age was related to length of stay for women and men. CONCLUSIONS: Older women were at no greater risk of mortality or the occurrence of postoperative complications compared with younger women or older men. A functional component influencing recovery and length of hospital stay needs to be considered to provide optimal nursing care after surgery.

Adult↗
PubMed1988

Reducing the negative impact of radiation therapy on functional status.

The effect of an informational intervention that provided objective descriptions, in concrete terms, of the usual experiences during the various phases of radiation therapy was tested in a random clinical trial. The patients had Stage A, B, or C prostatic cancer. Forty-two control patients received the information routinely provided to all patients in the treatment setting. Forty-two experimental patients received, in addition, four informational messages during the course of radiation therapy. The first message described the experience of treatment planning; the second described the experience of receiving a radiation treatment; the third described side effects that usually occur, their onset, their characteristics, and activities to lessen their impact; and the fourth described the usual experiences during the months following radiation treatments. The experimental group of patients, compared with those in the control group, reported significantly less disruption in usual activities during and following radiation therapy. The amount of emotional disturbance was low and did not differ by study group. The results of this study, with respect to the interventions' effect on radiation therapy patients' quality of life, were consistent with prior research in other health care situations.

Adaptation, Psychological↗
PubMed1988

Patient perceptions of recovery from coronary artery bypass grafting after discharge from the hospital.

Prior research has demonstrated that providing patients with descriptions of impending experiences in the form of concrete sensory information enhances recovery. Sensory information reflects the experience from the patient's point of view as it describes what the patient can expect. The purpose of this study was to describe recovery from coronary artery bypass surgery from the patients' perspective over a 2-month period after discharge from the hospital. Thirty-four subjects were interviewed via telephone six times over an 8-week period after discharge. Patients described general feelings of well-being, occurrences of symptoms (fatigue, sleep disturbances, changes in appetite, changes in bowel function, incisional and nonincisional discomforts), activity level, and changes in mood. Data can be used in postoperative teaching by giving patients a standard against which to compare their own experience. The ability to anticipate possible symptoms can be helpful to patients in making appropriate plans for activities during the recovery period.

Activities of Daily Living↗
PubMedDate not supplied

Correlates of fatigue in older women with heart failure.

OBJECTIVE: To examine the relative contribution of psychologic factors and physical symptoms to the variance in fatigue in older women with heart failure. METHODS: Eighty women who had been hospitalized in the previous 12 months for heart failure were interviewed. Fifty-seven women completed second interviews 18 months after the first interview. RESULTS: Fatigue was the most frequently occurring physical symptom at both measurement times, and it significantly increased with time. Other physical symptoms contributed uniquely to the variance in fatigue at both measurement times, but psychologic factors did not. At time 1, sleep difficulties, chest pain, and weakness each explained unique variance in fatigue. At time 2, dyspnea was the only variable that explained unique variance in fatigue (9%). Dyspnea also explained a significant portion of the variance (7%) in time 2 fatigue, when time 1 fatigue was controlled. CONCLUSIONS: Fatigue in older women with heart failure is related more to other physical symptoms than psychologic factors.

Adaptation, Psychological↗
PubMedDate not supplied

Perceptions of patients with cardiovascular disease about the causes of coronary artery disease.

This study was an examination of perceptions about the causes of coronary artery disease and the timeline of the disease among 105 patients hospitalized because of myocardial infarction or for coronary angiography and receiving the diagnosis of coronary artery disease. Although 79% of subjects named at least one of three modifiable risk factors (smoking, hypertension, elevated cholesterol), only 7% identified all three. Subjects known to have risk factors varied in their recognition of those risks as a cause of their coronary artery disease. Sixty-four percent of smokers recognized smoking as a personal cause of their coronary artery disease, whereas only 15% of subjects with hypertension recognized hypertension as a cause. The majority of subjects (55%) believed that coronary artery disease was a chronic disease. The other subjects were unsure (13%) or believed the situation would be short term (28%). Despite general knowledge about coronary artery disease, individuals with known risk factors continue to be largely ignorant of their personal risks and to some extent of the course of the disease.

Adult↗
PubMedDate not supplied

Long-term chest wall discomfort in women after coronary artery bypass grafting.

OBJECTIVE: The purpose of the study was to determine the occurrence of long-term chest wall discomfort in women after coronary artery bypass grafting. DESIGN: Prospective repeated-measures design. SETTING: Posthospitalization. SAMPLE: Fifty-one women who had undergone coronary artery bypass grafting. Data were collected at 12 and 18 months by self-report and data collection instruments. INSTRUMENTS: Life Orientation Test, Satisfaction with Life Scale, Profile of Mood States, Sickness Impact Profile, interview schedule, and discomfort scale 0 to 10. RESULTS: Women who had an internal mammary artery graft had significantly (p = 0.003) more discomfort. Most discomforts were intermittent and did not interfere with daily activities. However, the feelings of numbness and itchiness tended to be continuous.

Activities of Daily Living↗
PubMedDate not supplied

Perceived side effects and benefits of coronary angioplasty in the early recovery period.

OBJECTIVE: To examine patients' perceptions of the side effects and the treatment benefit of percutaneous transluminal coronary angioplasty (PTCA) in the early postdischarge recovery period, and to determine whether selected demographic and clinical variables were associated with perceptions of side effects and treatment benefit. DESIGN: Descriptive, correlational study. SAMPLE: Convenience sample of 62 subjects, with a mean age of 62 years (SD 11 years), 77% of whom were men, who had undergone successful, elective PTCA. RESULTS: Fifty-two percent of subjects reported side effects 2 weeks after PTCA. The most frequently reported side effect (22.5%), was discomfort in the groin site. Seventy-nine percent of subjects reported PTCA made things better, and 5% reported that PTCA made things worse. The most commonly reported benefit of PTCA was relief of chest pain. Age, sex, and a history of previous PTCA were not related to reported side effects or reported benefits. Subjects who experienced chest pain since the time of hospital discharge were less likely to report that PTCA was beneficial. CONCLUSION: More emphasis should be placed on helping patients who are candidates for a PTCA to predict and to manage treatment side effects and to have realistic expectations concerning the trajectory of recovery from PTCA. Further research is needed to examine the impact of patients' uncertainty concerning treatment benefit or perceptions of no treatment benefit in the early recovery period on intermediate and long-term PTCA recovery outcomes.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Social comparisons and temporal comparisons after coronary artery surgery.

OBJECTIVE: To examine the use and efficacy of social and temporal comparisons used before and after coronary artery surgery. DESIGN: Secondary analysis of data from a prospective study designed to examine social support. PATIENTS: 141 subjects undergoing surgery. RESULTS: One third of subjects made spontaneous social comparisons. Most who made a social comparison before and 1 month after surgery viewed themselves as similar to others. Social comparisons were related to mood states only before surgery. The majority of subjects made temporal comparisons 1 year after surgery. Subjects generally saw themselves as the same or better than they were before surgery. Temporal comparisons were related to both emotional and functional outcomes. CONCLUSIONS: Social comparisons were not consistently related to emotional and functional status; thus whether they can be used to formulate interventions needs further exploration. On the other hand, use of temporal comparisons was related to better mood state and functional status. Enhancing an individual's ability to view self as stable or improved compared with before surgery may be beneficial. Results are discussed in terms of how social comparison theory fits within the overall context of coping with physical illness.

Adult↗
PubMedDate not supplied

Concerns and risk factor modification in women during the year after coronary artery surgery.

BACKGROUND: Future plans or return to a usual lifestyle has been shown to be of concern to persons recovering from coronary artery surgery. However it is not clear whether early concerns remain stable or evolve over time. OBJECTIVE: To examine women's concerns about having coronary artery surgery and living with coronary artery disease after surgery over time. METHODS: Concerns and risk factor modification strategies were measured in 55 women at 1, 6, and 12 months after coronary artery surgery. The Carr and Powers Stressor Scale and an investigator-developed interview were used. RESULTS: Women's primary concerns shifted over the year from surgical recovery to living with coronary heart disease. At 1 month after surgery, issues related to future plans, such as progress in recovery and resuming lifestyle, were rated as causing the most concern. Concern about diet was the highest rated concern 1 year after surgery. More than half of the women reported exercising more, and approximately three fourths reported eating a better diet 1 year after surgery. CONCLUSIONS: The findings demonstrate that women are concerned about diet and exercise, and many women attempt to change their behavior. Capitalizing on women's concerns about living with coronary artery disease may help address risk factors. However, specialized interventions may be needed that focus on women who are not concerned about and/or not engaged in risk reduction behaviors.

Adult↗
PubMedDate not supplied

Empowering staff nurses to participate in the American Nurses Association's call for quality indicators research.

The American Nurses Association (ANA) advocates establishment of a national database, which can collect, aggregate, and analyze patient data to link nursing activities to 10 quality of care outcomes. These outcomes, developed through extensive research, can highlight the essential nature of nursing, demonstrate institutional compliance with external standards, and justify registered nurse staffing patterns. Staff nurses collect and record the data that provide the foundation for the quality nursing indicators research initiative. This paper focuses on the important and unique role that staff nurses can play in advancing this agenda.

American Nurses' Association↗
PubMedDate not supplied

Patient management of pain medication after cardiac surgery.

The purpose of this study was to investigate the effects of a personal control intervention in the form of self-administered versus nurse-administered pain medication after cardiac surgery, and its interaction with patients' desire for control, patients' perception of pain intensity, disruption in daily activities, emotional responses, and use of pain medication over time. Subjects were 64 adults undergoing coronary artery bypass or valve replacement surgery. Instruments included the Krantz Health Opinion Survey; a 7-point measure of discomfort scale to assess pain intensity, disruption in daily activities due to pain, and emotional upset due to pain; a shortened form of the Sickness Impact Profile; and the Bi-polar Profile of Mood States. No main effects were found between experimental and control groups on any of the dependent measures nor were interaction effects found between individuals' measured desire for control and the personal control intervention. A time by group interaction was found in reports of pain intensity, p less than .05, with subjects in the experimental group reporting higher levels of pain intensity than subjects in the control group in the early postoperative period.

Affect↗