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Biomedical subjects

L H Powell

Publications and source records attributed to L H Powell.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Change in coronary-prone behaviors in the recurrent coronary prevention project.

The Recurrent Coronary Preventive Project (RCPP) demonstrated that the addition of Type A counseling to standard cardiac counseling resulted in significant reductions in Type A behavior and in a 44% reduction in reinfarction in post-myocardial infarction patients. The purpose of the present study was to describe the specific behavioural and psychosocial changes that occurred during this Type A treatment. Patients undergoing Type A counseling showed significant reductions not only in Type A behavior, but also in the Type A components of hostility, time urgency, and impatience, when compared with patients in the cardiac control group. They also showed significant decreases in depression and anger, and gains in self-efficacy, and marginally significant gains in social support and well-being. Type A counseling resulted in a dose-response relationship with most psychosocial outcomes, such that an increasing amount of treatment contacts was associated with increasing change. These data are important in that they specify a range of psychosocial factors that were influenced by treatment. These factors can be considered to be among the possible explanations for the efficacy of the RCPP treatment on the reduction of cardiac recurrences.

Arousal↗
PubMedDate not supplied

Psychosocial predictors of mortality in 83 women with premature acute myocardial infarction.

This was an exploratory investigation of psychosocial risk factors for mortality in women with premature acute myocardial infarction (AMI). Subjects were 83 female participants in the Recurrent Coronary Prevention Project, who were between the ages of 30 and 63 in 1978, nonsmoking, nondiabetic, and at least 6 months beyond their index AMI. Follow-up ranged from 8 to 10 years, with an average of 8.5 years. Six deaths occurred in the 83 women over the follow-up. Univariate predictors of these deaths were arrhythmias on ECG (RR = 7.83, p = .003), being divorced (RR = 6.9, p = .003), being employed without a college degree (RR = 6.8, p = .03), and the inverse of Type A behavior, time urgency, and emotional arousability (p = .03; .005; .006, respectively). Multivariate stepwise logistic regression analysis produced a solution that included as independent predictors: arrhythmias on ECG (RR = 4.01, p = .004), being divorced (RR = 3.43, p = .01), and the inverse of time urgency (RR = 0.35, p = .02). In the multivariate model, "divorced" was interchangeable with "employed without a college degree" and "time urgency" was interchangeable with "emotional arousability." This small sample precludes firm conclusions, but provides a basis for hypothesis development.

Adult↗
PubMedDate not supplied

Association between depressive symptoms and mortality in medical inpatients.

The authors interviewed a consecutive series of medical inpatients (N = 241) using the Schedule for Affective Disorders and Schizophrenia to determine which depressive symptoms are associated with in-hospital mortality. Fifteen depressive symptoms, pain, and physical discomfort were assessed along with medical comorbidity. Twenty patients died in-hospital (8.3%). Logistic regression showed that anhedonia, hopelessness, worthlessness, indecisiveness, and insomnia predicted in-hospital death after adjusting for physical comorbidity and age. Clinicians should be aware that these depressive symptoms may predict mortality in medical inpatients. Future studies should address which treatment modalities lead to better outcomes.

Adult↗
PubMedDate not supplied

The impact of emotions on cardiovascular health.

Recent research suggests that the maintenance of emotional well-being is critical to cardiovascular health. People who feel lonely, depressed, and isolated have been found to be significantly more likely to suffer illnesses and to die prematurely of cardiovascular diseases than those who have adequate social support. Consequently, the development of appropriate interventions to improve the emotional health of people with certain psychosocial risk factors has become an important research goal. It is anticipated that such interventions will increase the life expectancy of people at risk and that it may also save millions of dollars in medical care costs. First, however, researchers in this field must identify specific emotional risk factors and must agree upon a working definition of "good emotional health." Such explicit definitions, as well as additional data, are essential to educating physicians and insurers so that consideration of emotional health can be integrated into basic medical care.

Cardiovascular Diseases↗