Biomedical subjects

L Hatchett

Publications and source records attributed to L Hatchett.

6 recordsLinked to original sources

PubMed1997

A comparison of attributions, health beliefs, and negative emotions as predictors of fluid adherence in renal dialysis patients: a prospective analysis.

Excessive fluid intake in hemodialysis patients can lead to serious cardiovascular complications. However, previous studies have not investigated factors that affect fluid adherence over time. The influence of three sets of factors--attributions, health beliefs, and negative emotions--was examined to determine their influence on changes in fluid adherence over time. We assessed patient's fluid-intake changes across two time periods, as well as their absolute level. The results indicated that attributions, while predicting absolute fluid adherence, did not predict changes in fluid adherence. On the other hand, health beliefs predicted changes in fluid adherence but not absolute levels. Negative emotions predicted neither absolute nor changes in fluid adherence. It is suggested that attributions are more responsible for maintenance and control of stable fluid adherence levels, while health beliefs are more responsible for motivational factors related to changes in fluid adherence over time.

Adult↗

PubMed1997

Interpersonal expectations, social support, and adjustment to chronic illness.

Chronic illness places considerable burdens on patients and their interpersonal relations with families. In this study, patients' perceptions of family and medical staff expectations regarding responsibility for care and routine functions were examined. The authors hypothesized that a patient's perceived inability to meet others' expectations about coping with illness would lead to poorer adjustment. Forty-two chronically ill patients were assessed prospectively for perceptions of others' expectations, social support, and psychological adjustment. Findings confirmed that expectations predicted subsequent decreases in psychological adjustment over a 3-month period, even when social support was controlled. A test of the reverse hypothesis showed that poorly adjusted patients did not misperceive others' expectations. Theoretical interpretations of the findings and their relation to social support research are discussed.

Adult↗

PubMed1997

Serum albumin and depression in end-stage renal disease.

The purpose of our study was to determine whether albumin influenced patients' depression or whether depression influenced patients' albumin. Patients from a tertiary care university medical hospital were assessed for both serum albumin and depression [Beck Depression Inventory (BDI)] at two time points separated by 6 months. Data were collected for 72 patients (43 male, 29 female; mean age 54 years). The sample consisted of 32 hemodialysis and 40 peritoneal dialysis patients. The outcome measures were changes in depression and albumin over time. Regression analysis indicated that all three Time 1 measures of BDI, BDICOG (BDI cognitive), and BDISOM (BDI somatic) significantly predicted decreases in albumin from Time 1 to Time 2 (beta = -0.22, p < 0.002; beta = -0.17, p < 0.015; beta = -0.23, p < 0.002, respectively). However, Time 1 measures of albumin did not predict changes in BDI, BDICOG, or BDISOM (beta = -0.04, p < 0.738; beta = -0.08, p < 0.375; beta = -0.07, p < 0.618, respectively). Thus depression at Time 1 predicted decreases in albumin from Time 1 to Time 2. The reverse effect that albumin influences depression from Time 1 to Time 2 was not found. In conclusion, this study suggests that depression influences the nutritional status indicated by albumin levels. Thus poor nutritional status may mediate the relation between depression and mortality in end-stage renal disease (ESRD).

Adult↗

PubMed1995

Burden of self-care in seriously ill patients: impact on adjustment.

Perceived, but not actual, control over the treatment has been consistently related to better adjustment in chronic illness. This study examined the relationship between actual control over treatment and severity of illness and their influence on depression in a chronically ill population of end-stage renal disease (ESRD) patients. The authors hypothesized that as severity of illness increases, the burden of control over treatment would increase depression. Severity of illness and depression were assessed for 98 ESRD patients. Control over treatment was represented by whether dialysis patients were self-administering treatment (high control) or were receiving treatment from the medical staff (low control). Results indicated that for the most severely ill patients, high control over treatment resulted in poorer adjustment. Furthermore, this effect was due in part to how illness interferes with social relationships in seriously ill, self-care patients.

Activities of Daily Living↗

PubMed1994

Comparison of quality of life in hemodialysis and peritoneal dialysis patients.

This study was designed to compare severity of illness and quality of life variables in chronic peritoneal dialysis (PD) and hemodialysis (HD) patients. The patient sample consisted of 63 PD patients (38 male, 25 female; mean age 54.5 years) and 35 HD patients (23 male, 12 female; mean age 54.9 years). Disease severity was greater in in-center HD patients than in PD patients (p < 0.008), although there were no significant differences in functional status as measured by the Karnofsky Index between HD patients (68.6 +/- 2.3) and PD patients (71.9 +/- 1.7). While both patient groups reported the same number of overall physical symptoms. HD patients reported significantly greater overall discomfort from symptoms than PD patients (p < 0.008). In terms of psychological adjustment, analyses revealed that 22 PD patients (36.7%) and 9 HD patients (25.7%) were classified as clinically depressed. PD patients reported higher anxiety scores than HD patients (p < 0.02) and lower positive mood scores (p < 0.021). HD patients were more severely ill and appeared to suffer from physical symptomatology to a greater degree than PD patients, although they were not more impaired in terms of functional status. Moreover, HD patients showed better psychological adjustment along several dimensions when compared to PD patients. One reason for this finding may be that PD patients experience greater distress, and isolation due to a lack of social support from similar others and medical staff in comparison to in-center HD patients.

Female↗

PubMed1992

Urodynamic dysfunction in walking myelodysplastic children.

We evaluated urodynamically and radiologically 54 children with myelodysplasia and neurological deficits at or below the S1 level. Baseline urodynamic testing was normal in 13 patients (24%), while 12 (22%) had an upper motor neuron and 13 (24%) had a lower motor neuron type of dysfunction. A total of 7 patients (13%) had a mixed upper and lower motor neuron type, and 9 (17%) had only lower motor neuron dysfunction of the urethral sphincter with a normally contractile bladder. Followup studies varying in time from 1 month to 10 years showed a changing neurourological lesion in 29 patients (54%): 25 deteriorated while 4 improved. Of the 54 children 20 had hydronephrosis and/or vesicoureteral reflux. Incontinence was the major problem in 41 patients (75%), and was managed initially with pharmacological agents and/or clean intermittent catheterization, with 9 of the 41 eventually requiring surgery. Urodynamic assessment reveals a variable picture that does not correlate well with the apparent neurological examination. Despite the low level of the neurological deficit, many children may be at risk for urinary tract deterioration. These findings emphasize the importance of continuous surveillance and appropriate management in this group of myelodysplastic children who have the greatest potential for a normal life.

Child↗