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Biomedical subjects

M A Swain

Publications and source records attributed to M A Swain.

17 recordsLinked to original sources
PubMed1990

Psychophysiological processes of stress in chronic physical illness: a theoretical perspective.

This paper proposes a theoretical framework and conceptual model for clinicians and investigators working with people who have a chronic physical illness. The framework is based upon nursing theory and classical propositions from psychology and physiology. The major premise of the model is that individuals with limited psychosocial attributes and a preponderance of unmet basic needs are more likely to perceive events as threatening and experience a maladaptive stress response, such as heightened symptoms and acute exacerbations of their illness. Conversely, those with strong attributes and a perception of need satisfaction are more likely to view events as challenging, thus avoiding symptomatic discomfort and enhancing personal growth. Implications for nursing practice and research are addressed.

Adaptation, Psychological↗
PubMed1990

Mobilizing self-care resources: a nursing intervention for hypertension.

This study was undertaken to assess the potential for mobilizing self-care resources in 10 persons with hypertension. Modeling and role-modeling theory provided the conceptual base for the experimental group. Ten persons with hypertension were matched with a comparison group. The results provide some evidence that theoretically sound nursing interventions can assist clients to mobilize self-care resources needed to enhance their well-being. Although further research with larger, randomly assigned samples is indicated, these findings suggest that nursing the person rather than the symptom might help people with hypertension contend with stressors, reduce stress, and deal with loss and grief.

Adaptation, Psychological↗
PubMed1989

Evaluation of two assessment techniques for adaptation to stress.

Two conceptual nursing models, Roy's adaptation model and Erickson and Swain's adaptive potential assessment model are explained, and knowledge is identified within these two assessment techniques for adaptation to stress. The purpose is to identify common, noteworthy areas of nursing science as well as areas where further development in nursing knowledge is needed. A case study is used to compare and contrast these models. When assessing adaptation to stress, one similarity between the approaches appears to be a propositional linkage that supports the influence of developmental level on basic need satisfaction. A divergent area between the two models identifies a need for further development in nursing knowledge regarding the adaptive potential status. This includes information pertaining to what an individual can reasonably do or be expected to do when contending with stressors.

Adaptation, Psychological↗
PubMed1989

Construct validity of an aspect of the coping process: potential adaptation to stress.

The focus of this study was to examine construct validity of the Adaptive Potential Assessment Model (APAM). Incorporated within a larger theory and paradigm entitled Modeling and Role-Modeling, APAM depicts three main states, arousal, equilibrium, and impoverishment; each state represents a different potential to mobilize coping resources. Arousal and impoverishment are considered stress states while equilibrium is considered a nonstress state. The sample was young, male students (N = 73) who were experiencing varying degrees of stress. Physiological and psychological data were gathered by utilizing several instruments and clinical assessment techniques. APAM was validated in a healthy population. Discriminant function analysis revealed motor-sensory behavior, fatigue-sadness, hope, and verbal anxiety as useful predictors in determining adaptive potential states. Misclassifications of subjects determined to be at risk by the investigator and not by the mathematical algorithm are considered. The benefits of holistically identifying clients' ability to mobilize coping resources is that nurses can plan intervention more effectively if these categorizations can be consistently verified.

Adaptation, Psychological↗
PubMed1986

Herpes simplex virus specifies two subunits of ribonucleotide reductase encoded by 3'-coterminal transcripts.

We have previously described a transcription unit located between map coordinates 0.558 and 0.595 on the herpes simplex virus type 2 strain 333 genome which encodes two mRNAs of 5.0 and 1.2 kilobases that share a common 3' terminus, and we have determined the nucleotide sequence of a 38,000-dalton protein specified by the smaller RNA (D. A. Galloway and M. A. Swain, J. Virol. 49:724-730, 1984). The entire nucleotide sequence of the 140,000-dalton protein specified by a 3,432-base-pair open reading frame within the large mRNA is presented, as are transcriptional regulatory sequences upstream of the RNA. The 140,000-dalton protein shows strong homology with the large subunit of well-characterized ribonucleotide reductase enzymes from the mouse and from Escherichia coli and with an Epstein-Barr virus gene. The 38,000-dalton protein has been shown previously to have homology with the small subunit of these enzymes (B.-M. Sjoberg, H. Eklund, J. A. Fuchs, J. Carlson, N. M. Standart, J. V. Ruderman, S. J. Bray, and T. Hunt, FEBS Lett. 183:99-102, 1985). This is the first example of a herpesvirus transcriptional unit that encodes functionally related proteins.

Amino Acid Sequence↗
PubMed1985

A proposed expert system for nursing practice. A springboard to nursing science.

The knowledge on which nursing practice is based comes largely from traditional sources, expert nurses passing on the wisdom of their experience to novices. Nursing research, although increasing, is usually parallel to nursing practice, and its findings, at best, are implemented only after long delays. Consequently, the most effective nursing responses to a particular client problem may be undiscovered or unknown. Nursing information systems reflect the nature and usage of nursing knowledge. They offer standard care plans, but the knowledge and decision structures for individualizing care remain exclusively in the mind of the nurse. Nurses may have great freedom to enter information into the information system, but the information is rarely retrievable in a form suitable for evaluation or research. Nursing practice, and the knowledge on which it is based, could be enhanced through the use of a novel expert system. This paper describes how such a system could be developed, with examples from the authors' prototype programs. Taxonomies of data, diagnoses, objectives, and interventions would make it possible to compare patients and to determine the relative effectiveness of nursing interventions. A built-in evaluation component would provide feedback and correction. Everyday nursing practice would become a field for research, and the knowledge gained from research would immediately be fed back into practice. In its development and in its implementation, this kind of system would help to build nursing science.

Computers↗
PubMed1985

A theoretical approach to nursing assessment.

Nurses use theory to sharpen their observations and to facilitate their understanding of the human responses to which they direct their interventions. An assessment tool, derived from the nursing theory 'modelling and role-modelling', was developed by nurses at the University of Michigan Hospitals. This tool appears to elicit the data necessary to assess and diagnose the health status of clients. This article describes the assessment tool, why it was developed, the objectives in utilization of the tool and suggestions for implementation.

Health Status↗
PubMed1985

Characterization of the gene encoding herpes simplex virus type 2 glycoprotein C and comparison with the type 1 counterpart.

The gene encoding the glycoprotein C (gC) of herpes simplex virus type 1 maps to the region of the viral genome from 0.62 to 0.64. Recently, a herpes simplex virus type 2 glycoprotein previously designated gF and now designated gC was mapped to a homologous location. Analysis of the herpes simplex virus type 2 mRNA species encoded in this region revealed a major transcript of 2.5 kilobases, a 0.73-kilobase transcript (the 5' ends of which were mapped by primer extension), and several minor species, all nearly identical to the herpes simplex virus type 1 pattern. A polypeptide of ca. 60,000 daltons was identified by in vitro translation of hybrid-selected mRNA. A smaller protein of ca. 20,000 daltons was also mapped to this region. The nucleotide sequence of a 3.4-kilobase segment of DNA encompassing gC was determined, and an open reading frame of 1,440 nucleotides specifying a 480-amino acid protein with properties consistent with that of a glycoprotein was identified. Comparative DNA sequence analysis showed regions of limited homology within the coding sequences for gC and a deletion which results in 31 fewer amino acids in the gC-2 near the amino terminus of the protein. The carboxy termini of gC-1 and gC-2 are very similar, as are the 20,000-dalton proteins.

Base Sequence↗
PubMed1984

Organization of the left-hand end of the herpes simplex virus type 2 BglII N fragment.

We have determined the complete nucleotide sequence surrounding the region coding for a 38,000-dalton protein of herpes simplex virus type 2 strain 333 that is encoded between map coordinates 0.58 to 0.595 on the viral genome. The sequence data have revealed an open translational reading frame of 1,011 nucleotides encoding a protein of 337 amino acids. Upstream of those sequences, transcriptional regulatory signals could be identified that overlap another open reading frame of 489 nucleotides, which presumably encodes the carboxy-terminal 163 amino acids of a 140,000-dalton protein. Downstream of the gene encoding the 38,000-dalton protein a polyadenylation signal was found as well as one further along on the other strand near a termination codon that presumably punctuates the gene specifying a 61,000-dalton protein. The DNA sequence data were compared with the amended sequence of the herpes simplex virus type 1 strain KOS 40,000-dalton protein (K. G. Draper, R. F. Frink, and E. K. Wagner, J. Virol. 43:1123-1128, 1982) and with the 5' end of the same gene from herpes simplex virus type 1 strain 17 (J. McLaughlan and J. B. Clements, J. Gen. Virol. 64:997-1006, 1983) to assess the degree of inter- and intratypic variation. The comparison of the sequences has provided a basis for the type specifity of this viral protein and for different mechanisms giving rise to the diversity between herpes simplex virus types 1 and 2.

Amino Acid Sequence↗
PubMed1983

Nucleotide sequence of the herpes simplex virus type 2 thymidine kinase gene.

We have determined the complete nucleotide sequence of the thymidine kinase gene of herpes simplex virus (HSV) type 2 strain 333. The sequence of the thymidine kinase gene exhibits an open translational reading frame of 1,128 nucleotides encoding a protein of 376 amino acids. The DNA sequence was compared with that of the HSV type 1 thymidine kinase gene from strain MP (S. L. McKnight, Nucleic Acids Res. 8:5949-5964, 1980) and from strain CL 101 (M. J. Wagner, J. A. Sharp, and W. C. Summers, Proc. Natl. Acad. Sci. U.S.A. 78:1441-1445, 1981) to assess the extent of intra- and intertypic variation for one viral gene. The nucleotides encoding the structural gene varied 1.7% between the two HSV type 1 strains and 19% between HSV type 1 and HSV type 2, which translated to differences in the amino acid sequence of the two proteins of 1.9 and 27%, respectively. The DNA encoding the 5' regulatory sequences appeared to be more conserved than the DNA coding for the structural gene, and the DNA at the 3' end of the gene was the least homologous.

Base Sequence↗
PubMed1982

A model for assessing potential adaptation to stress.

The purposes of this study were to determine if hospitalized medical-surgical patients could be classified reliably according to their potential to adapt to stress; and to explore the relationship between their adaptive potential and length of hospital stay. Forty-six patients were selected for participation by use of a table of random numbers. Three classes of significantly different adaptive potential were identified: the Alarm and Impoverished states were considered as stress states, while the state of Equilibrium was considered a nonstress state. Although it was possible to distinguish stress from nonstress states, using only physiological parameters, psychological parameters were required to distinguish between the two stress states. The differentiation among the three coping states was used to predict subjects' potential for mobilizing adaptive resources. Length of hospitalization was then related to classification of adaptive potential.

Adaptation, Psychological↗
PubMed1981

Influencing adherence among hypertensives.

In the treatment of hypertension, problems of nonadherence and consequent poor blood pressure control are particularly severe. Alternative intervention strategies were compared to explore means of improving adherence and lowering blood pressures. In a 3 x 4 repeated measures analysis of variance design, 115 patients were randomly selected and randomly assigned to one of three treatment modalities (routine clinic care, patient education, and contingency contracting) and were followed over four clinic visits. Subjects' knowledge about hypertension and its management, adherence to requests for regular medical follow-up, and blood pressure levels were measured. Patient education was not effective in lowering blood pressures; it produced an untoward outcome, a dropout rate higher than that for patients receiving only routine clinic care. However, contingency contracting was an effective intervention strategy for improving patient knowledge, F (1,59) = 51.32, p less than .0001; adherence to requests for regular medical care, Max L (2) = 25.9, p less than .0001; and decreasing diastolic blood pressures, F (2,49) = 3.39, p less than .05.

Adult↗
PubMedDate not supplied

Active patient orientation.

The successful treatment of chronic ambulatory illness requires that patients be involved actively in the management of their own conditions. How health providers orient services toward patients is likely to affect the quality of patients' involvement. In the study reported here, three programs of care were evaluated in terms of the extent to which the care provided was oriented toward patients as active participants in the treatment process. Ninety-one hypertensive patients, randomly assigned among the three programs, rated their care in terms of active patient orientation (APO). On the basis of the structural characteristics of the three programs, it was hypothesized that the contingency-contracting approach would afford a stronger APO than either the educational or routine-care approach. The findings conform to expectation. Observed linkages among structure of care, level of APO reported, and patient participation are discussed in addition to the practice implications.

Consumer Behavior↗
PubMedDate not supplied

Adjustment of patients and husbands to the initial impact of breast cancer.

This study compared the psychosocial adjustment of 50 newly diagnosed breast cancer patients and their husbands at two points in time. Time 1 interviews were conducted approximately 3 days after surgery; Time 2 interviews were conducted 30 days later. Psychosocial adjustment was measured as a multidimensional construct using the Affects Balance Scale, the Brief Symptom Inventory, and the Psychosocial Adjustment to Illness Scale. Repeated measures analysis indicated that husbands' scores did not differ significantly from patients' scores on the adjustment measures that assessed level of mood and amount of symptom distress. Both patients and husbands reported levels of distress significantly above the level reported for the normal population. Patients and husbands differed only on the adjustment measure that assessed problems in carrying out various psychosocial roles, with patients reporting more role adjustment problems than husbands. Although both patients and husbands reported dramatic improvement in their levels of mood from Time 1 to Time 2, no significant change occurred in their levels of distress. Medical and demographic factors had little relationship to subjects' levels of adjustments at either time.

Adaptation, Psychological↗