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Biomedical subjects

M D Sullivan

Publications and source records attributed to M D Sullivan.

44 records · Page 3Linked to original sources

Written language skills of children with cleft palate.

The written language abilities of children with cleft palates aged eight to 13 were studied to compare performance with norms for the Picture Story Language Test. Although intelligence of this sample, as measured by the performance portion of the WISC, was skewed toward the superior and very superior ranges, the group ranked below the 50th percentile in total words used, words per sentence, and syntax quotients. Also, percentile scores on the PSLT declined as the age of the subjects increased. These results differ from the Ebert, McWilliams, and Woolf (1974) study where younger children with cleft palates (ages six to eight) were found to exhibit age-appropriate written language. The influence of factors affecting language development among the cleft palate population, such as methods and success of management, hearing, articulation, intelligence, sex, and psychosocial adjustment needs to be further investigated.

Adolescent↗

"Practical suggestions on counseling how I do it": counseling the laryngectomized patient.

A laryngectomee's home environment may be a critical motivating factor for successful rehabilitation. Results from questionnaires to 45 wives of laryngectomees are discussed. The wives evaluated the adequacy of their preparation for the surgery and the type and severity of ensuing problems. Judgments as to the type and adequacy of counseling and the wives' factual understanding of the laryngectomy procedure and its consequences are reported. Results of the survey underscored the need for more counseling before and after laryngectomy. Wives of older laryngectomees were more optimistic post-operatively since their primary preoperative fear had been death. Younger wives' spirits are often lowest after surgery when the impact on daily living was more fully realized. The need for a team approach to total medical, speech, and vocational rehabilitation is indicated.

Adult↗

Psychiatric and medical factors associated with disability in patients with dizziness.

Dizziness is a common patient symptom and often remains medically unexplained even after an extensive work-up. The otologic disorders, psychiatric disorders, and functional disability of 75 patients presenting with dizziness to a community otolaryngology practice were assessed in 1991. The patients were classified according to the presence or absence of at least one current DSM-III-R psychiatric disorder and the presence or absence of a peripheral vestibular disorder. Decrements in mental health and role functioning, and increases in bodily pain and hypochondriacal focus were significantly associated with the presence of a psychiatric disorder and whether the etiology of dizziness was due to a peripheral vestibular dysfunction.

Depressive Disorder↗

Self-efficacy and self-reported functional status in coronary heart disease: a six-month prospective study.

OBJECTIVE: We examine prospectively the role of specific forms of self-efficacy in the physical and role function for patients with coronary heart disease after controlling for the effects of anxiety and depression. METHODS: A 6-month prospective cohort study was conducted after cardiac catheterization of 198 HMO members, demonstrating clinically significant coronary disease. Coronary disease severity was assessed through cardiac catheterization; physical function, role function, anxiety, depression, and self-efficacy were assessed through questionnaires. RESULTS: The Cardiac Self-Efficacy Scale had two factors (maintain function and control symptoms) with high internal consistency and good convergent and discriminant validity. In multiple regression models, the self-efficacy scales significantly predicted physical function, social function, and family function after controlling for baseline function, baseline anxiety, and other significant correlates. CONCLUSIONS: Self-efficacy to maintain function and to control symptoms helps predict the physical function and role function, after accounting for coronary disease severity, anxiety, and depression in patients with clinically significant coronary disease. Interventions to improve self-efficacy may have a broader applicability in the heart disease population than previously appreciated.

Activities of Daily Living↗

Depression and self-reported physical health in patients with coronary disease: mediating and moderating factors.

OBJECTIVES: The purpose of this study was to define how the relation between depression and self-reported physical health in patients with coronary disease is modified by other patient-centered factors. METHODS: We conducted a prospective cohort study of 111 patients (members of a health maintenance organization) with angiographically documented coronary disease, examining factors (physical symptoms, psychological states and traits, and spousal support) modifying the relation between depression and patient-reported physical health 5 years later using multiple hierarchical regression models. RESULTS: Five regression models (all including demographic and disease severity covariates) were constructed to predict physical health from depression only (R2 = 0.22); depression plus angina and fatigue (R2 = 0.53); depression plus positive affect and novelty seeking and their interaction (R2 = 0.48); depression plus spousal support (R2 = 0.27); and depression, angina, fatigue, positive affect, and novelty seeking (overall model) (R2 = 0.65). Depression remained significant in each model, but the proportion of variance it predicted was diminished in the presence of the other variables (bivariate r = 0.39, partial r = 0.37-0.13). CONCLUSIONS: The effect of depression on self-reported physical health is significantly mediated by physical symptoms (angina and fatigue), personality states and traits (positive affect and novelty seeking), and spousal support. Positive affect and novelty seeking had more marked effects on physical health in the presence of more depression. Thus, a broad range of factors beyond the severity of coronary disease itself affect the perceived physical health of patients with coronary heart disease.

Affect↗