[Multimodal assessment of life satisfaction: a study of patients with cardiovascular diseases].
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Biomedical subjects
Publications and source records attributed to M Myrtek.
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Based on an analysis of 45 studies recently reported in the literature and data from a psychophysiological investigation, the hypothesized physiological mechanisms underlying Type A behavior and the methods used to determine Type A behavior (e.g., Structured Interview, SI, and the Jenkins Activity Survey, JAS) are tested. After determining behavior type with both the SI and JAS, subjects (N = 58 physical-education students) participated in a laboratory/field experiment with two replications consisting of the following conditions: (1) rest, (2) mental arithmetic, (3) reaction time test, (4) preparing and giving a speech, (5) Cold Pressor Test, (6) bicycle ergometric exercise, and (7) 1000 m run. Blood pressure, heart rate, stroke volume, cardiac output, ventricular ejection time, pulse volume amplitude, pulse transit time, pulse wave velocity, electrodermal activity, respiratory volume, oxygen uptake, and uric catecholamine levels were measured. Results of the analysis of the literature indicate that, with the exception of change scores on systolic blood pressure, mean differences on the physiological measures exhibited by Type A and B men are primarily not significant. The Structured Interview shows only a modest inter-rater reliability. The Jenkins Activity Survey demonstrates relatively low stability upon retest and fails to show sufficient internal consistency. Correlations between these measures are low. No consistent differences on physiological measures could be found in our subjects based on behavior type (according to SI or JAS criteria), although the challenging conditions were selected to elicit Type A behavior. Four our data, differences between Types A and B were also not found for systolic blood pressure, regardless of which behavioral assessment method was employed.
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In the course of a cardiac rehabilitation program 36 patients with myocardial infarction and 18 patients with functional cardiovascular disorders have been studied for 4 to 6 weeks. Data included daily self-report scales of condition, mood, bodily complaints, and daily routine. Physiological variables (blood pressure, heart rate, ventilation, respiratory gas exchange) were measured three times weekly under different conditions (breath holding, hyperventilation, reaction time, multiple reaction test). Analysis of variance indicated positive effects of the rehabilitation program for physiological as well as psychological variables. There were no obvious differences in state change between groups but there were some differences in the average level of variables. Time series analysis by means of autocorrelations revealed circaseptane periodicities which may be interpreted as a reflection of the exogene weekly rhythms.
210 male patients hospitalized for cardiac rehabilitation have been studied. As a result of age matching the sample was reduced to 190 patients: 72 patients with myocardial infarction, 90 patients with functional cardiovascular diseases, and 28 patients with angina pectoris. At the beginning and at the end of the 4 to 6 week rehabilitation program total lipids, cholesterol, triglycerides, phosphatides, GOT, GPT, LDH, HBDH, cholinesterase, aldolase, blood sugar, creatinine, electrolytes, hemoglobin, erythrocytes, leukozytes, and catecholamines were measured. In addition to the statistical comparison of the three groups and their specific change patterns, effects of body weight reduction and improvement of physical fitness were analyzed. The decrease of lipids is especially associated with weight reduction, whereas the decrease of enzyme activity and electrolyte concentration is accompanied as well with weight reduction as with the improvement of physical fitness.
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A longitudinal (time series) study was performed (N = 20 students; T = 16 points of observation during 8 weeks) on a considerable number of psychological and physiological variables to investigate the suitability of these parameters for general and individual state change description. Some problems of correlational analysis and the generality-individuality-dilemma of this kind of research are discussed.
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40 healthy male students were randomly assigned to either the exercise or control group. The latter was asked not to alter their common physical activity while the exercise group trained three times weekly on the bicycle ergometer for 15 minutes with a constant heart rate of 140bpm. At the beginning and after five weeks physiological data comprising cardiovascular and pulmonary responses at rest and under submaximal ergometric exercise were assessed. Additional data included psychological achievement tests, self reports of personality dimensions and frequency of physical complaints. Results indicated a marked increase in physical fitness for the training group improving the work load from 158 watt to 197 watt at constant heart rate. At rest and especially at submaximal work load there was an improvement of the economy of the cardiovascular and respiratory system. Contrary to these findings there were no changes or impairment in the psychological achievement tests, measuring concentration. Compared with the control group self reports of personality dimensions did not change except for a tendency to more extrovert behavior in the exercise group. Unexpectedly, the frequency of physical complaints did not decrease. The reason for this discrepancy is discussed.
In a repeated measurement design (16 times during 8 weeks) active orthostasis was investigated in a sample of twenty male students, utilizing a tilt table. Additional data included cardiovascular and pulmonary tests, psychological scales, items from a diary and meterorological data. Analysis of orthostatic time-series was carried out with hierarchical grouping analysis for heart rate and blood pressure. Results indicated three intraindividual patterns of orthostatic reaction called normo-, hyper- and hyporeactive. These patterns are independent of the known interindividual orthostatic reaction types. Analysis of variance of the described patterns revealed differences for physiological and meteorological data and some items of the diary. These results have been crossvalidated.
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In psychosomatic research there is a lack of multivariate studies based on samples that are adequate for statistical analysis. The present study is concerned with two samples of male students (N=107 and N=100) who took part in an extensive physiological and psychological assessment in order to find out psychosomatic patterns. Results indicate that correlational analysis including factor analysis too is insufficient to meet the complexity of the data. Multivariate classification procedures, in particular hierarchical grouping analysis, prove to be more useful in this respect. Some conclusions regarding diagnosis and therapy of the general psychosomatic syndrome are discussed.
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