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Biomedical subjects

S A Cupples

Publications and source records attributed to S A Cupples.

14 recordsLinked to original sources
PubMed2001

Use of behavioral contingency contracting with heart transplant candidates.

For many years, behavioral contingency contracting has been useful in increasing compliance in a variety of patient populations. More recently, this type of contracting has been used to facilitate communication and motivate behavioral change among patients referred for transplantation. This article discusses the theoretical basis of behavioral contingency contracting and describes the development and implementation of a multipurpose behavioral contract for patients receiving heart transplants. The scarcity of donor organs and the stringent posttransplant regimen mandates that psychosocial as well as medical variables be considered during the transplant evaluation process. Behavioral contingency contracting is useful in identifying those individuals with the potential to maintain a transplanted organ capably.

Health Behavior↗
PubMed2000

Evaluation criteria for the pretransplant patient.

As Achuff notes, transplant evaluation can be a lengthy and difficult process for patients and transplant personnel; however, the scarcity of donor organs mandates that heart transplant teams carefully evaluate all relevant physiologic and psychosocial data. By doing so, transplant professionals enhance their ability to select patients who are most likely to benefit from transplantation in terms of survival and quality of life, thereby making prudent use of a limited societal resource.

Comorbidity↗
PubMed1998

Perceived stressors and coping strategies among heart transplant candidates.

This study examined heart transplant candidates' perceived stressors and coping strategies at the time of placement on the waiting list and at 3, 6, 9, and 12 months following. Mean stress scores were relatively low at each assessment time. The 4 greatest stressors were (1) having a terminal disease, (2) needing a heart transplant, (3) worrying family members, and (4) undergoing prolonged hospitalization. Total stress scores indicated that candidates were effectively using a moderate number of coping strategies, the 5 most frequently used ones being thinking positively, trying to keep life normal, keeping a sense of humor, praying or trusting in God, and trying to distract oneself. The 5 most effective coping mechanisms were thinking positively, keeping a sense of humor, thinking of good things, praying or trusting in God, and trying to keep life normal. No significant differences were seen in coping use or effectiveness over time.

Adaptation, Psychological↗
PubMed1997

Cardiac transplantation in women.

This article reviews key physiologic and psychosocial issues that affect female heart transplant recipients. Pretransplant concerns ranging from possible gender bias to preformed antibodies are addressed. Posttransplant survival rates by gender and by pretransplant diagnosis are discussed as well as the incidence of major complications. Side effects of immunosuppression therapy that may be of particular concern to women are presented. A number of pregnancy-related issues are summarized, including ethical concerns, contraception methods; pregnancy guidelines; the effects of normal physiologic changes; and peripartum, intrapartum, and postpartum management. Key areas for future research are presented.

Female↗
PubMed1991

Effects of timing and reinforcement of preoperative education on knowledge and recovery of patients having coronary artery bypass graft surgery.

Studies of preoperative educational interventions with patients having cardiac surgery suggest that the life-threatening nature of this type of surgery impedes learning and undermines the effectiveness of preoperative education in the immediate preoperative period. In this study the effectiveness of preadmission preoperative education for patients having coronary artery bypass graft surgery (CABG) was investigated. The sample consisted of 40 patients scheduled for an initial, elective CABG procedure. A randomized, experimental, posttest-only design was used. Subjects in the experimental group received both preadmission and postadmission preoperative education; those in the control group received only routine postadmission preoperative education. Outcome measures were (1) preoperative knowledge of CABG surgery and routine, (2) postoperative state anxiety, (3) postoperative mood state, and (4) physiologic recovery. Subjects in the experimental group had significantly higher preoperative knowledge levels, more positive mood states, and more favorable physiologic recoveries than those in the control group.

Adult↗
PubMedDate not supplied

Psychophysiological manifestations of anxiety in patients undergoing electrophysiology studies.

OBJECTIVE: To measure state anxiety and related physiological correlates at 3 selected times when patient education regarding electrophysiology (EP) studies is likely to occur: 24 hours before the EP study (pre-procedure teaching), 1 hour before the EP study (reinforcement of pre-procedure teaching), and 3 hours after the EP study (explanation of results; reinforcement of post-procedure instructions). DESIGN: Descriptive-exploratory. SETTING: Military medical treatment facility in mid Atlantic region. SUBJECTS: Thirty-two adults who underwent initial EP testing. OUTCOME MEASURES: The Spielberger State Anxiety score, frontalis muscle tension, heart rate, electrodermal activity, electrothermal feedback, and mean arterial pressure. METHODS: Outcome measures were obtained 1 day before (time 1), 1 hour before (time 2), and 3 hours after (time 3) the EP study. RESULTS: Both state anxiety scores and physiological variables indicated minimal psychophysiological reactivity. CONCLUSION: Patients undergoing initial EP studies experience moderate state anxiety and manifest a paradoxical pattern of autonomic responses over time. Moderate levels of state anxiety at each of the 3 assessment points would seem to indicate that patient education is appropriate at these times.

Adolescent↗
PubMedDate not supplied

Selection, care, and feeding of a research mentor.

The purpose of this article is to describe a process by which investigators can identify and select a research mentor and develop a mutually beneficial mentoring relationship. Such a relationship can benefit not only novice investigators, but also more experienced researchers who are branching out into a new field of inquiry. The term mentoring is defined and nature of the mentoring relationship is discussed. Specific information is provided regarding the types of assistance a research mentor can provide, sources of potential mentors, qualities of the successful mentor and protégé, stages of the mentoring relationship, and strategies for dealing with less than optimal relationships. Tools are provided to aid the reader in identifying research needs and in rating potential mentors.

Humans↗
PubMedDate not supplied

Publishing the research report.

Although research is not finished until it is published, many investigators fail to report their research. The purpose of this article is to discuss the dissemination of research findings via the published manuscript. Barriers to publication are reviewed and strategies for overcoming these barriers are presented. Selection of a target journal is discussed, along with the purpose of the query letter. The format of the research report is addressed and specific information is provided regarding the literature review and the use of illustrative materials. Practical tips are provided for each stage of the writing process.

Correspondence as Topic↗
PubMedDate not supplied

Pain as "hurtful experience:" a philosophical analysis and implications for holistic nursing care.

Pain is a universal phenomenon--and the most common reason why people seek medical advice. Yet despite its widespread prevalence, pain is among the least understood of all medical phenomena. This article discusses the epidemiology of pain and identifies both historic and contemporary definitions of pain. The proposition, "Pain is a hurtful experience," is analyzed in terms of five predicables: species, genus, specific difference, logical property, and logical accident. Implications for holistic nursing practice relative to each predicable are presented.

Holistic Health↗
PubMedDate not supplied

Perceived stress and coping strategies among families of cardiac transplant candidates during the organ waiting period.

OBJECTIVE: To explore and describe perceived stress and coping strategies among families of candidates for cardiac transplant during the organ waiting period. DESIGN: This descriptive, multiinstitutional study was guided by the T-Double ABCX Model of Family Adjustment and Adaptation (McCubbin & Thompson, 1987). SETTING: Five tertiary care centers with transplant programs in three Southeastern cities. SUBJECTS: Thirty-eight family members of patients on the active list for cardiac transplantation, including 35 women and three men with a mean age of 44 years (SD = 13.17). Subjects had a family member on the waiting list for a mean of 6.5 months. INSTRUMENTS: Family members completed the following three instruments: (1) Family Inventory of Life Events and Changes (FILE), (2) Family Crisis Oriented Personal Scale (FCOPES), and (3) Family Perception of the Transplant Experience Scale (FPTES). RESULTS: Stress: 53% and 47% of respondents indicated that they were experiencing moderate and low degrees of stress, respectively. Coping: Family members used more coping mechanisms than normative subjects in the literature. Coping strategies used in order of decreasing frequency: (1) knowing our family has the strength to solve our problems, (2) facing problems head-on, and (3) seeking support from friends. Appraisal: Mean score of 32.13 reflects subjects' positive perception of the pretransplant experience. The three statements with which the subjects most strongly agreed: (1) heart illness has changed roles of family members, (2) family member will survive the transplant operation; and (3) this is an experience that could bring out the family's strengths. CONCLUSIONS: An increase in the number of coping strategies used with low to moderate stress levels suggests the effectiveness of coping strategies in mediating stress. The preference for active rather than passive coping strategies may be reflective of the selection criteria for transplant candidates or nursing interventions during this period to minimize stress and promote family coping.

Adaptation, Psychological↗
PubMedDate not supplied

Perceived stress and coping strategies among candidates for heart transplantation during the organ waiting period.

The effectiveness of the transplantation team in diffusing stress during the pretransplantation period is increasingly important the longer the patient remains on the transplant waiting list. This study describes the stressors and coping strategies of heart transplant candidates during the waiting period. Thirty-nine candidates on the active list for heart transplantation from four mid-East Coast transplantation centers participated. With a possible stress score of 0 to 243, the mean score for this sample was a low 72.84 (standard deviation = 37.47). The three most common stressors were (1) requiring a heart transplant, (2) having terminal heart disease, and (3) worrying family members. The three most common coping strategies were (1) thinking positively, (2) using humor, and (3) trying to keep life as normal as possible. The finding of low stress levels was surprising but may reflect the presence of hope or the patient's desire to spare family members worry--a concern commonly cited by patients. Another explanation is that patients desiring to be perceived as ideal transplant recipients may have underreported their stress. This suggests that the transplantation team should support positive coping strategies when possible and that both patient and family coping should be closely monitored throughout the waiting period.

Adaptation, Psychological↗