PubMed Health⌕ Search

Biomedical subjects

S E Ward

Publications and source records attributed to S E Ward.

8 recordsLinked to original sources
PubMed1990

High incidence of cardiomyopathy in beta-thalassaemia patients receiving regular transfusion and iron chelation: reversal by intensified chelation.

Cardiac scintigraphy has been performed in 60 beta-thalassaemia major patients aged 8-35 years who received regular blood transfusions and subcutaneous desferrioxamine (DFX) chelation. Fifty-seven showed no clinical, radiological or electrocardiographic evidence of heart disease and 3 had clinically apparent cardiac failure. Twenty-two patients (37%) showed severe cardiac functional impairment defined by a resting left ventricular ejection fraction (LVEF) less than 45% and/or a drop of greater than 12% on stress, while 19 were normal and 19 had a mild abnormality. There was no significant correlation between abnormality of LVEF and age, serum ferritin, number of units transfused, dose and duration of subcutaneous DFX therapy, liver disease or sexual maturation. Non-compliant patients (defined as the use of subcutaneous DFX less than 4 times weekly) generally showed worse cardiac function. Repeat study on 17 patients after 6-28 months of better compliance with subcutaneous or intravenous DFX (using an indwelling catheter) showed a significant overall improvement in LVEF associated with a significant drop in serum ferritin. We conclude that cardiac scintigraphy uncovers a high incidence of cardiac functional abnormality in asymptomatic, well-transfused thalassaemia patients, particularly those poorly compliant with chelation. Those with poor LVEF results should be offered intensive chelation therapy to improve cardiac function.

Adolescent↗
PubMed1989

Caregiving demands and appraisal of stress among family caregivers.

Ambulatory treatment for cancer has increased patients' self-care requirements and placed demands on family members to manage the illness and treatment side effects at home. This exploratory study was undertaken to assess family caregiving demands (load) and to examine caregivers' appraisals of the illness/caregiving experience. Forty-seven persons involved in the care of patients receiving radiotherapy for cancer were observed. Appraisal of stress was measured with the Appraisal of Caregiving Scale (ACS). This newly developed measure, derived from cognitive appraisal theory, is designed to assess the intensity of four possible appraisals of caregiving: harm/loss, threat, challenge, or benign. Participants also completed the Caregiver Load Scale, a measure of the time spent in caregiving activities. Satisfactory reliabilities were obtained for both measures. Family caregivers reported spending the most time in providing transportation, giving emotional support, and in extra household tasks. They received the most assistance from family and friends, and made minimal use of professional services. Caregiver load was correlated positively with the length of time on treatment and with patient dependency. Caregivers in the poorest health, those with less education, and those of lower socioeconomic status had higher scores on the ACS appraisals of harm/loss and threat. Older caregivers had significantly higher challenge and benign appraisals. There was a strong positive correlation between caregiver load and the harm/loss and threat appraisals. Findings suggest a need for frequent reassessment of demands on family caregivers throughout the course of treatment and offer direction for future research.

Adult↗
PubMed1985

Reducing acute confusional states in elderly patients with hip fractures.

The extent to which the incidence of postoperative acute confusional states could be reduced in elderly (greater than or equal to age 60) patients with hip fractures was tested. Interpersonal and environmental nursing interventions were carried out with 57 patients on orthopedic units in three hospitals. The incidence of confusion was reduced from 51.5% in the comparison group (n = 170) to 43.9%. Analysis that controlled for risk factors in the two groups showed the drop in incidence to be significant (p less than .02). The most effective interventions appeared to be those that provided orientation and clarification, corrected sensory deficit, and increased continuity of care.

Aged↗
PubMedDate not supplied

Patients' reactions to completion of adjuvant breast cancer therapy.

Thirty-eight women with breast cancer were studied to determine the psychological distress they experienced at the completion of adjuvant treatment. Measures were completed at the start of adjuvant chemotherapy, one week after chemotherapy was completed, and following completion of radiotherapy. Approximately 30% of the women reported the termination of treatment was upsetting. For the group as a whole, depression scores decreased significantly from the first to the last measurement. Those who were most upset by termination of treatment had been more depressed since the onset of treatment, tended to view their illness as chronic rather than acute, and had more side effects during their last cycle of chemotherapy. Some women stated they were upset by the termination of treatment per se, but many other problems were reported including side effects that had continued after treatment ended.

Adult↗
PubMedDate not supplied

The role of the self in adjustment to cancer in elderly women.

One way that people may adjust to illness is through a redefinition of the self, especially with respect to the relationship between ideal self and actual self. To investigate psychological adjustment in community-dwelling elderly women, women with cancer (n = 17) were compared to women with other health problems (n = 30) based on measures of psychological distress and well-being, actual self, ideal self, and the discrepancy between actual self and ideal self. Women with cancer scored no differently than other women on measures of psychological well-being, psychological distress, and actual self, but their ideal-self ratings were lower. The positive adjustment of women with cancer may be the result of their ability to lower their ideal-self expectations, thereby reducing self-discrepancies that can result in psychological distress.

Activities of Daily Living↗