Biomedical subjects
Publications and source records attributed to S Jay.
The disabilities following laryngectomy are well recognized. The incidence of these disabilities and the acceptability of the surgery to the patients were assessed by a questionnaire method. Sixty-five patients participated in the study. The incidence of disabilities are discussed. Total laryngectomy was felt to be a worthwhile operation by most of the patients in the study despite the disabilities they experienced afterwards.
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To test a previous theoretical model, we studied the relationships between social, attitude, and psychological factors and adolescent contraceptive behavior over a 6-month period. A pretested questionnaire was administered to a random sample of 115 black females aged 12 to 18 years from a low socioeconomic population. Six months after the initial interview 113 of the subjects were administered a second questionnaire assessing their sexual and contraceptive behavior. Based on regression analysis, previous pregnancy and coital frequency explained 12.7% (p less than or equal to 0.0001) of the variation in engaging in unprotected coitus. When controlling for sexual activity, birth control knowledge and previous broken appointments explained an additional 5.5% of variation in the regression model (total R2 = 0.185). Coital frequency of the subjects was positively associated with Tanner stage, length of the relationship, effectiveness of previous contraceptive method(s), and degree of birth control knowledge. Coital frequency was inversely associated with a negative attitude toward pregnancy and negative parental attitudes toward adolescent pregnancy. The perceived risk of pregnancy was positively correlated with coital frequency and previous pregnancy. These findings support our model, but suggest that among low socioeconomic black female adolescents the interpretation of several model components depends on the subjects' attitude toward pregnancy and her perception of her parent's attitude toward adolescent pregnancy.
We tested the hypothesis that the nature of the heterosexual relationship would be associated with the contraceptive and sexual behavior among three groups of females: those with a boyfriend who agreed to be interviewed (n = 31); those whose boyfriends refused to be interviewed (n = 38); and those without a single identifiable boyfriend (n = 44). A pretested questionnaire was administered to a random sample of 113 black females aged 12 to 18 years from a lower socioeconomic population. The three groups did not differ in age, Tanner stage, previous pregnancies, or in demographic variables. Females with boyfriends were more likely than others to be currently sexually active. Overall, 47.8% of the sample was sexually active. Females whose boyfriends were interviewed were more likely to feel that having a baby would ruin their life. Among sexually active females (n = 54), a higher percentage of females whose boyfriends were interviewed (90%) were currently using a prescription method of birth control and demonstrated higher previous contraceptive compliance. There were no differences between the groups with boyfriends in the degree that the females felt their boyfriends supported their use of birth control; those without boyfriends perceived less support. Six months after the initial interview, a higher percentage of sexually active females had a boyfriend as compared with other subjects. Although the 31 females and their boyfriends differed in the mean scores of several sexual behavior and attitude scales, the girls' and their boyfriends' scores on these scales were moderately correlated. These findings suggest that the nature of the heterosexual relationship may influence both the sexual and the contraceptive behavior of black female adolescents.
The effects of oral contraceptive use and habitual physical activity on serum cholesterol and lipoproteins were studied in 37 black females ages 16 to 28 years over a 3-month period. By the third month of oral contraceptive use, high-density lipoprotein (HDL) levels were lower and the low-density lipoprotein (LDL) to HDL ratio and total serum cholesterol (T Chol) to HDL ratio were significantly higher in those receiving oral contraceptive with norgestrel. The level of physical activity had no significant effect on HDL levels. The active subjects had lower T Chol and HDL levels and a lower T Chol to HDL ratio at the end of 3 months. Subjects in the active-norethindrone group had lower T Chol to HDL ratios than those taking norgestrel. The nonactive norgestrel group had a continuous increase in their T Chol to HDL ratio over the 3-month period. These effects should be considered when counseling sexually active teenagers and when recommending an oral contraceptive.
This study assessed the influence of internal health locus of control (IHLC) and anxiety on the adolescent's response to the treatment of mild and moderate pain. Fifty-four adolescents (ages 16-22 years) from two adolescent clinics presenting with mild to moderate pain caused by dysmenorrhea, muscle sprain or strain, headache, or backache were studied. Following a physical examination and a pretest assessment of pain, IHLC, and the Spielberger State-Trait Anxiety Inventory, subjects were randomly assigned in a double-blind fashion to groups receiving placebo (n = 16), 100 mg of naproxen sodium (n = 19), or 200 mg naproxen sodium (n = 19) and assessed at 1, 2, 3, and 4 hours. Based on a repeated-measure analysis of covariance test, there were no differences between groups in the pretest measurements. All treatment groups had a decrease in pain over the 4 hours (p less than 0.0001). Patients from one institution had more pain reduction than at the other (p less than 0.0001), and females had more pain reduction than males (p less than 0.034). Subjects receiving 200 mg of naproxen sodium had more pain relief (p less than 0.034) than subjects taking placebo at hour 2. Baseline anxiety was positively associated with pain after receiving placebo, but inversely associated with pain after taking naproxen sodium. The IHLC appeared to have a positive effect on the response to naproxen sodium, but no effect on the response to placebo.
With the increasing number of adolescent females participating in organized athletics, there has been concern over their susceptibility to injury during participation. This study assesses whether females differ from males in the severity and frequency of abnormalities on the preparticipation athletic examination (PAE). Standardized PAEs were performed on 1259 high school athletes. Females were found to have significantly less orthopedic problems than males on both the health history and the physical examination. Females were found to have a lower percentage of abnormalities of the hips, knees, and ankles than males. Black males had a significantly higher rate of hip abnormalities than white males, and black females had a higher rate of knee abnormalities than white females. A significantly higher percentage of males than females were referred for further evaluation prior to athletic participation. Although our adolescent females had fewer physical problems on the PAE that might add to their risk of having an athletic injury, the types of problems that were found in our females suggest that they should participate in more aerobic and strength training sessions prior to the sports season.
Drawing on a theoretical model of adolescent contraceptive behavior, we examined the relationships between various social and behavioral variables and contraceptive use by sexually active female adolescents. Hypotheses were tested with the use of a national random sample of sexually active female adolescents (n = 1426), aged 15 to 20 years, from Cycle III of the National Survey of Family Growth. The data were analyzed with Pearson correlation coefficients and multiple regression analysis. Noncompliance with the initial birth control method was the strongest predictor of the adolescents' contraceptive behavior at the time of the interview. Not acquiring birth control at the initial family planning visit and the frequency of family planning visits during the previous 12 months were the second and third best predictors of subjects' contraceptive use. Coital frequency and the length of time between first coitus and the initiation of birth control each explained a small amount of additional variation in the regression model. When combined, these five variables explained 40% of the variation in the contraceptive behavior of this representative sample of sexually active female adolescents. The findings could be useful for clinicians in providing more effective birth control counseling to adolescent patients.
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Self-concept and autonomy are typically negotiated during adolescence, a time when many females also become sexually active. Nonuse and discontinuation of contraceptives by teenagers place them at high risk for pregnancy. The present study explores the relationship between these psychological factors and contraceptive noncompliance during adolescence. Fifty-five adolescent females beginning a contraceptive regimen were entered into the study. Compliance at four months after the initiation of an oral contraceptive was associated with scoring high on the Behavior Subscale of the Piers-Harris Self-Concept Scale and the Autonomy Scale modified from Eysenk.
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Identifying what it is about the way nurse-midwives care for women that might contribute to healthy outcomes for women and infants requires clear definition of that care process. This article describes our efforts to define the theoretical construct of the nurse-midwifery care process. These efforts culminated in the development of a middle range descriptive theory of nurse-midwifery care. We share those efforts with others in the hopes of encouraging dialogue and the testing of this theory in a variety of clinical settings.