Biomedical subjects

T O Woods

Publications and source records attributed to T O Woods.

4 recordsLinked to original sources

PubMed1993

Who's afraid of informed consent?

OBJECTIVE: To test the assumption that patients will become unduly anxious if they are given detailed information about the risks of surgery in an attempt to obtain fully informed consent. DESIGN: Preoperative anxiety assessed before and after patients were randomly allocated an information sheet containing either simple or detailed descriptions of possible postoperative complications. SETTING: Four surgical wards at two Sheffield hospitals. SUBJECTS: 96 men undergoing elective inguinal hernia repair under general anaesthesia. MAIN OUTCOME MEASURE: Change in anxiety level observed after receiving information about potential complications. RESULTS: Detailed information did not increase patient anxiety (mean Spielberger score at baseline 33.7 (95% confidence interval 31.3 to 36.2), after information 34.8 (32.1 to 37.5); p = 0.20, paired t test). A simple explanation of the facts provided a statistically significant degree of reassurance (mean score at baseline 34.6 (31.5 to 37.6), after information 32.3 (29.8 to 34.9); p = 0.012), although this small effect is likely to be clinically important only in those whose baseline anxiety was high (r = 0.27, p = 0.05). CONCLUSIONS: In men undergoing elective inguinal hernia repair a very detailed account of what might go wrong does not increase patient anxiety significantly and has the advantage of allowing patients a fully informed choice before they consent to surgery, thus reducing the potential for subsequent litigation.

Anxiety↗

PubMed1991

Psychiatric perspectives: an overview.

This chapter reviews the evidence concerning the importance of psychological and social factors in the aetiology and pathogenesis of chronic fatigue syndrome. The diagnosis is often offered to doctors by patients; and we consider attribution, stigma, collusion between doctor and patient, and abnormal illness behaviour in this context. We then give a brief description of a model for common mental disorders, and show how chronic fatigue syndrome relates to this model. It emerges that there are special vulnerability factors in these patients' personalities before the viral illness, but the disorder is seen as being released by the viral illness. By the time the disorder becomes established the original causal nexus is seen as no longer so important, and the disorder can be seen as a form of abnormal illness behaviour maintained by special factors. The implications for treatment are then considered.

Fatigue Syndrome, Chronic↗

PubMedDate not supplied

The effects of use and simulated reuse on percutaneous transluminal coronary angioplasty balloons and catheters.

A series of studies was undertaken to determine the effects of single patient use and simulated reuse on percutaneous transluminal coronary angioplasty (PTCA) balloon catheters. Catheters were retrieved from Walter Reed Army Medical Center and were low-level disinfected and cleaned at the US Food and Drug Administration. They were then tested for balloon compliance, and the results were compared against the manufacturer's specifications. Selected groups of catheters were subjected to EO-resterilization and a simulated reuse protocol. The results demonstrated that the effects of use and EO-resterilization is model specific. Furthermore, some balloons demonstrated a time-dependent behavior while others recovered from the effects of simulated reuse by compliance testing at high pressure. Testing for the slipperiness of the catheters after repeated EO-resterilization also demonstrated that changes were model specific.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

The effect of repeated ethylene oxide sterilization on the mechanical strength of synthetic absorbable sutures.

The purpose of this study was to determine the effect of repeated ethylene oxide sterilization using a standard clinical protocol on sutures, a type of medical device labeled for single use and reported to be reprocessed for use after being opened but not used. Four types of commonly used synthetic absorbable sutures were subjected to 1 and 2 ethylene oxide resterilization cycles. Knot tensile strength was determined for new sutures and for sutures that had been subjected to 1 and 2 ethylene oxide resterilization cycles. As has been found with other types of single-use devices, no general conclusions can be made for absorbable sutures. The strengths of different types of sutures increased, decreased, or stayed the same after repeated sterilization. In addition, the inner packages of some sutures were not intact after reprocessing, possibly exposing the sutures to increased humidity, which can produce degradation leading to loss of strength both immediately and after additional shelf aging and degraded performance after clinical use.

Ethylene Oxide↗