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Biomedical subjects

W Paris

Publications and source records attributed to W Paris.

28 records · Page 2Linked to original sources
PubMed1997

Psychosocial issues in heart transplantation: a review for transplant coordinators.

The latest advances in medicine and technology are used to care for transplant recipients, yet many patients have psychosocial difficulties that technology alone cannot resolve. Although most healthcare professionals acknowledge the importance of the staff's role in working with patients to resolve psychosocial problems, little research has examined the nature of staff-patient relationships and the proven ability of good relationships to improve outcomes. The purposes of this paper are to profile psychosocial risk and its relationship to outcomes after heart transplantation, explore staff-patient interactions in dealing with psychosocial problems, and present a growth and development model that can be used as a theoretical base to establish a more therapeutic alliance with patients.

Adaptation, Psychological↗
PubMed1996

A comparison of transplant patient and social worker attitudes in regard to transplant patient psychosocial selection criteria, role expectations and communication style.

Though much is known about organ transplant (TX) patient and family psychosocial needs, there is virtually no information about the nature of the interaction that exists between TX social workers and patients. A comparison of TX patient-social worker attitudes and beliefs found (i) patients supported a more egalitarian "consumer-centered" approach to health care, but were reluctant to assume the accompanying responsibility, and (ii) social workers were more "traditional" in their approach, which focused primarily on assessment and social support. Results argue for a more comprehensive clinical approach by social workers to deal with problems of patient compliance, substance abuse, and psychological needs in a TX service where emphasis is placed on results rather than subjective process measures.

Adult↗
PubMed1995

Determination of the HIV protease inhibitor BILA 2185 BS in rat plasma by liquid-liquid extraction and high performance liquid chromatography photodiode array detector.

A novel series of hydroxyethylamine-based inhibitors of HIV protease which contain a substituted pipecolinic amide were developed. After preliminary screening, a representative of this series, compound BILA 2185 BS, demonstrated an IC50 value of 3.3 nM in the enzymatic assay and an EC50 value of 2.0 nM in cell culture. The plasma profile and bioavailability values for BILA 2185 BS in the rat will be presented. The analyte was isolated from rat plasma using a liquid-liquid extraction procedure. The analytical technique used utilizes a high performance liquid chromatography system with photodiode array detector. The range of the standard curve was from 10 to 5000 nM. Recovery values averaged 72.4 +/- 8.6% (mean +/- S.D.). The limit of detection for BILA 2185 BS was 6-12 nM.

Animals↗
PubMed1992

Social rehabilitation and return to work after cardiac transplantation--a multicenter survey.

As the medical results of heart transplantation steadily improve, the social rehabilitation of patients, in particular, their ability to return to some form of employment, is becoming increasingly important. Two-hundred fifty patients were therefore surveyed at 7 heart transplant centers (5 of which were Medicare certified) from different geographic regions in the U.S.A. Over all, 45% were employed, 36% were unemployed, 13% were medically disabled, and 6% were retired. Of those employed, 87% had returned to their previous employment, and only 13% had secured new employment. Of the unemployed, 16% had made job applications, and no fewer than 63% had no current plan to seek employment. Factors found to negatively influence a return to work included the following: (1) length of medical disability prior to transplantation; (2) a patient's self-perception of being physically unable to work; and (3) the potential loss of health insurance and/or disability income. At 2 centers, where there was a definite policy of not supporting a patient's claim for medical disability in the absence of an absolute indication, there were significantly increased numbers who (1) secured new employment and (2) planned to seek employment. More serious attention must be paid to aspects of employment if heart transplant recipients are to become fully productive members of the community.

Adult↗
PubMedDate not supplied

Study of the relative incidences of psychosocial factors before and after heart transplantation and the influence of posttransplantation psychosocial factors on heart transplantation outcome.

Psychosocial factors substance abuse, noncompliance, psychiatric problems, and obesity in relation to the outcome of heart transplantation have been investigated. Data were gathered at the time of initial assessment, and patients (n = 53) were monitored during the follow-up after heart transplantation (mean 18 months). Noncompliance, psychiatric problems, or excessive weight before heart transplantation continued after heart transplantation. Significantly fewer substance abusers exhibited similar behavior after heart transplantation (p < 0.01), although in many cases this exposed other psychiatric or compliance problems. Patients with psychiatric problems after heart transplantation had a higher risk of infection (p < 0.01). Both these patients and those who were noncompliant had higher incidences of hospital readmission (p < 0.01) which were reflected in higher medical costs (p < 0.01) during the second year after heart transplantation in both subgroups. We conclude that (1) heart transplant recipients do not alter previous behavior after heart transplantation except with regard to substance abuse, (2) patients exhibiting substance abuse before heart transplantation and abstaining after heart transplantation have other psychosocial problems, (3) psychosocial problems after heart transplantation do not increase the risk for medical complications in the early posttransplantation period except with regard to infection, and (4) the presence of noncompliance and psychiatric problems after heart transplantation is related to increased readmissions and higher total medical costs.

Age Factors↗
PubMedDate not supplied

Returning to work after heart transplantation.

The purpose of this study was to determine what factors influence a patient's return to work after heart transplantation. Two hundred fifty patients who had undergone heart transplantation were surveyed at seven regional centers in the United States (five of which were Medicare-certified). Of these patients, 45% were employed, 36% were unemployed, 13% were medically disabled, and 6% had retired. A stepwise discriminant analysis resulted in the selection of six variables that helped differentiate those patients who did and those who did not return to work after the transplantation. The factors associated with a patient's return to work included (1) self report of being physically able to work, (2) no loss of health insurance, (3) longer length of time after transplantation, (4) education level of more than 12 years, (5) no loss of disability income, and (6) shorter length of disability before heart transplantation. This information could accurately profile 91% of the patients who were employed, 69% of the patients who were unemployed, and 80% for the entire group. The implication of this study is that social rehabilitation is not synonymous with the medical results of heart transplantation. More attention to social rehabilitation is required if heart transplant recipients are to enjoy a better quality of life and become fully productive members of the community.

Adult↗