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Biomedical subjects

B S Linn

Publications and source records attributed to B S Linn.

At least 37 records · Page 2Linked to original sources
PubMed1983

Surgical stress in the healthy elderly.

Surgery has sometimes been studied as a stressful event. The aim here was to determine the relationship between degrees of anxiety before surgery and postoperative outcomes in healthy old and young men. Old and young men were selected if they had no illnesses or prior surgery and were scheduled for elective hernia repair. Levels of anxiety were measured preoperatively along with other physiologic, psychologic, and immunologic modalities. Operative data and follow-up data for 30 days were obtained. Old and young men did not differ significantly before surgery. When age groups were divided by preoperative anxiety and their postoperative outcomes compared, more anxiety was associated with more pain-relieving medications and more disability days in each age group. Furthermore, the old anxious had even more disability days and complications than did other groups. The study points to the need to prepare the old, even those essentially in very good health, for even a minor surgical stress in order to improve their overall health outcomes.

Adult↗
PubMed1983

Liver damage, alcohol use, and diagnosis.

This study examined the degree of liver damage, reflected by standard laboratory tests, in a group of male veterans in regard to their self-reported histories and diagnosis of alcoholism. Fifty-two percent of the patients were diagnosed as alcoholic. The correlation between liver damage, judged by a physician reviewing the tests, and diagnosis of alcoholism was r =.33. Although liver damage does not develop in some alcoholics, this minimal correlation suggests the need to look for other nutritional and genetic factors that may interact with alcoholism in development of liver damage.

Adult↗
PubMed1982

Effects of counseling for late stage cancer patients.

Much has been written about working with the dying. Few, if any, controlled studies have examined the application of principles set forth. The authors evaluate the effectiveness of working with dying cancer patients by assessing changes in quality of life, physical functioning, and survival. One-hundred twenty men with end-stage cancer were randomly assigned to experimental or control groups; the 62 experimental group patients were seen regularly by a counselor. Patients were assessed before random assignment and at one, three, six, nine, and 12 months on quality of live and functional status. Experimental group patients improved significantly more than the control group on quality of life within three months. Functional status and survival did not differ between groups. A subsample of lung cancer patients provided cross-validation of findings. Although survival was not expected to differ, it was predicted that functioning would be enhanced if quality of life improved. One interpretation is that little can be done to alter physical function and survival when intervention occurs late in the progression of a fatal disease. This in no way reduces the value of improving overall quality of life, since enhancing the quality of survival for end-stage cancer patients is a high priority medical goal.

Counseling↗
PubMed1982

Values and attitudes related to career preference and performance in the surgical clerkship.

We investigated the values and attitudes of junior medical students in relation to career preference (particularly surgery), ward behavior, and cognitive performance in the surgical clerkship. Students choosing specialty surgery were more cynical and authoritarian than those selecting general surgery. Those choosing general surgery had more self-esteem, and along with those who selected specialty surgery, more intolerance for ambiguity than other students. None of the values or attitudes were associated with grades, but several were related to ward behavior as judged by faculty and house staff. Students who valued academic achievement more and independence and intellectualism less and those with more submissive authoritarian views and more ego strength were considered better ward performers. This raises the question of whether such values and attitudes should be reinforced in ward performance or whether such students are rated higher simply because they are less disruptive to busy ward routines.

Attitude↗
PubMed1982

Patient symptoms and physician prescribing patterns in the elderly.

The aim was to determine if different doctors prescribed differently for older patients with the same diagnoses as patients who were younger. Five ambulatory-care physicians were selected randomly from a staff of 15. Over age 65 male patients (N = 329) were compared with 889 younger patients in regard to symptoms and medications. Patient-rated symptoms differed by age of patients but not by the five physicians. Comparison of 20 types of medications showed seven differed by patient age but none by physician. Analysis of data in an age x physician grouping, however, showed that certain physicians treated older patients differently in regard to use of digitalis, tranquilizers and pain medications. The findings suggest remarkable similarity in symptoms for older patients seen by different physicians. While use of the medications did not differ between physicians for patients as a total group, they did differ when age of the patient was taken into account. The inconsistent use of certain medications for the old without support of symptoms and diagnoses raises questions about how the old are viewed as a group by some physicians.

Age Factors↗
PubMed1982

Beliefs about causes of cancer in cancer patients.

Beliefs about causes of cancer were studied in 120 patients with late-stage cancer and compared with beliefs of non-cancer patients matched for age, sex, and hospitalization. Cancer patients consistently had less strong beliefs about causes of cancer than did the other groups, even when causes such as smoking and having pulmonary cancer were probably associated with the development of their disease. Although some correlates of beliefs were found in cancer patients' personal and social background, these were generally of minimal levels of statistical significance. Those who had been diagnosed longer believed cancer was more often inherited. The non-cancer patients' beliefs were similar to those found in a large survey of the general population. It is likely that cancer patients need to defend themselves against self-blame as a means of coping with a terminal illness.

Attitude to Health↗
PubMed1982

Burn patients' evaluation of emergency department care.

We examined satisfaction with burn care in 1,418 patients treated in 20 community hospital emergency departments. Lower levels of satisfaction correlated with a poorer process of care measured by number of physician deviations from burn care algorithms. The less severely burned and older patients had higher degrees of satisfaction. The more satisfied the patient, the greater the compliance with medical regimens and the better the patient outcomes as measured by days lost from work and perceived disability. If better patient attitudes relate to process of care and in turn to increased compliance and better outcome, then patient satisfaction is an important part of an overall evaluation of emergency department care.

Adolescent↗
PubMed1982

Evaluation of results of surgical procedures in the elderly.

Authorities are not in full agreement in regard to risk of surgery in the elderly. One hundred eight studies of surgery in the elderly over the past 40 years were reviewed. The purpose was not merely to tabulate results, but to identify differences existing between reports with regard to data reported that could affect results independent of the surgical management itself. Sources of variance that need to be taken into account in comparing mortality rates between studies, such as whether mortality was computed by number of patients or operations, differing lengths of follow-up for recording mortality, proportions of emergency versus elective operations, and types of surgical procedures, were documented. A nine-item confidence in results scale was used to classify studies into high and low confidence groups. Surgical specialties scored substantially higher than general surgical studies. More recent studies received higher scores than earlier studies. Although mortality rates varied widely depending on methods of their calculation, there appeared to be a trend toward increases in elective, but not emergency, mortality rates in general surgery since 1941 that should be examined more closely. One thing that cannot be answered clearly from these studies is the relative risk of surgery with age. Some control of variations between studies and standardization of reporting surgical deaths are required before risk of surgery in the elderly can be assessed more accurately.

Aged↗
PubMed1982

Satisfaction with ambulatory care and compliance in older patients.

Predictors of satisfaction with ambulatory care and compliance in 267 older and 581 younger patients were determined. Each patient rated a 45-item satisfaction-with-care-scale. Race, SES, marital status, distance from clinic, severity of illness (as measured by physician ratings, self-health assessment, number of medications, number of diagnoses, and number of clinic visits and hospitalizations in the prior year), and physician expectations of improvement were entered as predictors into stepwise multiple regression analyses for the elderly and the young. Predictors of better satisfaction in the young were less severe conditions, being nearer to the clinic and having fewer prior clinic visits over the year. In the elderly, having fewer visits to the clinic, more expectation of improvement by the physician and less severe conditions were associated with better satisfaction. Severity and clinic visits were predictors in each age group. The young, however, were also influenced by distance from the clinic. The elderly were influenced separately by the physician's prognosis. Thus, when the more impaired elderly are seen frequently without expecting a benefit, their satisfaction with care is poor. Further, satisfaction with care was correlated significantly with compliance in the elderly but not in the young. Findings suggest that improving satisfaction with care might also improve rates of compliance with the medical regimen in older patients.

Adult↗
PubMed1982

Effectiveness of an ambulatory care telephone service in reducing drop-in visits and improving satisfaction with care.

The purpose of this research was to determine whether a specialized telephone service could cut down on unscheduled visits to ambulatory care and improve satisfaction with care. Patients who were to receive care (N = 561) were assigned randomly to a specialized telephone service or a control group. They were measured with regard to satisfaction with care before being assigned and 6 months later. The number of scheduled and unscheduled visits also were monitored for a 1-year follow-up period. The telephone service, which provided a triage system for referrals as well as a source of central contact for scheduling or for complaints, helped to improve satisfaction and reduce the number of unscheduled visits within 6 months. Such a service also may have application in other problem areas in the delivery of quality ambulatory care.

Ambulatory Care↗
PubMed1982

The rapid disability rating scale-2.

A revised version of the Rapid Disability Rating Scale (RDRS-2) is presented. Item definitions have been sharpened and directions expanded to indicate that ratings are based upon the patient's performance in regard to behavior, and that prosthesis normally used by the patient should be included in the assessment. Three items have been added to increase the breadth of the scale. Response items have been changed from three-point to four-point ratings in order to increase group discrimination amd make the scale more sensitive to changes in treatment. The new appraisals of reliability, factor structure, and validity are reported, along with the potential uses of the scale.

Activities of Daily Living↗
PubMed1981

Late stage cancer patients: age differences in their psychophysical status and response to counseling.

Much has been written about working with dying patients. To evaluate counseling, 120 terminally ill cancer patients were randomly assigned to counseling or no counseling and studied before random assignment and at 1, 3, 6, 9, and 12 months on quality of life variables (alienation, depression, locus of control, life satisfaction, self-esteem) as well as functional status and survival. Counseled patients changed significantly in comparison to controls and in a favorable direction by 3 months. The purpose here was to see if older and younger cancer patients differed at baseline and if outcomes of counseling differed by age. Patients under age 60 were compared with those 60 and over. There was no multivariate difference at baseline but univariate differences of more disability and less life satisfaction in the older group. Overall, response to therapy was similar in old and young, with both improving.

Adult↗