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D Glaser

Publications and source records attributed to D Glaser.

89 records · Page 5Linked to original sources
PubMedDate not supplied

Development and testing of a clinical tool measuring self-management of heart failure.

BACKGROUND: Self-management is a primary goal of treatment for heart failure. Yet no measure of self-management in this patient group currently exists. OBJECTIVES: To develop a clinically useful measure of the abilities of patients with heart failure to manage their disease. Self-management in this context was defined as a cognitive decision-making process undertaken in response to signs and symptoms of heart failure. A panel of experts agreed that the process involved 4 distinct stages: recognizing a change, evaluating the change, implementing a treatment strategy, and evaluating the treatment. The tool was developed to reflect this process. METHODS: Face validity of the process model was assessed in a sample of 25 patients with heart failure and used to develop a 65-item tool with 6 subscales. The subscales measure the 4 stages as well as the patients' ease in evaluating the signs and symptoms and their self-efficacy. The tool was pilot tested with 2 samples of patients with heart failure (N = 17; N = 129). Psychometrics of the final tool were then tested in a sample of 127 patients with heart failure. RESULTS: Face and content validity of the tool were demonstrated adequately through this study. Internal consistency scores of the 6 subscales of the Self-Management of Heart Failure instrument ranged from 0.79 (ease of evaluating treatment) to 0.92 (evaluating the change). Reliability could not be calculated for 1 subscale (evaluating the treatment) because of missing data that resulted from patients skipping sections because they had not experienced a symptom. CONCLUSION: Clinicians interested in evaluating the self-management abilities of their patients with heart failure are encouraged to use this tool and to contribute to additional testing.

Aged↗
PubMedDate not supplied

Development of an instrument to measure cardiac illness dependency.

OBJECTIVE: Dependency is frequently mentioned in the literature as a response of patients with cardiac disease. The purpose of this study was to develop and test a measure of dependency occurring in response to a cardiac illness. Illness dependency is defined as the need for emotional protection and social support after a significant change in health. DESIGN: Instrument development study. SAMPLE: Convenience sample of 311 patients with cardiac disease. RESULTS: The final version of the instrument has 25 items, each of which is measured on a 5-point Likert-type scale. Content validity was demonstrated using a panel of experts. Internal consistency of the total scale was 0.90; subscale alpha coefficients ranged from 0.64 to 0.81. Exploratory factor analysis supported a four factor solution: Attention, Reassurance, Concern, and Assistance, which accounted for 57.4% of the variance in scores. Discriminant validity was demonstrated by a low correlation with neuroticism. Social desirability of responses was minimal. CONCLUSION: Internal consistency reliability, content validity, and discriminant validity of the Illness Dependency Scale have initial support. This instrument is ready for use in research in which the investigator wishes to measure dependency associated with cardiac illness.

Aged↗
PubMedDate not supplied

[Rett syndrome--case report].

We report on a 13 years old girl with Rett syndrome (autism, dementia, ataxia and loss of purposeful hand use in girls). The Rett syndrome is unexpectedly frequent (1:15,000 in 1-14 years old girls). The diagnosis is based solely upon clinical development observation. Typical false diagnoses are: autism, some types of epilepsia, deprivation, cerebral palsy, degenerative encephalopathy, infantile psychosis and types of ataxia. The etiology is unknown, genetic factors, possibly an X-linked dominant new mutation, explain many, but not all findings. The empiric recurrence-risk is apparently low.

Ataxia↗
PubMedDate not supplied

A longitudinal causal model of cardiac invalidism following myocardial infarction.

BACKGROUND: Invalidism has been discussed in the cardiovascular literature for decades. Researchers have studied health perceptions, emotional distress, and dependency in patients after acute myocardial infarction in an attempt to understand the phenomenon. However, no theory of the manner in which these variables interact has been proposed. OBJECTIVES: Using previous research, a model of invalidism was specified in which individuals' perceptions that their health is poor lead to emotional distress and increased dependency. As health perceptions improve over time, emotional distress and dependency decrease. METHOD: Survey data were collected from 111 men and women 1 and 4 months after a first myocardial infarction and were tested using structural equation modeling. RESULTS: The model was rejected using a confirmatory approach (chi2(89) = 141.40; p= .00034). The fit indices, however, suggested an adequate fit of the model to the data (CFI = .96; NNFI = .94). CONCLUSION: The conclusion is that the model is reasonable and serves as a starting point for a theory-based empirical exploration of the invalidism process.

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