AIDS in Kentucky.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
R L Frierson
Publications and source records attributed to R L Frierson.
Psychiatric reactions to leeches.
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Adolescent↗
Patients who refuse heart transplantation.
Some terminally ill patients refuse proposed heart transplantation. Forty patients were offered this surgery; six (15%) declined. Candidates refusing surgery were likely to have a psychiatric diagnosis and heart disease longer than 1 year. Factors thought to influence the decision to refuse surgery included (1) depression, (2) ambivalence about surgery or survival, (3) previous negative experiences with surgery, (4) acceptance of the inevitability of death, (5) concerns about postoperative quality of life, (6) organic brain syndrome, and (7) denial of the severity of heart disease. Patient refusal of a heart transplant is often disconcerting for members of the transplant team.
Adult↗
Sexual concerns after heart transplantation.
Sexual concerns after heart transplantation are commonly experienced yet seldom voiced. Forty-five patients approved for this procedure were surveyed regarding sexual issues. Twenty-one (47%) persons responded, of whom 16 had undergone heart transplantation, and five were waiting for a donor. Sexual dysfunction included impotence, ejaculation problems, altered libido, and avoidance of sexual opportunities. Contributing factors to these sexual difficulties were fear of death during coitus, effects of medication on interest and ability to function, body-image concerns, depression, uncertainty about the sexuality of the donor, and altered roles and responsibilities within the family. Recommendations for members of heart transplant teams include (1) obtaining a routine sexual history during the evaluation of candidates, (2) heightening awareness of the sexual concerns of these persons, (3) aggressively treating clinical depression, (4) establishing peer support groups for spouses of transplant patients, (5) presenting didactic material on sexual issues after transplant, (6) adjusting medications when sexual problems arise, and (7) addressing one's own level of comfort in discussing sex-related topics with transplant patients.
Adult↗