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Biomedical subjects

S Boeke

Publications and source records attributed to S Boeke.

13 recordsLinked to original sources

A structural modeling analysis of anxiety and depression in patients undergoing coronary artery bypass graft surgery: a model generating approach.

The present study is a longitudinal study designed to explore structural relationships between anxiety, depression, personality, and background factors (e.g., gender, age, and complicated medical characteristics) in patients undergoing coronary artery bypass graft (CABG) surgery. At two timepoints before and two after CABG, 217 patients completed self-report questionnaires. To explore structural relationships, the structural equation modeling (SEM) method was applied. Using the model-generating approach, a model was developed, providing a good fit. The structural relationships revealed, in particular, the key position of neuroticism, which was related to both pre- and postoperative anxiety and depression. Relationships between anxiety and depression over time, both intra- and interrelationships, were relatively weak. Relationships between anxiety and depression at the same points in time were relatively strong, with preoperative depression leading to preoperative anxiety, and postoperative anxiety leading to postoperative depression. To provide a useful framework for development of intervention strategies, further research is needed to evaluate the plausibility of the final structural model.

Adult

Preoperative expectations of pain and recovery in relation to postoperative disappointment in patients undergoing lumbar surgery.

OBJECTIVES: In groups of lumbar surgery patients who had different expectations about postoperative pain and recovery, this study investigated disappointment three days and three months after surgery. Our hypothesis was that patients who did not expect any postoperative pain and who expected a fast rate of recovery were at risk of becoming disappointed. METHODS: One day before surgery, 120 patients who underwent lumbar surgery were interviewed about their expectations regarding postoperative pain, rate of recovery, and return to work. Levels of postoperative pain and disappointment were measured three days and three months postoperatively. RESULTS: Patients who did not expect to have any postoperative pain reported significantly less disappointment three days and three months after surgery than did patients who expected to have postoperative pain. No significant differences were found in postoperative disappointment between the groups with different expectations regarding the rate of recovery or the return to work. CONCLUSION: Contrary to our hypothesis, the results suggest that patients who do not expect to experience any postoperative pain will be less disappointed after surgery than patients who expect to be in pain. Implications for the theory of mental preparation and for preoperative intervention strategies aimed at diminishing the stress of surgery are discussed.

Adaptation, Psychological

The course of anxiety and depression in patients undergoing coronary artery bypass graft surgery.

A semilongitudinal study was designed to follow-up the course of anxiety and depression in patients undergoing coronary artery bypass graft (CABG) surgery. The focus was on possible effects of gender and age on variations in both mean level and interindividual differences over time. At two timepoints before and two after surgery, 217 patients completed self-report questionnaires. Multivariate testing revealed an overall decrease in mean levels of anxiety and depression in the postoperative period but different trends for men and women. Compared with men, women reported more anxiety and depression, both pre- and postoperatively, but showed a relatively stronger decrease in the early postoperative period. Regarding variations in interindividual differences over time, multivariate testing revealed different trends of depression for men and women. Women appeared to be most homogeneous in the early days after surgery, whereas interindividual differences for men showed a stable trend.

Adult

The influence of psychological variables on postoperative anxiety and physical complaints in patients undergoing lumbar surgery.

Previous research has indicated that postoperative distress is influenced by diverse biographic, medical and psychological variables, such as personality, coping behaviours and anxiety. The influence of state variables, apart from anxiety and coping behaviour, has received scant attention. Furthermore, the influence of coping behaviour has remained unclear. The present study investigated coping behaviour and indications of physical distress, i.e., preoperative fatigue, leg pain and back pain, besides preoperative anxiety, as predictors of postoperative anxiety and physical complaints in 126 patients undergoing lumbar surgery. Preoperative anxiety and leg pain independently predicted more postoperative anxiety beyond the influence of age, sex and medical variables. Preoperative anxiety and fatigue independently predicted more postoperative physical complaints. No associations were found between the coping behaviours and the postoperative variables. The implications of these results are discussed in relation to intervention strategies aimed at diminishing the stress of surgery.

Adaptation, Psychological

Pre-operative anxiety variables as possible predictors of post-operative stay in hospital.

The extent to which measures of pre-operative anxiety predict post-operative hospital stay, over and above what is predicted by biographical, medical status and post-operative anxiety variables, was examined in 81 cholecystectomy patients. Hierarchical multiple regression analysis revealed that patients who were older, had lower health status and suffered from wound infection, had a longer post-operative hospital stay than others. None of the pre-operative anxiety measures had a significant incremental value in the prediction of the post-operative hospital stay.

Anxiety

Psychological variables as predictors of the length of post-operative hospitalization.

The extent to which measures of anxiety and personality characteristics, which had been assessed preoperatively, could predict the length of hospital stay following surgery, above and beyond what could be predicted on the basis of biographical, medical-status and post-operative anxiety variables, was examined in 58 patients with gall-bladder disease. Hierarchical multiple regression analysis revealed that gender, previous operations, complications and State Anxiety (A-State) measured on the third day post-operatively, jointly explained a significant proportion of the variance in the length of hospitalization. Neither preoperative anxiety measures nor personality characteristics had any significant incremental value in the prediction.

Adult

[Relationship between perioperative anxiety and postoperative recovery].

One day before surgery and three days postoperatively, 118 cholecystectomy patients were investigated by means of several self-report anxiety-question(naire)s. On the basis of these, the patients were assigned to either the category more anxious postoperatively (A+) or the category less anxious postoperatively (A-). A+ patients rated preoperatively lower and postoperatively higher on the anxiety-question(naire)s than A- patients, and they stayed longer in hospital postoperatively.

Adult

Effects of sounds presented during general anaesthesia on postoperative course.

In a double-blind, randomized study, patients undergoing cholecystectomy were administered one of four different sounds during general anaesthesia: positive suggestions, nonsense suggestions, seaside sounds or sounds from the operating theatre. The effect of these sounds on the postoperative course was examined to assess intraoperative auditory registration. No differences were found between the four groups in postoperative variables.

Adult

The effect of carotid endarterectomy on mental functioning.

In order to ascertain the effect of carotid endarterectomy on mental functioning, carotid endarterectomy patients suffering from transient ischemic attacks (TIA) were compared preoperatively and postoperatively with cholecystectomy patients. Preoperatively, a tendency toward poorer verbal memory and greater well-being is found in carotid endarterectomy patients. Postoperatively, the overall mental functioning of the carotid endarterectomy patients is not significantly improved, though verbal fluency does show improvement. The well-being of both groups is significantly greater following operation. The complaints of the carotid endarterectomy patients during the (last) TIA had already diminished before operation and after operation remained practically on the same level. Preoperatively and postoperatively, no clear connection exists between mental functioning and age of patients in this experiment, not between mental functioning and the side of the operation. Finally, in the case of 5 patients, no long-term (4.5 months) effect of carotid endarterectomy could be indicated.

Aged

Prediction of quality of life after coronary artery bypass graft surgery: a review and evaluation of multiple, recent studies.

OBJECTIVE: To review studies predicting psychosocial outcome after coronary artery bypass graft surgery (CABG). METHODS: Seventeen prospective studies, appearing in the MEDLINE and PsycLIT data bases between 1986 and 1996, were reviewed regarding objectives, methodological issues, results, and clinical relevance. RESULTS: All studies reported that psychological factors bad predictive value. In particular, preoperative anxiety and depression predicted postoperative psychological maladjustment; social support, preoperative feelings of control, denial, and optimism contributed to psychological adjustment. CONCLUSIONS: Many specific psychological outcomes seem to be best predicted by preoperative assessment of functions in that specific area, especially in the case of anxiety and depression. Furthermore, personality factors including denial, optimism, control, and the need for support appear to be predictors of psychological outcome. Appropriate identification of predictive factors might improve the development of individually tailored interventions for patients at risk of postoperative psychological problems.

Adult