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Biomedical subjects

W F Baile

Publications and source records attributed to W F Baile.

36 records · Page 2Linked to original sources
PubMed1992

Psychosocial aspects of melanoma.

Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark level, or estimates of lymphocytic infiltration of tumor. Coping styles were paradoxically related to major life stress such that history of major stresses was associated with greater confrontation of the melanoma diagnosis, greater will to fight the disease, and less avoidance of its frightening aspects. Experience with fewer major life stresses was associated with a defeatist attitude characterized by an expectation of a poor prognosis and little control over outcomes. More than 50% of the sample had experienced at least one major life stress in the past 5 years. This figure is consistent with prior work and indicative of a higher than normal rate of major life stress in the years before diagnosis.

Adaptation, Psychological↗
PubMed1991

Impact of a hospital smoking ban: changes in tobacco use and employee attitudes.

The authors investigated the impact of a complete smoking ban on 349 employees of a cancer treatment center. A questionnaire administered approximately 4 months after the ban was initiated queried smokers on the impact of the ban on their smoking habits, their experience of withdrawal symptoms during the workday, and changes in work habits. A separate questionnaire asked nonsmokers about changes in the work environment. Results showed that few smokers quit while a majority decreased their consumption. Withdrawal symptoms were a problem in less than half the smokers, but those reporting signs of physical dependency on nicotine tended to smoke more before and after work and reported negative changes in work performance. Nonsmokers in general reported positive effects on the work environment.

Adult↗
PubMed1989

Integrating research with practice: the psychosocial impact of breast cancer.

Social workers collecting data in this study of the psychosocial impact of breast cancer not only gained insights into clinical efforts and program planning, but also had opportunities for clinical intervention. Empirical results from the study, as well as practice models implemented based on these results, are presented. This model integrating research with practice holds considerable potential for enhancing social work practice.

Adult↗
PubMed1984

Smoking following myocardial infarction: a critical review of the literature.

This paper critically reviews the available research on the effects of smoking cessation following acute myocardial infarction (MI). Studies that have examined the rate of smoking cessation following an MI indicate that approximately 1/3 to 1/2 of the smokers who suffer from MI subsequently reduce or quit smoking. Furthermore, studies that have examined subsequent mortality and morbidity suggest that individuals who quit smoking following MI exhibit lower mortality and morbidity than those who continue to smoke. It is argued that past studies may have overestimated post-MI smoking cessation rates, and by failing to control for a priori differences between quitters and continuing smokers (e.g., MI severity) may have underestimated the negative effects of smoking following MI. Suggestions for future research are proposed.

Adult↗
PubMed1982

Rapid resumption of cigarette smoking following myocardial infarction: inverse relation to MI severity.

In order to identify factors associated with relapse to cigarette smoking, medical and interview data were collected from 66 chronic smokers hospitalized for acute myocardial infarction (MI). Relapse to smoking during the in-hospital recovery period was prevalent (38% of patients). The major correlate of smoking relapse was MI severity, with relapse probability declining as MI severity increased; patients who relapsed to smoking during the recovery period had experienced less severe MIs, as indicated by their serum creatine phosphokinase (CPK) enzyme levels and their requiring significantly shorter intensive-care treatment. Smoking relapse was not related to patients' smoking histories, their reported craving experiences, their reported health beliefs or demographic characteristics. The fact that relapse is most likely among patients with the best medical prognostic status suggests that the benefits of post-MI smoking cessation may have been underestimated in previous studies.

Attitude to Health↗
PubMed1979

Signouts against medical advice from a coronary care unit.

Twenty-nine patients who were admitted to a Coronary Care Unit (CCU) but who subsequently discharged themselves against medical advice (AMA) were matched with a group of control patients who were admitted to the same unit but who remained in the hospital for the entire course of their treatment. The two groups were then compared on the basis of sociodemographic, medical, behavioral, and psychiatric variables. Results were that the AMA group differed significantly from the control group in a number of factors including age, number of previous AMA signouts, severity of medical problems, and self-reports of alcoholism and emotional difficulties. The relationship of these findings to the AMA behavior is discussed and intervention strategies are suggested.

Age Factors↗
PubMed1978

A behavioral strategy for promoting treatment compliance following myocardial infarction.

Seven men who had recently experienced a myocardial infarction were treated for medical noncompliance. Patient selection was based on recent and past noncompliant behaviors, denial of infarct, and degree of job involvement. Treatment strategy included (1) self-planning of a rehabilitation program by the patient (activity hierarchy), (2) self-monitoring of bio-behavioral data, (3) weekly visits to review data and decide on new activities. Results showed that all patients were highly compliant as determined by several criteria. The technique is relatively easy to apply and it seems to have wide appeal to patients who might otherwise be at high risk for self-injurious behavior.

Aged↗
PubMedDate not supplied

Sudden death.

Explore the source record for details and available documents.

Arrhythmias, Cardiac↗
PubMedDate not supplied

A behavioral analysis of chest pain in patients suspected of having coronary artery disease.

A group of 83 men and women who had been referred to Johns Hopkins Hospital for cardiac catheterization for evaluation of chest pain and possible coronary artery bypass surgery were assessed behaviorally for their chest pains. During the approximately 2-week period between clinical evaluation and catheterization, the patients completed self-report forms about their chest pains. Patients completed one form for each episode of chest pain. Referring physicians also completed a form about the patients "typical" chest pain. The data were analyzed in terms of the antecedents, concomitants, and consequences of the chest pain, and patients' reports were compared to physicians' judgments. Major findings were as follows: 1) Antecedents--most episodes occurred while the patient was at home at times when his mood was one of contentment. 2) Concomitants--the average patient reported fewer than one episode per day which persisted for about 4 min and was rated as 36 on a scale of 0 to 100. The most common physical symptoms accompanying the episode were breathlessness and weakness, and the most common pain sensations were reported to be pressing or aching. There was no consistency among patients either in primary location or path of radiation of the pain. Duration of pain did not correlate significantly either with sensation or symptoms; however, severity rating did correlate with symptoms and sensations. 3) Consequences--most episodes were self-treated with nitroglycerin or rest. Patients typically returned to their ongoing activities; however, there were a number of interactions between the likelihood of returning to ones ongoing activity and the antecedents of the episodes. 4) The referring physicians significantly overestimated the frequency and severity of their patients' episodes; furthermore, they were selective in their abilities to identify correctly the antecedents or concomitants associated with their patients' pain--e.g., they were reliable in their judgments about subjects who had sleep-related episodes; however, they were inaccurate in characterizing the typical sensations or symptoms reported by their patients. It is suggested that a behavioral analysis may enable a physician to characterize his patient's chest complaints better, and perhaps also may facilitate the differentiation between chest complaints indicative of coronary artery disease and chest complaints of a noncoronary origin.

Coronary Disease↗
PubMedDate not supplied

The relation of chest pain symptoms to angiographic findings of coronary artery stenosis and neuroticism.

The present article examines the relations among self-reported and physician-estimated chest pain variables to angiographically determined coronary stenosis (CAD) and neuroticism scores. Six of the 48 chest pain variables were significantly related to coronary stenosis, but only one variable, chest pain elicited by walking, was positively related to stenosis. Chest pain during sleep, sighing and dizziness accompanying chest pain, right lower chest pain radiation, and infrequent rest to cope with the chest pain were significantly negatively related to stenosis. Neuroticism scores (N) were not significantly related to CAD but were significantly correlated with 13 of the 48 chest pain variables. In addition to correlating positively with the chest pain variables that were negatively correlated with CAD, N scores were significantly related to higher pain severity ratings, being angry, annoyed, tense, afraid, worried, and upset before the chest pain, breathlessness during the pain episode, and pain sensations described as stabbing. The six chest pain variables significantly correlated with CAD yielded a multiple correlation of 0.58, accounting for 34% of the variance, whereas N scores accounted for only 5% of the variance; however, N contributed less than 1% unique variation to stenosis in combination with the six chest-pain variables. That N influences chest pain reports more than actual stenosis is further confirmed by the results of physicians' ratings of their patients' typical chest pain episodes. Recognition of patients' characteristic levels of distress or neuroticism may aid physicians in evaluating symptoms more accurately and in treating their chest pains more appropriately.

Age Factors↗
PubMedDate not supplied

The effect of duration of intervention and locus of control on dietary change.

Scientific evidence supports a relationship between diet and the incidence of cancer. This finding has resulted in dietary recommendations that have been disseminated to the public. To reduce actual cancer incidence, these recommendations must lead to dietary changes among the population. We compared two brief dietary interventions with a longer term intervention and found that all three interventions produced significant reductions of calories, fat, fiber intake, and weight. The duration of the intervention did not significantly affect the magnitude of these reductions. We also found that health locus of control did not affect dietary change. Participants who initially were found to have an internal locus of control, or who subsequently internalized their locus of control during the period of observation, did not demonstrate a significant change in their intake of any of the nutrients measured when compared to participants with an external locus of control. Thus, we suggest a brief dietary intervention as a feasible and effective mechanism to produce progressive incremental dietary changes in a large population.

Adult↗
PubMedDate not supplied

Psychological and behavioral dynamics in chronic atypical facial pain.

The authors discuss the relationship between atypical facial pain and psychiatric disturbance. They present contemporary viewpoints and describe four cases that illustrate underlying psychodynamic mechanisms associated with pain in patients who had undergone various dental procedures and other treatments without success. They identify factors which might lead to the early detection of underlying psychological problems and discuss the role of learning, the family system and other factors in producing a chronic pain syndrome.

Adult↗
PubMedDate not supplied

Terminally ill cancer patients. Their most important concerns.

PURPOSE: When the goal of treatment is palliative, the most important outcome is improving patient quality of life. The authors describe the major concerns of terminally ill cancer patients with a prognosis of 6 months of less. OVERVIEW: In phase I of this three-part study, 74 terminally ill patients were interviewed to identify their major concerns. In phase II, interviews with 120 terminally ill cancer patients showed that their most important concerns encompass existential, spiritual, familial, physical, and emotional issues. Phase III will determine the validity and reliability of a quality-of-life scale based on these patients' most important concerns. The information presented here summarizes the results of interviews from phases I and II. CLINICAL IMPLICATIONS: Patients were receptive to being interviewed and remarked on the relevance and importance of these issues to their own experience. Several patients commented that although their disease was assessed and reassessed throughout their care, the existential, spiritual, familial, and emotional aspects of their illness rarely were a focus of their care. Healthcare professionals can create an atmosphere in which these patients feel comfortable exploring the quality-of-life issues that are most important to them. The systematic assessment of patient concerns about quality of life may complement disease assessment and facilitate referrals to appropriate members of the healthcare team. The wide range of concerns reported suggests that a team approach, including physicians, nurses, social workers, psychiatrists, psychologists, and chaplains, is the most effective way to meet the needs of terminally ill patients.

Attitude to Health↗
PubMedDate not supplied

An ovarian cancer support group.

PURPOSE: Because of the low rate of cure and high rate of relapse, the disease course of ovarian cancer can be emotionally devastating. Using psychological interventions to support patients emotionally and to enhance their quality of life should therefore be considered an important complement to medical care. OVERVIEW: The authors describe a support group for patients with ovarian cancer, which was conducted over a 2-year period. The group consisted of patients with poor prognoses whose experience ranged from initial medical treatment, remission, and relapse to the dying experience. Key themes that arose during the sessions are identified, and differences between psychotherapy groups and support groups are highlighted. In contrast to psychotherapy groups, existential issues stood out as the most important therapeutic factor in this support group. CLINICAL IMPLICATIONS: Because it is widely acknowledged that support groups have unique value in the total care of women with ovarian cancer, this description of issues related to group process hopefully will assist others who may plan to offer this type of psychological intervention for patients. With increasing technology and the resulting extension of life for patients with ovarian cancer, support groups like this may become an important aspect of care to enhance quality of life. The multidisciplinary team, including psychiatry, social work, nursing, and chaplaincy, is essential in expanding support groups in healthcare settings.

Female↗