published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

No description available.

No description available.

The purpose of this study was to validate a set of predictor variables which identify perspective orthognathic surgical patients who may be poor surgical risks. The predictive qualities of four MMPI scales, two Bloom Sentence Completion scales, and seven Dental Inventory scales were used to identify presurgical, orthognathic patients who were likely to express postsurgical dissatisfaction.All variables were considered jointly to assess their significance in predicting surgical satisfaction versus dissatisfaction. Subsequently, a minimal set of predictors, which accounted for a significant proportion of the criterion variance, were derived by using factor analysis.A nonrandomized, pretest-posttest design with a one-way, multivariate analysis of variance yielding a Hotelling T square statistic was used. A discriminate analysis of variance was used as a follow-up to the Hotelling T square to note those variables which caused the differences between the means.This study was conducted at a large military teaching and research hospital in Southwest Texas. Patients used in this study were identified during routine dental examinations or were referred by their dentists. Eighty-nine subjects participated in the research project. All subjects were between the ages of 15 and 50 with a mean age of 23.7. They were all volunteers and received their surgery in the same hospital by the current staff of oral surgeons. All subjects were informed that the psychological evaluation was an integral part of the oral surgery evaluation.Upon admission to the hospital the patient received the scheduled surgery and underwent 8 weeks of routine postoperative care. Prior to being discharged from the hospital the patient was readministered the MMPI, Bloom Sentence Completion, and the Dental Inventory. The 8-week period was chosen for postoperative testing because patients were medically cleared to resume normal functioning at that time.A statistically significant difference between the four MMPI scores on the results of the orthognathic surgery variable was evident when comparing satisfied versus dissatisfied patients (F = 3.020, P 0.028). Additionally, there was a multilinear relationship among the presurgical test and the level of postsurgical satisfaction.Factor analysis rendered a minimal set of predictor variables which proved practical in identifying satisfied from dissatisfied patients.Considering the limitations of the study and the above-mentioned results, it can be concluded that a minimal set of predictor variables could be effective in helping surgeons screen out those patients who have the potential of being poor surgery risks.

The underlying purpose of this study was to identify presurgical predictors of surgical recovery. The psychological variables of interest were trait and state anxiety and active coping style. An examination was made of a multifactor trait anxiety scale, the S-R Inventory of General Trait Anxiousness. Specific emphasis was on the subscale related to anxiety aroused in physical danger situations, its relationship to presurgical state anxiety, and to surgical recovery. Two other anxiety measures, as well as a measure of active coping style, were also included as potential predictors of recovery. Responses to the S-R Inventory of General Trait Anxiousness (S-R GTA), the Present Affect Reactions Questionnaire (PARQ), and the Fear of Surgery Scale (FSS) were obtained from 48 patients on the day prior to their surgery and on the fifth day after surgery. A rating of the patient's active coping style was obtained from an interview taped during the presurgical testing session. The dependent measures were the five individual components of a Recovery Index. Based on a multiple regression analysis, the Fear of Surgery Scale (FSS) was the most efficient predictor of the indices of recovery. There was no support for the hypothesis that active coping style would be an important predictor of recovery. Despite expectations to the contrary, the subscale of the S-R Inventory of General Trait Anxiousness (S-R GTA-PD) which measures anxiety in physical danger situations was not a reliable predictor of recovery nor was it the best of the five subscales in predicting state anxiety in the surgical situation. The recommendation was made that the Fear of Surgery Scale be employed to enable early identification of patients with potentially high state anxiety in the surgical situation in order to make interventions in such a way as to reduce that anxiety and foster a smooth recovery. Various concepts of intervention were discussed as well as recommendations concerning the indices to be considered in evaluating recovery. / Master of Science

No description available.

This study explores the facilitation of preparation for breast cancer surgery. The aim of the study was to develop a reasonably comprehensive scheme of categories that would describe, from the perspective of women with breast cancer, what facilitates or hinders positive psychological preparation for breast cancer surgery and, therefore, identify and conceptually organize a broad array of these experiences. The research method involved interviews with 30 women who underwent an operation for breast cancer 6-12 months prior to their interviews. The Critical Incident Technique was used to collect and analyze the data. The women were interviewed and asked to recall incidents that were helpful or hindering in their preparation for a breast cancer surgery. A total of 362 incidents from 30 participants were collected, analyzed, and placed into categories. These incidents were organized into twenty-three categories: Receiving Educational Materials and/or Information; Obtaining an Explanation of Medical Procedures or Problems; Discussing Problems with Loved One; Getting Support and Encouragement from Others; Being Accompanied to a Medical Appointment; Helping Others; Engaging Oneself in Physical and Creative Activities; Developing Helpful Habits; Taking Action on Realizing Own Mortality; Experiencing Physical Closeness; Experiencing Deep Emotional Closeness; Realizing Shift in Relationship with Loved Ones; Healing Through Spiritual Experience and Visualization; Changing Perspective Through Comparison; Using Inspiring, Comforting Material; Getting Alternative Treatment; Establishing Professional Communication; Waiting for Medical Results; Sharing Experiences in Support Groups and Counseling; Perceiving Professional Manners; Experiencing Positive Medical Settings; Getting a Recommendation/Approval of Medical Personnel, Questioning Competence of Medical Care or Personnel. The data also included information about participants' decision-making process regarding the type of operation for breast cancer and some observations on them were drawn. Several procedures were used to examine validity, soundness and trustworthiness of the categories and subcategories. Three narrative accounts were analyzed in an effort to provide meaning and action to these categories. The findings of this study may serve as a basis for better understanding of the process of preparation for breast cancer surgery. Through further examination of the categories and narratives some suggestions and recommendation for research and practice were made.

Preoperative instruction has been documented to benefit patients. With recent health care changes, most patients are now admitted to the hospital on the day of surgery. The optimal time for preoperative instruction requires re-examination. This study evaluated differences in anxiety levels of patients who received structured preoperative instruction prior to hospital admission and patients who received unstructured preoperative instruction after admission on the day of surgery.Roy's Adaptation Model guided this study. The state scale of the State-Trait Anxiety Inventory (STAI) measured anxiety in a convenience sample (n=40) admitted for same-day surgery. Participants in one group received structured preoperative instruction 1-7 days prior to surgery. Participants in a second group received unstructured preoperative instruction on the day of surgery. All participants completed the STAI 1-7 days before surgeryand on the morning of surgery. Paired t-tests on difference scores showed no significant difference in anxiety between the groups. / School of Nursing

Patient education has become more important in decreasing patient anxiety about surgery. The purpose of this study was to examine the effects of two methods of teaching instruction on 2 groups of surgical patients (25 in each group): traditional (film and interview) and traditional plus nurse teaching-coaching on anxiety scores on two groups of surgical patients. Sister Callista Roy's Adaptation Model (1984) was the conceptual framework for this study.The research questions are a) "Are there significant differences between preoperative and postoperative scores on State Anxiety between two groups of surgical patients using two methods of preoperative instruction: traditional preoperative teaching and traditional preoperative teaching plus nurse teaching-coaching interventions" and b) "Are there significant differences in pre- and postanxiety scores of men and women?"State anxiety was measured by Form Y-1 of the State-Trait Anxiety Inventory by Speilberger, Gorsuch, & Lushene (1983). The nurse teaching-coaching intervention was performed in a 30 minute session that focused on content covered in the traditional preoperative teaching. Procedures for the protection of human subjects were followed.Findings of this study showed that no significant differences between pre- and post- anxiety scores for two groups of surgical patients, regardless of the method of instruction. There was, however, a significant difference between pre- and post- scores for two groups of surgical patients in regards to men and women. Women had greater levels of anxiety before surgery and greater decreases postoperatively than did men.Conclusions indicated that further research is needed to demonstrate the effectiveness of the nurse teaching-coaching intervention on decreasing anxiety levels of surgical patients. The nurse teaching-coaching intervention warrants strong consideration for further study and use in nursing practice in assisting in recovering from surgery. / School of Nursing