Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 1996. / Typescript. Bibliography: leaves 115-123. Also available online.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.Sc.)--York University, 2008. Graduate Programme in Biology. / Typescript. Includes bibliographical references (leaves 77-94). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR51626

This study used the research method of phenomenology to elicit the patient's perspective of the illness experience following a myocardial infarction (MI). The purpose of studying this experience was to gain an understanding of what it meant to men and women to have a MI, what the learning needs were following a MI, and how these learning needs were met. It was proposed that patients would view the illness experience differently from health professionals, thus the patients would identify different learning needs. Anderson's (1985) adaptation of Kleinman's health care system framework was used to conceptualize this problem. Three males and two females, ranging in age from 42 to 77 years, participated in the study. Data were collected through 11 in-depth interviews. From analysis of this data significant statements were extracted to provide a description of the phenomenon under study. The findings of this study suggest that health professionals and patients do view the MI experience from different perspectives. The emphasis of the patients on understanding the MI experience from the reality of their world is reflected in their attempts to rationalize the occurrence of the MI and their desires to know more about their own MI, prognosis, and treatment. In order to plan patient education that will assist post-MI patients in their recovery health professionals must assess patients individually for their: (1) beliefs regarding risk factors and causes of MI; (2) desire for Information; (3) preference for method of instruction; and, (4) preference for timing of education. / Applied Science, Faculty of / Nursing, School of / Graduate

This descriptive correlational and longitudinal study was designed to assess the changes in cognitive appraisal of emotions and coping strategies which myocardial infarction (Ml) patients used at two points in time. Additionally, the variables of cognitive appraisal of emotions were investigated for their relationships to coping strategies. A convenience sample of 21 confirmed first MI patients was selected from coronary care units (CCU) of four hospitals in western Canada. Participants completed the Emotion Appraisal Scale, the Revised Ways of Coping checklist as well as an information sheet. Overall, the participants experienced a wide range of the four appraisal types of threat, harm, challenge and benefit. Challenge emotions were the most frequent appraisal type at both interviews. Initially-, benefit emotions were the least frequent appraisal type, while harm emotions were the least frequent at the second period. While results indicated changes, no significant changes were found in the four emotion appraisals of threat, harm, challenge and benefit over time. The complexity of emotions experienced reflects the multifacated nature of the MI situation influencing patients in early phases of recovery. The participants used a variety of coping strategies which are related to emotion-focused and problem-focused coping to manage the demands of their MI. Most of the participants used all eight available types of coping. The strategies of seeking social support, distancing and positive reappraisal were the most predominant types of coping at both interviews. The strategies of self-controlling, planful problem-solving and accepting responsibility were moderately used, while escape-avoidance and confrontive coping were the least used types of coping at both times. The findings suggest that coping with a cardiac event is a complex process. The MI crisis present the patients with multiple tasks which require a combination of coping strategies. At the initial period, a significant relationship was found between threat emotions and planful problem-solving coping. Harm emotions were significantly and positively correlated with accepting responsibility, planful problem-solving and confrontive coping. Similarly, challenge emotions correlated with seeking social support and positive reappraisal coping. Significant relationships were found between benefit emotions and two forms of coping: confrontive and seeking social support coping. At the second period, only two significant correlations were found: benefit emotions significantly correlated with self-controlling and accepting responsibility. The findings suggest that a heart attack is appraised as moderately stressful by first MI patients in early phases of recovery. The MI patients' perception or understanding of the contextual factors affect appraisal of harm, threat, benefit and challenge emotions which in turn influence the choice of coping strategies. / Applied Science, Faculty of / Nursing, School of / Graduate

The potential use of four radioiodinated fatty acids as myocardial imaging agents were evaluated. Preliminary distribution studies revealed that the terminal labeled fatty acids demonstrated higher myocardial uptake. Thus, 10-Iodocapric acid (10-iododecanoic) and 12-Iodolauric acid were subjected to further investigation. Comprehensive tissue distribution studies involving both radioiodinated fatty acids in mice indicated that the highest accumulation of the total injected activity occurred in the muscle and the blood. Other organs investigated included the heart, liver, lung, kidneys, spleen, stomach, intestines, bone and adrenals. The heart exhibited the highest concentration of the radioiodinated fatty acids for the relative accumulation of activity per unit weight. Erom the tissue distribution studies, the optimum scanning time was found to be immediately following injection of the radiopharmaceutical. Toxicity studies were performed in mice after intravenous administration of 10-Bromocapric acid and 12-Bromolauric acid. The LD₅₀ of Sodium Bromolaurate in 10% Human Serum Albumin was found to be 210 mg/kg (194 mg/kg - 228 mg/kg). The stability problem encountered with 10-Bromocapric acid necessitated the use of a different solvent system. The LD₅₀ obtained after intravenous injection was found to be 86.1 mg/kg (83.0 mg/kg - 89.3 mg/kg). However, this observed toxicity may not necessarily reflect the toxicity of the Bromocapric acid solely. Whole body excretion studies were performed in mice and revealed a triexponential excretion curve. For 10-Iodocapric acid, the effective half-lives were .90 hours (36.7%), 3.91 hours (61.6%) and 74.9 hours (14.5%). For 12-Iodolauric acid, the effective half-lives were 1.67 hours (46.6%), 7.68 hours (38.4%), and 71.6 hours (17.8%). For both 10-Iodocapric acid and 12-Iodolauric acid, the first as well as the second component of the excretion curve presumably represented a decrease in the whole body activity due mainly to urinary excretion. The third component appeared to represent activity which was tightly bound and slowly released. The third component presumably represented elimination by fecal excretion. The excretion of the injected activity was primarily in the urine, although some activity was recovered in the feces. For 10-Iodocapric acid, 82.4% of the injected activity had been recovered in the urine within the first 24 hours and 8.88% had been recovered in the feces. For 12-Iodolauric acid, 78.9% of the injected dose was recovered in the urine at 24 hours and 9.4% in the feces. From the urine results, the effective half-life of the radio-iodinated fatty acids in the kidneys was found to be 4.8 hours. Myocardial scans were done on rabbits using ¹³¹I-capric acid, ¹³¹I-lauric acid, NaI-131 (6% Human Serum Albumin), and Thallium-201 at specified time intervals after injection. Iodine-123, a radionuclide possessing more favorable imaging properties, was not readily available due to production problems at the time of scanning. The mean absorbed dose to the whole body, the liver, the kidneys, the muscle, and the heart were computed based on the results from the distribution and excretion studies. The dosimetry calculations were done using Iodine-123 as the radionuclide. For ¹³¹I-capric acid, the radiation doses were calculated as 34.76 mrads/2 mCi for the whole body, 136.3 mrads/2 mCi for the kidneys, 86.6 mrads/2 mCi for the liver, 38.5 mrads/2 mCi for the muscle, and 25.89 mrads/2 mCi for the heart. For ¹³¹I-lauric acid, the radiation doses were 41.73 mrads/2 mCi for the whole body, 199.8 mrads/2 mCi for the kidneys, 185.9 mrads/2 mCi for the liver, 52.07 mrads/2 mCi for the muscle, and 46.39 mrads/2 mCi for the heart. / Pharmaceutical Sciences, Faculty of / Unknown

This exploratory study examined the phenomenon of loss as expressed by the spouses of myocardial infarction patients. The purpose of the study was to describe the thoughts, feelings, actions and observable behaviours of the spouses from the initial impact of illness to six weeks post myocardial infarction and to develop a framework, based on the literature, which related the concept of loss to the experience of spouses of M.I. patients. The study was conducted with a convenience sample of 12 spouses, ten women and two men, whose partners had experienced their first myocardial infarction. Using a semi-structured interview guide with open-ended questions, the investigator interviewed each subject four times over a six week period; from the initial impact of illness to approximately six weeks post myocardial infarction. Each interview covered three content areas: thoughts, feelings and actions. Broad open-ended questions were used to elicit data on the spouses thoughts, feelings and actions. During the interview the investigator observed the verbal (type, quality, characteristics of speech, focus of conversation) and non-verbal (activity, eye contact, body language, appearance) behaviours of the spouses. An empirical inductive approach was used as the methodology for this study. Data coding and analysis were approached using the constant comparative method, an inductive method of discovering grounded theory developed by Glaser and Strauss (1967). The findings revealed that the spouses experienced behaviours in response to loss that were common and formed a pattern through time. Three distinct phases were identified: Phase I The Event and Initial Spousal Response; Phase II Reaction to the Event; Phase III Impact of the Event. The phases were described further in light of the constructs formulated from the literature review: (1) Reactions to Loss; (2) The Elements of Loss; (3) The Meaning of Loss. This study was designed to provide insight into understanding the event of a myocardial infarction within the context of the phenomenon of loss. The findings supported the use of a loss framework for assessing the reactions of spouses who are threatened with the death of their partner. Nurses are in a critical position to assist spouses experiencing loss. Implications and recommendations for nursing education, practice and research were delineated in light of the conclusions of the present study. / Applied Science, Faculty of / Nursing, School of / Graduate