Articles: patients.
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Rev Esp Anestesiol Reanim · May 1999
Comparative Study[Psychological distress and preoperative fear in surgical patients].
To study the prevalence of psychological disorder, cognitive deterioration and anxiety in patients undergoing surgical procedures with general anesthesia. ⋯ The prevalence of psychological disorder is somewhat lower than that reported by other authors for presurgical patients, probably because our study enrolled patients with no history of mental illness related to other causes. The prevalence of anxiety found is similar to that reported in the literature.
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A new emergency vascular cover service came into effect on 1 May 1997 involving three district general hospitals, eight surgeons and covering a patient population of 600 000. Each week one of the three hospitals is on call, accepting the transfer of patients requiring urgent surgical or radiological vascular intervention between 17.00 and 09.00 hours each weekday and throughout the weekend from the other two hospitals. The aim of this project was to evaluate the pattern, appropriateness of referral and increased workload in the first year following the implementation of this model of emergency vascular cover. ⋯ These data demonstrate that one consultant-led vascular team can provide an out-of-hours emergency vascular service for a population served by three hospitals. The workload is manageable without the predicted drain on resources and is preferred by the participating consultants.
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The aim of endovascular repair of an abdominal aortic aneurysm is to exclude the aneurysm from the systemic circulation in order to prevent aneurysm expansion and rupture. Lumbar artery (LA) endoleaks have been associated with continued expansion of the aneurysm sac and occur with a reported incidence of approximately 10 per cent. The aim of this study was to reduce the incidence of LA or inferior mesenteric artery (IMA) endoleaks. ⋯ An intraoperative aneurysmograph can help select patients for aneurysm sac packing with gelatin sponge and has been successful in the short term in preventing LA and IMA endoleaks.
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A national audit of surgical deaths can be seen as the final step in what has been termed the 'journey of care' for both the individual patient and for the population as a whole. ⋯ These figures reflect the high quality of vascular services in Scotland, where there is a considerable consultant presence in the management of high-risk patients. This consultant involvement is higher than in other subspecialties and, bearing in mind the high percentage of emergencies, has significant resource implications for the delivery of vascular services.
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According to the cognitive-behavioral model of chronic pain, patient beliefs about their chronic pain influence their behavioral and psychological functioning. Previous correlational and longitudinal studies have supported this hypothesis. However, since previous research has relied almost exclusively on patient self-report to assess both beliefs and functioning, shared method variance may explain some of the relationships found. ⋯ Measures of patient beliefs were more strongly associated with self-report measures of pain behaviors and functioning than with spouse and observer ratings of patient pain behaviors. However, significant associations between patient beliefs and both spouse- and observer-reported frequency of patient pain behaviors were found. These findings argue for the generalizability of the relationship found between patient beliefs and patient behaviors across assessment domains, and for the continued application of the cognitive-behavioral model to the understanding of patient adjustment to chronic pain.