Personality differences between hypertensive and normotensive individuals: influence of knowledge of hypertension status

Personality characteristics such as anxiety and anger have long been associated with essential hypertension, but the results of past studies have often been confounded by inadequate diagnosis of hypertension, antihypertensive medications, and use of unvalidated measures of personality. Moreover, little attention has been given to the importance of differential exposure to medical attention and labeling as determinants of personality. To overcome these shortcomings, personality characteristics were measured by self-report using validated questionnaires in untreated male and female hypertensives who were either aware (n = 80) or unaware (n = 82) of their hypertension at the time of assessment. Hypertension diagnosis was based upon repeated blood pressure measurements over 5 months. Hypertensives were compared to age-, sex-, ethnicity-, and occupation-matched normotensives. Results indicated that aware hypertensives scored significantly higher than normotensives and unaware hypertensives on neuroticism, trait and state anxiety, and self-reported Type A behavior. They also scored higher than normotensives on state anger, and there was a similar trend for anger suppression. There were no differences between unaware hypertensives and normotensives. The findings suggest that these personality factors are not a fundamental characteristic of hypertension but reflect the influence of exposure to medical attention or knowledge of hypertension status.     

Validation of scale measuring environmental barriers to diabetes-regimen adherence

This study reports on the validation of a diabetes-specific measure of environmental barriers to regimen adherence. The reliability and validity of the environmental barriers to adherence scale (EBAS) were determined for a sample of 214 insulin-dependent and non-insulin-dependent diabetic patients. The scale was shown to be a valid measure of barriers to adherence as assessed by its relationship to the barriers to adherence questionnaire and the barriers to adherence portion of the diabetes-care profile. The medication, testing, exercise, and diet subscales of the EBAS were correlated with four corresponding and three noncorresponding measures of self-care behavior from the diabetes self-care behaviors scale. Each subscale correlated well with its corresponding self-care behavior. The internal consistency of the scale and the test-retest reliability were found to be good. The results suggest that the EBAS scale is a valid, reliable measure of barriers to diabetes-regimen adherence.     

Deconvolution of emission tomographic data: a clinical evaluation

A method of improving the quality of images in single photon emission computed tomography (SPECT) is demonstrated using transaxial images of the liver and brain. Deconvolution of the nuclear medicine data by a point source response function (PSRF) acquired previously in a scattering medium attempts to compensate for scattered radiation within the patient. The average geometric response of the collimator of the gamma camera is also compensated for with this technique. Three patients with known metastatic lesions in the liver and three with primary lesions in the brain were imaged. Clinical assessment of reconstructed slices both before and after deconvolution demonstrates that compensating for the effects of scatter and of collimator blurring leads to enhanced detail of pathological lesions. In all cases, cold lesions seen prior to deconvolution were enhanced in detail and, in addition, new lesions were seen with this technique.     

An approach to the management of medical problems in demented patients

The appropriate management of medical problems in demented patients plays an important role in maximizing their quality of life. Demented patients present medical problems differently and require treatment strategies that incorporate the strengths and weaknesses of the patients and their caregivers. The goals for treatment must be developed and followed in balance with any plans to limit the treatment because of the dementia.     

Measuring children's social skills using microcomputer-based videodisc assessment.

This article describes the development of a microcomputer-based videodisc assessment prototype for measuring children's social skills. The theoretical and empirical foundations for the content are described, and the contributions of interactive microcomputer-based video technology to assessment of children with handicaps are detailed. An application of Goldfried and D'Zurilla's "behavior-analytic" approach to development of the content of assessments is presented, and the related video and computer technology development is detailed. The article describes the conceptual foundations of the psychometrics of the assessment prototype as well as the psychometric methodology that was employed throughout the development process. Finally, a discussion of the potential applications and implications of the social skills assessment prototype is included.     

A study of patients receiving no billed nursing care

Although home health care traditionally is conceptualized as nursing care, in today's environment care at home may be delivered by a myriad of professional and nonprofessional practitioners. In fact, many patients who receive home care do not receive billed nursing visits. We studied a group of patients (n = 200) who received no billed nursing care, but rather received billed care from therapists, social workers and home health aides. This cohort of patients differed from patients who received billed nursing care in several ways: they were more frequently referred to home care from the community, their prognoses on admission to home care were significantly better, and their outcomes from home care services were considerably more favorable. Clearly patients not receiving billed nursing care have service and resource needs different from those of the population receiving billed nursing care. Therefore, new perspectives must be used when considering how to assess, deliver and perhaps pay for the requirements of these patients.