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The relationship between the physiologic and psychologic stress response in patients with an acute myocardial infarction.
- Format:
- Book
- Thesis/Dissertation
- Author/Creator:
- Frizzell, Joan Parker.
- Language:
- English
- Subjects (All):
- Psychophysiology.
- Clinical psychology.
- Nursing.
- 0569.
- 0622.
- 0989.
- Penn dissertations--Nursing.
- Nursing--Penn dissertations.
- Local Subjects:
- Penn dissertations--Nursing.
- Nursing--Penn dissertations.
- 0569.
- 0622.
- 0989.
- Physical Description:
- 86 pages
- Contained In:
- Dissertation Abstracts International 58-03B.
- System Details:
- Mode of access: World Wide Web.
- text file
- Summary:
- The relationship between stress, emotions, and health status has interested health care professionals for more than three hundred years. The stress response is a complex phenomenon that involves both physiologic and psychologic changes. Serious illnesses, such as an acute myocardial infarction, can be considered major stressors causing both physiologic and psychologic alterations. Alterations such as increased sympathetic nervous system activation have been associated with a poorer prognosis. The purpose of this research was to: (1) study the relationship between the physiologic and psychologic stress response in patients with an acute myocardial infarction and (2) to determine if this relationship changes at three months post infarction. Physiologic changes were measured by beta$\sb2$ adrenergic receptor density. Psychologic alterations were evaluated by the Multiple Affect Adjective Check List (MAACL). Myocardial injury was determined by left ventricular ejection fractions. Both Pearson Product Moment correlation coefficients and multiple regression analysis were used to test the relationship between these variables.
- The results demonstrated greater levels of hostility and depression in conjunction with lower levels of beta$\sb2$ adrenergic receptor density in subjects who were in New York Heart Association (NYHA) functional categories II through IV as compared to subjects in NYHA I during the acute phase of the illness. There was no difference in left ventricular ejection fractions between these two groups of subjects. There was a significant inverse relationship between hostility and beta$\sb2$ adrenergic receptor density and between hostility and age. A multiple regression analysis demonstrated that age, NYHA functional category and hostility accounted for 10.5% of the variance in beta$\sb2$ adrenergic receptor density.
- At three months post infarction, the subjects in NYHA categories II through IV still had greater levels of hostility and lower levels of beta$\sb2$ adrenergic receptor density than the subjects in category I. Although the inverse relationship between hostility and age persisted, the relationship between hostility and beta$\sb2$ adrenergic receptor density was no longer significant. These findings suggest that both the physiologic and psychologic responses in concert stimulate sympathetic nervous system activation. Therefore nursing care should identify and target nursing interventions toward those subjects most at risk for deleterious consequences.
- Notes:
- Thesis (Ph.D. in Nursing) -- University of Pennsylvania, 1997.
- Source: Dissertation Abstracts International, Volume: 58-03, Section: B, page: 1210.
- Local Notes:
- School code: 0175.
- ISBN:
- 9780591363609
- Access Restriction:
- Restricted for use by site license.
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