Surgery Commons^™

Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Surgeon Practices And Attitudes Toward The Control Of Surgical-Site Infections In Jordan, Sara Ali Mater

Independent Study Project (ISP) Collection

The purpose of this study was to determine the attitudes and practices of Jordanian surgeons on the control of surgical-site infections, evaluated by the Center of Disease Control’s guidelines toward the prevention of surgical-site infections, in addition to gaining respondents opinions on infection control in Jordan. This study was conducted through the distribution of 75 questionnaires given to surgeons at five hospitals in Jordan. Additional insight on SSI infection control was gained through interviews with two cardiac surgeons and three infection control directors. The results of the survey were compared with the Center for Disease Control’s guide to surgical-site infection …

Physicians' Attitudes About Recommending Surgery For Early Stage Lung Cancer And Possible Reasons For Racial Disparities, Franklin R. Mcguire

Journal of Health Disparities Research and Practice

PHYSICIANS’ ATTITUDES ABOUT RECOMMENDING SURGERY FOR EARLY STAGE LUNG CANCER AND POSSIBLE REASONS FOR RACIAL DISPARITIES

ABSTRACT

Purpose: Patient refusal for lung cancer surgery is significant, but other factors, such as negative framing of the treatment discussion, may be involved. Physician attitudes could influence the nuances of and therefore the conclusions of these discussions. We determined physicians’ attitudes and the influence it has on possible decisions against lung cancer surgery, particularly surgical rates for blacks, using a companion survey.

Methods: The study is a prospective, multicenter observational trial conducted at five sites in North and South Carolina from December …

Refusal To Autopsy: A Societal Practice In Pakistan Context, Laila Akber Cassum

School of Nursing & Midwifery

Autopsies or post-mortem examinations have become a common practice in Western medicine for verifying the cause of death, and to obtain additional scientific information on certain diseases. In monotheistic religions autopsies present several ethical questions even though the advantages attributed to post-mortems in the West are well acknowledged by people living in this modern world. In Islamic Republic of Pakistan where Islam is the prevailing religion followed by the Muslims, Pakistani society have diverse perception, assumptions and hypothesis on the concept of autopsy. This presumption is due to presence of diverse objections raised in religious and sociocultural context. In our …

Patient Safety In The Cardiac Operating Room: Human Factors And Teamwork: A Scientific Study From The American Heart Association, Joyce A. Wahr, Richard L. Prager, J. H. Abernathy Iii, Elizabeth A. Martinez, Eduardo Salas, Patricia C. Seifert, Robert C. Groom, Bruce D. Spiess, Bruce E. Searles, Thoralf M. Sundt Iii, Juan A. Sanchez, Scott A. Shappell, Michael H. Culig, Elizabeth H. Lazzara, David C. Fitzgerald, Vinod H. Thourani, Pirooz Eghtesady, John S. Ikonomidis, Michael R. England, Frank W. Selke, Nancy A. Nussmeier

Publications

The cardiac surgical operating room (OR) is a complex environment in which highly trained subspecialists interact with each other using sophisticated equipment to care for patients with severe cardiac disease and significant comorbidities. Thousands of patient lives have been saved or significantly improved with the advent of modern cardiac surgery. Indeed, both mortality and morbidity for coronary artery bypass surgery have decreased during the past decade. Nonetheless, the highly skilled and dedicated personnel in cardiac ORs are human and will make errors. Refined techniques, advanced technologies, and enhanced coordination of care have led to significant improvements in cardiac surgery outcomes.

The Identification And Classification Of Flow Disruptions In The Operating Room During Laparoscopic Cholecystectomy And Open Hernia Repair Procedures, Sacha N. Duff

Doctoral Dissertations and Master's Theses

The operating room is one of the most complex work environments in healthcare; it is estimated that at least 7% of adverse events due to medical error occur in the operating room. Flow disruptions are events that cause a "break" in the primary surgical task, or the loss of any team member's situational awareness. An empirical link between flow disruptions and surgical errors in the OR has been established; therefore, identifying and classifying the specific flow disruptions present during different types of procedures should facilitate the development of evidence-based interventions. The goal of this study was to identify and classify …

Evaluation Of Stress On Laparoscopic Skills Of Surgical Residents In Simulation-Based Education, William C. Boyer Dhsc, Ms, Hubert K. Huang Ms,Med, Charles Scagliotti Md,Ffacs, Robert Ruhf

Department of Education

No abstract provided.

She’S A Survivor: Post-Operative Counseling And Its Importance To The Recovery Of A Woman Victimized By Female Genital Mutilation, Jacent Wamala

McNair Poster Presentations

The prevalence of Female Genital Mutilation and the difficulty in preventing its practice call for a fresh way of resolving the problem. As the availability of medical professionals equipped with the ability to correct clitoral mutilation grows, there is also an increasing need for professionals that can help the victims after the reconstructive surgery. Post-operative therapy for victims that have opted to receive reconstructive surgery is necessary in order to fully recover. Furthermore, more research in this area is needed to support the findings of this review and will fill the physical and emotional gap exhibited in prior studies related …

Use Of Geocoding And Us Census Data To Assess Determinants Of Outcome In Trauma Patients, Krista M. Goodman Md, John J. Hong Md, Sherrine Eid Mph, Leslie Baga Bsn, Ccrc, Michael M. Badellino Md, Mph, Facs, Michael D. Pasquale Md, Facs

Department of Surgery

No abstract provided.

A Case Study Of Appendicitis At Antanimalandy Lutheran Hospital, Jennifer Gemmell

Independent Study Project (ISP) Collection

From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the …

Psychological Profiles In A Female Bariatric Surgery Sample, Aimee L. Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Morbid obesity is an epidemic. Current literature suggests that people with morbid obesity tend to show increased levels of psychological dysfunction. This is especially pertinent to the clinicians who work with morbidly obese patients who seek bariatric surgery as the method for weight control. Surgery should be performed on patients who are psychologically ready to adjust to the stringent post-operative lifestyle.

The purpose of the present study was (1) to compare two groups of bariatric patients (a White group and a non-White group) on pre-surgery measures: specific scales on the Millon Behavioral Medicine Diagnostic (MBMD), the Beck Depression Inventory II …

Effect Of Donor Ethnicity On Kidney Survival In Different Recipient Pairs: An Analysis Of The Optn/Unos Database., C O. Callender, W S. Cherikh, P Traverso, A Hernandez, Tolulope A. Oyetunji, D Chang

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.

METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient …

Factors That Affect Performance On Executive Functioning After Coronary Artery Bypass Grafting, Sapna Mahesh Patel

Loma Linda University Electronic Theses, Dissertations & Projects

Research suggests that individuals who undergo coronary artery bypass grafting (CABG) experience declines in neuropsychological functioning post-operatively. This decline has been observed in up to 80% of patients early after surgery, and in up to 30% of patients after six months. Many studies have examined the potential effects of CABG on neuropsychological functioning in general, and numerous studies have found that executive functions are impaired in particular. However, none have examined what factors contribute to observed executive dysfunction after CABG. This study investigated the role of memory functions on executive functions in a selected sample of patients undergoing CABG. This …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

L’Imagination Du Corps Greffé : Filtres Bilingues, Mireille Rosello

Présence Francophone: Revue internationale de langue et de littérature

Contemporary narratives featuring organ transplants speak of a painful but also life-saving contact when the “donor” body is African and the receiving body is European. At this point the surgical operation and that of the imagination assume a whole other dimension, as the inequality and interdependence of these two bodies invite the reader to re-imagine the links between the concept of the “body,” on the one hand, and culture and language, on the other. This article looks at the transplanted body as an imagining machine capable of articulating a vision of itself different from the one that words impose upon …

Visual-Spatial & Visual-Motor Function In Pediatric Heart Transplant Recipients, Stephanine Dianne Griffone

Loma Linda University Electronic Theses, Dissertations & Projects

Heart surgery is commonly used to repair congenital heart defects and to perform heart transplantation. The associated hypoxia before or during the surgery may cause damage in the parasaggital area of the cerebral cortex, with resulting difficulty during tasks requiring visual-spatial and visual-motor skills. This study compares the performance of children who received a heart transplant during infancy to that of nonclinical children with no medical complications on three visual-motor measures, three visual-spatial measures, and two computerized visual-spatial tasks - a Block Design Matching task and a Mental Rotation task. The children who received a heart transplant achieved significantly lower …

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Art Therapy As A Measure Of Children’S Concept Of Surgery: A Preliminary Study, Emily C. Clark

EVMS School of Health Professions Theses & Dissertations

Surgery is a strange, and often frightening experience for children. A number of programs have been studied which attempt to prepare children for the surgery experience. Art therapy may be especially suited to help prepare children for surgery because art making is an effective form of communication for children, and can allow them to express their thoughts and fears about surgery. Unfortunately, studies of art therapy preparation programs are rare, and usually take the form of case studies. This research study is the first step in designing an art therapy preparation program for preparing children for surgery.

The purpose of …

Update - May 2002, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- The Compleat Physician
-- Informed Consent Documentation for Total Artificial Hearth Technology
-- Ralph J. and Carolyn Thompson Endowment established in 2001

Lake Mead Hospital Conversion To Complete Delivery System, Roger W. Noorda

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this case study is to determine the cost difference between using a conventional type of inventory system in the operating room versus using a pack system in the operating room. In this study three different ways of delivering disposables for a laminectomy procedure were considered: 1) multiple distributors of disposables, 2) single distributor of disposables, and 3) the pack system (CDS by Medline). The first comparison was of multiple distributors vs. a single distributor with a cost difference of $90.08 per procedure and $18,916.80 annually, multiple distributor costing less. The second comparison was between Medline as a …

Needle Localization For Breast Biopsy: The Patient's Experience, Marian De Walt Morgan

Psychology Theses & Dissertations

The needle localization procedure for breast biopsy (NLP) can be painful and distressing for some women. This study was carried out to learn what factors might increase or decrease NLP pain and distress, and to gain insight into possible interventions to make the procedure more comfortable for all patients. One hundred and thirty-eight women were surveyed following breast needle localization at two central Virginia hospitals. The influence of eight variables (lidocaine, self-regulation, anxiety, worry about breast cancer, breast tenderness, finding mammography painful, difficulty with surgery, and distress of blood drawing) on four outcome variables (pain incidence, pain intensity, pain unpleasantness, …

The Degree And Time-Course Of Stress In The Patient Undergoing Cardiac Surgery, Hulda Esther Serra, Patricia Jo Yvonne Tygret

Loma Linda University Electronic Theses, Dissertations & Projects

An important nursing objective is to assist patients through stressful experiences. It has been assumed that cardiac surgery constitutes such a stress situation. For this reason, twenty-two patients undergoing cardiac surgery at Loma Linda University Hospital studied for the purpose of exploring the degree and time-course of were psychological stress.

The methodology consisted of administration of psychological tests before and after surgery; determination of urine catecholamines (UCA) before, during and after surgery; administration of a coping assessment tool before surgery, and a recall interview on the fifth day after surgery. The Multiple Affect Adjective Check List (MAACL)-Today form, and the …

Play Preparation For The Adeno-Tonsillectomy Patient, Carol Brown, Harriet Hecker

Loma Linda University Electronic Theses, Dissertations & Projects

Hospitalization and surgery have been recognized as being psychologically stressful for the majority of children. Hospital personnel have attempted to reduce some of the unnecessary psychological stress incurred by children by the use of many different methods. This study attempted to evaluate the use of preoperative play preparation sessions for minimizing this stress. The method was experimental with one variable. The subjects were forty-one children aged three and one-half to seven and one-half who had adeno-tonsillectomies. Twenty-one children comprising Group E were involved in a play session by the researchers. Twenty children were not prepared in this way. The tools …

A Comparative Study Of Discomfort Experienced By Surgical Patients On Three Selected Postoperative Days, Lillian Barker Bartlett

Loma Linda University Electronic Theses, Dissertations & Projects

A descriptive survey was conducted to compare the discomfort experienced on three selected postoperative days to determine if there is one day identified by the patient as the most uncomfortable and to assess the symptoms of which he might complain. A checklist of twelve symptoms common to postsurgical patients was administered on the evenings of the second, third and fourth postoperative days by the researcher. Findings indicated that nineteen or 56 per cent of the thirty-four patients interviewed stated that the second day was most uncomfortable, nine or 27 per cent the third and six or 17 per cent the …