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Panminerva Medica 1998 March;40(1):8-12

lingua: Inglese

Health-relat­ed phys­i­cal func­tion ­and qual­ity of ­well-­being ­prior to ­and fol­low­ing car­di­om­yo­plas­ty. A preliminary report

Sevick M. A., Magovern J.*, Kamlet M. S.**, Rawson I.*, McCall M., Locke C.

From ­the Bowman Gray School of Medicine Wake Forest University, Winston-Salem, NC
* Department of Cardiothoracic Surgery Allegheny General Hospital, Pittsburgh, PA and
** H. John Heinz ­III School of Public Policy and Management Carnegie Mellon University, Pittsburgh, PA, ­USA


Objective. The pur­pose of ­this ­study ­was to ­obtain pre­lim­i­nary ­data regard­ing ­the ­effects of car­di­om­yo­plas­ty on ­health-relat­ed phys­i­cal func­tion ­and qual­ity of ­well-­being. Experimental ­design. Quasi-experi­men­tal ­with repeat­ed meas­ures. Patients ­were inter­viewed ­prior to sur­gery, ­with ­post-sur­gi­cal fol­low-up inter­views at 6 ­weeks, 6 ­months, ­and 12 ­months.
Setting. Interviews ­were usu­al­ly con­duct­ed by tele­phone ­with ­patients ­who ­were at ­home at ­the ­time of ­data col­lec­tion.
Patients or par­tic­i­pants. Four ­patients receiv­ing car­di­om­yo­plas­ty at Allegheny General Hospital in Pittsburgh, Pennsyl­vania.
Interventions. Patients ­received car­di­om­yo­plas­ty ­between November 1992 ­and April 1993. Cardiomyoplasty ­using ­the ­right lat­is­si­mus dor­si mus­cle ­was per­formed on ­the ­first ­patient. A ­left mus­cle-­wrap ­was per­formed on ­the sub­se­quent ­three ­patients.
Measures. Self-report­ed func­tion ­and ­well-­being ­were meas­ured ­using ­the Sickness Impact Profile (­SIP), ­the Quality of Well-Being Scale (­QWB), ­and ­the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36).
Results. Patient respons­es on ­the SF-36 dem­on­strat­ed gen­er­al improve­ment in car­di­om­yo­plas­ty sur­vi­vors. Results on ­the ­QWB ­and ­SIP ­are ­mixed.
Conclusions. Due to ­the ­small, incom­plete sam­ple ­and ­lack of ­any com­par­i­son ­group, ­extreme cau­tion ­must be ­used in draw­ing ­any clin­i­cal con­clu­sions ­from ­this pre­lim­i­nary ­data. Future ran­dom­ized clin­i­cal ­trials of car­di­om­yo­plas­ty ­need to ­include qual­ity of ­life ­and ­health-relat­ed phys­i­cal func­tion as depen­dent var­i­ables. Further psy­cho­met­ric ­study is nec­es­sary ­which com­pares ­the use­ful­ness of ­these var­i­ous meth­ods ­for assess­ing ­the val­ue of out­comes ­for ­patients ­with ­end-­stage ­heart dis­ease.

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