Browsing by Author "Lucas, Richard Henry"
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Item Social contact in a rehabilitation hospital : Analysis of observational data(1974) Lucas, Richard Henry; Vineberg, Shalom E.; Willems, Edwin P.; Blakeney, Roger N.Naturalistic observation of spinal cord patients at Texas Institute for Rehabilitation and Research in Houston, Texas, has generated a great deal of information about the behavior of these patients. This information is contained in patient protocols, which are continuous narratives of the behavioral stream of twenty-seven patients observed for one full day in 1968 and 1971. Included in the protocols are data on patients' social contact with staff and other persons in the hospital. In the present study, the narratives were examined for instances of socializing behavior. This procedure yielded a new set of data: a topological description of social contact throughout the hospital by patients, staff, and behavior settings. The amount and initiation of social contact for patients was correlated with different settings, patient age, time spent in hospital, and length of time since spinal lesion. There are analyses of the amount and initiation of social contact with staff and other persons. This study's topographical description depicts the pattern of social contact throughout a patient's day and compares changes over the three year period when patients were observed. Correlational analysis showed some trends that: patients earlier in treatment converse more than later patients; patients increase social contact the longer they have had their spinal lesions; staff initiate social contact more to patients who have been in the hospital longer; and patients initiate more social contact to non-staff persons than to staff. This study discusses the merits of certain types of observational research for the study of socializing behavior and suggests that the observations or encoding procedures at Texas Institute for Rehabilitation and Research be changed to yield more specific data on this behavior.Item The affective and medical effects of different preoperative interventions with heart surgery patients(1975) Lucas, Richard Henry; Millham, Jim; Willems, Edwin P.; Lubin, Bernard; Matre, Marc D.; Kopel, Kenneth F.A growing area of interest in psychosomatic medicine is the relationship between psychological variables and reaction to major surgery. Research has demonstrated beneficial effects of providing patients with information or emotional support prior to surgery. However, previous research has left ambiguous results and reasoning to explain why or how preoperative interventions help improve patients' recovery from surgery. This study used a four group design to (a) investigate the medical and psychological effects of different modes of preoperative interventions with heart surgery patients, and (b) explore relationships between emotional states and medical recovery. Patients in Group I received a preoperative intervention actively focusing on plans for recovery and future life; Group II patients were asked to merely think about recovery and future plans; Group III patients were given an attention placebo; and Group IV patients were no treatment controls. It was hypothesized that (a) presurgical patients who experience more active, encouraging, and specific planning show better recovery, and (b) there is a relationship between positive affective state and better recovery. Analysis of results showed no significant difference among the four groups on the medical measures of recovery. However, treatment (Groups I, II, and III) versus no treatment (Group IV) analysis showed significant difference in the expected direction. No consistent pattern of relationships was found between patients' psychological state immediately following intervention just prior to surgery or during recovery with indices of medical recovery. Initial, pre-intervention testing of anxiety and mood state did show significant correlations with later medical recovery. Although the levels of interventions used did not distinguish groups, the results support the notion that attention prior to surgery in itself contributes to improved recovery. This effect cautions against research using two group, treatment and control intervention designs that then argue for the effectiveness of the content of the intervention. Data from anxiety and mood testing suggest that the relationship between current mood and current medical recovery is not clear, and that patients' emotional state a few days prior to surgery is a better indicator of recovery than emotional state immediately prior to surgery. This study suggests (a) the need for further clarification of the attention effects during preoperative interventions, and (b) the investigation of emotional support or information at a point when patients first learn they will have surgery rather than immediately prior to the operative procedure.