Title

The goal of this study was to examine differences in the psychological characteristics of patients admitted to the hospital for acute or chronic Myocardial Infarction (MI) or Unstable Angina (UA). Depression, anger, anxiety, curiosity, defensiveness, social support, and coping were evaluated for 165 patients (86 MI and 79 UA), who were tested on the Cardiology Stepdown Ward of Tampa General Hospital. The following psychological measures were administered to these patients: the Beck Depression Inventory (BDI), the State-Trait Anger Expression Inventory (STAXI-2), the Rationality/Emotional Defensiveness (R/ED) Scale, the Adult Form of the Coping Responses Inventory (CRI-Adult), the Interpersonal Support Evaluation List (ISEL), the Illness Perception Questionnaire (IPQ), the State-Trait Personality Inventory (STPI), and the Structured Clinical Interview (SCID-I) for the DSM - IV. Significantly more chronic patients than acute patients met criteria for depression as measured by the SCID following admission to the hospital, and more UA than MI patients also met these criteria. However, no differences were found between the acute vi and chronic MI and UA patients two weeks prior to admission. Results of this study also indicated that chronic patients and UA patients reported a greater frequency of illness symptoms and tended to cope with their heart disease through avoidant strategies. Chronic patients endorsed higher levels of state and trait anger compared with acute patients, and UA patients were less likely to believe that their illness could be cured or controlled (Control of Cure) than MI patients. Based on the results of this study, it appears that avoidance coping may be an insufficient strategy for addressing negative emotions of chronic patients and UA patients. In addition, perceived lack of control over the success of treatment may be related to depression for UA patients. These findings have important implications for the development and implementation of interventions designed to address perceived control over treatment effectiveness and coping skills for negative emotions in the treatment and rehabilitation of cardiac patients.

Graduation Year

2002

Document Type

Dissertation

Degree

Au.D.

Degree Granting Department

Audiology

Major Professor

Theresa Hnath-Chisolm, Chair

Committee Member

Harvey B. Abrams

Committee Member

Lois G. Ratcliff

Keywords

hearing aids, auditory perception, APHAB, long term benefit, hearing aids

Abstract

he purpose of this study was to investigate the stability of hearing aid benefit, as measured by the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox & Alexander, 1995), between three months post hearing aid fitting and at next the annual audiological re-evaluation. The annual re-evaluation was at least, and as close to nine months as possible, after the previous audiological. The maximum time between the two evaluations was 18 months. Thirty-six hearing aid patients participated in this study. The participants were both male and female, and were fitted monaurally or binaurally with hearing aid(s). All participants had sensorineural hearing loss with no ongoing or permanent conductive or retrocochlear pathology. The APHAB scale was administered at the three month hearing aid check (HAC) and again at the annual audiometric reevaluation. Analysis of covariance (ANCOVA), with length of time between the three month hearing aid check (HAC) and the next audiological re-evaluation as a covariate, was used to examine the main effects of time of administration and subscale [e.g., ease of communication (EC), reverberant conditions (RV), background noise (BN), and aversiveness of sounds (AV)] and their interactions. Results revealed a significant reduction in the mean benefit scores between the 3-month HAC and annual re-evaluation APHAB administration. It is hypothesized that the causal factor of the decrease in benefit in the EC, RV, & BN are multifactorial. These reductions in benefits may be do to the Hawthorne effect, unrealistic hearing aid benefit expectations by the participants, or a heightened expectation of hearing aid benefit due to the financial expense. It should also be noted, however, that using the 90% confidence interval for “true” clinical benefit, 21 of the participants maintained stable benefit over the course of the study. Finally, although not statistically significant, the fourth APHAB scale, aversiveness of sounds (AV), improved over time.

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