Postcardiac-event elderly: effect of exercise on cardiopulmonary function.

1. The findings of this study contradicted those of previous studies in the areas of respiratory rates, conditioning, and the effect of exercise on diastolic blood pressure. 2. This study indicates that the heart's requirement for oxygen at a given MET load (a unit of energy cost-related to workload) is significantly reduced in elderly cardiac-event patients following a 6-week conditioning program; thus, a similar program would appear to provide cardioprotective effects to this population. 3. This study demonstrated that, as a result of physical conditioning, heart rate, systolic blood pressure, and rate-pressure product showed significant beneficial reductions which would allow elderly postcardiac-event patients to function more effectively in daily activities.

Factors related to the keeping of appointments by indigent clients.

Few recent studies address how situational variables and the characteristics of clients and organizations predict whether indigent clients will keep medical appointments. In this study at a southern urban charity hospital, lack of transportation was a main reason given for not keeping the last appointment at an internal medicine clinic. In contrast, clients who kept their last appointment had higher incomes; had visited the facility for pain, infection, or follow-up after hospitalization; and had been referred to the clinic less than two weeks before their appointment. Overall, whether appointments were kept or broken seemed to depend on the recency of medical attention and the perceived severity of a problem. Implementation of a system-wide discharge-planning system resulted in fewer broken appointments. Perceived communication difficulties with clinic personnel and long waits were important predictors of overall utilization. Decentralizing care through community health clinics and adopting a more holistic approach to care may improve utilization of health care facilities.

Health beliefs and behaviors of Saudi women.

This paper describes perceptions of familiarity with symptoms and beliefs about illnesses based on interviews with 50 Saudi women. The sample was young, with 82% under the age of 40, and not well educated by Western standards, with one-third being illiterate and 80% having no more than a primary school education. More than half lived in households of six or more. Although there was greater awareness of germs as causative factors in illness than previous studies in Saudi Arabia had demonstrated, beliefs in multiple causes, including religious beliefs about disease causation, persisted. There was an apparent lack of understanding of specific causes of various illnesses or of the rationale for preventive measures. This lack of understanding may be related to the low education levels and/or deeply ingrained cultural beliefs.

PIP: This study describes the types of knowledge and beliefs held by 50 Saudi women during 1984-85 in Riyadh, Saudi Arabia. Interviews were conducted in Arabic at 2 urban community health clinics and 1 urban pediatric clinic by bilingual female Egyptian and Saudi nursing faculty members. The study women believed in the tenets of Wahhabism, a conservative version of Islam prevalent in Saudi Arabia. All wore complete vessel in public and traveled in the company of a female or family member. A pilot study with 11 Saudi women was used to develop the questionnaire, which focused on 8 illnesses and their symptoms. Health beliefs referred to beliefs about the severity, prevention, and cure of illness. Health status and illness-related knowledge and behavior were also queried. Sociodemographic data were also requested for respondent, spouse, and children, age, marital status, educational level, household size, and family type. The sample was 82% women 40 years and 80% married (18% divorced). 36% lived in shared households (16%) or extended families, and 48% were members of nuclear families. 36% were illiterate and 44% had only a primary education. The influence of the evil eye belief may be reflected in the belief that 70% reported their family's health about the same as others. 54% of the women reported family members having a respiratory illness within the last 4 weeks, but only 24% recognized the "air" as a means of transmission. Common childhood illnesses were recognized. There was less familiarity with tuberculosis or chest disease; around 25% would rely on a doctor for a diagnosis. Vaccinations were considered necessary, and children's health was valued. God was believed to be the primary cause of illness by 10% and to be a contributory cause by 20-30%. More than 50% believed that extreme shifts in temperature were the cause of diarrhea, chest disease, and epistaxis. Measles and diarrhea were viewed as serious diseases. Modern medicine's impact may be reflected in the few who recognized germs as a cause of disease and mentioned, several causes for diseases. In general, little understanding was shown for causes of various illnesses or the rationale for prevention in vaccination. Among these women prevention may be a concept which conflicts with God's will.

A comparison of coping strategies used effectively by older Anglo and Mexican-American widows: a longitudinal study.

This longitudinal study of older Anglo and Mexican-American widows provides data on coping strategies and coping effectiveness as measured by perceived physical and psychological health. Previous health levels were the best predictors of later physical and psychological symptoms. Contrary to expectations, both ethnic groups preferred nonconfrontational strategies for widowhood problems, with the Mexican Americans using more confrontational strategies. Ways of coping with problems during the first months of widowhood had significant long-term effects upon the widow's health. The most effective coping methods over the first year involved combinations of independent action and emotional release. Over a longer period, more effective strategies included being able to ignore problems, accept the situation, and release tensions, or to actively seek advice about general problems. Contradictory findings over the two time periods for those Mexican Americans using independent action and emotional release strategies appear to be related to cultural patterns of familial support after a death occurs.