Chest
Clinical Investigations in Critical CarePsychological Defenses and Coping Styles in Patients Following a Life-Threatening Attack of Asthma
Section snippets
PATIENTS AND METHODS
Flinders Medical Center is a 500-bed teaching hospital in Adelaide, South Australia. For the purposes of this study, asthma was defined by a history of variable cough, wheeze, and dyspnea, with measured increased bronchial responsiveness to inhaled histamine, or a 20 percent increase in forced expiratory volume in one second spontaneously or in response to inhaled bronchodilator agents. The Respiratory Unit is following those patients who have suffered a near miss asthma death. The NMAD has
RESULTS
The 25 patients were comprised of 19 women and six men. Their mean age was 35.7 years (range 18 to 68, standard deviation 13.3). The mean age of the men was 39.5 years (range 18 to 68, standard deviation 18.8) and the women was 34.4 years (range 19 to 57, standard deviation 11.1). Seven patients were single and 18 were married or in de facto relationships. The study interviews took place in the outpatient setting on average 13 months following the NMAD (range 1 to 58 months), and all patients
DISCUSSION
The major finding of this study is that the psychiatric and psychological profiles of the group of patients who have suffered a NMAD are most unusual. The prediction that they would not have particularly high levels of denial because of the consequences of their NMAD has not been upheld. Instead, what has been found is that while the patients as a whole have very high levels of denial anyway, they seem to respond psychologically to the NMAD by either decompensating psychiatrically and
ACKNOWLEDGMENTS
Professor Ross Kalucy and Dr. John Alpers gave advice and assistance, Mr. Nicholas Potts and Miss Susan Haynes helped with interviewing, Miss Joylene Eden rendered statistical assistance, and Miss Gwyn Jones gave secretarial expertise.
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Read before the Thoracic Society of Australia Annual Meeting, Sydney, Australia, May 1988. This study was supported by grants from the Flinders Medical Center Research Foundation and the Asthma Foundation of Australia.
Manuscript received July 13; revision accepted October 11.