Ross Lazarus

Harvard University, Cambridge, Massachusetts, United States

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Publications (2)6.74 Total impact

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    ABSTRACT: The level of agreement between index and proxy respondents on assessment of health status of clinical cohorts is variable. There is limited information regarding agreement between cardiac surgery patients and their proxies, and levels of agreement examined across repeated measures. This study examined the level of agreement between index and proxy respondents' perceptions of the patient's health status prior to and following cardiac surgery. A prospective, paired-respondent, repeated measures observational study of elective cardiac surgical patients and their next of kin, from the cardiac surgical unit of a tertiary hospital in Sydney, Australia. Health status domains were examined using the15D and SF-36 instruments at three points: prior to surgery, at hospital discharge, and at 6 months post discharge. Moderate to good level of agreement was noted for physical function (physical functioning, role functioning-physical, mobility, breathing, speech, hearing, usual activities, sexual activities) and some psychosocial dimensions (role functioning-emotional, sleeping, depression, mental health). Agreement was highest for presurgery and 6 months post discharge. Differences in scores were not clinically important. Proxy respondents can reliably assess the quality of life of a cardiac surgical patient using 15D or SF-36, particularly for domains reflecting physical function.
    Journal of Clinical Epidemiology 03/2006; 59(2):153-9. · 5.33 Impact Factor
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    ABSTRACT: The study assessed health-related quality of life (HRQOL) of patients before and after cardiac surgery. This was a prospective repeated-measures observational study. The study took place in a 650-bed tertiary referral hospital in Sydney, Australia. HRQOL was measured using the Medical Outcomes Study Short Form 36-item health survey (SF-36) and the 15 Dimensions of Quality of Life questionnaire before surgery, at hospital discharge, and 6 months postdischarge. Participants were representative of the cardiac surgery population. Scores for several concepts deteriorated at hospital discharge when compared with presurgery. There were significant improvements in health status at 6 months postdischarge when compared with previous measures for the majority of SF-36 and 15 Dimensions of Quality of Life questionnaire concepts, although mental health and social functioning demonstrated significant deterioration. SF-36 scores were substantially lower than population norms, but similar to previous studies of patients undergoing cardiac surgery except for mental health. Deterioration in health status at hospital discharge when compared with presurgery status reinforces the need for further patient care and support after discharge. All dimensions improved after 6 months, except mental health. This information can guide patient expectations regarding rehabilitation posthospitalization, and cardiac surgical services should implement and evaluate formal "outreach programs" for these patients.
    Heart and Lung The Journal of Acute and Critical Care 01/2006; 35(4):245-51. · 1.40 Impact Factor