A Predictor Analysis of Clinical Assessment of Outcome among Patients Operated on for Duodenal Ulcer

Abstract

During a period of 1 year, data concerning life events, non-specific psychological symptoms, individual social history, and ulcer history were obtained for consecutive cases of patients about to have elective surgical treatment for duodenal ulcer. At the 1-year follow-up examination a blind, clinical evaluation was performed (dumping, dyspepsia, recurrence, and Visick grading), and information concerning the 94 patients' assessment of outcome was obtained. A multivariate predictor analysis was performed. Most patients (85%) benefited from treatment. The excess rate of non-specific psychological symptoms indicating impairment remained unchanged. The patients assessments of outcome were correlated with the clinical assessment. A positive correlation was found for women to have dumping and poor Visick grade and for unmarried persons to have postoperative dyspepsia and a poor Visick grade. A negative correlation between a long ulcer history and postoperative dyspepsia and a positive correlation between pyloroplasty and dumping were found. Non-specific psychological symptoms predicted poor clinical assessments. It is suggested that it is relevant to apply the patients' assessments for the purpose of evaluation, supplementing the clinical assessment of the more biomedical aspects of outcome.

Adherence to Lithium Prophylaxis: II. Multivariate Analysis of Clinical, Social, and Psychosocial Predictors of Nonadherence

“…The soeiomedical interview held before start of the lithi um treatment included data on family background variables and life events during upbringing, soeial and geographical mobility, present social background and aetivity, soeial network and support, level of information about the treatment, consumption of drugs, alcohol and eigarettes, and life events which had occurred during a 12-month period prior to the start of the prophylactic lithium treatment. The social and psychosocial parameters in the interview schedule had earlier been applied in an analysis of predictors of outcome (Aagaard et al, 1983). For a comparison of these two patient groups, see Aagaard et al, 1987.…”

The personality pattern of duodenal ulcer patients in relation to spontaneous ulcer healing and relapse

“…Earlier studies focusing on stressful life events and peptic ulcer disease have failed to show any influence of such events on the course of the disease [22–24]. However, a recent study [25] showed that even if ulcer patients and controls experienced a similar number of potentially stressful life events, ulcer patients perceived their events more negatively by having a significantly lower ego‐strength and coping ability.…”

Life Stress and Gastrointestinal Upset

“…[37], Preoperatively and 1 year after the operation, UD patients were asked questions about twenty-two nonspecific psy chological symptoms. Compared with an age-and sex-matched population group, the absolute frequency of affirmative answers were high.…”