Journal of Religion and Health, Vol. 14, No. 3, 1975
Prediction of Results in Open Heart Surgery M I T C H E L L M I L L S , D O N A L D MIMBS, E D W A R D E. J A Y N E , and R O B E R T B. R E E V E S , Jr. Surgeons k n o w t h a t t h e r e are certain d e p r e s s e d , pessimistic p a t i e n t s w h o h a v e an u n u s u a l l y high o p e r a t i v e risk. R e c o g n i t i o n o f such p a t i e n t s t a k e s e x p e r i e n c e a n d d e m a n d s t h a t c o n s i d e r a b l e t i m e be s p e n t getting t o k n o w t h e p e r s o n . Even t h e n , the e v a l u a t i o n is subjective and d i f f i c u l t t o c o m m u n i c a t e to others. H o s p i t a l chaplains have s h o w n an increasing willingness t o serve as c o n s u l t ants o n the p a t i e n t - c a r e t e a m . T h e i r d e p t h o f k n o w l e d g e c o n c e r n i n g m a n ' s i n t e r p e r s o n a l r e l a t i o n s h i p s and t h e i r religious c o n c e r n f o r the w h o l e n e s s o f sick p a t i e n t s c o m b i n e to g e n e r a t e d a t a t h a t p h y s i c i a n s can use in p l a n n i n g t h e i r p a t i e n t s ' care. D a t a t h a t are m o s t useful to p h y s i c i a n s are q u a n t i t a t i v e a n d a m e n a b l e t o statistical analysis. T h e chaplains at t h e N a t i o n a l Naval Medical C e n t e r suggested t h a t t h e A c c e p t a n c e Scale d e v e l o p e d b y M a s o n , Clark, Reeves, a n d Wagner m i g h t p r o v i d e such d a t a p r e o p e r a t i v e l y in a v a r i e t y o f surgical illnesses o t h e r t h a n retinal d e t a c h m e n t . 1 It was d e c i d e d t o t e s t this h y p o t h e sis for o p e n h e a r t surgery.
Methods One h u n d r e d a d u l t p a t i e n t s s c h e d u l e d f o r o p e n h e a r t surgery b e t w e e n M a r c h 21, 1 9 7 2 , and J a n u a r y 17, 1 9 7 4 , w e r e i n t e r v i e w e d p r e o p e r a t i v e l y b y a chaplain and t h e n scored on an A c c e p t a n c e Scale essentially identical t o t h a t used b y M a s o n et al. 2 (Figure 1). This was a c o n s e c u t i v e series w i t h r a n d o m lapses o n l y w h e n the chaplain c o n d u c t i n g t h e s t u d y was a b s e n t . N e i t h e r t h e p a t i e n t n o r t h e surgeons were a w a r e o f t h e r a t i n g score. T h e scores w e r e Capt. Mitchell Mills, M.D., MC, USN, is Chairman of the Department of Thoracic and Cardiovascular Surgery, National Naval Medical Center, Bethesda, Maryland. Lt. Donald Mimbs, B.D., CHC, USNR., and LCDR Edward E. Jayne, D. Min., CHC, USN, are members of the Department of Religious Activity, National Naval Medical Center, Bethesda, Maryland. The Rev. Robert B. Reeves, Jr., S.T.M., recently retired from the chaplaincy at the Presbyterian Hospital, Columbia-Presbyterian Medical Center, New York. The opinions or assertions contained in this paper do not necessarily reflect the views of the Bureau of Medicine and Surgery of the Navy Department or the Naval Service at large. 159
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4.1 4.0-3.0
Prediction of Results in Open Heart Surgery M I T C H E L L M I L L S , D O N A L D MIMBS, E D W A R D E. J A Y N E , and R O B E R T B. R E E V E S , Jr. Surgeons k n o w t h a t t h e r e are certain d e p r e s s e d , pessimistic p a t i e n t s w h o h a v e an u n u s u a l l y high o p e r a t i v e risk. R e c o g n i t i o n o f such p a t i e n t s t a k e s e x p e r i e n c e a n d d e m a n d s t h a t c o n s i d e r a b l e t i m e be s p e n t getting t o k n o w t h e p e r s o n . Even t h e n , the e v a l u a t i o n is subjective and d i f f i c u l t t o c o m m u n i c a t e to others. H o s p i t a l chaplains have s h o w n an increasing willingness t o serve as c o n s u l t ants o n the p a t i e n t - c a r e t e a m . T h e i r d e p t h o f k n o w l e d g e c o n c e r n i n g m a n ' s i n t e r p e r s o n a l r e l a t i o n s h i p s and t h e i r religious c o n c e r n f o r the w h o l e n e s s o f sick p a t i e n t s c o m b i n e to g e n e r a t e d a t a t h a t p h y s i c i a n s can use in p l a n n i n g t h e i r p a t i e n t s ' care. D a t a t h a t are m o s t useful to p h y s i c i a n s are q u a n t i t a t i v e a n d a m e n a b l e t o statistical analysis. T h e chaplains at t h e N a t i o n a l Naval Medical C e n t e r suggested t h a t t h e A c c e p t a n c e Scale d e v e l o p e d b y M a s o n , Clark, Reeves, a n d Wagner m i g h t p r o v i d e such d a t a p r e o p e r a t i v e l y in a v a r i e t y o f surgical illnesses o t h e r t h a n retinal d e t a c h m e n t . 1 It was d e c i d e d t o t e s t this h y p o t h e sis for o p e n h e a r t surgery.
Methods One h u n d r e d a d u l t p a t i e n t s s c h e d u l e d f o r o p e n h e a r t surgery b e t w e e n M a r c h 21, 1 9 7 2 , and J a n u a r y 17, 1 9 7 4 , w e r e i n t e r v i e w e d p r e o p e r a t i v e l y b y a chaplain and t h e n scored on an A c c e p t a n c e Scale essentially identical t o t h a t used b y M a s o n et al. 2 (Figure 1). This was a c o n s e c u t i v e series w i t h r a n d o m lapses o n l y w h e n the chaplain c o n d u c t i n g t h e s t u d y was a b s e n t . N e i t h e r t h e p a t i e n t n o r t h e surgeons were a w a r e o f t h e r a t i n g score. T h e scores w e r e Capt. Mitchell Mills, M.D., MC, USN, is Chairman of the Department of Thoracic and Cardiovascular Surgery, National Naval Medical Center, Bethesda, Maryland. Lt. Donald Mimbs, B.D., CHC, USNR., and LCDR Edward E. Jayne, D. Min., CHC, USN, are members of the Department of Religious Activity, National Naval Medical Center, Bethesda, Maryland. The Rev. Robert B. Reeves, Jr., S.T.M., recently retired from the chaplaincy at the Presbyterian Hospital, Columbia-Presbyterian Medical Center, New York. The opinions or assertions contained in this paper do not necessarily reflect the views of the Bureau of Medicine and Surgery of the Navy Department or the Naval Service at large. 159
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4.1 4.0-3.0
