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Biomedical subjects

A Blaser

Publications and source records attributed to A Blaser.

At least 19 recordsLinked to original sources
PubMed1990

[Amniocentesis: psychological stress and coping by the pregnant female].

Anxiety as induced by aminocentesis and consequential strategies for coping there with, are the focus of this study. A group of 32 women were selected for AC due to age, and a second group of 30 women as a result of risk factors in the case history. Anxiety related to AC was self-assessed by the patients and coping strategies were rated according to the "Bernese Coping Modes" prospectively and retrospectively. Results indicate, that AC is anxiety-inducing, but does not vary with parity, indication or the degree of information, but solely with the fact of preexisting experience or absence of such with AC. 50% of the patients would have been willing to interrupt the pregnancy, had the result indicated a high risk of malformation. The coping with the waiting time until the result of AC was known was such, that the "age" group showed a great deal of optimism, whereas the risk group used several coping modes, which are more complex and also potentially problematic. This does not make the somatic risk group a psychological hazard group, but nevertheless suggests, that professionals should stand by to intervene on a psychological plane.

Adaptation, Psychological↗
PubMed1990

Teaching problem-oriented therapy.

The therapeutic concept is problem- and patient-oriented. In analogy to it the didactic concept is problem- and therapist-oriented. The essential point is learning in groups from practical cases. Problem-oriented in this context means that the problems-solving process in which the patient and the therapist are engaged is supported by the observer group. Therapist-oriented means that the learning process should take account of the different preferences and experiences of the therapists. That can only be accomplished by problem-oriented learning. Each psychotherapy training group consists of 4 assistant doctors and a supervisor and stays together about 1 year. The strongly structured concept of problem-oriented therapy (POT) [Blaser et al., 1988] offers the beginner a framework by which he can guide the dialogue with the patient. The eclecticism of POT allows the more experienced therapist to try out new methods without losing track of the problem. The constantly changing role of being observer or therapist supports the group coherence, and furthermore it promotes an important element of therapeutic competence, the ability to get into a close relation with the patient and at the same time being able to observe oneself, the patient and the therapeutic process from a more distant view. In addition to the POT training group tutorials in special psychotherapy methods and single supervision sessions are offered.

Clinical Competence↗
PubMed1990

Theory and technique of problem-oriented therapy.

Problem-oriented therapy (POT) features the following essentials: problem orientation, eclecticism, patient orientation and brevity. These ingredients, above all the eclecticism, are detailed: diverse psychotherapeutic interventions are administered to foster awareness, modification of thought patterns, modification of behavior, emotionality, awareness of the body, ability to relax, and support. The required abilities of the therapist are mainly flexibility and transparency of his therapeutic actions. The definition of the problem which is negotiated together with the patient is decisive for the selection of the intervention strategy. An example illustrates the use of POT especially as in contrast to school-consistent traditional therapies.

Combined Modality Therapy↗
PubMed1990

Subjective illness concepts and problem-oriented therapy.

Subjective illness concepts mean the comprehensive psychological explanations about causes and functions of actual problems by the patient. These concepts are related to basic needs and they historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at reorganizing the needs of the sick individual as well as monitoring his experience of being ill. Often they do not accomplish this aim because they appear to be deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as 'problem definition'.

Adaptation, Psychological↗
PubMed1990

[Overview of brief psychotherapies--a basis for discussion of problem-oriented therapy].

Historical and pragmatic reasons justify short term practice of psychotherapy. Some of the better known methods are discussed in respect to their concept, indication and setting: Malan and the Tavistock-group; Mann: Time limited psychotherapy; Sifneos: STAP, Short term anxiety provoking psychotherapy; Davenloo: Broad focus short term dynamic psychotherapy; Strupp: TLDP, Time limited dynamic psychotherapy; Luborksy: Supportive-expressive psychoanalytic psychotherapy; Klerman: Interpersonal psychotherapy; Beck: Cognitive therapy. After a cross-comparison arguments are given why there is still a need for a more problem- and patient-oriented, eclectic and limited psychotherapy. Besides theoretical reasons there are practical and didactic aspects in favour of such a method.

Adaptation, Psychological↗
PubMed1990

[Problem oriented therapy. A new therapeutic and didactic concept].

Problem Oriented Therapy (POT) is a short-term therapy concept that is characterized by the following essentials: Problem orientation, patient orientation, eclecticism and process-structuring. These essentials will be explained and their therapeutic and didactic implications shown. POT is not committed to a certain psychotherapeutic school but uses selectively reliable methods from different therapeutic approaches. The indication to specific therapeutic strategies is made from a pragmatic point of view on the level of problem definition and takes account of the patient's own comprehension of the problem. Transparency and flexibility of therapeutic thinking and acting are essential in POT. This will be illustrated by a case report. The training-settings of POT will also be briefly described.

Adaptation, Psychological↗
PubMed1990

[The value of subjective illness theories in problem oriented therapy].

Subjective illness concepts mean the more or less comprehensive psychological explanations about causes and functions of actual psychosocial problems by the patient. These concepts historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at monitoring the individuals' experience of being ill or healthy. Often they don't accomplish this aim because they are deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as an important issue for our problemoriented therapy.

Adult↗
PubMed1989

[Microbiological findings of 97 cases of acute pyelonephritis].

To optimize the therapeutic approach to acute pyelonephritis (PNA), the medical records of 89 patients (73 women and 16 men) hospitalized with diagnosis of PNA between January 1984 and 1987 have been studied. According to routine bacteriological urinalysis, gram-negatives were found in more than 92% (E. coli in 79%, Proteus in 6%). Gram-positives were found in only 8%. The gram-negatives (n = 82) showed resistance to amoxicillin in 36%, to amoxicillin/clavulanic acid in 17%, to cotrimoxazole in 18%, and to ceftriaxone in 1%. No resistance to netilmicin or norfloxacin was found. These results justify treatment with norfloxacin or ceftriaxone instead of amoxicillin, amoxicillin/clavulanic acid or cotrimoxazole for gram-negatives. Among the 7 cases with gram-positives, resistance was found to amoxicillin/clavulanic acid, cotrimoxazole and also netilmicin, and to norfloxacin, ceftriaxone and amoxicillin. Therefore, an initial therapy using the association amoxicillin-netilmicin is recommended in PNA.

Acute Disease↗
PubMed1989

[Henry E. Sigerist: creation of medical historical study. An unpublished manuscript in the Zurich medical history institute].

In 1951 Henry E. Sigerist (1891-1957) wrote a manuscript paper on the structure of lectures on medical history. In this paper, which has remained unpublished yet, Sigerist's considerations are based on many years of experience in teaching in Leipzig and Baltimore. According to him, a lively medical history must always refer to current medicine. Furthermore, it should try to bridge the gulf between the arts, the social and the natural sciences. His proposal for a possible schedule includes an introductory course of lectures into medicine for beginners and a course on the history of medicine for advanced students. Lectures on medical ethics and sociology of medicine are also part of his programme. Finally, Sigerist stresses the fact that, in addition to these four lecture courses, seminars and a colloquy may provide students with the possibility of working on a specific subject in more detail.

Historiography↗
PubMed1989

[The mirror as a possibility of participation in routine gynecologic examination: effects on the psychological status of the female].

The effect of active participation by means of a hand-mirror during gynecological examination was investigated in that three groups were formed: one that wanted and got the mirror, one that wanted the mirror but was not given it and thirdly refusers. The mirror leads to significantly greater satisfaction, which however does not override preexisting attitudes concerning one's body and sexuality as well as the image of the doctor. In that respect acceptance or refusal of the mirror reflects in some ways the open-mindedness or conservatism of the patients.

Body Image↗
PubMed1989

[The impact of perceptual stereotypes in indications for psychoanalysis].

Results of several experimental studies concerning the practice of selecting patients for psychoanalytic therapies are presented. The convergent findings strongly suggest that the indication for psychoanalytic therapies are heavily stereotyped and are dependent upon stimuli that do not result from communicative interaction with the patient. These facts are confronted with the psychoanalytic understanding of the role of countertransference during the indication process. Countertransference and stereotypes person perception do not necessarily contradict each other. It is proposed that countertransference reactions in this situation are partly a consequence of compatibility stereotypes vis á vis the patient which are quickly and unconsciously formed and which are afterwards differentiated and extended but also rationalized on a conscious level.

Countertransference↗
PubMed1988

Effect of artificial insemination with donor semen on the psyche of the husband.

It has been argued that artificial insemination with donor semen (AID) can be detrimental to the psyche of the sterile husband. This issue has been scrutinized on a larger scale empirical basis using four groups of husbands whose wives were either pregnant due to AID or were under AID without being pregnant yet or were pregnant without AID or were assumedly fertile without being pregnant. Psychometric data was obtained of the corresponding husbands. The results indicate that AID is no threat to the husbands of all groups. Infertile men do not seem to be a psychological risk group. Fertile men tend to reject AID.

Adaptation, Psychological↗
PubMed1987

Coping with breast cancer--a longitudinal prospective study.

In a prospective longitudinal study over several years, 58 patients with breast cancer are compared to 52 patients with fibrocystic disease and 24 patients with mastodynia. Results of coping (as assessed with the Bernese Coping Modes) are presented for the illness course of the first 6 months: (1) There is considerable variation of coping depending on illness situation and illness state. A core group of coping modes is predominant in most situations: 'attention & care', 'problem analysis', and 'Tackling'. In average 10 different coping modes were used by patients per given illness situation. (2) The different aspects of illness (in the same organ) ask for different coping. In the initial evaluation phase, however, the possibly fatal diagnosis overrides these differences. (3) Change over time (first 6 months) is net. Besides the core group of coping modes mentioned above, there is more variability in coping; in cancer a trend from a more fighting to a more accepting attitude is obvious; in fibrocystic disease more restricted coping is observed. Interdependence of coping with emotional stability and social adaptation will be studied as well.

Adaptation, Psychological↗
PubMed1985

[Diagnosis and indications in psychotherapy].

The more recent literature on the reliability and the status of psychiatric diagnosis is reviewed and confronted with the latest experimental results on the indication for psychotherapy. Accordingly it can be hypothesized that at least for outpatient psychiatry/psychotherapy there is no meaningful relationship between diagnosis and indication. Diagnoses do not imply indications for psychotherapy. This assumption is verified by the results of an outpatient fieldstudy and the implications are discussed.

Adjustment Disorders↗
PubMed1978

[Transsexualism].

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Diagnosis, Differential↗