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B Badura

Publications and source records attributed to B Badura.

8 recordsLinked to original sources
PubMed1992

Effecting institutional change.

The paper deals with the need for institutional change and behaviour change in the medical care and social security system of the Federal Republic of Germany. The data reported are from the Oldenburg Longitudinal Study (OLS), in which a thousand males suffering from a first myocardial infarction have been surveyed with mailed questionnaires five times in five years. In this study, special emphasis has been given to the influence of social support from the spouse, the medical care system, and workmates on the coping process. Special emphasis has been given as well to institutional factors and organizational problems in the rehabilitation system of general practitioners, rehabilitation clinics and the social security system. The paper concludes that there is a clear need for comprehensive services and other measures that promote self-reliance and self-help activities among patients and their relatives. In the literature on heart disease, "health promotion" is mostly defined as behavioural change on the part of the individual--i.e. patients or members of what is conventionally called a "higher risk group". In this paper, however, I shall concentrate on another aspect which is no less important: the need for institutional change and behavioural change in the medical care and social security systems. This change, I argue, is needed in order to promote the health of patients who survived a first myocardial infarction.

Adaptation, Psychological↗
PubMed1988

[Long-term anxiety and depression following myocardial infarct].

Data from the 5-year Oldenburg Longitudinal Study were used for investigating the causes of differences in psychological well-being in a national sample of 1000 cardiac patients. In a subsample of 400 married patients, for whom data from the spouse were available, exogenous influences, cognitive mediators, and two measures of psychological distress were linked up in models explaining/predicting the level of anxiety and depression. A major hypothesis was the salience of the illness-related cognitions of the patient as a determinant of long-term behavior and mood state. Early patient subjective health perceptions, the 'primary appraisal' of threat/harm/loss, were found to be the most important predictors of subsequent psychological well-being at the fourth wave of the study several years later. As an instrument for patient screening and psychosocial intervention, Type A's and other groups of subjects seemed to constitute high-risk patient groups.

Adaptation, Psychological↗
PubMed1988

[Social support and community health care].

Concepts of health have changed considerably over the last decades. Of particular interest is the relations between social support and health, between the social context of the individual, the social network of his family, friends, neighbours and workplace on one side, and health on the other side. The importance of social support is illustrated with data from the "Oldenburg Longitudinal Study (OLS)".

Chronic Disease↗
PubMed1988

Marriage and the psychological consequences of a heart attack: a longitudinal study of adaptation to chronic illness after 3 years.

As part of a larger study on recovery from myocardial infarction in a national sample of male cardiac patients, data was collected on slightly under 400 men and their wives over a 5-year period. This longitudinal data set was used to investigate the role of patient health cognitions and marital factors on long-term psychological response to the illness. Negative appraisals of threat and loss due to cardiac impairment/disability were found to be the best predictor of anxiety and depression at 3-4 years after hospitalisation. Patient cognitions appeared to be a chief mediator of medically-defined illness. Supportive marital environments were defined by scales measuring intimate attachment and spouse conflict. The latter was found associated with negative health cognitions and elevated anxiety. High intimacy marriages appeared to provide adequate social support, and the level of intimacy between the spouses was inversely related to the level of depressed mood. These findings were suggestive of a buffering effect of the patient's social support system. Other predictors, including the type A pattern, 'vital exhaustion', and social class were investigated as components of a multifactorial model for clinical screening purposes.

Adaptation, Psychological↗