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Biomedical subjects

Bogdan de Barbaro

Publications and source records attributed to Bogdan de Barbaro.

6 recordsLinked to original sources

[The effect of music therapy on anxiety level in hospitalized asthmatic patients].

The role of music therapy as a supportive treatment is not well defined. The music therapy cannot be estimated as the isolated method it is often only the part of the complex therapy. The aim of this study was to evaluate the influence of music therapy on anxiety level in hospitalized asthmatic patients. The patient group was consisted of 36 patients with bronchial asthma (23 women and 13 men). In all patients we evaluated the level of anxiety (attribute and state) according to Spielberger and intensity of dyspnoe according to Borg scale at the first day of examination and after 10 days of rehabilitation program. Moreover we performed spirometry. The respiratory rehabilitation program included: exercise of breath control, correction of respiratory pattern, training of diaphragm and additional respiratory muscles. The duration of music therapy lasted 15 min. After 10 days rehabilitation with or without music therapy we found the reduction of anxiety (state) (p<0.0001). However we did not observe the difference between two studied groups with or without music therapy in diminishing of anxiety (p = 0.55). In conclusion, we believe that the music therapy can play important role in treatment of somatic disease but our study did not confirm its additive positive meaning in patients with bronchial asthma.

Adult↗

[Family assessment measures by Manfred Cierpka].

In the first part of the paper, authors describe some research tools for the assessment of family functioning, concentrating mainly on self-report questionnaires of the family members. Advantages and methodological limitations of such methods are discussed. Several questionnaires of self-report type are described such as e.g. the Family APGAR, Family Environment Scale, Mc Master Family Assessment Device, as well as Family Assessment Measure (FAM) of Skinner and Steinhauer. Manfred Cierpka Family Assessment Measures are a modification of this last questionnaire. In the second part of the paper authors present in details Cierpka Family Assessment Measures. They describe seven dimensions of the family functioning such as task accomplishment, role performance, communication, emotionality, affective involvement, control and values and norms. Family Assessment Measures consist of three questionnaires such as General Scale, Dyadic Scale and of Self-Rating Scale. General Scale focuses on how individual member views the family as a whole, The Dyadic Scale assesses specific relationship dyads within the family and Self-Rating Scale addresses how an individual member views his or her functioning within the family. At the end, psychometric properties of these questionnaires are presented, as well as the general description, how they should be used in the process of the assessment of the family for research and in clinical practice of family therapy.

Family↗

[Some psychometric attributes of the Family Assessment Questionnaires].

In this article we present some of the more important findings from research aimed at the validation and normalisation of the Family Assessment Questionnaire (Dyadic Questionnaire, Family Questionnaire, Self-Estimation Questionnaire), which is the Polish adaptation of Manfred Cierpka's and Gabriele Frevert's "Familienboegen". In the presented study 1511 individuals from 557 families took part. Of these 658 individuals (including 162 children) came from 248 families which had no clinical health or adjustment problems, while 853 individuals (including 305 children) came from 309 families with problems due to schizophrenia, anorexia nervosa, coronary heart disease or family crisis. A new method of analysing raw results from the questionnaire scales was formulated and verified. This method was based on the criterium of sufficient satisfaction regarding the aspect of family life measured by the scale. The original scales of all the questionnaires (Task Completion, Role Performance, Communication, Emotionality, Affective Involvement, Control, and Values and norms) were characterised by average or low reliability; the general scales were characterised by high reliability (the Dyadic Questionnaire with very high reliability). As a result of factor analysis new scales were created with acceptable or high reliability. These were the scale of Positive statements, the scale of Negative statements in the dyadic and family questionnaires, and the scales of kindness, care and resentment in the Self-Estimation Questionnaire. The general scales and the factor scales generally significantly differentiated between the sub-samples selected due to the type of family problems present and relationship. On the other hand the 7 original scales did so only sporadically or weakly. Better results were obtained by families without health or adjustment problems while the worst results were obtained by families in crisis.

Evaluation Studies as Topic↗

[Systemic consultation--about possibilities and limitations].

The paper presents the role of systemic consultation in the diagnostic and therapeutic process of the people hospitalised for the first time because of a psychotic episode. The following questions are going to be put: What is the role of systemic family consultation in the diagnostic and therapeutic process on the inpatient ward? What are the differences between systemic consultation and others forms of family interventions f.e. family interviews, psycho--education, systemic therapy? What are possibilities and limitations of consultation? What does it invite to? These are only some of those questions, which are typical for daily clinical practice, in which the family consultation takes an important part. In this paper according to our clinical experience, we would like to share some of our thoughts on the questions put. In spite of difficulties the family consultation confronts us with, we are deeply convinced that it has an important part in therapeutic and diagnostic process.

Communication↗

[Role of systemic consultation in the psychiatric diagnosis].

Basing on the example of one patient and her family, the advantages and disadvantages of a systemic consultation are presented. The patient was hospitalised due to schizophrenia. In the given example the psychiatrist was an observer of the consultation conducted by a therapist from the ward. A systemic consultation allowed a "multiple-picture" to be obtained: the family members and the patient presented their own understanding of the situation, their "stories" This new and multi-perspective description, showing the patient's symptoms functionality caused diagnostic uncertainty in the psychiatrist--how far is the diagnosis of schizophrenia a justifiable one. The possibility to empthasize with the existential, psychological and family problems of the patient caused a scepticism in the psychiatrist, towards the stigmatizing diagnosis. The authors stress the danger arising in the systemic consultation, which broadens and deepens the knowledge on the patient's situation. According to the authors, the systemic consultation is necessary to understand the social context of the patient and to formulate a complex treatment plan. At the same time however, the multiple layered perspective (which contains the psychological, social and existential domains of the patient) should not over-shadow the psychopathological domain. For the therapeutic team, the consideration of the given levels of systemic reality description remains a challenge.

Adult↗

[Between a psychiatric diagnosis and a familial diagnosis].

If the idea of a biopsychosocial model is not going to be merely a phrase, then every clinical diagnosis and therapeutic vision need to consider the familial issues. Taking the family issues into consideration has evident gains; it allows for a better understanding of the patient and allows for actions which reduce the risk of a relapse of illness. The fact that such issues are not part of the therapeutic armament, despite the effectiveness of psychoeducation, is bewildering: on one hand the families are not always invited to co-operate, on the other hand--they often give up this co-operation. In such a situation, the relation between the patient's family and the personnel needs analysis, especially common, often unconscious emotions and prejudices. They can form a dysfunctional 'knot', which does not allow for a therapeutic alliance to be formed. How to come out from such an impasse and make a common positive alliance? Paradoxically, the therapeutic possibilities are bigger when--especially in the initial phase of treatment--the psychiatrist "is able to not know" and is capable of listening into the patient's family perspective, and has an interest in the 'family story'. It is only after the knowledge on the family is gained and the family perspective is accepted, that the deconstruction of that part of the family's story that forms the problem and a common search for "positive changes" are possible. Although it may not appear to be so, such an ordeal can be very difficult for the psychiatrist who is used to controlling the situation through psychiatric theory and diagnosis, psychiatric language and the psychiatric institution. The issue presented appears to be part of a universal dilemma: what is the range of "the language power" of the psychiatrist and when is the sharing of this power with the patient and the family beneficial for the therapy.

Attitude to Health↗