Biomedical subjects

C Buddeberg

Publications and source records attributed to C Buddeberg.

At least 19 recordsLinked to original sources

PubMed2007

How does psychological processing relate to compliance behaviour after lung transplantation? A content analytical study.

Non-compliance is one of the crucial problems impairing outcome after transplantation. Fourteen lung transplant recipients were interviewed about their thoughts regarding transplant-related topics. Compliance was assessed by doctors. The psychological processing was investigated by content analysis. Highly compliant patients perceived more advantages by transplantation. In contrast, low-compliant patients reported either an emotional distance to the lung or a closer relationship to the donor. Furthermore, they showed a contradictory relationship to the medical staff. There are some indications that perception of advantages by transplantation is crucial to compliance. This experience takes place in the context of a good staff-patient relationship. Emotional distance to the lung or nearness to the donor are further contributing factors of non-compliance.

Adaptation, Psychological↗

PubMed2006

[Psychosocial aspects of patients with sexual dysfunction].

UNLABELLED: Sexual dysfunctions are common among the general population. An essential part of the assignments to specialized sexual medicine care units are from primary care physicians. METHODS: In 2002 to 2004 for a period of 18 months questionnaires were given to all patients, who attended the special sexual medicine care unit at the University Hospital of Zurich for the first time. At the beginning of their treatment, the patients were questioned about different psychosocial characteristics and aspects of their sexuality. RESULTS: We studied 43 women (48.3%) and 46 men (51.7%). Women were with an average age of 33.8 years 10 years younger than men, 43.5 years. The most common sexual dysfunction in women was lack or loss of sexual desire (51.2%), followed by nonorganic vaginism (20.9%) and orgasm disorders (11.6%), in men erectile dysfunction (50.0%), followed by premature ejaculation (26.1%) and lack or loss of sexual desire (15.2%). The studied subjects showed distinctively lower values in their sense of coherence than men and women in the general population. The patients were much more anxious than people in the average population. The questioned men were also much more depressive than men in the general population and than the examined women. The examined men reported sexual wishes, needs and sexual activities significant more frequently than the examined women. CONCLUSIONS: As men and women with sexual dysfunctions are much more anxious than people from the general population, physicians should address sexual themes in the conversations with their patients carefully but actively.

Adult↗

PubMed2006

Waiting for a liver transplant: psychosocial well-being, spirituality, and need for counselling.

UNLABELLED: The number of patients in need of a liver transplant vastly exceeds the number of available organs; the demand worldwide for organs leads to increased waiting times and mortality of patients on the waiting list. The aim of our study was to assess the psychosocial well-being of transplant candidates and their need for psychosocial counselling. METHODS: Sixty-nine liver transplant candidates were asked about their psychosocial well-being, quality of life, spirituality, and need for counselling assessed by interview and questionnaire (HADS-D, FLZ, LOT, SOC, SF-36, SBI-15R) during the initial evaluation procedure for organ transplantation as well as 3 and 6 months after listing. RESULTS: Candidates for a liver transplant exhibited a significant limitation in the levels of their quality of life and psychological well-being, compared with the community normal samples. They showed significantly higher levels of anxiety, but lower levels of spirituality. Almost half of the candidates (47%) expressed a need for counselling during the evaluation procedure. Patients with advanced diseases reported a lower need. Age and the personality-related "Sense of Coherence" correlated negatively with need for counselling. On the waiting list, psychosocial parameters and functions remained largely stable; the need for counselling decreased significantly. CONCLUSIONS: There is a relevant need for psychosocial counselling during the process of liver transplant evaluation. Need for counselling is associated with personality and age, as well as with somatic parameters.

Adult↗

PubMed2006

[Bio-psycho-social history--is it still up to date in the time of media communication?].

Specialization in medicine changes the kind of communication between doctor and patient. The direct personal communication is quite often complemented by the indirect communication via interactive media. A clinical investigation still demands a broad bio-psycho-social anamnesis which should encompass the history of the illness, the patient, and his/her ailment. The bio-psycho-social anamnesis is subdivided into nine steps: Joining, "map", actual disease, former illnesses, family history, personal development, social anamnesis, overview of the functioning of the systems, finalization of the anamnesis. The different steps are explained, and adequate techniques of exploration are described. How to conduct a professional doctor-patient conversation and exploration can similarly be learnt as the techniques of a physical investigation. These communication skills should be continuously taught during the education of medical students as well as during the further training of physicians.

Clinical Competence↗

PubMed2005

[Neurotoxic encephalopathy caused by neuroleptics and lithium].

Treatment of psychiatric patients often necessitates overlapping neuroleptic medication. We report a 60-year-old woman suffering from a schizoaffective disorder who received temporarily three neuroleptics, together with lithium. She developed neurotoxic encephalopathy with symptoms of a malignant neuroleptic syndrome. It is unclear if irreversible brain damage will remain. We recommend frequent electroencephalographic controls for early detection of neurotoxicity.

Antipsychotic Agents↗

PubMed2005

[Erectile dysfunction in men in their second half of life].

BACKGROUND: Studies to date on the prevalence of erectile dysfunction (ED) report varying results. The present study investigates the frequency and degree of ED, its determining factors as well as the help-seeking behavior of the patients. PATIENTS AND METHODS: A random sample of 628 Swiss men (mean age: 61.5 years) were examined by questionnaire regarding their sexual functioning, comorbidity, and help-seeking behavior. RESULTS: Of the respondents, 9.6% reported complete, 18.0% moderate, and 41.4% minimal ED. All grades of the disorder increased with age and correlated with somatic and psychiatric comorbidity as well as with drug intake. Only 3.2% reported having used drugs for improvement of erectile functioning. CONCLUSION: Only a small number of men suffering from ED seek the help of a doctor. Considering the efficacy of PDE5 inhibitors, objective information and competent medical counseling of ED patients are indicated.

Adult↗

PubMed2003

[Effects of hip arthroplasty followed by by inpatient rehabilitation on physical function and quality of life].

The aim of the present study was to investigate the effects of hip arthroplasty followed by an inpatient rehabilitation. Moreover, the relationships among functional status, quality of life and satisfaction with life or health status were examined. Patients were assessed before hip arthroplasty, at the start and at the end of the inpatient rehabilitation. Functional status was measured by using the WOMAC questionnaire and quality of life with the Medical Outcome Survey Short Form 36 (SF-36). Satisfaction was determined with a specific questionnaire (FLZ). Hip arthroplasty followed by an inpatient rehabilitation resulted in significant and clinically highly important improvements of functional status, quality of life and satisfaction with health and life.

Adult↗

PubMed2003

[Determinants in the careers of male and female physicians from the viewpoint of chief physicians].

BACKGROUND AND OBJECTIVE: Chief physicians play an important role for physicians' careers by providing advanced training and allocating time and research resources. This study examined which characteristics will help physicians to achieve a leadership position and how chief physicians conduct career promotion. SAMPLE AND METHODS: All 532 chief physicians in Switzerland's German speaking cantons with medical schools were approached with a questionnaire covering professional motivation and personal attributes of career-oriented physicians career-promoting personal and institutional factors, and type of career promotion. RESULTS: 207 chief physicians (189 men, 18 women; participation rate 38.9 %;) participated. Respondents rated achievement motivation combined with professional interest and job enjoyment (intrinsic), and interest in advancement and social prestige (extrinsic motivation) as beneficial. Extraprofessional concerns such as family obligations and leisure interests were viewed as less important. Instrumental attributes were rated as advantageous. Expressive qualities were also seen as beneficial but less crucial. Ratings were independent of respondents' age, specialty, or type of workplace. The following personal factors were named: professional commitment, professional and social competence, goal orientation, endurance, and strength of character. The institutional factors referred to quality of training and teaching, a good work atmosphere, a transparent and flexible clinic structure. Career promotion was offered predominantly in the form of coaching, career planning, and support in job search. CONCLUSION: Career promotion should be more targeted and structured, e. g. be conducted in mentoring programmes, thus providing the prerequisites for a truly equal career promotion of female and male physicians.

Career Choice↗

PubMed2003

Patient well-being after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia.

BACKGROUND: The aim of this study was to assess postoperative patient well-being after total i.v. anaesthesia compared with inhalation anaesthesia by means of validated psychometric tests. METHODS: With ethics committee approval, 305 patients undergoing minor elective gynaecologic or orthopaedic interventions were assigned randomly to total i.v. anaesthesia using propofol or inhalation anaesthesia using sevoflurane. The primary outcome measurement was the actual mental state 90 min and 24 h after anaesthesia assessed by a blinded observer using the Adjective Mood Scale (AMS) and the State-Trait-Anxiety Inventory (STAI). Incidence of postoperative nausea and vomiting (PONV) and postoperative pain level were determined by Visual Analogue Scale (VAS) 90 min and 24 h after anaesthesia (secondary outcome measurements). Patient satisfaction was evaluated using a VAS 24 h after anaesthesia. RESULTS: The AMS and STAI scores were significantly better 90 min after total i.v. anaesthesia compared with inhalation anaesthesia (P=0.02, P=0.05, respectively), but equal 24 h after both anaesthetic techniques (P=0.90, P=0.78, respectively); patient satisfaction was comparable (P=0.26). Postoperative pain was comparable in both groups 90 min and 24 h after anaesthesia (P=0.11, P=0.12, respectively). The incidence of postoperative nausea was reduced after total i.v. compared with inhalation anaesthesia at 90 min (7 vs 35%, P<0.001), and 24 h (33 vs 52%, P=0.001). CONCLUSION: Total i.v. anaesthesia improves early postoperative patient well-being and reduces the incidence of PONV.

Adult↗

PubMed2002

[Psychosomatic research in primary health care--ideal concept and reality].

UNLABELLED: The cooperation between research institutions and primary care doctors can be seen as a possible model for practical research in psychosomatic medicine. Cooperation experience with a study in the field of sexual medicine are reported as well as recommendations regarding the planning and implementation of similar studies are given. 7455 Swiss physicians specialized in psychiatry, internal or general medicine were asked to fill out a survey on "sexual dysfunction and anti-depressants". They were also asked if they were willing to interview their patients on the same issue. 1100 physicians agreed to answer the doctors survey and 62 were interested in interviewing their patients. However, only 12 physicians actually did. In 55 telephone interviews doctors mentioned as their main reasons for not participating: lack of time and their hesitation to discuss sexual issues with depressive patients. CONCLUSION: The collaboration in research projects means a considerable effort on the side of primary care doctors. Therefore, their cooperation should be rewarded appropriately, e.g. time could be counted as further training.

Academies and Institutes↗

PubMed2002

[Differential diagnosis of chronic pain syndromes of the musculoskeletal system--coding according to ICD-10].

Primary care for patients suffering from chronic pain is regularly provided by either family physicians or inpatient medical wards. A delay in initiating specific pain treatment is associated with poor outcome in terms of pain intensity, work disability and diminished quality of life. We present a diagnostic classification scheme for chronic pain disorders following the biopsychosocial disease model. This classification may help primary care providers initiate appropriate treatment early in the course of chronic pain, and aid in referral of their patients to services familiar with the treatment of chronic pain. Given increasing requests for quality control in health care and for transparency in disease management by health insurance companies, we propose a coding system of chronic non-malignant pain syndromes with the ICD-10.

Adult↗

PubMed2002

[Differential therapy of chronic pain syndromes of the musculoskeletal system in primary health care].

For treatment of chronic non-malignant musculoskeletal pain syndromes to be successful, simultaneous medical and psychosocial interventions are required. We provide different treatment options for chronic pain disorders for the primary care physician who is not a trained psychotherapist. We stress that the physician must adopt a particular therapeutic attitude towards his patient. We further emphasize the elaboration of a biopsychosocial disease model with the patient, cognitive-behavioral interventions, treatment of associated sleep disorders, the use of a rational drug therapy regimen, physical therapy, relaxation techniques, and involvement of the social environment. Such treatment strategies may help primary care physicians to treat their patients suffering from chronic pain more successfully and with greater patient satisfaction.

Chronic Disease↗

PubMed2002

[Treatment follow-up of transsexual patients. A catamnestic study].

In a retrospective study, 33 transsexual patients, 22 male-to-female transsexual (MF-TS), and 11 female-to-male transsexuals (FM-TS), were interviewed 53-121 months after their first referral to the psychiatric department of a university hospital. Social integration proved to be satisfactory and relatively stable. Twenty-five patients had gone through surgical sex reassignment, while 29 were currently undergoing hormonal treatment. Regarding the course of treatment, the FM-TS were a more homogeneous group than the MF-TS group. Overall, physical and psychosocial well-being was satisfactory. Psychometric measures yielded remarkably normal values, with some pathological findings regarding personality traits. In the majority of patients, self- and observer-rating appraisals of gender-specific physical appearance were equally positive. The results suggest a three-step procedure for the treatment of transsexual patients, as is practiced in other centers within German speaking continental Europe.

Adult↗

PubMed2002

[Ultrasound examinations in the context of suspected fetal malformations: satisfaction of concerned women and their appraisals].

UNLABELLED: BACKGROUND AND RESEARCH QUESTIONS: Fetal malformations can be detected at an early stage during pregnancy by today's ultrasound technology. This study examined how pregnant women appraise the application of ultrasound technology when a fetal malformation is suspected and how this appraisal is influenced by the confirmation or rejection of the diagnosis and by the subsequent course of the pregnancy. METHOD: In a prospective study 86 pregnant women for whom a fetal malformation had been suspected in an ultrasound examination were assessed at three points in time: before the ultrasound examination at a specialized centre, one to two weeks after the examination, and four weeks after giving birth or after the premature termination of pregnancy. Assessments were conducted by means of questionnaire and semi-structured interviews. RESULTS: 96.4 % of pregnant women advocated routine ultrasound examinations, irrespective of whether the suspected malformation was confirmed or not and irrespective of whether the pregnancy was continued or terminated prematurely. The women rated as being most important the medical goals of the examination (e. g. determination of the child's health status) and less so the subjective and personal goals (e. g. visualization of the child). Communicative competence in the context of the examination (e. g. quality of information) were judged less favourably than technical competence (e. g. performance of the exam). 94.2 % of the women believed that the cost of the ultrasound exam should be carried by health insurances. DISCUSSION: The findings of the study show the strong significance which prenatal ultrasound examinations have for pregnant women. Acceptance of ultrasound technology is high even when the examination results cause psychological stress. However, they also indicate that more attention should be given to aspects of communication and interaction in training and application of ultrasound technology.

Abortion, Eugenic↗

PubMed2002

[Suspected fetal malformation in ultrasound examination: effects on the psychological well-being of pregnant women].

OBJECTIVE: Today's ultrasound technology permits the detection of foetal malformations during pregnancy. This study examined pregnant women's psychological responses to a suspected fetal anomaly and the subsequent course of psychological well-being. METHOD: 86 pregnant women with a suspected fetal malformation were assessed by means of questionnaires three times: before an ultrasound examination at a specialized centre, one to two weeks after the examination, and four weeks after giving birth or after premature termination of the pregnancy. Anxiety (STAI), depression (HADS-D) and feelings towards the child were assessed. RESULTS: A suspected fetal malformation results in psychological stress with anxiety and depression levels significantly higher than in normal samples. Regardless of either confirmation or rejection of the diagnosis of a malformation, stress decreases significantly after the ultrasound examination at the specialized centre. Only women who decide to terminate the pregnancy prematurely show increasing levels of stress in this period. Four weeks after giving birth or termination of pregnancy the assessed psychological parameters of all participants fall within the normal range. CONCLUSIONS: A suspected fetal malformation results in immediate psychological stress but not in an enduring psychological disorder. Women facing immediate premature termination of pregnancy exhibited the highest stress levels. The psychosocial distress caused by the diagnosis of a fetal malformation should be taken into consideration in the psychosocial consultation and treatment of concerned women and their partners.

Abortion, Eugenic↗

PubMed2002

[Suspected fetal malformation in ultrasound examination: The partner's distress and attitudes towards ultrasound. Technology].

AIM: The involvement of fathers in the preparation for birth was a major progress in modern obstetrics. The present study investigates how fathers evaluate the ultrasound examination during pregnancy and how much they are stressed by the diagnosis of a possible fetal developmental disturbance. METHOD: In a specialized ultrasound center at the University Hospital in Zurich 54 couples who came in with the diagnosis of a possible fetal developmental disturbance were interviewed for their emotional stress and attitudes towards ultrasound examinations during pregnancy. RESULTS: Levels of state anxiety were significantly above the norm for both men and women. However, male partners felt less stressed and experienced less anxiety than the pregnant women. Men were also more optimistic about the health status of the unborn baby. There were no differences in attitudes towards ultrasound examination between women and their male partners, however, men rated their experiences with ultrasound examinations more critical and knew less about it. The support of ultrasound as a routine examination method during pregnancy was high in both sexes. CONCLUSION: The diagnosis of a possible fetal developmental disturbance is a big emotional distress for pregnant women and the fathers of the baby. It does not result in a negative attitude towards ultrasound examination, though.

Anxiety↗

PubMed2001

[Sex-typical aspects of the physician-patient relationship of elderly patients in general practice].

So far the issue of gender combination in the patient-doctor relationship has not been investigated in depth. In a cross sectional study 84 general practitioners of the Canton of Zurich were asked to give information on health problems and expectations of their patients over 55 years. Data regarding fears and expectations on the part of the physicians pertaining to their own age were assessed. Results show that cardio-circular, muscular-skeletal, fibre-tissue, urological, nutritional and metabolic system diseases as well as psychological and behavioural problems were most commonly diagnosed in older patients in general practice. Patients often had expectations not or difficult to fulfill by their physicians. Gender stereotypes appeared in the descriptions of typical older male or female patient. Female doctors characterise their patients similarly to their male colleagues. Regarding their own aging both genders reported fears of dependency. Female doctors primarily hoped for wisdom, whereas, their male colleagues wished for themselves health and more time for their own interests. Results indicate that the issue of gender combination and the competence in dealing with psychosocial problems of older patients should be given special consideration in graduate programs and continuous training of doctors.

Activities of Daily Living↗

PubMed2001

Prediction of psychiatric morbidity in severely injured accident victims at one-year follow-up.

The objective of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) and symptoms of depression and anxiety in severely injured accident victims 1 yr posttrauma and to predict psychiatric morbidity by means of variables assessed shortly after the accident. The sample consisted of 106 consecutive patients with accidental injuries (mean Injury Severity Score = 21.9, mean Glasgow Coma Scale score = 14.4) admitted to the intensive care unit of a University Hospital. Patients with severe head injuries, suicide attempters, and victims of physical assault were excluded. At 1-yr follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Eighteen patients (17%) had clinically relevant symptoms of anxiety, and nine (8.5%) were depressed. Overall, 27 patients (25.5%) showed some form of psychiatric morbidity (full or subsyndromal PTSD and/or anxiety and/or depression). Logistic regression analysis, using 1-yr psychiatric morbidity status as the dependent variable, allowed correct classification of 83.8% of patients 12 mo postaccident (specificity 91.8%, sensitivity 61.5%). Biographical risk factors and a sense of death threat contributed significantly to the predictive model. We conclude that a substantial proportion of severely injured accident victims develop some form of psychiatric morbidity that can be predicted to some degree by mainly psychosocial variables.

Adaptation, Psychological↗