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E Scheuer

Publications and source records attributed to E Scheuer.

10 recordsLinked to original sources

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↗

[The online-consultation of the University Hospital Zurich].

Since August 1999 free medical Internet consultations are offered by the University Hospital Zurich. Overall 13,984 inquiries have been answered until December 2003. As of today an average of about 10 questions has been received per day. The users are predominantly between 20 and 50 years old and most of them show normal characteristics in terms of weight and size. The incoming questions refer to a wide variety of medical subjects and 53% of them have been asked by women. Frequently asked questions refer to topics like HIV, nutrition, vaccination as well as contraceptive methods. Intimate questions concerning e.g. sexual dysfunction disorder as well as changes on male genitals are also overrepresented. Therefore medical Internet consultation is characterised by low thresholds and is particularly well suited for the consultation of intimate and sensitive topics.

Adult↗

[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↗

[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↗

[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↗

[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↗

[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↗

[Joubert syndrome].

Joubert syndrome was first described in 1969 and 100 cases have been published so far. It includes: partial or complete agenesis of the vermis, episodic hyperpnea, ataxia, a disorder of ocular movement and mental retardation. It is autosomal recessive and there are descriptions of families with involvement of multiple children, both boys and girls. Since dysmorphic signs are not prominent in this syndrome, diagnosis is often delayed. To the best of our knowledge, Joubert syndrome has not been previously described in Israel. We present a family with 3 siblings with this syndrome. Increased awareness will lead to earlier diagnosis, proper developmental treatment, and accurate genetic counseling.

Abnormalities, Multiple↗