PubMed Health⌕ Search

Biomedical subjects

F Balck

Publications and source records attributed to F Balck.

12 recordsLinked to original sources
PubMed2001

Resuscitation decision index: a new approach to decision-making in prehospital CPR.

Retrospective and prospective studies have been undertaken to assess physicians' practice-patterns by studying cardiopulmonary resuscitation (CPR) case summaries. Most summaries reveal similar influences by the physician, patient and situation-related variables on the patterns of resuscitation. The initiation of resuscitation efforts is addressed frequently, but, very few studies discuss the topic of termination of resuscitation. Prehospital emergencies are addressed very rarely. The objective of this study was to introduce a new methodological approach towards initiation and termination of resuscitation efforts in prehospital situations. The subject studied were the physicians' decisions concerning initiation/withholding, termination/withdrawal and the resulting early survival rates. The result is termed the "Resuscitation decision index" (RDI). The "RDI" could be a tool allowing comparisons on a quantitative level, between different EMS systems or disciplines and giving an insight into the decision process. The "RDI" can enhance audit of resuscitation. The process of decision-making can be used to help future theoretical decision-making strategies.

Adult↗
PubMed2001

[The effects of psychotherapy on Crohn's disease patients--results of a randomized multicenter study].

In a prospective multicenter study of Crohn disease patients, the influence of psychotherapy on the course of the disease and on psychosocial variables (anxiety, depression, life satisfaction and data of the PSKB) was studied. Psychodynamic oriented psychotherapy was provided in addition to a standardized medical treatment and took place during the first year of the two-year observation period. 108 of 488 patients were recruited and randomly assigned to the psychotherapy and the control group. 84 patients completed the somatic and 81 the psychosocial follow up. 23% of the control group and 30% of the psychotherapy group showed episode-free courses, 29% and 17% respectively underwent surgery (worst outcome group). The ranking and comparisons of the disease course showed no significant difference (p = 0.125) between psychotherapy and control group. The psychosocial variables also showed no differences between these groups. Subjectively, the patients report favourable effects to psychotherapy.

Adolescent↗
PubMed1996

The quality of life during intravesical bacillus Calmette-Guerin therapy.

PURPOSE: In the treatment of cancer the subjective evaluation of therapy induced side effects and quality of life must be considered. Adjuvant intravesical bacillus Calmette-Guerin (BCG) immunotherapy is regarded as highly effective but associated with significant side effects. To clarify whether these side effects significantly impact on patient satisfaction with life, a prospective survey of the health related quality of life and side effects was performed during an intravesical BCG treatment course. MATERIALS AND METHODS: Symptoms and side effects were recorded daily during the 6-week instillation period in 30 patients. The quality of life was determined before, during and after intravesical therapy with the assistance of a self-reported questionnaire. RESULTS: Due to a detailed subjective assessment of side effects, the course of local symptoms could be characterized with great reliability. Although side effects occurred, satisfaction with life in the patients studied was high and was not impaired during the treatment. The incidence of side effects correlated well with patient subjective evaluation of quality of life. CONCLUSIONS: Assessment of side effects and quality of life, as presented in this pilot study, can assist in the quantification of localized symptoms in intravesical therapy could contribute to the comparability of clinical studies. With regard to intravesical BCG immunotherapy, our results suggest that the specific side effects do not seriously impair satisfaction with life in these patients.

Adjuvants, Immunologic↗
PubMed1994

[The physician's cognition during cardiopulmonary resuscitation of the human].

The cognitions of 20 emergency-physicians while working on a mobile resuscitation unit were examined by means of questionnaire in over 260 situations of resuscitation. A pattern of cognitions could be detected: Emergency physicians appear not to think very much during resuscitation. If there are thoughts, these usually concern the obvious, or what is immediately present in the situation, i.e. the patient or the patient's relatives; repression may also play a role. Cognitions which are reflective of self are rare and only develop late in the situation, depending on the surroundings and the amount of stress. The cognitions concerning the relatives are frequent in those situations with direct physician-relative contact. The physicians often report in retrospect having felt compelled to a decision for resuscitation by the presence of the relatives; nevertheless, the decision itself appears to be a result, rather, of their cognitions of the relatives. Distancing by means of cognition was ubiquitously employed as a coping strategy by physicians when in situations which were perceived as not having a positive outcome. Thoughts about "own death" or "about the patient" are specific, however, for certain groups of doctors. Results of the present investigation suggest that physicians have cognitions about relatives during the process of decision making, and cognitions about the patient during the resuscitation manoeuvre.

Adult↗
PubMed1979

Problems in interaction between patients undergoing long-term hemodialysis and their partners.

186 patients undergoing hemodialysis and their partners were examined with a personality inventory (Giessen test) and a questionnaire which was specially developed for this purpose. The instrument was used to measure the social interaction between patient and partner. The Giessen test was applied in four versions: self-description, description by the partner, referring to the present, referring to the past. One of the main interests of the analyses was in finding dependencies of the variables upon the types of hemodialysis setting (unit, private unit, and at home). Various correlations were found.

Dominance-Subordination↗
PubMedDate not supplied

[Effectiveness of a systematic treatment model in an inpatient department of child and adolescent psychiatry].

This is a report on the findings of the effectiveness of the "Viersener Modell", a inpatient systemic child psychiatry model. The therapy effects were recorded, by means of self and therapists assessment, in several relevant areas of change. The index clients (ic) show typical characteristics of a child psychiatry population. The ic (n = 43) and also their parents (37 mothers and 22 fathers) showed significant improvement on the level of psychiatric symptoms, individual problems and in general experience and behavior. The psychiatric symptoms that were conspicuous by both ic and parents at the beginning of therapy, were mainly inconspicuous at the end of the treatment (effectsize (es): icfemale, n = 28 = .82, icmale, n = 15 = .22, motherswithout partner(accompanying) = .20, motherswith partner(accompanying) = .44, fathers = .44). There was no essential improvement in the quality of the couples relationship, on the other hand the relationships were not clinically conspicuous at the beginning of therapy. Family members and therapists assessed quality of the treatment results and process mainly in accordance with our hypothesis. While the therapists noticed a significant improvement in the functioning of the family relationships (es = .87) at the end of the therapy, the parents (reported no difficulties in family functioning at the beginning of therapy) reported no essential improvement of family relationships in the follow-up questionnaire (n = 32). The improvement of the problems and the assessment of the quality of the treatment results remained stable over an eight month period.

Adolescent↗
PubMedDate not supplied

[Chronic renal failure: predictors of good adjustment to disease and treatment].

N = 109 patients with chronic renal failure were studied referring to somatic, psychological and social parameters, which are often discussed in psychonephrology. N = 25 of the patients were in the status of compensated retention, n = 43 were undergoing hemodialysis and n = 41 lived after transplantation. At the same time the treating physicians were asked to judge different criterias referring to the adaptation of the patients to the disease and treatment. Using a discriminant analysis, we were successful in predicting the quality of adaption in 75-85% using the patient variables. The results show, that each of the three treatment groups is to be considered separately, although some variables seem to have a generally strong prediction power: Serum level of Calcium, psychosomatic complaints and the extent of depressive disorder. Some aspects for further prospective studies and for the practical treatment are shown.

Adaptation, Psychological↗