PubMed Health⌕ Search

Biomedical subjects

G Heuft

Publications and source records attributed to G Heuft.

At least 19 recordsLinked to original sources
PubMed2004

[Changes of a sample of aged > or = 60 years of age in-patients after five years: results from the ELDERMEN-Study].

METHOD: The ELDERMEN Study, which was funded by the German Research Association, comprises baseline assessment during 1994-1997 and a second assessment during 2000-2002. A total of 261 in-patients participated in an extensive examination at baseline assessment and were contacted again five years later. RESULTS: Five years after baseline assessment, 135 former participants had deceased, 29 newly fulfilled exclusion criteria. Of the 97 individuals who matched the study's inclusion criteria at the second assessment, 74 participated in the second evaluation. Baseline assessment revealed no significant differences between participants at second assessment and those persons who refused the second participation. However, participants in the extensive examination and longitudinal design were a positive selection when compared to the whole baseline sample. DISCUSSION: Because of increasing morbidity and mortality, longitudinal gerontological studies have to deal with the problem of selective diminishment of the sample, which can endanger the validity and generalizability of results. The problem has to be dealt with by careful documentation and evaluation of selectivity effects. We focus on the problems of longitudinal studies in gerontologic research and examine the longitudinal development of a sample of geriatric in-patients aged > or = 60 years.

Aged↗
PubMed2003

[Diagnosis related groups in psychiatry and psychotherapy--alternatives to DRGs].

Diagnosis related groups (DRGs) will be introduced in Germany in 2003 as a basis for hospital funding in all areas except for psychiatry and psychotherapeutic medicine. The following article provides an overview of the use of alternative casemix-systems in the treatment of patients with mental disorders. Overall, DRGs and alternative systems have proven to be poor predictors of resource consumption due to the high variation in the length of stay and the variable treatment opportunities. Therefore, a DRG-system must include the possibility of coded therapeutic treatments, analogous to the procedures used in surgical DRGs, in order to integrate psychiatry and psychotherapeutic medicine into a DRG-based payment system.

Diagnosis-Related Groups↗
PubMed2003

[The "Sisi syndrome": a new form of depression?].

A new depressive entity called the "Sisi syndrome," named in reference to the former empress of Austria, was introduced by a drug company in 1998. Their advertising campaign presents information about nosology, symptoms, and recommended therapy. We review the relevant literature about this syndrome and are not able to confirm the statements about it. The lack of scientific proof of it as an independent entity of depression stands in contrast to the widespread media coverage in Germany, which was organized by a public relations company. Therefore, we discuss new kinds of marketing strategies ("disease mongering") by drug companies and conclude with some preventive recommendations.

Advertising↗
PubMed2003

[Influence of psychic comorbidity on the treatment process of patients with diabetic foot ulcer].

Until now there are only few studies with small samples dealing with psychosocial aspects of patients with diabetic foot ulcer. The main interest concerns the quality of life of these patients. By reviewing the literature and our own clinical experience, the influence of psychic comorbidity on the treatment process will be demonstrated. Mobility and hospitalization are also related to problems of coping with diabetic foot ulcer and psychosocial problems (e.g., job, partnership, and social support). Therefore, disease management programs for patients with diabetes mellitus types I and II should include psychosomatic-psychotherapeutic diagnostics. The necessity for interdisciplinary work between orthopedics and psychosomatics is discussed.

Adaptation, Psychological↗
PubMed2002

[Resource allocation and justice in distribution of services in medical management of elderly patients].

This paper presents the most important arguments in medical allocation based on an analysis of the relevant literature. The main arguments of rationing scarce medical resources are scrutinized. Especially the use of age limit considerations are critically reviewed. The discussion takes place against a backdrop of aggravating pressure on old people as cost factors. As a basis for further discussion, the authors give a brief history of theories of justice in philosophy. Finally minimum requirements for a constructive and responsible discussion are stated.

Aged↗
PubMed2001

[Coping with illness and psychotherapy for patients after amputation].

Psychology is often neglected or glossed over in most works dealing with the rehabilitation of the amputee. Treating the psychological and social problems faced by the amputee often has more significance for his-satisfaction with life than the quality of the surgery or the nature of his prosthetic device. In the following paper, a complex model for the biopsychosocial adaptation after amputation is presented. In this model, the important diagnostic criteria in interaction with specific individual coping strategies are formulated, which explain the difficult psychosocial adaptation. Professional diagnosis and further indication are necessary on an individual basis. The main goal of every intervention is the psychic stabilization of the patient by taking into account his personal resources. Because of the complex somatic, social, and psychic problems which arise after an amputation, thorough cooperation between specialists is recommended.

Adaptation, Psychological↗
PubMed2001

[Diagnostic control. Psychiatric comorbidity in patients of technical orthopedic units].

Because of the new hospital finance law a DRG (Diagnosis Related Groups) controlled discount liquidation under consideration of the medical impairment becomes necessary. In this paper the importance of a correct and complete description of the psychic comorbidity for the development of German-Refined-DRGs (GR-DRGs) in the orthopedic field is described. Therefore we analysed data of orthopedic in-patients, who are diagnosed by consultation of the clinic for psychosomatics and psychotherapy. A psychic comorbidity (ICD-10 Chapter F (V)) was diagnosed by 95% of the consulted patient. 30% of the patients showed difficulties in coping with their disease. 40% suffered from chronical psychoneurotic patterns and conflicts, which can be explained (a) as consequence of a difficult psychosocial adaptation by chronic disease or after an amputation (b) as basic mental disorders (c) as cause of the orthopaedic complications. Therefore the number of indications for a psychotherapeutic or psychiatric treatment is very high. The knowledge about a psychic comorbidity can--beside financial aspects--help the team on the orthopaedic station in the treatment of difficult patient.

Adaptation, Psychological↗
PubMed2001

[Treatment outcome of inpatient psychosomatic rehabilitation of elderly patients].

Empirical data about the different effects of a specific inpatient psychotherapeutic intervention for elderly patients (over 55 years) are presented in this study. An analysis of sub-units presented four different groups of elderly patients with different psychotherapy effects. Three of four groups showed significant reduced stress in self-rated well-being and depression, only one group had no significant effects one year after the inpatient psychotherapy. Because the patients of this group describes themselves at the beginning of the treatment as "quite normal", significant effects in outcome are hardly to be expected. For a better understanding of this group, other-rated information is necessary. Implications for changing the treatment are discussed.

Aged↗
PubMed1999

[Significance of trauma reactivation in old age].

Psychic symptoms by psychic traumas are fundamentally different from those caused by psychodynamic conflicts or cognitive behavioral conceptualizations. For the purposes of a discriminating psychotraumatology, there is the need to differ traumas by their etiology. Adults suffering not immediately after a specific trauma from a posttraumatic stress disorder (PTSD) can develop a trauma reactivation 30 or more years after the trauma by demands of the somatic process of aging. It is discussed that the possibility of being helpless in the face of the somatic aging process could reactivate the traumatic dynamic. Need is stressed to differ trauma reactivation from retraumatization. Psychotherapeutic possibilities of trauma reactivation in old age are discussed.

Adult↗
PubMed1999

[The degree of Objective Health Burden (OHB) - an expert assessment of the impairment caused by somatic illnesses in geriatric medicine].

The degree of Objective Health Burden (OHB) is an expert assessment of the impairment caused by somatic illnesses. It allows an overall clinical rating of the severity of a patient's somatic condition, considering all available information, not only the content or number of diagnoses. The rating on a five point scale is demonstrated with clinical examples. Interrater-reliability is satisfactory, being at least 0.74. External criteria indicate the OHB's validity. As the OHB is easy to comprehend and to employ, it is suitable for broad clinical application in geriatric basic assessment as well as for scientific purposes.

Adaptation, Psychological↗
PubMed1999

[Not Available].

Psychosomatic aspects of the normal aging process are not discussed by the international literatur nor psychotherapeutic treatment strategies with functional disorders or somatization disorders. By creating the concept "gerontopsychosomatics" 1990 in Germany there is an increasing interest for the implications of the somatic aging process in the second half of adult life span. In order to a competent evaluation of the different therapy indications during the diagnostic process the importance of training in gerontopsychosomatics is stressed.

Development↗
PubMed1999

[Not Available].

The paper examines differences between cases of psychogenic illness and noncases with regard to sociodemographic and health-related variables, coping and biographical reconstructions, evaluating their significance for psychic health in old age. A consecutive sample of 156 patients aged >60 treated for a variety of internal medical complaints in an acute geriatric hospital were examined with the help of comprehensive somatic diagnostics, the Impairment Score (IS), self-evaluation scales and a semistructured biographical interview. 27.5% (n = 43) of the study participants were classified as cases of psychogenic illness. 22 (14.1%) of them fulfilled diagnostic criteria for depressive disorder. Depressive patients were physically more impaired, reported rare and less satisfying social contacts and different coping strategies than the other study participants. With regard to their biographical reconstructions, cases reported more experienced bürden and less experienced support. In discrimination analysis, 78.4% of the study participants were correctly classified as cases vs. non-cases of psychogenic illness by one biographical variable and two coping strategies. Results are discussed as risk factors or protective factors for psychic health in old age considering their clinical relevance.

Biography↗
PubMed1999

[Psychogenic impairment and current feelings in the elderly. Which options are offered by the biographical perspective?].

In the Eldermen study funded by the German Research Association (DFG), a consecutive sample of patients, aged > or = 60 (n = 120) and being treated for a variety of internal medical complaints in an acute geriatric hospital were examined with the help of comprehensive somatic diagnostics, standardised questionnaires, and a semi-structured biographical interview. The study investigates the relationship between burdensome and supportive biographical experiences and the extent of psychogenic impairment as well as aspects of feeling tone and self-concept in later life. For the degree of psychogenic impairment (Impairment Score. IS; Schepank 1995), subjectively experienced burdens and support were found to be more relevant than "objective" burdens. As expected, subjective burdens consistently experienced over several life phases, particularly in association with limited experienced support, were found to be associated with greater psychogenic impairment and a higher "case risk" in later life. However, the patients with the highest values for current life satisfaction as well as a more positive self-concept were not those patients who never experienced more burdens than support in their biographies, but rather those who experienced more burden than support in one life phase. The results are presented in relation to models of learning theory and object relation theory and discussed for their clinical relevance.

Aged↗
PubMed1998

Pain, coping and psychological well-being in late life.

In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed.In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗
PubMed1998

[Geriatric psychosomatic disorders and psychotherapy of the elderly. Current concept and approaches to treatment].

In a geriatric acute hospital, a minimum of 20% of the patients aged 60 or older fulfilled the case criteria for a psychogenic illness. Previously published epidemiological investigations had presented similar results. However, due to the limited theoretical training and treatment experience, psychotherapists continue to show extreme reluctance to formulate an indication for psychotherapy in elderly patients. The paper gives an overview of current concepts in development psychology for the second half of life drawing attention to the role of physical aging processes as an "organiser" of development. Sexuality in late life and approaches to dealing with chronic pain are presented as somatic-psychosomatic aspects of aging that challenge present old age stereotypes. Taking typical symptoms into consideration, a basis is established for the discussion of a differentiated therapy indication for elderly patients. Emphasis is on psychoanalytical and cognitive behavioural psychotherapy methods. Finally, perspectives of research are presented.

Aged↗
PubMed1997

[Early and differential diagnosis of 1,000 patients examined in a memory clinic].

The results from 1000 patients included in a consecutive sample of older persons showing signs of "age-related memory deficits" clearly demonstrate the necessity for a wide spectrum of differential diagnostic competence. The patients included in the study were diagnosed in succession by an interdisciplinary team of psychiatrists, neurologists, geriatric medical specialists, psychologists and gerontologists. The diagnostic process for clarification of DSM-III-R and ICD-10 criteria are discussed in detail. In all, 49.6% of the patients were diagnosed as suffering from dementia of the Alzheimer type, 31% from vascular dementia and 10% from a mixed form. In all, 12.5% of the patients were somatically ill and 31.4% displayed other psychiatric conditions, 50% of which were evaluated as being treatable with psychotherapy. The results are primarily discussed for their relevance to the reality of current treatment.

Adult↗
PubMed1997

Biographical reconstruction of WWII experience: an exploration of German remembrance.

First results of the Eldermensch-Study (N = 50) indicate that German National Socialism and the historical events associated with World War II play a central role in the oral histories of older Germans. Six distinct patterns of late life cognitive appraisal of war-time experience: survival challenge (further divided into "active" and "passive" survivorship), passive benefit, opportunism, value verification, and acceptance despite hardship are presented and discussed as structural themes in the life story. These categories not only represent interindividual differences in the appraisal of war-time experience, but often reflect contrasting patterns of personal response to the social and political circumstances of this era of German history. In addition to cohort and gender differences, divergence in locus of control orientation as well as the role of social bonding and instrumental social support are discussed. Differences revealed in the biographical interviews are further reflected in the results of standardized questionnaires.

Adaptation, Psychological↗