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Biomedical subjects

G M Krüskemper

Publications and source records attributed to G M Krüskemper.

15 recordsLinked to original sources

[Change sensitivity and construct validity of the revised multi-dimensional pain scale].

PROBLEM: Assessment and evaluation of perceived pain is an interdisciplinary task. This study focused on the change sensitivity and construct validity of the German version of the Revised Multidimensional Pain Scale (MSS). METHODS: In this experiment, 72 students were assigned to one of three treatments:a) Applying a blood pressure sphygmomanometry cuff with a maximum pressure of 300 mm Hg, b) or with a maximum pressure of 175 mm Hg, c) or a control condition, applying a cuff with no pressure. During the treatment, blood pressure was continuously non-invasively measured by the Penazmethod. At the end of the experiment, the subjects worked on the revised multidimensional pain scale, on the state/trait anxiety inventory (STAI) and a Likert-scale (range 1-28) for perceived pressure. RESULTS: As expected, inflating the arm cuff induced a significant increase in pressure perception compared to the control group. However, only the subscales electrical and thermic of the MSS showed an increase across the treatment groups. No differences were found for the anxiety ratings. Correlation analysis showed that state anxiety was positively related with the subscales chronic, chemical, and thermic. Trait anxiety was related with the subscales chronic, inconvenient, and chemical. Systolic blood pressure increase was positively correlated with the subscale general of the MSS. DISCUSSION: The study shows that the MSS has a limited change sensitivity for short term pain stimuli like arm cuff pressure. Anxiety was correlated with three subscales of the MSS, indicating that perceived pain intensity assessed with the MSS is more related to emotional factors rather to the physical intensity of the arm cuff pressure.

English Abstract↗

[Psychological concepts in pain therapy practice. 2: Behavior therapy, self-management and overview of cognitive interventions].

In this part, the contribution of cognitive behavior therapy and the self management approach in psychological pain therapy is presented. A five-step-model of cognitive behavior is explained. The different steps are diagnostics, development of a new cognitive model of the disorder, acquisition of coping strategies, applications, transfer and relapse prevention. Focus of this paper are the coping strategies, thus, the interventions in confrontation with a pain stimulus. The self management approach has the goal to enable the patient to use coping strategies as quickly as possible by himself and to support the self-regulation of the patient. At the end, a survey about cognitive self-control strategies is given.

Adaptation, Psychological↗

Quality of life of patients with renal cell carcinoma or prostate cancer after radical surgery.

OBJECTIVES: To study the impact of radical tumour surgery in prostate and renal cell cancer patients on quality of life (QOL). METHODS: In 38 male patients suffering from organ-confined prostate or renal cell cancer, a prospective study was performed. For the evaluation of QOL, we used the EMPK (Erfassung multipler psychischer Konstrukte). Urologic symptoms were evaluated with a specially designed symptom score. The test instrument was filled out the day before surgery and one year after operation. RESULTS: The EMPK was able to detect and describe significant changes in certain aspects of QOL in renal cell cancer and prostate cancer patients. Moreover, there seems to be a difference between the two groups. A direct relation between QOL and the different quality and quantity of operation-related symptoms, however, could not be proven. CONCLUSIONS: In this pilot study, radical surgical therapy did not significantly change QOL in prostate cancer patients, but seemed to have a positive influence on the QOL of renal cell cancer patients.

Aged↗

Effects of pain-incompatible imagery on tolerance of pain, heart rate, and skin resistance.

Imagery is an important component in strategies for coping with pain. In this study, we examined, whether imagery influences tolerance for pain and whether subjects, trained in pain-incompatible imagery differ in heart rate and skin resistance from these in a control group during a pain-induction session. 39 subjects were randomly assigned to two groups: imagery and control. Both groups had two pain-induction sessions. At intake into the study (t1). Pain Tolerance and Psychophysiological Reaction to Pain were assessed using a pressure algometer. After the first session, the experimental group received 1 hr. of training in pain-incompatible imagery. Seven days later, the session was repeated (t2). The results showed that Pain Tolerance was significantly increased in the group who used pain-incompatible imagery. One might follow the notion that increased Pain Tolerance is associated with increased Psychophysiological Pain Reaction, but results suggest the contrary. Subjects trained in pain-incompatible imagery had lower heart rates during the second pain induction than the control group. Groups did not differ with regard to skin resistance. It can be stated that besides information, cues on coping with pain may be helpful in clinical practice.

Adaptation, Psychological↗

Effects of nondirective suggestions on pain tolerance, pain threshold and pain intensity perception.

In this experiment, we followed the issue whether nondirective suggestions have an effect on pain threshold, pain tolerance, and perception of pain intensity. 48 healthy subjects consented to take part. At intake into the study (t1), pain threshold and pain tolerance were assessed in all subjects using a pressure algometer. Perception of maximum pain intensity perception was rated on a scale of 0 to 25. Seven days later, the session was repeated (t2). Subjects were randomly assigned to one of two groups. One group received nondirective suggestions as pretreatment. Subjects listened to a tape of 20 min. which consisted of general information about pain theory. In this context, suggestions for coping with pain were placed. The other group served as a control and received no pretreatment. Analysis showed that pain tolerance was significantly prolonged in the group who received nondirective suggestions, while pain threshold and perception of maximum pain intensity did not differ across groups. This study demonstrates that nondirective suggestions are effective in prolonging pain tolerance. It can be stated that, beside information, cues on coping with pain may be helpful in clinical practice.

Adaptation, Psychological↗

[Psychological concept of pain therapy. 1. Relaxation therapy, imagery methods, hypnotherapy and psychoanalysis].

In this article, the contribution of the psychotherapy schools to psychological pain therapy shall be explained. In the first part, relaxation methods, imaginative techniques hypnotherapy, and psychoanalysis as well as their importance for psychological pain therapy are presented. Research findings for autogenic training, progressive muscle relaxation and meditative methods are shown as example for relaxation methods. Imagery is shortly explained and associated to hypnotherapeutic methods. In hypnotherapy, research results, the pattern of a session and hypnotherapeutic strategies for pain reduction are demonstrated. In the explanation of psychoanalysis, the aims and explanation principles of analytic methods for the psychogenic pain development are shown.

Humans↗

Underestimation of sensorimotor task-induced blood-pressure changes by posttask sphygmomanometry.

For assessment of cardiovascular effects of sensorimotor work, blood pressure is commonly measured by arm sphygmomanometry. A technique introduced by Penaz makes it feasible to monitor blood pressure noninvasively and continuously from the finger artery which measures give high correlations with intraarterial measurement. This study compared blood-pressure changes induced by a standard sensorimotor task using sphygmomanometry and the Penaz-method. It was investigated whether sphygmomanometrically recorded blood pressure can be used to estimate task-induced blood-pressure changes and whether inflating the cuff to different maximum pressures induces blood-pressure changes. 46 normotensive individuals were randomly assigned to the discomfort group (maximum arm-cuff pressure of 280 mmHg) or to the control group (maximum arm-cuff pressure of 160 mmHg). The experiment consisted of six tasks of 4 min. each. Results indicated that sphygmomanometries under-estimated task-induced blood-pressure changes and that phasic systolic and diastolic blood-pressure elevations during the task were leveled off shortly after the end of the task. Effects of 'cuff-inflation hypertension' were not found. The Penaz-method appears to be more appropriate than sphygmomanometry if dynamic aspects of blood pressure are of interest.

Adult↗

Emotional adjustment and perceived locus of control in heart transplant patients.

Orthotopic heart transplantation has been established as a routine clinical operation. In this study, we were interested in: (a) how patients cope emotionally with the situation pre- and postsurgically, especially with regard to anxiety and depression; and (b) whether the patient's perceived locus of control is related to emotional adjustment before and after heart transplantation. Twenty patients who were on the waiting list for heart transplantation with highest priority provided complete psychological questionnaires presurgically and 20 days after surgery when intensive care was no longer required. During the waiting period, patients rated high on depression, state and trait anxiety in comparison with healthy references while ratings on perceived locus of control scales were within the norm ranges. After surgery, heart transplant patients experienced significantly less state/trait anxiety and depression reaching levels which were no longer statistically different from health references. While postsurgical ratings of anxiety (state and trait) and depression were not significantly correlated with presurgical ratings, both were closely related to ratings of locus of control. Belief in powerful others was positively correlated with pre- and postsurgical anxiety and depression. Chance control orientation was related only to presurgical emotional disturbances. It can be concluded that emotional adjustment after heart transplantation is more likely to be predicted by presurgical ratings of locus of control than by presurgical emotional adjustment.

Adaptation, Psychological↗

Effects of rehabilitation exercise programmes on anxiety and depression in coronary patients: a meta-analysis.

In coronary patients, emotional disturbances in the sense of increased anxiety and depression have often been documented. Over the last years, there has been a growing interest in the effects of exercise on emotion. This meta-analysis, based on 13 to 15 studies on psychological effects of exercise programmes in coronary patients, showed a positive effect size both for anxiety (dmean = .3137) and depression (dmean = .4569). Nevertheless, these effect sizes have to be evaluated as less than medium by convention and in comparison to the effect size of psychotherapeutic interventions. The effect sizes on anxiety or depression were not related to methodological characteristics of the included studies, like duration of the exercise programme, time chosen for follow-up, publication year or use of control groups. But there was a significantly negative correlation between sample size and effect size. This might indicate a potential publication bias in the sense that significant rather than non-significant results may be published on small subject samples. We concluded that exercise programmes should not be considered the only treatment for emotional disturbances in coronary patients, but that they can be psychologically beneficial as an additional treatment component.

Anxiety↗

Rise in systolic blood pressure during sphygmomanometry depends on the maximum inflation pressure of the arm cuff.

OBJECTIVE: Sphygmomanometric recordings of blood pressure are a standard technique in clinical practice. We investigated whether arm-cuff inflation can induce short-term blood pressure changes ('cuff-inflation hypertension'), limiting the generalizability of recordings. METHODS: Progress in biomedical methodology makes it feasible to monitor blood pressure continuously and non-invasively at the finger artery (the Peñaz method). Seventy-two normotensive subjects were randomly assigned either to a series of sphygmomanometric recordings in which a maximum cuff pressure of 300 mmHg was applied, to a series in which the maximum cuff pressure was 175 mmHg or to a control group in whom no sphygmomanometric recordings were made. RESULTS: The subjects exposed to arm-cuff inflations perceived the cuff inflation pressure, but their perception could not differentiate between the two maximum cuff pressures. Furthermore, increases in systolic blood pressure during the inflation period were recorded when a maximum cuff pressure of 300 mmHg was applied. The effects on diastolic blood pressure were not significant. CONCLUSIONS: The maximum arm-cuff pressure during sphygmomanometry should be not too far above the pressure needed to occlude the brachial artery. A high maximum arm-cuff pressure increases the chances of inducing 'cuff-inflation hypertension'.

Adult↗

[Behavior modification and obesity (author's transl)].

Good results were obtained treating 49 obese patients with an elaborated selfcontrol behavior modification program. This program was an addition to the normal program of the obesity clinic of the 2. Medizinische Klinik der Universität Düsseldorf. The normal program contains some principles of behavior modification but less accentuated. After the initial 12 weeks of controlled training patients tried to reduce weight further decreasing external control. Only few patients were able to loose additional pounds during this period of 8 weeks. At the end of the initial 12 weeks patients had asked for another control before the vacational season, but only 10 out of 49 appeared at the control sessions 9 months after the program's start. If an additional behavior modification program is considered for incorporation into an already existing weight reduction clinic, additional costs and expected results have to be checked. Durative success of behavior modification techniques in weight loss programs has still to be submitted to proof.

Behavior Therapy↗

[Psychological problems in obesity (author's transl)].

The MMPI was administered to 209 obese women and 72 obese men before onset of a weight reduction regime. Obese subjects differ in a variety of MMPI-standard-scales from the standard population as well as from a control group of healthy women: 1. Scales Hypochondriasis (Hs) and Hysteria (Hy) have significant higher values for the obese. This somatic impairment grows in the group of obese women with increasing age and obesity. In men, scale Hs corresponds to the degree of overweight but the youngest male age group (up to 19 years) has a Hs-peak as well as men above 35 years of age. 2. Higher than normal values for obese men and women in scales Depression (D) and Psychasthenia (Pt) in the obese point towards emotional upset. 3. Obesity does not decrease Hypomania (Ma) values for men or women; to the contrary: obese men felt more active than the standard population. With growing age women had a decrease in Ma-values.

Adolescent↗

[Serial studies of the long-term effects of a total-fasting regimen (author's transl)].

The long-term results of total fasting during hospitalisation were evaluated an average of 21 months after the end of the hospital stay in 42 patients treated for obesity between 1971 and 1975. Further weight reduction occurred in 14, while the remainder had regained some weight. Nine of the latter had, in fact, surpassed their prehospitalisation weight. Neither age not sex, social status, time interval since fasting had any influence on the long-term results of total fasting. It is concluded that, in view of the poor correlation between cost and long-term result of such total-fasting regimen, it should be undertaken in this form only exceptionally.

Adult↗

[Therapy-monitoring control of subjective feelings in rheumatic patients].

A significant psychological aspect of rheumatic disease is the subjective emotional feeling in general and the pain stress in particular. The question as to what extent therapeutic measures are able to ease psychic stress was best to be answered by means of continuous observation. In this work, a study of 19 rheumatic patients during a treatment at a spa is presented. Moreover, this demonstrates the possibility of validating the physician's concluding opinion on the basis of the patient's subjective emotional self-judgement during the process of treatment.

Emotions↗