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Biomedical subjects

H D Basler

Publications and source records attributed to H D Basler.

At least 19 recordsLinked to original sources
PubMed1995

Patient education with reference to the process of behavioral change.

From a traditional aspect, behavioral change is conceptualized as a shift from one stable state to another, from stable unhealthy behavior to stable healthier behavior. This approach will influence the type of intervention program to be adopted as well as the type of assessment instrument applied. A concept supported by the results of studies involving a large number of subjects, which enable the natural process of behavioral change to be observed, suggests that behavioral change is a non-stable condition with distinct stages called precontemplation, contemplation, action, and maintenance. There may be relapse at any stage and this should be interpreted as a natural part of the change process. Health educators are confronted with different tasks at each level, and by addressing these tasks and tailoring the intervention programs to suit the stage of the individual subject, better support during the process of change can be given. A project involving cooperations between university institutes and the pharmaceutical industry has developed and evaluated education programs which address different stages of change in a primary care setting. Action-oriented programs for the prevention of coronary disease, sleep disturbance, and chronic pain have proven to be effective. Target behaviors are smoking, stress management, nutrition, and physical exercising. These programs have recently been complimented by others addressing precontemplation and contemplation stage subjects. Further research will have to be carried out in order to find assessment instruments designed to assign the right program to the right person.

Health Behavior↗
PubMed1994

[Chronification process of backache].

The high economical costs produced by the impact of low back pain on sick-listing and loss of manpower at work encouraged the search for personal or situational characteristics that indicate an increased risk for an acute onset of back pain or for its continuation towards chronicity. Risk factors for the onset of acute pain identified at the workplace refer to mechanical and psychomental strain. Vibration as well as lifting and carrying of heavy loads, especially if combined with a twisting of the trunk, are the most prominent mechanical risks, whereas dissatisfaction with the job or the working conditions, especially if there is a lack of social support either at the workplace or at home by the family or the spouse, increase the risk on a psychosocial level. Although these risks continue to be effective in the process of chronicity, other risks pertaining to behavioral and emotional reactions to the acute pain episode gain in importance. At the acute level, avoidance of physical and social activities are often encouraged by physicians who prescribe bed rest or give advice to regulate the active reinvolvement in daily life by assessing pain levels ('let the pain guide'). On the other hand, with regard to the prevention of chronicity, a strategy of graded early activation aiming at a reinforcement of healthy behaviors has more beneficial effects. After a short period of bed rest, no longer than two days, if at all necessary, patients are taught to maintain their daily activities and to practice specified exercises, while receiving time-contingent pain medication.(ABSTRACT TRUNCATED AT 250 WORDS)

Back Pain↗
PubMed1993

Group treatment for pain and discomfort.

Rheumatic patients very often suffer from chronic pain and impairment and show psychological reactions as a consequence of their physical condition. These reactions may vary from psychophysiological symptoms to anger, anxiety, or depression. We developed a cognitive-behavioral treatment programme in a group setting format with components of relaxation, cognitive restructuring, and the promotion of well-being. Subjects included in the study were given diagnoses of low back pain, tension headache, rheumatoid arthritis, and ankylosing spondylitis. Treatment effects in different diagnostic groups were compared to each other, supporting the assumption that pain reduction is greatest in low back pain and least in ankylosing spondylitis. Subjects with inflammatory rheumatic diseases showed some improvement in self-reported physical complaints and in their feelings of well-being.

Arthritis, Rheumatoid↗
PubMed1991

Cognitive-behavioral therapy in patients with ankylosing spondylitis in a German self-help organization.

A cognitive-behavioral treatment program for pain control was administered to 22 subjects with a diagnosis of ankylosing spondylitis (AS) in a self-help setting of the German Rheumatism League. A sample of 17 AS subjects from the same setting served as waiting-list controls. The program consisted of training in progressive muscle relaxation, cognitive restructuring, attention related techniques and pleasant activity scheduling, and was aimed at an improvement of self-control strategies. Ratings of pain severity, anxiety, depression, psychophysiological complaints, and sleep disturbances were used to evaluate the outcome. Follow-up assessments were conducted six months post treatment. A significant interaction between treatment condition and assessment period was demonstrated. Further analyses indicate a beneficial effect of the treatment in all outcome measures apart from general symptoms during pain attacks at the follow-up assessment. Reductions of pain intensity, anxiety, and psychophysiological symptoms were maintained at 12 month follow-up. Although pain reduction was statistically significant, it did not exceed 14% in the pain diary. The more important aspect of the treatment appears to be emotional stabilization and increased feelings of well-being.

Adaptation, Psychological↗
PubMed1988

[Modification of the risk profile of obese essential hypertensive patients by the group "hypertension discussion" program].

The programme "Discussions on Hypertension" is a programme for group treatment of obese essential hypertensives in medical practices on the basis of behavioural therapy. A co-operation model was developed between the Department for General Medicine of the "Medizinische Hochschule Hannover", the Institute for Medical Psychology of the "Philipps-Universität Marburg" and the company Galenus Mannheim and was offered to doctors in general practice. The effects of the programme on the modifying of the risk profile for coronary heart disease was investigated in a controlled study in 137 patients by nine general practitioners. 81 patients were enrolled in the experimental group and 56 patients were assigned to a control group that was not using the programme. The experimental and control groups were comparable with respect to sociodemographic, psychological and medical parameters. Three months after completing the programme, the results of the study was shown in specific effect both on the psychological criteria of success (well-being, health knowledge, healthy behaviour, salt use and compliance) and in a reduction of the diastolic blood pressure in spite of a reduction of the antihypertensive drug treatment. The blood lipid levels (cholesterol and triglycerides) and the blood glucose level were also favourably affected. Patients in the experimental group had reduced their weight by an average of 5.6 kg. The patients in the control group only by 0.8 kg. Overall, there was a marked reduction in the proportion of patients with several risk factors in the experimental group, so that the programme can be attributed a preventive effect.

Antihypertensive Agents↗
PubMed1987

The safety of and the strain on the donor during thrombocytapheresis on the cell separator. A psychological study.

The study deals with the question as to what extent and under which existing personal characteristics does thrombocytapheresis on the cell separator (Fenwal CS-3000) lead to psychological stress for the blood donor? A comparison is made with the stress experienced during the established 450 ml full-blood donation. Because of the different procedural conditions, it was postulated that the donation on the cell separator creates greater psychological stress than the established type of donation. To examine this hypothesis, a sample group of 76 cell-separator and full-blood donors were asked to complete a questionnaire concerning the stress they experienced and their attitude before, during, and after the donation. Their personalities were also examined. A control group of 45 full-blood donors was examined in the same way. No significant statistical difference was found regarding the extent of stress under both conditions of donation. These findings are verified by the general satisfaction expressed by the cell-separator donors. Although it is confirmed that the personal cost to the donor is greater, it involves, on the other hand, a greater commitment, a positive evaluation of the more intimate involvement of the donor, and an increase in self-esteem. Since it could not be proven that there is an increase in the amount of stress during cell-separator donation, it also seems plausible that no clear decrease in stress would be observed after repeated donations. On the whole, it seems that the cell separator is well accepted by the donors. The extent of experienced stress is related to the donor's habitual anxiety and negative expectations. Since negative expectations can be influenced, it is to be expected that an informative conversation in a quiet atmosphere would further decrease the stress experienced.

Adaptation, Psychological↗
PubMed1985

Psychological group treatment of obese essential hypertensives by lay therapists in rural general practice settings.

Two hundred and sixty-one obese essential hypertension patients from 15 rural general practices were assigned to either an experimental group (n = 155) or to waiting control group (n = 106). The experimental group underwent psychological group treatment aimed at weight reduction, improvement of stress coping, and reduction of salt-intake. Sixteen therapy sessions were conducted in each of the general practices by specifically trained lay therapists who applied a standardized, highly structured therapy programme. During the time of the study, both experimental group and waiting control group received intensified medical attention. After the 6-months therapy, health knowledge and health behaviour of the patients had improved. Mean weight reduction was 5.2 kg. Blood pressure had decreased by a mean of 14.4 mm Hg (systolic)/7.4 mm Hg (diastolic). After a follow-up period of four months, the beneficial effects of the group treatment were confirmed: Patients needed less anti-hypertensive medication and consistent reduction of body weight prevailed.

Adaptation, Psychological↗
PubMed1982

Psychological group treatment of essential hypertension in general practice.

One hundred and seven obese patients with essential hypertension from eight general practices received one of the following psychological group therapy procedures: (1) modification of nutritional patterns; (2) modification of nutritional patterns plus self-monitoring of blood pressure and training in social competence; (3) modification of nutritional patterns plus Jacobson's relaxation training; (4) information about the causes and consequences of high blood pressure. An approximately equal number of patients served as a waiting-control group. All patients had received pharmacological treatment for at least a year. Each procedure was administered by a psychologist with groups of up to 15 patients in 12 weekly sessions. The blood pressure values measured before and after intervention showed a clear reduction; this fall is greatest when the initial values were high. Even when the magnitude of the initial values was statistically controlled there was a distinctly greater reduction in blood pressure in the treatment groups than in the waiting-control group. No differential effect between the various therapy procedures could be demonstrated, however. The changes in general health behaviour of the treatment groups was statistically confirmed. In addition, there was a distinct reduction in body weight. Medication compliance also improved in the treatment groups. Since group procedures were accepted both by the doctors and the patients involved, they should be included to a great extent in the basic care of hypertensive patients in the future.

Antihypertensive Agents↗
PubMed1981

[Psychological group treatments of patients with essential hypertension in a general practice--results of a pilot study (author's transl)].

Sixty patients with essential hypertension received psychological group treatment in a general practice in 4 groups of 15 persons. The following methods were applied: adiposis training, self-measurement, relaxation training, information. Another 15 hypertensives were untreated controls. A short-term hypotensive effect is most distinctly demonstrable in the information group, suggesting the recommendation to intensify the group information of hypertensives.

Adult↗