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Biomedical subjects

H U Wilms

Publications and source records attributed to H U Wilms.

6 recordsLinked to original sources

[Dementias and daily competence: effects beyond ADL and IADL].

Using a time-budget method in a 3 year longitudinal study with a control group design, substantial reductions in the engagement of nonobligatory instrumental, social, and leisure activities could be found in a group of mildly to moderately demented patients. Controlling these changes for differences in baseline parameters, the dementia-specific reduction was about 1 1/2 hours compared to a non-psychiatric control group. These clinically relevant changes in activity levels underscore the importance of these activity domains with regard to the development of diagnostically useful indicators at the early stages of dementia. Time-budget methods seem to be particularly useful to close the diagnostic gap with regard to the assessment of everyday competence indicators especially at early stages of the dementia illness.

Activities of Daily Living↗

Daily life in very old age: everyday activities as expression of successful living.

The goals of this article are (a) to describe the daily life of the very old in terms of frequency, duration, variety, and social and physical contexts of activities, and (b) to examine the effects of background variables (e.g., age, sex, residential and marital status, income, and education) on late life activity engagement. A representative sample of 516 adults aged 70-105 was interviewed about their activities using the Yesterday Interview. In contrast to most research on activity engagement, this measurement approach allows for assessment of both the type and context of activities engaged in during the day preceding the interview. The results indicated high frequencies of obligatory activities but also showed substantial time spent in discretionary activities, with television viewing occupying most of the participants' leisure time. Most activities were done alone and at home. In bivariate and multiple regression analyses, age and residential status had the strongest association with activity frequency, duration, and variety; the oldest-old and those residing in long-term care facilities had lower levels of activity engagement. Results are discussed in terms of their relevance for successful aging.

Activities of Daily Living↗

[Schizophrenic patients in ambulatory treatment of a psychiatric hospital and in general practice of established psychiatrists].

Two large samples of schizophrenic patients treated in a psychiatric hospital outpatient clinic (n = 108) and by psychiatrists in office practice (n = 265) are compared in regard to socio-demographic and illness characteristics, pharmacological treatment, tardive dyskinesia rate and psychopathological status--also with respect to results on an outcome-scale. For the outpatient clinic patients changes in hospitalization rates and duration of stay, together with predictors of psychosocial outcome dimensions are reported. The strongest differences between the samples are found in a more complicated course of illness for the outpatient clinic patients, which is interpreted as indication for a higher vulnerability. Against expectation, socio-demographic variables showed no significant differences.

Activities of Daily Living↗

[Definition, significance and measurement of disease concepts of patients. The Disease Concept Scale for schizophrenic patients].

Illness concepts represent cognitive interpretations, explanations and predictions of health status. Illness concepts are a consequence and an expression of the patient's cultural background, view of the world, value system, way of living, and personal life experiences. Illness concepts are significant in that they influence patient's informed consent and compliance behavior. Illness concepts have been formulated in phenomenological-descriptive, formal-structural and psychological approaches. Based on these alternative conceptualizations, a scale was developed to measure seven dimensions of illness concepts. including trust in medication, trust in the treating physician, negative treatment expectations, guilt, chance control, susceptibility, and idiosyncratic assumptions. The reliability and validity of the scale (KK-scale) was tested in a group of schizophrenic patients in different treatment settings. The psychometric properties of the scale were found to be satisfactory. Support for the discriminant validity of the scale was found in relation to patient's age, education, sex, and compliance treatment institution.

Adolescent↗

Limitations in activities of daily living: towards a better understanding of subthreshold mental disorders in old age.

Based on a representative sample of elderly subjects, a description of the limitations in activities of daily living (ADL) and instrumental ADL (IADL) at subthreshold levels of dementia and depression is presented and compared against a sample of psychiatric non-cases and samples with specified levels of the respective illnesses. Additionally, it was analyzed whether these limitations are useful diagnostic markers with regard to subdiagnostic psychiatric disorders. Even at subthreshold levels of depression and dementia, elderly people suffer quite extensively from ADL and IADL limitations. However, multifactorial analyses indicate little evidence that these limitations are specific for psychiatric morbidity, be it at subdiagnostic or specified levels. By and large, ADL and IADL limitations in an elderly sample have to be considered instead as consequences of physical health-related comorbidity. Thus, issues regarding the treatment of ADL and IADL limitations at subdiagnostic as well as specified levels of psychiatric morbidity may not be solved from a psychiatric point of view alone, and a multifactorial, i.e., multiprofessional, perspective is strongly recommended.

Activities of Daily Living↗