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Biomedical subjects

Hermann Spiessl

Publications and source records attributed to Hermann Spiessl.

At least 19 recordsLinked to original sources
PubMed2006

[Paranoid schizophrenia in monozygotic twins--from caregiver to patient affected].

OBJECTIVE: The aim of this case study is to show how a monozygotic twin perceives the schizophrenic disorder of his twin brother and how these experiences affect his own handling and coping after the beginning of his own schizophrenic disorder. PATIENT: A 46-year-old patient with a first episode of schizophrenia who took care of his twin brother with a disease history of 25 years of schizophrenia. RESULTS: In this case the little knowledge the patient had of his schizophrenic disorder and his lasting lack accessing his illness in the context of a defensive mechanism were striking. Concurrently, the patient overestimated his loading capacity. CONCLUSIONS: A long time of caregiving of a schizophrenic twin brother does not necessarily facilitate the coping with a schizophrenic illness of one's own. Defensive mechanisms could inhibit the implementation of constructive coping strategies with the illness.

Adaptation, Psychological↗
PubMed2006

[Burden of siblings of inpatients with schizophrenia].

OBJECTIVE: Previous studies dealing with effects of psychiatric illness on patients' families mostly focussed on concerns of the parents. The siblings' role as a caregiver, however, has been mostly disregarded or forgotten about. METHOD: 37 narrative interviews with siblings of schizophrenia patients were analysed using a summarizing content analysis. The global statements and categories were quantitatively analysed to assess their relative importance. RESULTS: Analysis of the 492 individual statements of the siblings revealed 26 global types of statements which were assigned to five categories: 1. "Burden arising in the daily contact with the sibling" (36.2 %), 2. "Burden with respect to the healthy sibling's privacy" (26.8 %), 3. "Burden with respect to the contact with the family" (15.7 %), 4. "Burden with respect to the contact with institutions and professionals" (14.2 %), 5. "Burden with respect to the siblings' own social contacts (friends/public)" (7.1 %). The three types of burden most reported by the healthy siblings are: "Handling the symptoms of illness" (100 %), "Emotional burden due to the illness of the sibling" (100 %) and "Uncertainty in judging what amount of stress the schizophrenia patient can cope with" (81.1 %). CONCLUSIONS: Siblings of schizophrenia patients are burdened in many aspects. More attention should be given to their outpatient and inpatient medical treatment.

Activities of Daily Living↗
PubMed2006

[Discharge letters addressed to patients--confidence enhancement and psychoeducation].

OBJECTIVE: There are only some reports about discharge letters addressed to patients. By a case report benefits and potential of letters to patients should be shown. METHOD: The presented case report describes the hospital stay of a 19 year old patient suffering from schizophrenia. RESULTS: The case report indicates that letters to patients provide a useful source of information and can help the patient to understand the nature of his illness. Furthermore, letters to patients are important to increase confidence and can lead to an open atmosphere in the therapeutic process. CONCLUSIONS: Letters to patients enhance the role of patients as self-responsible partners in health care. In single cases a personal addressed letter to the patient is feasible in psychiatric hospitals despite shortness of time.

Adult↗
PubMed2006

[Schizophrenic patients' quality of life--association with coping, locus of control, subjective well-being, satisfaction and patient-judged caregiver burden].

OBJECTIVE: The interrelation of subjective concepts to quality of life has been mainly separately explored so far. METHODS: Beside quality of life (WHOQOL-BREF) of 117 schizophrenic inpatients coping (FKV-LIS), locus of control (KKG), subjective well-being under medication (SWN-K), patient satisfaction (ZUF-8), caregiver burden (FBA) as well as sociodemographic and disease-related variables (German Basic Documentation System, BADO) were analysed using Pearsonian correlation and regression analyses. RESULTS: Predictors of quality of life were physical well-being, social and occupational integration, active problem-focused coping, less minimization of illness, voluntary admission to hospital, high satisfaction with treatment and life, being aware of positive changes as a consequence of illness and low-rated caregiver burden. In contrast, locus of control, sociodemographic and disease-related variables as well as medication (conventional or atypical antipsychotics) had no significant influence. CONCLUSIONS: Active problem-focused coping, social and occupational integration and physical well-being play an important role for schizophrenic patients' quality of life and should be considered in treatment regimens.

Adaptation, Psychological↗
PubMed2005

[Between responsibility and delimitation: emotional distress of caregivers].

OBJECTIVE: The purpose of this article is to provide an overview regarding the emotional burden of relatives of the mentally ill. METHODS: The relevant literature were identified by means of a computerized MEDLINE research on the years 1993 - 2004 and scanning of review articles. A content analysis of interviews with 32 caregivers about their emotional burdens was carried out to complete and elucidate the review. RESULTS: The emotional burden of caregivers are manifold. Following categories can be distinguished: anxiety and sorrows due to the lack of information about the illness and treatment, unsureness and overcharge with the symptoms of the illness, sorrows about the treatment of the patient, helplessness and palsy, loneliness and responsibility on his own, feelings of being excluded from the treatment of the patient, anxiety about the future, feelings of restrictions of the own autonomy and problems in demarcation, hope and disillusionment, grief and feelings of loss, fear of relapse and suicide, sense of shame and stigmatization, discouragement, feelings of guilt, anger and disappointment, changes in family roles and role-conflictions, problems in the sexuality of the partnership and anxiety about an illness of one's own or heredity to the children of one's own. CONCLUSIONS: The distinct knowledge of caregivers' emotional burdens can help to avoid overcharging the capacity of the carers, to decline high expressed-emotion-levels in the families and to reduce relapse rates of the patients.

Affective Symptoms↗
PubMed2004

[Evidence-based hospital management considering data from the psychiatric basic documentation system].

OBJECTIVE: The study aimed to demonstrate how data from the psychiatric basic documentation system (DGPPN-BADO) are able to support the hospital management in making evidence-based decisions. METHODS: Data from 14 327 psychiatric in-patients in the years 1997, 1999 and 2001 were analysed. RESULTS: About 40 % of patients were admitted without any medical sending, 20 % were referred by a general practitioner and 10 % by a psychiatrist in private practice. Between 1997 and 2001 an increase of patients with affective disorders and personality disorders was found. Comparing 1999 to 2001, patients showed greater deficits in their psychosocial capability (measured with GAF) at admission, but also at discharge. Outpatient aftercare was recommended to more than 80 % of in-patients, about 50 % by a general practitioner and about 33 % by a psychiatrist in private practice. 10 % of patients were cared by the own outpatient clinic. CONCLUSIONS: Data from the psychiatric basic documentation system could be shown as being relevant for evidence-based hospital management ensuring an effective and efficient in-patient treatment.

Aftercare↗
PubMed2004

[Pathways of psychiatric in-patients].

OBJECTIVE: Pathways of psychiatric in-patients before and after their hospital stay should be evaluated. METHOD: Based on data of the psychiatric basic documentation of 4066 patients, predictors of type of referral as well as outpatient aftercare were analysed by means of logistic regression. RESULT: 42.5 % of patients were admitted without any medical sending, 18.4 % by a general practitioner, and 9.8 % by a psychiatrist in private practice. Patients referred by a general practitioner suffered more frequently from affective disorders (Odds Ratio = 4.0) or schizophrenia (OR = 3.3), and were residents of a senior citizen home (OR = 3.5). Inpatients sent by a psychiatrist were more often residents of a sheltered home (OR = 2.8), had a present episode lasting more than three months (OR = 1.9) and psychopharmacological pre-treatment with atypical antipsychotics (OR = 1.6) or SSRI (OR = 1.8). Outpatient aftercare was recommended to 83.1 % of in-patients: Aftercare by a general practitioner was more frequent in patients with addiction disorders (OR = 2.0) and elderly patients (OR = 1.03). Referral by a psychiatrist in private practice (OR = 4.5) as well as schizophrenia (OR = 3.3) or affective disorders (OR = 2.4) led more often to an outpatient aftercare by a psychiatrist. CONCLUSIONS: Beside therapeutic requirements the referring person predicted the type of outpatient aftercare.

Adult↗
PubMed2004

[Relatives expectations and satisfaction of psychiatric in-patients].

OBJECTIVE AND METHOD: Relatives expectations and satisfaction of psychiatric in-patients referring the psychiatric institution should have been explored. A questionnaire, based upon a content analysis of interviews with relatives (n = 32) about their expectations and satisfaction of psychiatric in-patient care was developed and sent to 139 relatives. The response rate was 41.7 % (n = 58). RESULTS: Nine of the ten most important expectations of the relatives et all refer to the successful and individual treatment of the patient. Referring their own person, relatives expect mostly an understandable and sincere enlightenment and information about the illness and therapy of the patient. CONCLUSIONS: Consumer-orientated treatment could help to make the treatment of the patient and consolidation accounting of the relatives more efficient and effective.

Caregivers↗
PubMed2003

[Caregivers' expectations towards psychiatric hospital].

OBJECTIVE: Caregivers' expectations regarding optimal psychiatric inpatient care should be evaluated using qualitative methodology. METHODS: A content analysis of interviews with 32 caregivers was carried out. The statements and categories were quantitatively analysed to assess its relative importance. RESULTS: "Much time of doctors and psychologists for discussion with the caregivers" was expected most frequently. In addition, caregivers assigned high importance to successful treatment of patient by competent physicians and psychologists and to information provided to caregivers about therapies, medication, side-effects and treatment progress. 53 % of all statements were related to the category "treatment and contact", 20 % to "information and education", 15 % to "clinical organisation and equipment", and 13 % to "admission and discharge". CONCLUSIONS: Taking into account these findings, more attention should be paid to caregivers' expectations to reduce problems of interaction between clinicians and caregivers. This might be helpful to improve the cooperation between caregivers and psychiatric hospitals resulting in a higher consumer satisfaction.

Adult↗
PubMed2003

[Single or Mixed Sex Wards in Psychiatric Hospital from the Patients' Viewpoint]

OBJECTIVE: Preference on separate or mixed sex treatment should be evaluated from the viewpoint of patients of a psychiatric hospital. METHODS: The preference of patients were surveyed by questionnaire before and after mixing four single sex wards. The adjusted response rate was 74.5 %. RESULTS: About 75 % of psychiatric patients prefer a mixed sex ward, about 25 % prefer a single sex ward. Females more frequently confirm the type of ward to whom they were actually allocated. By contrast, males are in favour for mixed sex wards independently of the presently experienced type of ward. Younger patients, voluntarily admitted patients, and patients with substance addiction prefer mixed sex wards. After mixing the sexes of formerly single sex wards a significant increase in preference of mixed sex wards was found, due to increased affirmation by female patients. CONCLUSION: If single sex wards can be established in a psychiatric hospital considering their size, specialisation of wards, and sector of care, patients are enabled to choose between a single and mixed sex ward at admission.

Journal Article↗
PubMed2003

[Segregated or mixed sex treatment in the psychiatric clinic--what do patients prefer?].

OBJECTIVE: Preference on separate or mixed sex treatment should be evaluated from the viewpoint of patients of a psychiatric hospital. METHODS: The preference of patients were surveyed by questionnaire before and after mixing four single sex wards. The adjusted response rate was 74.5%. RESULTS: About 75% of psychiatric patients prefer a mixed sex ward, about 25% prefer a single sex ward. Females more frequently confirm the type of ward to whom they were actually allocated. By contrast, males are in favour for mixed sex wards independently of the presently experienced type of ward. Younger patients, voluntarily admitted patients, and patients with substance addiction prefer mixed sex wards. After mixing the sexes of formerly single sex wards a significant increase in preference of mixed sex wards was found, due to increased affirmation by female patients. CONCLUSION: If single sex wards can be established in a psychiatric hospital considering their size, specialisation of wards, and sector of care, patients are enabled to choose between a single and mixed sex ward at admission.

Adult↗
PubMed2002

[Privacy within psychiatric wards].

OBJECTIVE: Privacy within psychiatric wards should be evaluated from the patient's point of view. METHODS: Different aspects of privacy were assessed by a self-rating scale given to all patients of a psychiatric hospital at a qualifying date. RESULTS: The adjusted response rate was 74.5 %. By means of a factor analysis, four factors were extracted: Intimacy, sexual restriction, discretion, and care. A lack of discretion when entering the patient's room were reported by more than 80 % of patients, disturbances of intimacy by nearly 25 %. Disturbances by patients or staff when taking a shower were especially found bothersome. 15 % of patients reported about being touched by patients or staff against their will. CONCLUSIONS: Disturbances of privacy play an important role in psychiatric wards. The therapeutic team should be aware of these findings and should pay attention to preserve patient's privacy during inpatient care.

Germany↗
PubMed2002

[Heavy users in a psychiatric hospital--a cohort study on 1811 patients over five years].

OBJECTIVE: The aim of the study was to examine the extent of use of acute psychiatric inpatient care, and to determine sociodemographic and disease-related characteristics of so called "heavy users". METHODS: A cohort of 1811 patients with first hospitalisation in 1995 was followed by means of the German psychiatric basic documentation (DGPPN-BADO) over a five-year period from 1995 to 1999. RESULTS: The average cumulative length of stay was 63.2 days (SD 98.4), the median 32 days. 5 % of patients stayed in hospital more than 238 days and 1 % even more than 538.1 days within five years. 50 % of patients "consumed" only 10 % of inpatient days, whereas other 10 % of patients accounted for nearly 50 % of the resources. By means of a regression analysis ten significant predictors for a long cumulative hospital stay could be found, e. g. schizophrenia, personality disorder, socio-therapeutic modalities, sheltered living, and low psychosocial capability (GAF) at discharge. Within five years an average number of hospital stays of 1.8 (SD 2.1) was found. 5 % of patients had more than four inpatient stays, 1 % even more than ten. Regressions analysis revealed seven significant predictors for a high number of hospital stays, e. g. alcohol dependence, comorbid alcohol abuse, and a short interval between first and second admission. CONCLUSIONS: As no distinct group of "heavy user" could be identified, individual treatment strategies should be addressed, and qualitative studies and in-depth statistic analyses must be performed.

Adult↗
PubMed2002

[What do patients expect from a psychiatric department at a general hospital?].

OBJECTIVE: The study aimed to investigate the expectations of patients of a psychiatric department at a general hospital regarding their inpatient care. METHODS: At a key day 131 patients were surveyed by a questionnaire comprising 39 items. The response rate was 70 % (n = 91). RESULTS: The patients assign most importance to successful treatment, empathic doctors, preservation of human rights, competent doctors, and friendly staff. The expectations of patients of a psychiatric department are similar to those of patients of a psychiatric state hospital. Patients' expectations are not confounded with the psychiatric disorder, psychopathology, subjective feeling, heaviness of illness, or psychosocial functioning. The internal consistency is alpha = 0.93. CONCLUSIONS: The questionnaire is suitable for valid and reliable measuring the expectations of both patients of a psychiatric department and patients of a psychiatric state hospital when evaluating patient's satisfaction.

Germany↗