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Biomedical subjects

I Jedlicka-Köhler

Publications and source records attributed to I Jedlicka-Köhler.

9 recordsLinked to original sources

Parents' recollection of the initial communication of the diagnosis of cystic fibrosis.

BACKGROUND: The diagnosis of a chronic disease in children challenges parents' emotional coping abilities and cognitive capacities. OBJECTIVE: To study parents' emotional and cognitive reactions to the diagnosis of cystic fibrosis (CF) in their children. METHODS: Postal survey by means of a written questionnaire. PARTICIPANTS: Forty-six parents of 29 children with a median age of 2 months at diagnosis. RESULTS: Most parents initially lacked knowledge of CF (76%) and were provided only oral information (96%). Parental estimates of how much of the information given they had understood and retained were 77% and 76%, respectively, with 15 parents (33%) having understood and remembered less than 50% of what the physicians had told them. The most frequent stressing feelings were fear (83%) and despair (56%). Fifty-four percent of parents had initial shocklike reactions. In this group, a significant decrease in the understanding and recall of information was noted compared with parents who had less-emotional responses. CONCLUSIONS: Parents learning the diagnosis are, in effect, receiving a kind of lecture, which contains more information than they can possibly assimilate. Because of the incompatibility of emotional distress and optimum learning, impairment of early comprehension and retention of information about CF is unavoidable. Repeated interviews with both parents and the provision of written and audiovisual materials should be mandatory.

Adult↗

Utilization of prenatal diagnosis for cystic fibrosis over the past seven years.

OBJECTIVE: First trimester prenatal diagnosis (PD) by DNA analysis for cystic fibrosis (CF) has been available for parents of affected children since May 1986. METHODS: In a prospective study 37 couples with a single child affected by CF were investigated. Fathers and mothers were interviewed simultaneously, and their attitudes towards further childbearing and potential utilization of PD ascertained. Parental answers were treated as one. A 7-year follow-up allowed comparison between intended and actual behavior. RESULTS: At the time of the interview, 16 parents (43%) were determined to have further children. Nineteen parents (51%) said they would certainly or probably utilize PD in case of pregnancy. Their predominant reason for favoring PD was the strong desire to have a healthy child (47%). Among the 18 rejectors (49%) the fear of an unsolvable conflict in case of an affected fetus prevailed (39%). Twenty-four pregnancies actually occurred in 18 families. Utilization of PD was arranged in five (21%) and finally performed in four (17%) cases. CONCLUSION: Availability of PD does not substantially change the reproductive behavior of parents of children with CF. Reasons for this were multifactorial, with anticipated difficulty in deciding to continue or terminate pregnancy being predominant.

Cystic Fibrosis↗

[Psychological management of patients and families with cystic fibrosis].

The care of families with a child with cystic fibrosis requires a concept which includes psychological and social aspects caused by the disease. The contribution of a psychologist offers a valuable support for this. Methods for the emotional care of patients are presented. The importance of counselling and the possibility of preventive work and distribution of information are underlined. The example of psychosocial stress (coping with the diagnosis, self esteem, life crises etc.) permit insight into the requirements of patients and their relatives and contribute to increase the awareness of the caregiver for age-independent and for age-specific problems.

Adaptation, Psychological↗

[Reactions of patients and families with cystic fibrosis to psychological management].

A model of care for patients with cystic fibrosis including the possibility for continuous psychological counselling besides medical care is presented. In order to evaluate reactions of those affected to the offer of counselling 243 sessions between 81 patients or/and parents and the psychologist (IJK) were attributed to one of the following reaction types: type 1: negation/rejection, type 2: acceptance of talks, type 3: reactive wish to be counselled, type 4: active acceptance. The high proportion of reaction type 4 in the age groups 0; 1-1 (65.0%), 1-3 (45%) and in adult patients (46.6%) shows that the majority of parents approach the psychologist with questions, anxieties and worries in the first months and years after the diagnosis has been established. In the adult age group patients themselves request support for coping with a variety of difficulties. Type 2 sought contact with the psychologist on the assumption that in the future they could draw on the help of someone familiar in moments of crisis; this reaction dominated in the 3 groups aged 3-15 years. In adolescents the offer of a counselling session is made use of to discuss current problems (type 3).

Adaptation, Psychological↗

Interventional assessment of physical and mental health in children and adolescents with cystic fibrosis.

In spite of being an integral part of health care the subjective estimation of health status in patients with cystic fibrosis is frequently neglected. In a prospective study in 65 patients maternal, paternal, and patients' ratings were determined and correlated with objective data such as Shwachman scores and lung function tests. No statistically relevant correlations were obtained for parental physical assessment versus Shwachman and lung function data. The adolescents' own assessment of health had a significant relationship to clinical evaluation (r = 0, 42; p less than 0.05). Misjudgements, mainly in the form of overestimations, occurred with a frequency of 28.6% to 53.8%, reflecting inadequate understanding of the disease and its psychological consequences.

Adolescent↗

[Seckel dwarfism based on a personal case].

Report on a girl with Seckel-syndrome (bird-headed dwarfism). In addition to the known symptomatology she had a congenital heart failure (ASD II, VSD, PDA). Endocrine evaluation revealed decreased growth hormone stimulation. In the CT-scan of the skull enlarged ventricles were demonstrated.

Abnormalities, Multiple↗

[Effect of timing of surgery on the intellectual and psychosocial development of children with tetralogy of Fallot].

Chronic hypoxemia in patients with Tetralogy of Fallot may influence intellectual and social development. Even though the physical situation is the most important factor for the time of operation, psychosocial aspects should be considered as well. 24 children underwent intelligence tests and questionnaires, 13 of them having had surgery in early infancy, 11 between 7 and 11 years of age. No significant difference was noted between the two groups concerning early childhood development and mean IQ. Early operation does appear to improve the social situation. Such children are able to participate in kindergarten, start school in time and pass through school without delay. These results suggest a possible beneficial relief of the stressed situation of the whole family.

Adolescent↗

[Cognitive development of children and adolescents after correction of transposition of great vessels].

BACKGROUND: To study the effect of transposition of the great arteries on later cognitive functioning. PATIENTS: Twentyeight children and adolescents underwent psychometric testing 3.5 to 13.7 years following operation. METHODS: A battery of intelligence, attention and visual memory tasks as well as the Draw-a-Man-Test were administered. Parents completed standardized questionnaires on developmental milestones. RESULTS: Both, mean verbal (93 +/- 15) and performance IQs (97 +/- 21) were normal. The length of interval between operation and psychologic test but not age at repair was a significant predictor of intelligence quotient. Half of the children (9/18) showed attention deficits, 7/11 (64%) were identified as suspect of brain dysfunction. Performance on the Draw-a-Man-Test disclosed 12 (43%) as slightly mentally retarded. CONCLUSIONS: (1) Cognitive functions in children with TGA are more impaired than suggested by the results of intelligence tests. (2) Psychological and neurologic follow-up should be mandatory from early on. (3) Previous studies have overestimated children's intelligence due to unrecognized changes of test norms.

Adolescent↗