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Biomedical subjects

J A Hunfeld

Publications and source records attributed to J A Hunfeld.

At least 19 recordsLinked to original sources
PubMed2001

Quality of life in adolescents with chronic pain in the head or at other locations.

The differences in quality of life and school absence were studied in one hundred adolescents from the open population who had reported chronic headache or chronic, physically unexplained, pain at other locations. The adolescents kept a 3-week diary about their pain and completed a quality of life questionnaire. Of all chronic pain sufferers in this study, it was the adolescents with headache who showed the least frequent pain, but they reported the poorest quality of life and the largest school absence due to their pain. Adolescents with headache or adolescents with back pain showed the highest negative correlations between pain parameters and quality of life. Headache sufferers showed highly negative relationships between pain parameters and most quality of life domains (median r = -0.46), and only in headache sufferers did this involve both intensity and frequency of pain. Qualitative studies are needed to reveal the background to these differences.

Absenteeism↗
PubMed2000

Chronic pain among children and adolescents: physician consultation and medication use.

OBJECTIVE: The goal of this study was to assess physician consultation and use of medication in Dutch children and adolescents (0-18 years old) having chronic pain in relation to sociodemographic factors and pain characteristics. DESIGN: This was a population-based cross-sectional survey. A questionnaire was either mailed to the participants' parents or distributed at school, and it was filled out by the parents (for children aged 0-7 years) or by the participant (for children and adolescents aged 8-18 years). SETTING: The study was conducted in the Rotterdam area. PATIENTS: Participants included a random sample of 1,300 children aged 0 to 3 years taken from the register of population. In addition, 41 schools were selected to obtain a representative sample of 5,336 children and adolescents aged 4 to 18 years. OUTCOME MEASURES: Reported physician consultation and medication use were assessed. RESULTS: Of the 6,636 children and adolescents surveyed, 5,424 (82%) responded. A total of 1,358 respondents (25%) reported chronic pain. Of these, 57% had consulted a physician and 39% had used medication for the pain. Respondents with earache, more intense pain, and more frequent pain and those attending lower vocational training programs were more likely to consult a physician for the pain than the average respondent. Respondents with earache, sore throat, headache, more intense pain, and multiple pain; children aged 0 to 3 years; and girls were more likely to use medication for the pain. Logistic regression analyses showed that for physician consultation, the most significant predictive factors were the intensity of pain, age, and earache as well as the level of education for respondents aged 12 to 16 years. The use of medication was predicted by earache, headache, limb pain, intensity of pain, and age. CONCLUSIONS: Chronic pain is a common complaint in children and adolescents, frequently resulting in consultation of a physician and medication use. Regarding physician consultation, children and adolescents with a lower educational level seem to be a group at risk.

Adolescent↗
PubMed1999

Brief report: parental burden and grief one year after the birth of a child with a congenital anomaly.

OBJECTIVE: To assess parental burden and grief one year after having a child with a congenital anomaly. METHOD: Twenty-five couples completed the Impact on Family Scale (IFS) and 22 couples answered the Perinatal Grief Scale (PGS). In addition, 27 mothers completed the Functional Health Status Scale (FSII-R). RESULTS: Mothers and fathers showed no significant differences in overall burden (IFS) and grief (PGS). Regarding the subscales, mothers reported significantly more personal strain. Foreknowledge from prenatal diagnosis about the anomaly, a low perceived functional health status of the child, and multiple congenital anomalies increased the burden and grief. CONCLUSIONS: A perinatal counseling team that provides clear and consistent information about the anomalies, the treatment, and the prognosis would help to reduce unnecessary stress and uncertainty, particularly for parents who received prenatal information and whose infant has multiple congenital anomalies.

Abnormalities, Multiple↗
PubMed1999

Prenatal consultation after a fetal anomaly scan: videotaped exploration of physician's attitude and patient's satisfaction.

The main aim of the study was to evaluate the relationship between the physician's attitude (using the non-verbal Global Affective Measure of the Roter Analaysis System and the Counselor Rating Form-short version) and the satisfaction of the pregnant women with the prenatal consultation. A secondary aim was to evaluate the women's recall of essential information (i.e. location, severity, prognosis and cause of the anomaly). To this end, 24 prenatal consultations (pregnant women, partners and physicians) were videotaped following a fetal anomaly scan, and a few days later, the pregnant women completed questionnaires to assess their perception of the physician's attitude and their satisfaction with the consultation and the extent to which they could recall the essentials of the information given about the fetal anomaly. In descending order, the physician's dominance/assertiveness (i.e. being self-confident and decisive) (assessment of the videotapes by two psychologists), trustworthiness (women's report) and expertise were significantly positively associated with the women's overall satisfaction, i.e. satisfaction with the information given and affective behaviour on the part of the physician during the prenatal consultation. All the women (n=24) recalled the essentials of the information given about the location of the fetal anomaly. The majority of them correctly reproduced the severity, the prognosis and the cause of the anomaly. Our findings indicate that women in whom a fetal anomaly has been detected derive particular benefit from a self-confident, decisive, expert and trustworthy physician.

Adult↗
PubMed1998

Cognitions, emotions, and behavior of patients with migraine when taking medication during an attack.

Fifty-three patients with migraine, recruited from the Dutch Society of Migraine Patients and a general practice, were investigated regarding pain, moods, thoughts, and functioning during their most recent migraine attack, using a semistructured interview. Salient findings were: the high pain intensity the patients endured before they took analgesic medication, concerns about medication damaging their health, overoptimism regarding the effect of analgesic medication, and the relatively large proportion of patients (43%) who took medication primarily to be able to continue their activities. We recommend that future clinical trials on the effects of medication on migraine should not only include the measurement of pain during the attack, but also emotions, concerns about potential side effects and the ability to continue or resume work. Furthermore, it is important to provide patients with information about the side effects of medication and to apply cognitive-behavioral techniques for improvement of their mood during the attack.

Adult↗
PubMed1997

Trait anxiety, negative emotions, and the mothers' adaptation to an infant born subsequent to late pregnancy loss: a case-control study.

Women with (n = 27) a history of late pregnancy loss (> or = 20 weeks) due to congenital anomalies who had completed the subsequent pregnancy with a live-birth were compared with a group of mothers with newborns without such a history (n = 29) at 4 and 16 weeks post-partum. The following aspects were assessed; depression, anxiety, psychological distress, and mother-infant adaptation. The women with a previous pregnancy loss showed significantly more negative emotions than the women without such a history. In addition, they considered that their healthy baby experienced more problems with sleeping, crying, eating, and acquiring a regular pattern of this behaviour than the average baby. They also perceived their baby as being less ideal than the women without a previous pregnancy loss. These problems were particularly present 4 weeks post-partum and were significantly positively related to trait anxiety. The implications of this study are that in women with a history of late pregnancy loss, family physicians and welfare officers should be made aware of possible problems in the mother and in mother-infant adaptation shortly after a normal live-birth, particularly in those with high trait anxiety. They will then be able to arrange psychological support at an early stage.

Adaptation, Psychological↗
PubMed1997

The grief of late pregnancy loss.

We studied 46 women who had an ultrasound diagnosis of a lethal fetal anomaly (gestational age > or = 24 weeks). Shortly after the diagnosis, 45% of these 46 women showed severe psychological instability established by a consensus diagnosis. Three months later, this percentage had diminished significantly to 22%. The total GHQ-28 score revealed that after 4 years, 11 out of the 29 remaining participants (38%) had a score of 5 or more, which indicated a clinically significant degree of general psychological distress. Depression and despair measured with the Perinatal Grief scale, did not decrease significantly over the 4-year period. Women with a strong disposition towards feelings of inadequacy or 'neuroticism', measured with the Dutch Personality Questionnaire, displayed significantly more intense grief reactions than women without such a strong disposition. The implications of our study are that in the face of (threatened) late pregnancy loss, medical care should include (i) paying attention to the need for medical information and emotional support and (ii) performing psychosocial screening of women identified as showing signs of inadequacy.

Adaptation, Psychological↗
PubMed1997

Prediction and course of grief four years after perinatal loss due to congenital anomalies: a follow-up study.

The emotional reactions of women (N = 29) after perinatal loss were evaluated over a four-year period by means of standardized questionnaires and a semi-structured interview. Eleven women (38 per cent) displayed a level of general psychological distress which is clinically significant. Grief reactions declined significantly during this period, except for difficulties with coping and despair concerning the loss, and a quarter of the women still showed a clinically significant high level of distress for intrusive images. The disposition for feelings of inadequacy (i.e. feeling anxious, insufficient, depressed and having low self-esteem) was strongly and positively related to the intensity of stress, grief and general psychological distress after four years. Our findings emphasize the importance of psychosocial screening of those women identified as showing signs of inadequacy in the face of (threatened) pregnancy loss with the objective to offer them additional psychological support.

Abnormalities, Multiple↗
PubMed1997

Measuring chronic pain in children, an exploration.

The study focused on the feasibility and validity of pain instruments and the optimal period of diary registration for measuring chronic pain intensity of 13 children. Highly positive associations were found between the registration of pain on a Visual Analogue Scale and on the Postoperative Pain Measure for Parents. For children under medical treatment for chronic limb pain a one-week dairy registration suffices.

Adult↗
PubMed1997

Mothers' trait anxiety and adaptation to an infant born subsequent to the loss of a late pregnancy.

21 women with one infant each born subsequent to the loss of a late pregnancy were invited to complete the State Trait Anxiety Inventory, and two Dutch mother-child adaptation scales one month after delivery. Scores on trait anxiety appeared to be significantly related to maladaptive behavior of the mother to her child in the first four weeks following the birth, suggesting that women with high anxiety and a past of lost pregnancy are at risk for the development of an unfavorable mother-child relation.

Abortion, Spontaneous↗
PubMed1996

Quality of life and anxiety in pregnancies after late pregnancy loss: a case-control study.

Pregnant women with (n = 24) and without (n = 26) a previous pregnancy loss (> 16 weeks) due to congenital anomalies were compared on quality of life and anxiety. Pregnant women with a previous loss were divided into those with and those without a normal livebirth since the loss [cases+ (n = 6) and cases- (n = 18), respectively]. Psychological measurements were carried out before and after an ultrasound scan in the second trimester of the pregnancy. Women with a previous loss who had not delivered a healthy infant between the loss and the present pregnancy showed a lower quality of life as revealed by feelings of social isolation, negative emotional reactions, and pain than the other groups. In addition, they showed more pregnancy-related anxiety. The negative emotions were particularly present just before the anomaly scan. Feelings of social isolation, negative emotional reactions, pain, and pregnancy-related anxiety were significantly positively related to trait anxiety, irrespective of having experienced late pregnancy loss. The implications of this study are that the referring gynaecologist, physician, or midwife should be aware of the strong emotions and major concerns of women in a pregnancy subsequent to a late pregnancy loss. In addition, they should offer these women the opportunity to express their emotional distress.

Abortion, Spontaneous↗
PubMed1996

Do couples grieve differently following infant loss?

13 couples who lost an infant due to a major congenital anomaly were assessed using the Perinatal Grief Scale. Contrary to the research findings of generally less intensity of grief in men, couples did not differ significantly in this respect one-half year after the loss of their infant. On the other hand, there was no strong relationship between the scores of women and men, indicating that, apart from intensity they grieve differently.

Abnormalities, Multiple↗
PubMed1995

Previous stress and acute psychological defence as predictors of perinatal grief--an exploratory study.

We evaluated whether the emotional reactions of women at 2-6 weeks after the prenatal diagnosis of a lethal anomaly and at 3 months after perinatal loss might be predicted by previous stress and acute psychological defence reactions to the diagnosis. Previous stress was defined objectively as a history of major life event(s) and having received professional mental health treatment in the past, and subjectively as the disposition for feelings of inadequacy and anxiety. Forty-one women were interviewed and completed measures on their history of major life events, whether they had received professional mental health treatment in the past, inadequacy, acute psychological defence reactions and perinatal grief. Regression analyses showed that inadequacy was the most strongly positive predictor of perinatal grief shortly after receiving the unfavourable diagnosis and three months after perinatal loss. In addition to inadequacy, having received professional mental health treatment in the past led to significantly more intense grief, but only shortly after receiving the unfavourable diagnosis. Previous life events intensified grief three months after perinatal death. The grieving process was significantly moderated by the defence of 'principalization' while it was significantly intensified by 'turning aggression against oneself', but only shortly after receiving the unfavourable diagnosis. These effects were not contaminated by relationships with pregnancy-related variables. Our findings imply that psychological support for women with perinatal loss should particularly be offered to those who have been identified as generally anxious, who have reported previous major life events and have received professional mental health treatment in the past.

Adult↗
PubMed1994

[Care and experiences of 20 set of parents concerning the death of children in a surgical intensive care unit].

OBJECTIVE: To gain insight into the attitude and experiences of parents concerning the death of children in a paediatric surgical intensive care unit of a University Children's hospital. DESIGN: Retrospective evaluation of records from 1988-1992, supplemented with semistructured interviews in the second half of 1992. SETTING: Sophia Children's Hospital-University Hospital Rotterdam. PATIENTS AND METHODS: The evaluation concerned 104 children. In 36 children death was a direct consequence of their illness, 11 died unexpectedly after an unsuccessful attempt at resuscitation, and in the remaining 57 treatment had not been initiated or had been withdrawn. Six months after the death of their child, twenty couples of parents of 20 children were asked after their experiences before, during, and after this death; in addition they were asked whether they would appreciate a longer contact with the hospital. RESULTS: Most parents chose to be present at the moment of dying. The parents generally highly appreciated the talks about the decision-making process and about coming to terms with the loss of their child, both with doctors and nurses. Most also appreciated a talk at some later time. CONCLUSION: The results from this study indicate that structured guidance of parents concerning their child's death in the form of a counselling programme, is advisable.

Adult↗
PubMed1994

Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica.

Quality of life and maladjustment related to hair loss were studied by means of a standardized interview in a group of 58 women with alopecia androgenetica who applied for treatment at the Department of Dermatology. The hair loss was found to have a negative influence on the quality of life on the majority of them. In 88%, hair loss had negative effects on their daily life; in about 75%, the hair problems were manifested in negative self-esteem and about 50% experienced social problems. General psychosocial maladjustment in relation to hair loss was indicated in almost one-third of the women.

Adaptation, Psychological↗
PubMed1994

Pregnancy termination, perceived control, and perinatal grief.

In a group of 30 women who underwent induced delivery after they had been informed of a lethal fetal anomaly, 18 women reported that this was the outcome of a clear decision process and 12 reported that they had no choice. In contrast to findings in other research areas, the experience of having perceived control was not associated with lower grief scores three months after perinatal loss.

Abortion, Induced↗