Biomedical subjects
Publications and source records attributed to P Hünecke.
We studied both the frequency of changes in the therapeutic management regarding in-patients with skin diseases and the estimation of these changes by dermatologists, nurses, and the patients concerned. Changing the procedures of topical treatment have been found a special source of conflict between doctors, nurses, and patients.
Our pilot study deals with the systematic investigation of the clinical experience that, in correlation with psychosocial events, atopic dermatitis may take an unexpected course (deterioration or improvement) during hospitalization. We describe our procedures regarding the proposal of hypotheses, the operationalization of the variables "deterioration of eczema" and "psychosocial factor", and our methods in gaining the data required. In the evaluation of 19 courses of treatment, we first checked the possible correlations between individual deterioration of eczema and various psychosocial events. We had to rule out, however, that a positive reaction like this was purely coincidental. In this respect, the event "confrontation with every day life" has significantly been confirmed. We discuss possible further studies which may ensue from our psychosomatic research concept.
70 patients suffering from atopic dermatitis and receiving in-patient care were discharged for one or two days upon achieving an improved and stable dermatological state. Back in hospital after their short-term demission, two thirds of these patients showed a deterioration of their cutaneous condition. The majority of them were able to perceive a connection between their worsened skin condition and the acute psychosocial constellation during their brief stay at home. A second short-term demission brought about more acceptable and steady skin conditions, especially in patients treated psychosomatically. Some of the patients declared definite changes in their own modes of behavior to be responsible for this stabilized improvement.
Ten years' experience in handling psychosomatic aspects as part of dermatology courses in Göttingen have revealed an unexpected need for such courses among students. Our program includes lectures as well as work in small groups.
Our psychodiagnostic studies were concerned with two female patients considering themselves disfigured although their residual somatic findings were only minimal. Two main factors could be derived from analysis: "feelings of anxiety and insecurity" and "obsessive-compulsiveness". The compulsive and sometimes paranoid ideas of the patients suffering from dysmorphophobia require differentiated conclusions by the doctor.
Current attempts in the research to identify a single relevant personality type amongst patients with psoriasis appear questionable from a factual and methodological approach. On the basis of psychometric personality data, we were able to identify five different personality structures amongst psoriatic patients. Therefore, in our opinion blanket testing directed toward individual personality characteristics is not indicated. Concern should be directed toward more thoroughly defined and differentiated questions via use of psychometric personality data. In discussion not only the problem of specificity but also the compelling necessity of a multi-variable psychometric approach, including temporal aspects, as well as subjective degree of illness, is elaborated.
The psychosomatic aspects of the pruritus symptom of endogenous eczema patients are presented. The phenomenon of "scratching" is analysed descriptively from observations of the behavior of the patient and his family. Psychotherapeutic approaches as a supplement to the dermatological therapy of endogenous eczema are described.
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The influence of pharmaceutics with unknown modes of action on an ultraviolet erythema with familiar etiology offers conclusions as to the pharmaceutic's points of operation. Inversely, the influence of pharmaceutics with a known mode of action on erythemas whose pathomechanism is unknown permits insights into the erythemas' etiology. Based upon these propositions a new precise method for measuring intensities of erythema was developed. The article describes the use of this method in investigating various types of erythemas and the influence of different drugs upon them. The objective measurement of various erythemas was conducted by means of reflectometry. The term "treatment factor" is newly introduced and defined as a quotient of the reflectance of treatment and control fields. The data processing method used to evaluate the individual reflectance values is elaborated. Various possibilities for coordinating control and test fields are illustrated.
Discussing the medical importance of the topic, the necessity of cooperation with social-scientific disciplines is demonstrated. Reflecting some relevant psychological theories, an experimental concept for analysing the interpersonal communication with persons suffering from skin-diseases is developed. It is a purpose of this investigation, not only to get the estimations of persons with and without skin-diseases but also the opinion which the other group is supposed to have. It was assumed that the state of health in persons with dermatoses is depending on these supposed estimations by the social environment. After describing the experimental setting, the results which were received from the answers of 465 persons (mean and women with and without dermatoses) are referred. Finally the findings are discussed from different points of view (methodical, cognition-theoretical, learning-psychological, psychoanalytical and last not least medical).