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W Laubach

Publications and source records attributed to W Laubach.

11 recordsLinked to original sources
PubMed2001

[Attitudes of students of medicine, sociology and jurisprudence towards autopsy].

UNLABELLED: Attitudes of students of medicine, sociology and jurisprudence towards autopsy. SUBJECT: The autopsy is an important instrument of quality control in medicine. Nevertheless, we observe a dramatic decrease of post-mortem examinations. Because physicians take a important role as mediators, we tried to examine the attitudes of medical students towards autopsy and possible differences to students of other faculties. PROBANDS AND METHODS: Data of medical students (n = 335), students of jurisprudence (n = 95), and of sociology (n = 26) at Leipzig University were collected with the help of a specially elaborated questionnaire >>Post-mortem Examination<< (Fragebogen zur Sektion, FBZS), and two questionnaires >>Death and Dying<< (Fragebogen zu Tod und Sterben, FIMEST) and >>Personality<< (Persönlichkeitsfragebogen, Giessen-Test). RESULTS: Referring to the attitudes towards post-mortem examination there is only a slight difference between students of the above-mentioned faculties. Even preclinical students showed no difference with their attitudes towards autopsy compared to the students of other faculties and they showed lack of knowledge and ethical doubts towards autopsy. CONCLUSION: Due to the significant lack of knowledge of the medical students of the University of Leipzig it seems questionable, if they will be able to convince relatives to give consent to an autopsy in later activity as physicians. More instructional work during study and further medical education should be done.

Attitude to Death↗
PubMed2001

[Bodily symptoms and utilization of medical care]

Bodily symptoms and utilization of medical care. OBJECTIVE: An important aspect in a person's attitude towards disease, which also determines when medical help is sought, relates to one's perception of bodily symptoms and to the manner in which the impact of an illness is dealt with. It was the aim of this study to ascertain what bodily signs of disease in an organ system would make healthy persons within a normal population seek medical help. MATERIAL AND METHODS: A representative sample of the population of Germany (n=2050), aged between 14 and 92 years, was presented with the description of 20 symptoms of diseases of various organ systems and asked which of these symptoms would induce them to consult a doctor. RESULTS: Between 8% and 10% of those asked said that they would not go to a doctor even if they had clear bodily symptoms, e. g. blood in the urine , persistent joint pains , dizziness of fainting or pain in the lower abdomen . Analysis of variance for individual symptoms revealed that a significantly higher percentage of women and elderly persons would go and see a doctor than men and younger persons. Significantly fewer persons in the eastern (former DDR) Lands than the western ones would seek medical help. There was no significant correlation between the seeking medical help and subjective complaints, as measured by the Giessen Complaint Questionnaire, as well as any tendency towards hypochondria, as measured by the Whiteley Hypochondria Index. CONCLUSION: It is clear that complex processes of bodily awareness and assessment of symptoms precede medical consultation. These processes must be considered as part of a person's attitude towards illness and, most of all, of its congnitive component ( health beliefs ). They are dependent on charakteristics of sociodemography and social structure ant they have far reaching significance for ambulatory care. It is clear that there is a great need for research in this area.

Journal Article↗
PubMed2000

[Social class, life satisfaction and health assessment. Results of a representative study of the German population].

The supposition that a higher risk of morbidity and mortality is connected with the belonging to a particular social class has been confirmed by numerous national and international researches. But still unsolved is the question of how objective social situations do lead to individual processes of disease. In order to solve this question in a representative assessment of the german population, data of 2948 individuals, referring to aspects of life-satisfaction, personality, subjective complaints and attitudes to current state of health, has been ascertained. In nearly all scales of the chosen instruments significant gradients connected to social class have been found. Persons belonging to a lower social class show a minor life satisfaction, significant differences in personality, higher subjective complaints and a poor state of health. This persons also seem to be convinced that they could do less to care for their health. This self-assessment indicates processes, that stand before the state of manifestation of disease. They can be seen as an expression of persons mental reflection of their social situation. Within the context of this analysis of social inequality and disease we argue to include psychological theories and stress theory in sociological theories. They achieve an important contribution to the clarification of the interface between social class, respectively life circumstances, experiences of distress, available resources of coping with the situation and the individual process of development of disease.

Adolescent↗
PubMed2000

Informed consent in neurosurgery: patients' recall of preoperative discussion.

OBJECTIVE: Informed consent (IC) is an important principle of modern medicine and the quality of the process is likely to receive increasing attention in future due to complex surgical procedures and a development of social mistrust for medical treatment. Medico-legal action is also becoming an important influence on IC, in particular the extent of warning to be given about the degree of risk. Evaluation of IC, however, encounters various problems. One key element of a knowledgeable decision is an analysis based on the disclosed risks. METHODS: In a prospective study, 104 consecutive patients were asked to write down as many items of the list of risks as possible two hours after consent interview. The sample included adults (mean age: 52 years) without any significant neuropsychological impairment who underwent elective intracranial (52%) or spinal (48%) surgery. Consent interview based on the proposals of the Deutsche Gesellschaft für Neurochirurgie and the Berufsverband Deutscher Neurochirurgen 1998. The average number of disclosed risks was 32 in intracranial and 25 in spinal surgery. According to the results in the literature 6 'typical major risks' of the proposed treatment were selected. RESULTS: The median value of the total of recalled risks was 4 in the spinal group and 5 in the intracranial group. The mean score of general information retention was 18%. 65% of the patients did not recall more than 2 of 6 'typical major risks'. No significant correlation between recall performance and age or education was found. CONCLUSION: The general principles of memory apply and have implications in states of emotional arousal. Whereas education and age, unlike in previous reports, did not appear to influence recall, thus indicating that we had succeeded in tailoring IC to the individual, recall rate was low in most cases. Physicians should highlight the discrepancy and conflict between the requirements for the defence of medical practice in the law courts and the actual interests of patients. They should promote research to establish what really is 'appropriately informed consent'.

Adult↗
PubMed1999

[Dimensions of work stress and job satisfaction in psychiatric-psychotherapeutic practice].

Empirical studies of nursing in psychiatry and psychosomatics rarely consider the dialectics between work load and positive aspects of social support. Resulting from theoretical considerations and practical experiences seven dimensions were defined that might influence overall job satisfactions and stress. To measure this, a questionnaire containing 53 items was developed. This instrument was answered by 134 nurses of a psychiatric hospital. The results show that factor analysis and item analysis only partly confirm the presumptions. The five empirical scales include "stress due to work conditions and patients", "collaboration in teamwork", "collaboration with physicians and therapists", "collaboration with superiors in nursing" and "responsibility, competence and decision-making". Theoretical dimensions and empirical scales are discussed. The high work stress caused by work conditions and difficult patients is compensated by a positive evaluation of the collaboration in the nursing-team with physicians and therapists as well as with superiors.

Adult↗
PubMed1999

[Cooperation and job satisfaction in a nursing-physician team. An analysis of nursing evaluation in psychiatry].

PURPOSE: Empirical studies of nursing in psychiatry rarely consider the collaboration between nurses and doctors. Which variables determine the quality of the cooperation between nurses and doctors? METHODS: In 1992 and 1997, all nurses of a psychiatric hospital were interrogated by means of questionnaire (FAPP) in order to measure the quality of collaboration. RESULTS: In spite of major changes in the hospital management and higher work-load assessment by the nurses concerning the collaboration with doctors and with other nurses, the quality of team-work and participating in treatment decisions, was more positive in 1997. Nurses with a "negative" collaboration with doctors, also have difficulties to collaborate with other nurses. This finding did not depend on gender, age or length of professional career. CONCLUSION: All institutional provisions that improve the cooperation, the competence, the responsibility, and the ward-atmosphere, also ameliorate the cooperation with other occupational groups in the hospital.

Adult↗
PubMed1998

["All that time we were working hand in hand ..." a comparative study on the effects of professionalization on German and American intensive care nurses].

The discussion about improving and reevaluating nursing education and nursing practice in Germany is often oriented at the US-american nurses' training. Here one finds a higher degree of professionalisation and university nursing programs. A German-US-American comparative study of 13 ICU nurses each analyzes what effects a higher degree of professionalism has on every day nursing practice. Using the data of structured interviews, dimensions of job perception and aspects of coping capabilities with stress in regard to patient care and relation with physicians of both nursing groups are compared. Results show that US-American nurses often refer to cognitive aspects of being in control of a situation and emphasize their professional part. When assessing their experiences they mainly describe actions they took emphasizing cooperation and help they gave each other. German nurses accentuate the emotional side, describing fear, anger, rage and helplessness. In their relations with physicians the US-American nurses are more likely to insist on their nursing competence, while German nurses tend to be annoyed, resignated, and try to withdraw from the situation. These differences are discussed in relation to the different nursing programs. The US-American education, stressing supervision and the ability to reflect upon one's action seems to have a positive influence on coping capabilities and enhance job satisfaction.

Adaptation, Psychological↗
PubMed1995

[Follow-up and typologic description of requirements in an intensive care unit].

Presented is the description of the objective, environmental demands of a medical intensive care unit (MICU). These are significant as the situational background of the subjective perception of working-situation by nurses and physicians. Therefore on the one hand a strain-index of the MICU in process of 101 days shows the daily variation of straining variables and a cycle of 33 days. On the other hand, we found days with a specific pattern of straining variables by a factor-analysis. These results were discussed on a stress-theoretical view.

Adult↗
PubMed1994

[Psychopathology, coping and defence in intensive-care patients].

We performed a follow-up study of psychosocial aspects of intensive care during 3 months on 122 consecutive patients admitted to a medical intensive care unit for at least 8 hours. 54 patients were interviewed in the intensive care unit. These data were evaluated using 2 rating scales for the course of the interview and the psychopathological findings (AMDP-system). Coping patterns based on both rating scales were intra- and interindividually highly variable and did not show systematic trends in time. High variability was interpreted as showing an effort towards more efficient individual coping strategies. The reaction to ICU admission remembered later on general ward was almost uniform: threat to life was minimized and personal capabilities enhanced. Systematically coloured recollections are seen as a part of further coping strategies restoring the individual competence of coping and minimizing the narcissistic offence of illness.

Adaptation, Psychological↗
PubMedDate not supplied

Nurses and physicians evaluate their intensive care experiences.

OBJECTIVE: Analysis of the evaluation of intensive care experiences of nurses and physicians in relation to their educational background and degree of professionalization. DESIGN: Cross-cultural, qualitative study design: German nurses and physicians and American nurses. SETTING: German medical intensive care unit (nine beds), German surgical intensive care unit (six beds), and an American medical-surgical intensive care unit (16 beds). SUBJECTS: Thirteen German nurses (eight women, five men) of a medical intensive care unit, six German nurses (five women, one man) of a surgical intensive care unit, nine German physicians of a medical intensive care unit (two women, seven men), and 13 American nurses of a medical-surgical intensive care unit (10 women, three men). METHODS: The interviewing technique by the method of Role Repertory Grid Test by G.A. Kelly. We focused on important job experiences in intensive care and the remembered evaluation of these experiences. RESULTS: The reported experiences of intensive care unit nurses and physicians show negative as well as positive appraisals. No correlation can be shown between negative appraisals and the degree of professionalization or training of German nurses and physicians, and American nurses, respectively. The qualitative-content analysis of positively appraised experiences does indicate, for all four studied groups, that even primarily so-called "positive" experiences are closely connected with negative aspects and connotations. CONCLUSIONS: The results indicate that nurses and physicians experience intensive care work with extreme ambivalence. To be content with and successful on the job it appears necessary to develop a high level of ambivalence. From a methodologic point of view, the advantages of the interviewing technique (Role Repertory Grid) are discussed.

Adaptation, Psychological↗