[Misbelieves about medical communication]. / Tévhitek az orvosi kommunikációról.

Despite a growing body of evidence about the importance of good communication skills in healthcare, every day practice shows several common myths or false believes about it. In the opinion of the authors these misbelieves are often behind doctors' or students' negative attitudes, which hinder the quality improvement or shift towards patient-centered approach. The scope of this article is to present the most frequently heard misbelieves from our empirical experiences in line with the evidence derived from current research data.

[Aspects of communication regarding medical malpractice suits]. / Az egészségügyi kártérítési perek kommunikációs vonatkozásai.

Due to problems experienced in health care, there is an increased amount of malpractice suits nowadays. Nevertheless, some physicians are more likely to be sued, or more frequently sued, than others. Numerous studies indicate that this phenomenon fundamentally results from a lack of interpersonal and communication skills on the part of the sued doctor, namely, deficiencies in questioning the patient, listening, conveying information, etc. Communication is of pivotal importance in patient care vis-à-vis medical errors as well. The majority of physicians aim to conceal the error, albeit this may lead to further deterioration of the patient's condition. In institutions where open communication regarding errors was introduced within the medical team and toward the patient and their family alike, the number of malpractice suits decreased. It is crucial to establish a means of support for doctors, and to promote communication trainings, as well as a supportive legal environment.

[The importance of the doctor-patient communication in the care of somatizing patients]. / Az orvos-beteg kommunikáció jelentosége a szomatizáló páciensek ellátásában.

The term "somatization" refers to the manifestation of multiple somatic complaints not explained by organic changes. According to the literature, 15-25 percent of all medical visits are related to somatization. As medical training does not put enough emphasis on the evaluation of the possible psychological background of certain somatic symptoms, physicians may feel powerless and make unjustified diagnostic and therapeutic efforts. The patients may also feel helpless and frustrated, their anxiety and the intensity of their complaints may increase. As stress is an important factor in the somatization process, stress reduction and improvement of coping are key elements of the treatment guidelines for chronic diseases. Evidence based interventions range from short counselling and medication to cognitive and behavioral psychotherapy. Reattribution, a short (10-30 minutes) structured intervention that can be implemented in primary or secondary care, in certain cases can result in significant decrease in somatic symptoms and anxiety.

Psychometric properties of the Cannabis Abuse Screening Test in Hungarian samples of adolescents and young adults.

AIM: The aim of our study was to analyze psychometric properties of the Cannabis Abuse Screening Test (CAST). METHODS: Our sample comprised Hungarian high school (n = 476; male 56.3%; mean age 19.0 years, SD = 0.65 years) and college students (n = 439; male 65.1%; mean age 23.9 years, SD = 1.56 years) who reported cannabis use in the past year. The sample covered the five biggest universities of Hungary. Besides the CAST, participants responded to the Munich-Composite International Diagnostic Interview. Factor structure was analyzed by a confirmatory factor analysis. Receiver operating characteristic curve analysis was made to assess cut-off scores. Data collection took place in 2010. RESULTS: CAST proved to be a reliable (Cronbach's α 0.71 and 0.76) one-dimensional measure. Regarding both cannabis dependence and cannabis use disorders, a cut-off of 2 points proved to be ideal in both samples, resulting in optimal specificity, negative predictive values and accuracy, but less than optimal positive predictive values (dependence) and low sensitivity (cannabis use disorder). DISCUSSION AND CONCLUSIONS: In line with former results, the CAST proved to be an adequate measure for the screening of cannabis-related problems among adolescents and young adults in an Eastern European country where this scale has not been studied before.

[Professions and fear of death--are they correlated?]. / Összefüggésbe hozható-e a halálfélelem a foglalkozással?

INTRODUCTION: There are relatively few data on the relationship between professions and fear of death. AIM: The aim of the authors was to examine the association between profession and fear of death. METHOD: Physicians, medical students and other healthcare workers, priests, psychologists and non-healthcare workers (N = 1062) were asked about their attitude to death by means of the Multidimensional Fear of Death Scale. RESULTS: Significant differences were found in the total and some factor scores among the study groups. Priests showed the lowest fear of death values. Scores on the Fear of the Dead Factor was the highest in psychologists and non-healthcare workers who had no contact with the dead and dying. CONCLUSIONS: Fear of death seems rather to be present in professions dealing less directly with the dead and dying.

Relationship between religiosity and health: evidence from a post-communist country.

BACKGROUND: The relationship between religiosity and health has been investigated in the western world for decades. However, very little data are available from the post-communist region of Europe, where religion was suppressed for a long time. PURPOSE: The aim of the present study was to lessen this gap. METHODS: In 2002, 13 years after the regime change, 12,643 persons (mean age = 47.6 ± 17.9 years; 44.8 % male) were interviewed in a Hungarian representative survey. The relationship of mental and physical health indicators with religious worship and personal importance of religion-controlling for several psychological and lifestyle characteristics-were analyzed using the general linear model procedure. RESULTS: Our results showed that practicing religion was largely associated with better mental health and more favorable physical health status. However, persons being religious in their own way tended to show more unfavourable results across several variables when compared to those practicing religion regularly in a religious community or even to those considering themselves as non-religious. The personal importance of religion showed a mixed pattern, since it was positively associated not only with well-being but depression and anxiety as well. CONCLUSIONS: We can conclude that even after an anti-religious totalitarian political system practicing religion still remained a health protecting factor.

Proposal for a short version of the Beck Hopelessness Scale based on a national representative survey in Hungary.

In our study we assessed the frequency of reported hopelessness and suicide attempts in the national representative survey Hungarostudy 2002. The randomly selected sample consisted of 14,000 individuals over the age of 18. We created a short version of the widely used Beck Hopelessness Scale for screening purposes in suicide prevention. The short version of the BHS consists of four items and has high internal consistency (Cronbach's alpha = 0.85). Moreover, we conducted an investigation into psychological, somatic, sociological and socio-economic as well as cultural variables that show a positive or negative correlation with hopelessness and important predictors of suicide. The following psychological variables showing a positive correlation with hopelessness were identified: dysfunctional attitudes, exhaustion, psychological distress, hostility, lack of life goals and inability to cope emotionally. Sense of coherence, social support, perceived self-efficiency, subjective well-being and problem-solving coping showed a negative correlation with hopelessness. Concerning the relationship between hopelessness and suicide attempts, we found that participants who attempted suicide in the last year scored higher (mean = 4.86) than participants who attempted suicide more than 3 years ago (mean = 3.57). These results indicate that applying the short version of the BHS could be very useful in general practice and in psychiatric care.

Mediators between bereavement and somatic symptoms.

BACKGROUND: In our research we examined the frequency of somatic symptoms among bereaved (N = 185) and non-bereaved men and women in a national representative sample (N = 4041) and investigated the possible mediating factors between bereavement status and somatic symptoms. METHODS: Somatic symptoms were measured by the Patient Health Questionnaire (PHQ-15), anxiety with a four-point anxiety rating scale, and depression with a nine-item shortened version of the Beck Depression Inventory. RESULTS: Among the bereaved, somatic symptoms proved to be significantly more frequent in both genders when compared to the non-bereaved, as did anxiety and depression. On the multivariate level, the results show that both anxiety and depression proved to be a mediator between somatic symptoms and bereavement. The effect sizes indicated that for both genders, anxiety was a stronger predictor of somatic symptoms than depression. CONCLUSIONS: The results of our research indicate that somatic symptoms accompanying bereavement are not direct consequences of this state but they can be traced back to the associated anxiety and depression. These results draw attention to the need to recognize anxiety and depression looming in the background of somatic complaints in bereavement and to the importance of the dissemination of related information.

[Are oppressive dreams indicators in bereavement?]. / Van-e a nyomasztó almoknak indikátorszerepük a gyászban?

OBJECTIVES: It is widely believed that oppressive dreams are frequent in bereavement--despite the lack of scientific investigations of the subject. The aims of our study were the analysis of dream quality as well as the correlates of oppressive dreams in bereavement. METHOD: Participants with (N = 473) and without bereavement were compared upon the database of a national representative study (Hungarostudy Epidemiological Panel Survey 2006, N = 4329). Dream contents were assessed with the Dream Quality Questionnaire (DQQ). Depressive symptoms (BDI-S) and the presence anxiety were also investigated. RESULTS: Oppressive dreams occurred significantly higher frequency in the first year of bereavement (men: F = 17.525, p < 0.001, women: F = 8.291, p = 0.004). Oppressive dreams were significantly associated with anxiety (F = 37.089, p < 0.001) and with depressive symptoms (F = 50.562, p < 0.001). DISCUSSION: Oppressive dreams are significantly more frequent in the first year of bereavement, and may act as indicators of bereavement-linked mental health consequences like depression and anxiety. These are often masked by the symptoms of grief and therefore remain untreated. Our preliminary results could be a starting point for the development of further research aiming to clarify the relationship amongst dream contents, anxiety, and depression in bereavement.

[Physicians' attitudes toward death and dying]. / Orvosok halállal és haldoklással kapcsolatos attitúdjei.

INTRODUCTION: In the study the physicians' knowledge and attitude was examined towards death and dying. During the study a questionnaire survey was executed, including 124 physicians (family doctors from Budapest and from the country, hospital and clinical doctors) in which there were questions edited by the authors and also used the Lester and Neirmeyer scales to assess the fear of death. AIMS: The aim was to assess how much the physicians were prepared during their education to face with dying people and death, how much they are able to get in touch with dying patients, and how much they are afraid of death. METHODS: The questionnaires evaluated by the SPSS statistical program. RESULTS: According to results most physicians in Hungary have a very little knowledge with regard to death and dying. This lack of knowledge, their own fears and refusal in connection with the transitoriness can have a negative influence on their relationship with dying people: their attitudes towards dying are generally negative, many of them try to avoid dealing with the questions worrying the dying people and if after all there is a communication situation most of them avoid the more difficult fields instead. CONCLUSIONS: To draw attention to these problems, to point out the necessity of the gradual education of issues connected to death and dying and to stress how important is to mold attitudes towards dying people. The study is finished with some particular education program-proposals.

Alcohol use in the first three years of bereavement: a national representative survey.

BACKGROUND: Earlier results concerning alcohol consumption of bereaved persons are contradictory. The aim of the present study was to analyze the relationship between bereavement and alcohol consumption accounting for time and gender differences on a nationally representative sample from Hungary ("Hungarostudy Epidemiological Panel Survey", N = 4457) METHODS: Drinking characteristics of mourning persons (alcohol consumption, dependence symptoms, and harmful consequences of alcohol use) in the first three years of grief were examined among persons between 18-75 years using the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Men bereaved for one year scored higher on two dimensions of AUDIT (dependence symptoms and harmful alcohol use), while men bereaved for two years scored higher on all three dimensions of AUDIT compared to the non-bereaved. The rate of men clinically at-risk concerning alcohol consumption among the non-bereaved is 12.9%, and among men bereaved for one year is 18.4% (a non-significant difference), while 29.8% (p < 0.001, OR = 2,781) among men bereaved for two years. However, men bereaved for three years did not differ from the non-bereaved in their drinking habits. In case of bereaved women, again no difference was found with respect to alcohol use compared to the non-bereaved. CONCLUSION: Among bereaved men, the risk of alcohol related problems tends to be higher, which can be shown both among men bereaved for one year as well as men bereaved for two years. Considering the higher morbidity and mortality rates of bereaved men, alcohol consumption might play a mediator role. These facts draw attention to the importance of prevention, early recognition, and effective therapy of hazardous drinking in bereaved men.