RESUMO
BACKGROUND: With the purpose of improving healthcare, past research has examined the link between healthcare utilization and attachment. It is suggested that an individual's attachment style influences both the quality of their patient-physician relationship and healthcare utilization patterns. Nevertheless, most studies concentrate on the individual aspect, overlooking the dyadic dimension; specifically, the investigation of how insecure attachment relates to health behavior within patient-physician relationships. This gap leaves the role of the patient-doctor relationship in this process unclear. Therefore, to elucidate this complex interplay, we hypothesized that the correlation between attachment and healthcare utilization is mediated by the quality of the patient-physician-relationship. METHOD: Participant selection was based on electoral districts, a random-route procedure, and the Kish selection grid. The participants were visited by a trained interviewer who collected psychometric and sociodemographic information. Participants answered the Experiences in Close Relationships-Revised questionnaire (ECR-RD8) and the Patient-Doctor Relationship Questionnaire (PDRQ-9). Additionally, participants were asked about their healthcare utilization. The final sample consisted of N = 2.275 participants. RESULTS: In average the participants reported consulting their primary health care practitioner M(SD) = 4.44 (4.76) times in the past 12 months. Generally, the participants rated the quality of the relationship with their primary health care practitioner close to "totally appropriate" (M = 4.12 ± .69). The degree of insecure attachment manifested towards the lower extremity of the scale. The total effect of the mediation analyses was significant. Regardless, the indirect effect indicated a trend result with minimal effect sizes. CONCLUSION: The findings of the current study bridged the gap between attachment styles and healthcare utilization. Nonetheless, our results suggested insufficient support for the mediating role of the primary care physician in the relationship between attachment style and healthcare utilization. Considering the characteristics of the sample, this outcome may not apply in a clinical context. However, further research is needed to shed light in the revealed trends and indicate implications.
Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Relações Médico-Paciente , HumanosRESUMO
Aim This study addresses the examination of the factorial validity of the National Eye Institute Visual Function Questionnaire 39 (NEI-VFQ 39) and the neuro-ophthalmological supplement in a German sample. Method Eighty-one patients with visual field defects affecting at least one eye answered the NEI-VFQ 39 and the supplement. Theoretical factor structures reported in the manuals were examined in confirmatory factor analysis. Because of a misfit, items retained after item analysis were subjected to exploratory factor analysis. Results The originally postulated factor structures could not be replicated. Many items revealed floor effects. The 21 remaining items could be assigned to two factors - "visual functioning" and "socio-emotional impairment". Conclusion The weakness of the theoretical factors can be avoided by using the 2-scale model.
Assuntos
Interpretação Estatística de Dados , National Eye Institute (U.S.) , Psicometria/métodos , Qualidade de Vida/psicologia , Inquéritos e Questionários , Transtornos da Visão/diagnóstico , Transtornos da Visão/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estados Unidos , Adulto JovemRESUMO
The short version of the Brief Symptom Inventory (BSI-18) is an easily applicable, reliable and valid self-report measure in wide international use. It assesses the syndroms of somatisation, depression and anxiety by means of 6 items each. For the psychometric evaluation of the German translation, undergraduate students, non-clinical subjects and psychosomatic outpatients were administered the BSI-18. Across these populations, all scales showed satisfactory to good internal consistencies (Cronbachs alpha ranged between 0.63 and 0.93). The item-total correlation as item discrimination index was sufficiently high, patricularly in the patient sample (rit ≥ 0.40). The correlations of the BSI-18 with measures of similar dimensions were moderate to high indicating a good convergent validity. Criterion-related validity was established in so far that patients scored significantly higher in all BSI-18 scales than did the non-clinical samples. With some exceptions, the German translation of the BSI-18 has similarly good psychometric qualities as the American original.
Assuntos
Escalas de Graduação Psiquiátrica , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Alemanha , Humanos , Classificação Internacional de Doenças , Idioma , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Psicometria , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologia , Traduções , Adulto JovemRESUMO
There is growing evidence for the effectiveness of multimodal intervention concepts for chronic low back pain in the international literature, and accordingly several German rehabilitation programmes for the treatment of chronic low back pain patients have been developed. Focus of this paper is to describe and compare frequently used German multimodal intervention programmes for in- and outpatient rehabilitation of patients with chronic low back pain. Programmes were chosen by searching the most relevant online resources as well as the online pages of Deutsche Rentenversicherung and Zentrum Patientenschulung during September 2008. Keywords guiding the search were: Patientenschulung, Rückenschmerzen, Manual, psychologische multimodale Interventionskonzepte, Rehabilitationsprogramm, psychology, intervention, low back pain, manual and therapy. By this means, six manually supported multimodal rehabilitation programmes for the in- and outpatient therapy of patients with chronic back pain could be identified: Göttinger Rücken-Intensiv-Programm (GRIP), the psychological programme for chronic head- and low back pain, the Münchner Rücken-Intensiv-Programm (MRIP), Back to Balance, Arbeiten und Leben--Back to Balance (ALEBABA) und Rückenfit: Lebenslust statt Krankheitsfrust. These programmes are depicted and compared with regard to their potentials and limitations in supporting the rehabilitation process of patients with chronic low back pain. While comparing the programmes, a number of similarities between them can be detected, as well as pronounced differences, e. g., regarding settings and complexity. In most programmes, lack of appropriate evaluation studies and lack of aftercare turn out to be critical aspects.
Assuntos
Dor Lombar/prevenção & controle , Dor Lombar/reabilitação , Equipe de Assistência ao Paciente , Educação de Pacientes como Assunto , Terapia Combinada , Alemanha , Cefaleia/reabilitação , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Reabilitação Vocacional , Prevenção SecundáriaRESUMO
BACKGROUND: Obesity is a widespread illness in Western industrialized countries, causing a high financial burden for the health systems. Several studies could demonstrate the positive effects of bariatric surgery on psychological and psychosocial parameters. PATIENTS AND METHODS: Twenty patients with morbid obesity (BMI > or =40 kg/m(2)) answered two questionnaires, the SCL-90-R, assessing psychological distress, and the IIP-D, measuring interpersonal problems, before and 6 months after gastric banding. Six months after surgery an additional questionnaire measuring subjective feelings was administered, too. RESULTS: Seventy-five percent of the patients were dissatisfied with therapy and outcome. They reported a lack of psychological support as well as new surgery-related physical and psychological symptoms. CONCLUSION: This study pointed out the necessity for psychotherapeutic help after surgery to manage already existing or new psychological needs due to gastric banding.
Assuntos
Gastroplastia/psicologia , Obesidade/psicologia , Obesidade/cirurgia , Satisfação do Paciente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND AND PURPOSE: Little is known about whether and to what extent health- and vision-related quality of life in stroke patients with visual field defects is influenced by the severity of visual function loss and which quality of life is achieved compared to healthy control persons. PATIENTS/MATERIALS AND METHODS: Results of the National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ) and the Medical Outcome Study Short-Form 36 Health Survey (SF-36) of 177 first stroke patients with visual field defects were compared with scores of age- and sex-matched healthy reference persons. The influence of visual field loss, perimetric data, reduced visual acuity and demographic variables on NEI-VFQ and SF-36 scores were estimated by analyses of variance. RESULTS: First stroke patients showed worse results in 11/12 NEI-VFQ and in 6/8 SF-36 subscales when compared to healthy controls. The factor "intact central visual field" influenced 9/12 NEI-VFQ subscales (F-range 3.16 - 14.11; all p < 0.05), but only one SF-36 scale (F = 3.15; p < 0.05). Patients with larger intact visual fields, shorter reaction times in the visual field test and better visual acuity reached higher NEI-VFQ and SF-36 scores. Male patients reported worse scores for SF-36 subscale General Health Perceptions than female patients (F = 8.61; p = 0.004), but no differences in vision-related quality of life due to the factor gender could be detected. CONCLUSIONS: Patients with visual field defects showed considerable reductions in vision- and health-related quality of life compared to healthy control persons. These were mainly influenced by variables of visual functioning such as size of intact visual field, reaction times or visual acuity. The size of the intact central visual field influenced vision-related quality of life rather than health-related quality of life.
Assuntos
Infarto Cerebral/psicologia , Hemianopsia/psicologia , Qualidade de Vida/psicologia , Baixa Visão/psicologia , Acuidade Visual , Campos Visuais , Adulto , Idoso , Atitude Frente a Saúde , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/estatística & dados numéricos , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Due to the demographic development in western industrialised countries, the proportion of visually impaired persons is likely to increase in the future. Currently there is a shift in scientific recognition from relative neglect of psychopathological distress in the visually impaired to better notice of disease-related subjective impairments that are detectable with specific questionnaire measures. Visual acuity primarily determines the subjective rating of visual functioning independent from the eye disease. Ophthalmic patients who show only mild symptoms from a medical point of view normally suffer considerably diminished vision-related quality of life with respect to physical, functional, mental, and social aspects. Treatment effects have been shown using vision-related quality-of-life measures for different ophthalmic diseases, particularly cataract surgery. Assessment of vision-related quality of life provides a meaningful complement to objective data.
Assuntos
Oftalmopatias/psicologia , Qualidade de Vida/psicologia , Transtornos da Visão/psicologia , Acuidade Visual , Campos Visuais , Atividades Cotidianas/psicologia , Oftalmopatias/reabilitação , Humanos , Relações Interpessoais , Satisfação do Paciente , Ajustamento Social , Inquéritos e Questionários , Transtornos da Visão/reabilitação , Baixa Visão/psicologia , Baixa Visão/reabilitaçãoRESUMO
BACKGROUND: Advances in transplantation medicine are linked to improved efficacy of immunosuppressive agents. At the same time, these agents endanger medical success by side effects that may impair survival and quality of life (QOL). This study examined whether conversion to tacrolimus-based immunosuppression due to cyclosporine-related side effects improved. QOL in patients after kidney transplantation. METHODS: In total 64 patients (29 men) with an average age of 51 years (SD+/-12) who had received a kidney allograft an average of 5.6 years (SD+/-4) before conversion participated. The reasons for conversion were cardiovascular/metabolic (n=26) or periodontal/dermatological side effects (n=38) of cyclosporine therapy. QOL was assessed before conversion and in average 7 months thereafter by a global (SF-36) and a disease-specific instrument (ESRD-SCL). RESULTS: Disease-specific QOL (ESRD-SCL, global index) improved significantly (P<.001, explanation of variance [EV]=16.6%) after conversion from cyclosporine to tacrolimus. In detail, cardiac and renal dysfunction (P<.01, EV=12.9%) as well as increased growth of gum and hair (P<.0001, EV=53.2%) were significantly reduced at end of the study. However, global QOL (SF-36) remained unchanged. CONCLUSION: Regardless of the indication (cardiovascular or cosmetic), switching to tacrolimus due to cyclosporine-related side effects improved disease-specific QOL within the short term.
Assuntos
Ciclosporina/efeitos adversos , Transplante de Rim/fisiologia , Qualidade de Vida , Tacrolimo/uso terapêutico , Adulto , Idoso , Cognição , Feminino , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Atividade Motora , Estresse PsicológicoRESUMO
To investigate disease-specific quality of life (QOL) in Turkish patients after successful kidney transplantation, the End-Stage Renal Disease Symptom Checklist Transplantation Module (ESRD-SCL-TM), a multidimensional questionnaire measuring disease-specific QOL, was translated and administered to a sample of successfully transplanted patients. Intercultural differences between Turkish and German patients as well as the influence of demographic (age, gender) and clinical (duration of graft function, living versus cadaver transplantation) data in the Turkish patients were evaluated by multivariate analyses of variance, and correlative techniques. The 152 investigated Turkish patients, including 106 (69.7%) men and 46 (30.3%) women, had a mean age of 34.8 years (SD = 10.8, range, 14 to 67 years). Time since successful kidney transplantation varied between 1 and 297 months (mean = 19.2 months; SD = 36.9). One hundred twelve patients (73.7%) received a kidney from a living donor, and 40 (26.3%) from a cadaver. The Turkish patients suffered statistically significantly more from disease-specific distress than the German patients (19% explanation of variance). They reported higher distress regarding four of six subscales. Turkish women suffered statistically significantly more from "Limited Physical Capacity," and "Side-effects of Corticosteroids" (10% explanation of variance) than men. The demonstrated higher disease-specific distress in successfully transplanted Turkish patients compared to the German samples may be the result of intercultural differences in reporting psychological and disease-specific distress. On the other hand, the higher distress of women compared to men is well known. Both results pointed out the necessity of psychological support.
Assuntos
Transplante de Rim/fisiologia , Transplante de Rim/psicologia , Qualidade de Vida , Cognição , Alemanha , Nível de Saúde , Humanos , Falência Renal Crônica/cirurgia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , TurquiaRESUMO
Abstract The aim of the present study was to differentially determine quality of life (QOL) in patients with end-stage renal disease (ESRD) after successful kidney transplantation (RT, Group A) compared with ESRD patients on a waiting list for RT (Group B). and with healthy controls (Group C) because opinions vary as to which treatment modality can best assure ESRD patients a high QOL. Groups A, B and C each consisted of 149 persons, matched for age and gender. The Munich Quality of Life Dimensions List (MLDL) was used to measure global aspects of QOL. Distinct aspects of QOL were investigated by the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support (K-22). Groups A and C reported similar QOL. Which was significantly higher than in group B (p < .0001). This was particularly true for the physical and psychological status and daily activities, but not for the social situation. Groups A and B reported similar social support, which was significantly, lower than in group C (p < 006). Both ESRD groups reported higher satisfaction with social support than healthy controls (p < .0001). Successful RT nor only improved distinct aspects of QOL in patients with ESRD, but even put them on par with healthy controls regarding physical and psychological QOL. Lower social support and higher satisfaction with social support in both groups of ESRD patients should be evaluated further. From a clinical viewpoint. the improvement of physical and psychological aspects of QOL in RT patients is impressive; but more attention should be paid to constantly low social support in this group of patients. International multi center longitudinal studies to investigate QOL in ESRD patients under different treatments am necessary.
RESUMO
A Symptom Checklist (SCL-90-R) is a potentially useful measure of psychological distress; it is frequently used in psychotherapy research and clinical practice. The purpose of this study was to illustrate the use of the SCL-90-R for determining statistically reliable change and clinical significance outlined by Jacobson and Truax in 1991. This paper describes the concepts of statistical and clinical significance of change. A proposal for obtaining and characterizing samples is made. Then a clinician's perspective is taken. Reliable change estimates and cut-off scores are chosen based on outcome data. Selected data from a single psychotherapeutic process and outcome study then were used to test the estimates of change and cut-off scores.
Assuntos
Transtornos Mentais/diagnóstico , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Inventário de Personalidade/estatística & dados numéricos , Transtornos Psicofisiológicos/diagnóstico , Psicoterapia , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Seleção de Pacientes , Psicometria , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapiaAssuntos
Imunossupressores/uso terapêutico , Falência Renal Crônica/cirurgia , Transplante de Rim , Qualidade de Vida , Tacrolimo/uso terapêutico , Estudos de Casos e Controles , Ciclosporina/uso terapêutico , Feminino , Seguimentos , Humanos , Falência Renal Crônica/economia , Transplante de Rim/economia , Transplante de Rim/imunologia , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Análise de SobrevidaRESUMO
BACKGROUND: In patients with visual field defects, measurement of health-related quality of life (hQoL) and vision-related quality of life (vQoL) is an important adjunct to clinical measures such as perimetry. The purpose of this study was to describe hQoL and vQoL of patients with visual field defects after cerebral lesions such as infarction, traumatic brain injury, and tumor. METHODS: The National Eye Institute -- Visual Function Questionnaire (NEI-VFQ) for vQoL and the SF-36 Health Survey for hQoL were administered to 24 patients about 2 years after occurrence of the visual field defect. Visual fields were measured by standard perimetry and a near-threshold campimetric method. Visual acuity was measured by the Landolt-Ring-Test. RESULTS: The NEI-VFQ scores -- but not SF-36 scores -- were not only lower than those of a disease-free group but also lower than those of patients with visual impairments not caused by cerebral damage. Rank correlations between the size of the visual field defect and NEI-VFQ subscales were significantly high or modest. With SF-36 scores these correlations were generally low and moderate at best. CONCLUSION: The NEI-VFQ is a valuable measure of self-reported visual impairment in patients with visual field defects after cerebral lesions. The measurement of unspecific hQoL is not sufficient to reflect the problems of patients with visual field defects.
Assuntos
Dano Encefálico Crônico/psicologia , Qualidade de Vida/psicologia , Transtornos da Visão/psicologia , Campos Visuais/fisiologia , Adaptação Psicológica , Adulto , Idoso , Dano Encefálico Crônico/diagnóstico , Dano Encefálico Crônico/fisiopatologia , Comorbidade , Diagnóstico por Computador , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refração Ocular/fisiologia , Papel do Doente , Ajustamento Social , Transtornos da Visão/diagnóstico , Transtornos da Visão/fisiopatologia , Acuidade Visual/fisiologia , Testes de Campo VisualRESUMO
OBJECTIVES: Health-related quality of life (HRQL) has become an important outcome criterion of medical interventions, but was hardly studied in patients with facial spasms. MATERIALS AND METHODS: Patients with blepharospasm or hemifacial spasm treated with botulinum toxin were included. A healthy control group sociodemografically matched to patients was established. Instruments applied included the SF-36 (global HRQL), the NEI-VFQ (disease-specific HRQL) and the Blepharospasm Rating/Disability Scale, the latter to patients only. RESULTS: Thirty-one patients with blepharospasm and 21 patients with hemifacial spasm took part. The Blepharospasm Rating/Disability Scale revealed minor functional limitations, but identified some symptoms to be improved. In both patient groups global (both SF-36 Component Summaries) and disease-specific (eight of 12 subscales) HRQL were significantly impaired compared with controls. CONCLUSION: HRQL should be integrated as core outcome criterion in treatment of patients with facial spasms. Assessment by a generic and a disease-specific instrument is recommended.
Assuntos
Blefarospasmo/psicologia , Espasmo Hemifacial/psicologia , Qualidade de Vida , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Medical treatment of HIV infection has changed dramatically since 1997. The uncontrollable threat became a chronic disease. On the other hand, many HIV-infected people suffer from high psychological distress and multiple physical complaints. Interaction in HIV prevention could transform into psychological counseling. Counselors should initiate rehabilitation measures and occupational reintegration by utilizing all legal possibilities for handicapped people. Patients and physicians, psychologists and social workers as well as self-help groups should initiate successful reintegration into the workforce and daily life; this could positively influence compliance behavior.
Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/reabilitação , Terapia Ocupacional/métodos , Psicoterapia/métodos , Estresse Fisiológico/etiologia , Estresse Fisiológico/prevenção & controle , Estresse Fisiológico/reabilitação , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/reabilitação , Pessoas com Deficiência/reabilitação , Infecções por HIV/complicações , Humanos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Grupos de Autoajuda , Resultado do TratamentoRESUMO
Empirical results of two studies on the practice of computer administration of psychodiagnostic inventories are presented. Based on the "Freiburger Persönlichkeitsinventar" (FPI-R, a German multidimensional personality inventory, Fahrenberg, Hampel & Selg, 1994) two studies (total N = 600 university students) were conducted in which (1) the standard paper-pencil questionnaire was compared with a computer administrated version, and (2) the standard item arrangement was contrasted with the presentation of the items of each subscale as a block (homogeneous item blocking), which corresponds to the extraction of subscales from more extensive inventories. The results confirm low significant effects of computer administration and of item blocking as to the means, as well as no interactions with the factor "gender." The parameters of reliability increased partially under computer administration. Computer administration itself led to a higher degree of self-consciousness. The adequacy of the FPI-R, which was standardized by paper-pencil inquest, and a computer administrated version is thus demonstrated proven.
Assuntos
Diagnóstico por Computador , Transtornos da Personalidade/diagnóstico , Inventário de Personalidade/estatística & dados numéricos , Software , Adulto , Feminino , Humanos , Masculino , Transtornos da Personalidade/psicologia , Psicometria , Valores de Referência , Reprodutibilidade dos Testes , Estudantes de Medicina/psicologiaRESUMO
PURPOSE: As a result of its increasing incidence and social medical implications, low back pain with either chronic or acute symptoms presents a major challenge for our society. The psychological background of pain perception and valuation has been explored in various studies; frequently, no positive correlation was found between subjective pain perception and structural orthopedic findings. METHOD: A symptoms checklist (SCL-90-R) was used to compare a group of patients hospitalized because of low back pain with a group of asymptomatic controls. Additionally, the pain-specific questionnaire (ERSS) was employed to verify the validity of the depressive mood scale by means of the corresponding scale in the SCL-90-R. RESULTS: When the SCL-90-R was given to both groups, significant differences could be observed between the patients and the controls on the scales for somatisation, depressive mood, anxiety, phobias and psychoticism. Moreover, patients with chronic pain had higher scores on the scales for phobias and the global marker of "positive symptom total" (PST) than patients with acute back pain. On the scales for somatisation and insecurity during social contacts, women reported higher levels of psychological distress than men. Age-related differences were not observed. The depressive mood scale of the ERSS appears to be valid. With the SCL-90-R we could demonstrate significant differences between patients with acute and chronic pain, and between the sexes. No differences were found in the age-group comparison. CONCLUSION: In patients with low back pain, psychological parameters have to be taken into account in any comprehensive concept of conservative treatment.
Assuntos
Dor Lombar/psicologia , Admissão do Paciente , Transtornos Somatoformes/psicologia , Estresse Psicológico/complicações , Doença Aguda , Adulto , Ansiedade/diagnóstico , Ansiedade/psicologia , Doença Crônica , Depressão/diagnóstico , Depressão/psicologia , Feminino , Identidade de Gênero , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Transtornos Somatoformes/diagnósticoRESUMO
In order to complete the range of topical media, that is currently available for the visually impaired, a working group is developing and testing the "Westdeutsche Allgemeine Tageszeitung (WAZ) for the visually impaired", an auditive electronic daily newspaper. The intention of this project is to take into consideration the needs of the visually impaired, especially of those who acquired the handicap in middle or later age and might feel that not being able to read the daily newspaper anymore reduces their quality of life to a great extent. The central aim therefore is to put the modern computer technology at the disposal of the impaired in a way that enables them to make use of the newspaper without having had previous experience. In a first phase of several months twelve probands in different personal settings will test a first prototype of the newspaper reading machine, a modified and optimated multimedia computer system with modern and speech output, at home. During this period the users will be intensively looked after and undergo psychodiagnostic examination. By means of analysing the data collected in extended talks and questionnaires concrete proposals on how to improve the machine are to be made and a statement about the potential impact of the electronic newspaper on the quality of life of the visually impaired--in the sense of a contribution to their rehabilitation--is to be given.
Assuntos
Jornais como Assunto , Qualidade de Vida , Terapia Assistida por Computador , Transtornos da Visão/reabilitação , Adolescente , Adulto , Idoso , Criança , Feminino , Alemanha , Humanos , Internet/tendências , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Editoração , Interface Usuário-Computador , Pessoas com Deficiência Visual/reabilitaçãoRESUMO
The Symptom Check-List-90-R (SCL-90-R) is a widely used psychological status symptom inventory. The properties of the German SCL-90-R version were studied in two clinical samples: psychosomatic outpatients and primary care patients. The data were compared with a German community sample. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all original subscales. Mokken scale analysis indicated hierarchical structure for most of the subscales. Concurrent validity, evaluated by studying the relationship between the SCL-90-R subscales and the Inventory of Interpersonal Problems (IIP-C) and the General Health Questionnaire (GHQ-12) was also high. On the basis of receiver operating characteristic (ROC) analyses, it was found that the SCL-90-R was able to differentiate between subjects known to have a given psychological disorder and those who do not. Results of exploratory and confirmatory factor analysis failed to support the original nine factor model and two subsequent factor models. The strong interdependence of the original subscales and the strong first unrotated factor of the exploratory factor analyses raised concern regarding the multi-dimensionality of the SCL-90-R subscales. We concluded that the SCL-90-R is a useful tool for measuring psychological status, measuring change in outcome studies, or screening for mental disorders.
Assuntos
Transtornos Mentais/diagnóstico , Escalas de Graduação Psiquiátrica , Adulto , Área Sob a Curva , Análise Fatorial , Feminino , Alemanha , Humanos , Masculino , Programas de Rastreamento , Valor Preditivo dos Testes , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Autorrevelação , Sensibilidade e EspecificidadeRESUMO
HIV-infected women were an increasingly larger group among the risk groups in Germany. In order to illuminate the psychological situation of HIV-infected women in Germany, 100 women with HIV disease were enrolled in a basic study. 72% of the patients were intravenous drug addicted, 28% were infected through other means. The study population comprised patients of all stages of infection. We found 52% in the first stages, 28% in ARC and 20% with AIDS. Evaluated data included medical, socio-demographic, and data regarding the patients' history of drug abuse. The SCL-90-R, a psychological symptom inventory, was applied. Questions about differences between the two groups of HIV-infected women (iv drug addicted vs non-drug addicted) were answered first. Second, we described three clusters of HIV infected women with regard to different levels of psychological distress. Important factors to distinguish between these clusters are the subjective impact of physical distress (e.g. suffering from HIV-associated symptoms) and loss of joy and interest in sex. In order to illuminate the psychosocial situation, we discuss the specific situation of three patients.