[Barriers and Resources in Utilisation of HIV-Prevention Services for African Migrants]. / Barrieren und Ressourcen der Inanspruchnahme von HIV-Präventionsangeboten für Afrikanische Migrantinnen.

The evaluation of the "Africa Project" investigates barriers to and resources of the utilisation of HIV-prevention services by African migrants. A KAP study evaluates knowledge, attitudes and practice of an African sample population (n = 214). Results show that gender and cultural-psychological factors influence the perception of ways of infection and protection such as condom use and thereby determine the prerequisites for HIV prevention.

[Response and remission in schizophrenic subjects]. / Response und Remission bei an Schizophrenie erkrankten Patienten.

BACKGROUND: This naturalistic study investigates in detail symptom reduction during acute inpatient treatment (response), long-term symptom improvement in the post-acute phase (remission) and the rate of re-hospitalisations. MATERIAL AND METHODS: A total of 183 patients were enrolled. Criteria for response were PANSS total score and syndrome reductions of 20, 30, 40 and 50%. Remission criteria employed were based on recommendations from Andreasen et al. RESULTS: The average length of stay was 45.6 days (SD 42.7). PANSS total score response rates were found to be 63.9% for the 20% level and were reduced in the following consecutive levels by approximately 15%. Only 10.3% of the patients remitted during a 1-year follow-up period. At least one re-hospitalisation was reported for 43.9% of the subjects. CONCLUSION: Compared to previous randomised and controlled trials, the rates of response and remission are significantly lower. In daily inpatient care, the chronic course of schizophrenia is far commoner than expected from previous reports.

[Recovery and remission in schizophrenia. Results from a naturalistic 2-year follow-up inpatient study]. / Recovery und Remission bei Schizophrenie. Ergebnisse einer naturalistischen 2-Jahres-Katamnesestudie ehemals stationärer Patienten.

INTRODUCTION: Remission in schizophrenia is defined as a period of at least 6 months in which symptom reduction occurs. In comparison, the term recovery is defined to include not only long-term symptomatic improvement but also good psychosocial functioning and improved quality of life. The aim of this naturalistic study is to prospectively investigate all these variables and their interrelationship in a sample of subjects with schizophrenia over a period of two years. METHODS: Seventy-seven subjects were included into the analysis. Criteria of remission for each domain were assessed using the BPRS (brief psychiatric rating scale, symptomatic remission), GAF (global assessment of functioning, functional remission) and the SWN-K (subjective well-being under neuroleptics, remission of subjective well-being). Subjects were considered to have "recovered" if they remitted in all three domains at discharge (t0), one (t1) and two-year (t2) follow-up assessments. RESULTS: Symptomatic and functional remissions were rare and occurred only in 10 % of the subjects at t0, t1 and t2. Approximately one-third of the individuals had remission with a stable quality of life. Correlations between quality of life and functional and symptomatic remissions were weak. None of the subjects met the criteria for recovery. CONCLUSION: Compared to previous studies, the rates of remission and recovery in the current sample were quite low. The contrasting results may be due to the naturalistic characteristics of this sample of initially inpatient subjects while previous studies investigated selected samples of schizophrenic individuals. However, despite their functional and symptomatic impairments, the results also indicate that the schizophrenic subjects have a largely satisfying quality of life.

[Early intervention in alcohol abuse and addiction in general acute care hospitals]. / Frühintervention bei Alkoholmissbrauch und -abhängigkeit im Allgemeinkrankenhaus - Ergebnisse einer Explorationsstudie.

Early intervention has been shown to prevent alcohol-related diseases of the liver, the pancreas, and the gastrointestinal tract, as well as to reduce high blood pressure and the incidence of hospitalizations. At a general hospital, 27 patients were offered addiction counselling, six of whom were successfully referred to an outpatient addiction counsellor. However, prevalence rates of alcohol abuse and addiction were significantly lower than those reported in other studies. Similarly, referrals to addiction counselling were less frequent than in other programmes in which hospital staff had been specifically trained to identify problems of alcohol abuse and addiction and to initiate timely referrals. Intensive training of hospital staff as well as the provision of personal and logistical support at the hospital is crucial in the implementation of early intervention programmes for alcohol abuse and addiction in general hospitals.

Health-related quality of life and pulmonary function in lung cancer patients undergoing medical rehabilitation treatment.

Treatment for lung cancer results in reduced Quality of Life (QoL) and limited lung function are well-known. Yet, there are no results available concerning the interaction of objective lung function tests and QoL parameters for lung cancer patients during in-patient cancer rehabilitation. This is also true for outcome parameters in medical rehabilitation. The aim was to study the impact of lung and cardiopulmonary function on QoL (EORTC-QLQ C-30 and SF-36 Health Survey) and to identify possible outcome parameters for a rehab program. 56 lung cancer patients participated. Inpatient rehabilitation consisted of individual aerobic exercise and physical, psychological, social, educational and recreational components and only led to a gain of QoL by SF-36 Health Survey sub scales "Vitality" and "Mental Health". Lung function parameters improved; yet the correlation between lung function and health-related QoL questionnaires was not significant. Multivariate analysis for groups with high and low performance in lung functioning showed differences in the SF-36 Health Survey "Vitality" and "Mental Health" sub-scales. However, patients with high and low functional performance of the lungs did not differ in their QoL over time. Health-related QoL and pulmonary function therefore seem to be independent dimensions. Thus, for judging the outcome and success of medical rehabilitation of lung cancer patients, both, QoL and pulmonary function have to be taken into account.

[The diagnostic report as an aid for determination of referral to inpatient rehabilitation]. / Der Befundbericht als Entscheidungshilfe für den Zugang zur stationären Rehabilitation.

The investigation analyzes some 206 standardized diagnostic reports submitted by office-practice physicians, demonstrating the role of diagnostic reports in determining access to medical rehabilitation. It is found that the practitioners added no further information about their patients' health status in half of the diagnostic reports given, and no further medical documents in one third. On the other hand, diagnostic reports that included details about the patients' ability to work as well as information about previous treatments resulted to a greater degree in direct award of a medical rehabilitation measure.

[Quality of life: assessment instruments and results]. / Lebensqualität: Erhebungsinstrumente und Ergebnisse.

The article reviews instruments for measuring quality of life which are mainly used for the assessment of psychosocial impact of cancer and tumor illnesses. An early assessment of the psychosocial consequence of illnesses which are carried out during the interviews are given in addition to the questionnaires. Newer, multidimensional data-collections are described in detail.

[The treatment concept at the "Center for Pain Studies" of the Rehabilitation Institute of Chicago.]. / Interdisziplinäre Therapie bei chronischem Schmerz : Das Behandlungskonzept des "Center for Pain Studies" am Rehabilitation Institute of Chicago.

The article describes the interdisciplinary treatment of chronic pain at the Center of Pain Studies (CPS). The CPS is an intergral part of the Rehabilitation Institute in Chicago. An essential part of the program is a 1-day outpatient evaluation in which members of all disciplines take part. A team conference determines the appropriateness of the pain program for each patient accepted for further care at the CPS. In 50% of the patients chronic pain is connected with work-related accidents. General aims of the treatment are to return to productive life, improve emplopyability, increase activity level, improve mobility, apply pain management techniques, and improve coping. The program is monitored by an evaluation/follow-up system. Success criteria of the 6-month follow-up for the years 1987-91, such as less daily downtime in 58-78% of the patients, more time out on weekends in 40-68%, return to work in 50-67% and reduced depression in 37-70%, give an impression of the effectiveness of the pain management program.