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Biomedical subjects

E Heim

Publications and source records attributed to E Heim.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Modification of psychosocial adjustment by terminal disease].

Psychosocial adaption during or after somatic illness is relatively little studied--quite in difference to the better known psychosocial predictors of somatic illness. This study is concerned with a group of 31 female patients who suffered from a terminal vascular disease (primary vascular pulmonary hypertension)--an iatrogenic disease which with high probability is the consequence of a drug for weight reducing (Menocil), prescribed by their family doctors to these moderate overweight middle aged women. Psychosocial adaptions was assessed on a 5-point-scale, including the following dimensions: work-situation, socio-economic conditions, family adaption, social activities. Psychosocial adaption before illness was very good (just 10% below maximal values). Two or three years after illness started, however, there was a highly significant drop in all dimensions (most significant in "work" and "social activities"). To some extent success or failure of psychosocial adaption had a predictive power for the terminal course of this illness. Possible interaction between course of illness and psychosocial adaption is discussed and illustrated. There was also a significant correlation between psychosocial adaption and defense-processes.

Adult↗
PubMed1981

[Consequences of psychotherapeutic research in recent years for general practice].

Psychotherapy research nowadays has become a highly complex field. Its results are presented in 10 hypotheses of which the following are discussed in more details: 1. Indication-stereotype: Variables attractive to the therapist (as "interesting case; nice person; can help him") dominate in a unreflective way those variables characterizing the patient. Those patients called YAVIS (young; attractive; verbal; intelligent; successful) are mostly dealt within uncovering, psychodynamic concepts whereas non-YAVIS-patients are mostly treated with undifferentiated supportive techniques. 2. Of those variables which proofed to be effective, the unspecific factors are superior to the specific, technical factors. 3. Special emphasis is put on side-effects of psychotherapy--long proofed empirically but mostly ignored clinically. 4. Efficacy of psychotherapy as such can no longer be doubted, but its cost-effect-analysis becomes a more and more crucial aspect. The consequences are in favour of short term methods. Strupp has proposed a "Tripartite Model of Psychotherapy", which tries to integrate the needs of the 3 partners involved: patient, therapist and society.

Humans↗
PubMed1978

Defense mechanisms and coping behavior in terminal illness. An overview.

Psychosomatic medicine is increasingly concerned with illness behavior, a concept which includes defense mechanisms and coping styles. An attempt was made to compare defensive processes and social adaptation in a group of 31 patients suffering from a probable terminal illness of iatrogenic origin. The surprising degree of conformity between the defense profiles towards the illness and those towards general life stress was found. Reaction-formation and stoicism were the defense mechanisms most often associated with successful defense. Interdependence of several ego measures such as defense against general life stress, defense against illness and social adaptation could be shown in various evaluations. Surprisingly, however, aggravators of illness turned out to be psychologically more stable than minimizers, a result which is in contrast to behavior in nonterminal illness. Theoretical implications of the results are discussed.

Adaptation, Psychological↗
PubMed1978

[Steps toward a therapeutic community in a psychiatric hospital (author's transl)].

The psychiatric hospital is conceptualized as a social organism with its own development. Every important change or new development follows certain laws. When those steps of phases of development are known their unfolding can be guided more easily. Resistance must be expected and tends to hinder the planned development. There is also a risk of wrong or defective development, endangering the overall goal. The different systematic phases, resistances or risks in changing a psychiatric hospital from a traditional-custodial to a milieu-active institution are summarized in a table. The described milieu therapy is that of a therapeutic community; its conceptualization is briefly discussed. Milieu therapy as a term is at the same time understood in a inclusive and in a complementary way: Inclusive in so far as all therapeutic procedures in a hospital are coordinated via milieu therapy; complementary in the sense that all activities which take place beside the classical therapies (pharmacotherapy; psychotherapy, etc.) are understood as therapeutic activities.

Hospitals, Psychiatric↗
PubMed1975

[Psychological behavior in terminal illnesses].

The physician usually identifies the diagnosis - and implicitly the prognosis - of a terminal illness by its objective signs. The patient, however, recognizes fatal disease through pain and subjective symptoms as well as the reaction of his doctor and family. The overwhelming majority of patients suffering from a fatal disease realize that they will die within a given span of time; but most physicians still believe that frank information of the patient about the fatal character of his disease is irresponsible. The response of the patient to the approach of death is in many ways comparable to the usual adaptation to a psychological stress. As in illness behaviour in general, adaptation depends on personality structure (especially defense mechanisms), the given life situation and the illness. The main goal of psychotherapy in terminal illness is to answer the patient's questions as frankly as possible, without destroying hope for those in need of it. Support for the patient through the different phases of dying will preserve him from human isolation.

Attitude to Death↗