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Biomedical subjects

E Heim

Publications and source records attributed to E Heim.

71 records · Page 4Linked to original sources
PubMedDate not supplied

Coping and psychosocial adaptation: longitudinal effects over time and stages in breast cancer.

OBJECTIVES: This study examined the relationship between coping and psychosocial adaptation in cancer patients over time and across distinct clinical events. METHODS: In a prospective longitudinal study 74 patients with breast cancer were observed for 3 to 5 years at 3- to 6-month intervals. A total of 684 interviews were conducted at different observation points. Three rating scales were used to assess coping and adjustment: first, the Bernese Coping Modes, an observer rating scale devised to elicit 26 coping modes aggregated in this paper as the five Basic Coping Strategies of support, self-control, denial, diverting, and negative-emotional; second, an observer rating scale to ascertain psychosocial adaptation; and third, a self-rating scale as a measure of either emotional distress or well-being. RESULTS: a) When aggregated in illness stages, coping and distress data on the observed clinical time points showed greater variability than time measures alone (analysis of variance (ANOVA) for repeated measures p < .001). b) A significant relationship between the Basic Coping Strategies and psychosocial adaptation was demonstrated using discriminant and correlational analysis. Furthermore, in stage-dependent Pearson r correlations (p < .05 to .001), a clear-cut relationship was found for hospitalization, chemotherapy, and rehabilitation, but not for convalescence and metastasis. c) A positive relationship was demonstrated between psychosocial adaptation and strategies that can be generally categorized as good forms of coping such as support and self-control, and, to a lesser degree, diverting and denial. Conversely, poor coping exerted a negative effect on almost all illness stages and on most criteria of adjustment. CONCLUSIONS: In long-term studies on psychosocial adaptation and coping, stage-related measures should be preferred to time measures alone. The implications of different strategies for the psychological treatment of cancer patients are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

[Coping or adaptive processes in psychosomatic medicine].

In the last decade a new psychological concept was derived from the pre-scientific English term "coping" and introduced into what is known as illness-behaviour. Coping supplements the psychoanalytical defence theory by forming part of the adaption processes in illness and helping to overcome illness as a psychic crisis. The present paper is an attempt to provide a critical analyses of all literature available on the concept of coping. After various examples of a definition of the term, it was shown how coping differs from defence mechanisms, the connection between stress and coping was explained and a comprehensive illness model was presented. Then followed a discussion of the better known forms of coping to date and a brief presentation of fields of scientific research which could benefit from the coping concept.

Adaptation, Psychological↗
PubMedDate not supplied

[Coping with occupational stresses in health professions].

A model of coping with job stressors is presented, whereby the mediating effect of coping always is goal directed. There exists a variety of stressors in health professions which call for flexible adaptation. Results of studies by this author on coping with job stressors in nursing and dentists are presented. Coping strategies of nurses are not always optimal: in factor analysis coping by will and problem solving was followed by social support; less favourable is diversion and compensation by consumption, fatalistic-depressed withdrawal or aggressive acting out. Religions support seems to be especially helpful in a subgroup. Job satisfaction remains high (80% satisfied), with progressive satisfaction going with little stress values, but poor satisfaction with high stress. In the coping process of doctors and dentists there is a better correspondence between stressors and coping strategies. Quite in contrast to the rich literature on stressors there are few studies on coping of healthcare professionals, so that it is difficult to derive general conclusions. Nevertheless, based on qualitative analysis (repertory grid by Kelly) certain typical patterns were elaborated like "manager; denier; pleaser; problem seeker". Finally intervention strategies to improve coping of health professionals are reviewed.

Adaptation, Psychological↗
PubMedDate not supplied

[Coping--status of knowledge in the 90's].

After a brief historical introduction the literature that has appeared on coping since the middle eighties is reviewed. Theoretically Lazarus' concept of transactional coping has been developed with focus on emotions. Antonovsky's salutogenesis is considered to be innovative. Methodology is discussed in view of instruments, observers time and perspective and need for qualitative evaluation. Clinically it must be concluded from the many cross-sectional comparisons that diseases with comparable demands call for similar coping. Only in long-term studies can stage-dependent differences of efficacy be detected. Active, tackling coping based on social and emotional resources and problem-analysis is significantly superior to passive coping with social withdrawal, ruminating, resignation and self-accusation. More recently interest in coping is extended to families and caretakers of patients. It is concluded that more corresponding with stress-research is needed, methodology should be adjusted and in view of important intervention strategies evaluation of efficacy is necessary.

Acquired Immunodeficiency Syndrome↗