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Biomedical subjects

M Eisemann

Publications and source records attributed to M Eisemann.

At least 37 records · Page 2Linked to original sources
PubMed1998

Childhood experiences and personality traits in patients with motor conversion symptoms.

A total of 30 patients with newly diagnosed motor conversion disorder were consecutively investigated by means of a Swedish self-rating inventory designed to assess perceived parental rearing practices (EMBU), and the Karolinska Scale of Personality (KSP). DSM Axis I and II psychopathology was assessed using a Structured Clinical Interview (SCID), and comparisons were made with 30 age- and sex-matched in-patients with motor symptoms due to a neurological disorder. Depression, the presence of a personality disorder and also poor schooling proved to be significantly associated with motor conversion disorder. The index patients perceived a high degree of parental rejection as well as low levels of affection and emotional warmth during childhood, but contrary to most previous studies, childhood physical and/or sexual abuse was not found to be associated with motor conversion disorder.

Adolescent↗
PubMed1998

Predictive factors for the outcome of a multidisciplinary pain rehabilitation programme on sick-leave and life satisfaction in patients with whiplash trauma and other myofascial pain: a follow-up study.

OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation programme on sick-leave, coping resources and life satisfaction in whiplash patients and other pain patients. SUBJECTS: Forty patients suffering from symptoms after whiplash trauma and 33 patients with musculoskeletal pain in the neck or back were recruited for this study. Ninety-seven consecutive patients admitted to the Department of Neurosurgery with cervical pain, cervical disc herniation or symptomatic spondylosis served as a control group. RESULTS: Decreased coping resources and poorer life satisfaction were observed for whiplash subjects at the beginning of the rehabilitation programme compared to the control group from the Department of Neurosurgery. After the rehabilitation period 49% of the patients had improved their coping resources totalling to 63% after 2 years. At that follow-up 46% of patients had increased their life satisfaction. Furthermore, the group with whiplash injury showed a significant increase in sick absenteeism whereas the group without whiplash trauma had decreased their sick-leave. Eighty-eight per cent of the subjects could be correctly classified according to their vocational outcome by means of discriminant function. The elapse of time since working, low life satisfaction, lack of increase in coping resources during the rehabilitation programme, ethnic origin of the patient and living in the countryside predicted poor vocational outcome. CONCLUSION: Our results suggest variables from the social environment and coping resources as useful predictors for treatment outcome.

Adaptation, Psychological↗
PubMed1998

[Decisions and attitudes of nurses in the care of chronically ill elderly patients].

Data of 182 nurses from two teaching hospitals regarding their attitudes to determinants of the decision-making process in elderly patients in general and decisions in the treatment of an moderately demented, incompetent elderly man with a potentially reversible life-threatening illness using a scenario were analyzed. 68.1 percent complied to the patient's will when an advance directive existed. One fifth reported that the patient's directive was supportive for the decision. The more important the wishes of the patients were evaluated, the more frequent a less aggressive treatment choice was preferred and the less frequent the decision was for resuscitation in the case of a cardiac arrest. The increased use of advance directives is desirable to reduce the number of conflicts in decision-making for healthcare professionals and to reduce the patients' fears of over- or undertreatment and for increasing their possibilities of self-determination. A more intensive integration of topics such as death and dying, treatment of the chronically ill elderly as well as possibilities and limitations of patient directives and their use in the education of nurses is required.

Advance Directives↗
PubMed1997

[Physicians' attitude in the treatment of incompetent patients. Comparison between East and West Germany].

BACKGROUND: Health care decision-making in incompetent severely ill patients presents a number of difficult medical, ethical and legal problems for the physician. The factors and the degree to which various factors contribute to such decisions have rarely been investigated. SUBJECTS AND METHODS: 310 physicians from the state of Baden-Württernberg (Western Germany) and the state of Mecklenburg (eastern Germany) were asked by means of a questionnaire to rate the importance of eight factors in their health care decisions in the elderly. RESULTS: Both, ethical concerns and patients' wishes emerged as the most important factors for decisions in both subsamples. However, significant differences in the degree to which the factors hospital costs, patients' and family wishes, the level of dementia and the patients' age contribute to their decisions could be found between the answers of the doctors of the two lands. CONCLUSIONS: The socialization of the physicians in different health care and social systems seems to be one of the most important reasons for different health care decisions in old and incompetent patients.

Adult↗
PubMed1997

Sibship size, sibship position, parental rearing and psychopathological manifestations in adults: preliminary analysis.

Almost all investigations concerning the relationships between sibship size, sibship position and psychiatric disorders addressed more formal aspects, i.e. frequency and position, with contradictory and inconsistent results. Analyses considering sibship size and birth order as mediating factors between parental rearing and psychopathological manifestations in adults are lacking. The present results of an investigation of 1,013 psychiatric inpatients and 251 healthy volunteers support a systematic association between sibship size and parental rearing, mainly in terms of a reversed relationship between emotional warmth, overprotection and number of siblings. An excess of psychiatric patients in the middle position of a sibling seems to be related to specific unfavourable rearing patterns. A validation of our preliminary results would be required in terms of preventive measures for children of risk populations.

Adult↗
PubMed1997

Predictive factors of the outcome of primary surgical treatment of stress incontinence in women.

Forty-five women with stress incontinence (mean age 50 years) scheduled for surgical treatment randomized either to retropubic urethrocystopexy or to pubococcygeal repair were prospectively studied. Fifty healthy women were used as a reference group. No difference emerged concerning the outcome for these two surgical techniques in terms of success rate. Consequently, the subjects were treated as one group. The aim of the study was to test for predictive factors of the outcome of surgical treatment. Age of the patient, duration of stress incontinence, parity, personality, psychological and social factors were investigated. The outcome of surgical treatment was estimated both subjectively and objectively (pad test). The women were classified as cured or improved/failure. There was an 80% concordance between subjective and objective methods. In the stress incontinent women who were improved/failure one year after surgery, a high degree of neuroticism, low degree of extraversion, high degree of somatic anxiety, psychic anxiety, psychasthenia and suspicion was observed compared to the cured women. Furthermore, the improved/failure women had a lower level of social integration, in terms of loneliness compared to the cured women. Our findings point to the need of psychosocial support and care in addition to the medical treatment. According to a stepwise logistic regression analysis three variables have been found of importance as predictors of the outcome of the surgical treatment: duration of stress incontinence, neuroticism and age of patient.

Adult↗
PubMed1997

Personality differences between endometrial and cervical cancer patients in relation to sexual behavior.

Possible differences in personality were investigated in a sample of endometrial (n = 30) and cervical (n = 30) cancer patients and related to sexual behavior. The assessments were based on the Karolinska Scales of Personality (KSP) and semistructured interviews. The endometrial group reported both a higher age at sexual debut and a lower number of sexual partners whereas the corresponding figures for the cervical group were within the range of representative data from the general population. Strikingly, numerous significant correlations between personality characteristics and behavioral aspects appeared in the cervical group. In a discriminant analysis between the two cancer groups, verbal aggression, number of sexual partners, irritability, use of alcohol, age at sexual debut, impulsivity and social desirability appeared to be the most powerful variables. In view of the similarity of cervical cancer women in terms of personality and sexual behavior to normative data the elaboration of adequate and large-scale preventive measures aimed at young age groups is warranted.

Adult↗
PubMed1997

Parental rearing: a comparison between juvenile delinquents and controls in Russia.

Since parental maltreatment is commonly reported in studies of juvenile delinquency, our study aimed at a systematic investigation of perceived parental rearing by means of EMBU questionnaire in young male criminals (N = 190) compared to a matched control group (N = 120) in Russia. The results revealed significant differences between delinquents and non-delinquents in terms of the experience of more rejection, abuse, punishment and lack of emotional warmth in the former group. It became obvious that many of the differences were gender-specific, suggesting the crucial role of the fathers in the rearing practices towards their offsprings. The necessity of further study on the interrelationship between family variables and environmental correlates in an interactional model of delinquency is pointed out.

Adolescent↗
PubMed1997

Personality traits in women with endometrial or cervical cancer.

The objective of the study was to describe the personality characteristics of women with endometrial (n = 30) or cervical cancer (n = 30) and to test the hypothesis of diagnosis-specific personality profiles. The Karolinska Scales of Personality were administered at the first interview with the women before the initiation of treatment. Significant differences occurred both between the two clinical groups and in comparisons with healthy controls. Whereas the personality profile of the cervical group was almost identical to the controls, the endometrial group scored significantly lower on aggression scales and higher on social desirability and socialization. The findings of a normal personality profile in cervical cancer patients allow us to abandon some of the existing misconceptions and encourage us to consider personality factors in the management of those patients.

Adult↗
PubMed1996

Social adjustment and spouse relationships among women with stress incontinence before and after surgical treatment.

Forty-five women with stress urinary incontinence (SUI) and their partners have been interviewed three months before and one year after surgical treatment to investigate the social consequences of their impairment. One year after surgery 76% of the women reported that they were cured (group A, n = 34) and 24% that they were improved (group B, n = 11). The cured women were significantly younger than the improved women. The duration of urinary leakage before the operation was significantly shorter in group A than in group B. One year post surgery group A reported a significantly decrease in impediments to exert certain tasks due to urine leakage. As concerns leisure time, group A reported a higher level of overall activities before surgery than group B, whereas postsurgery both groups obtained about the same level of activities. Regarding social support, no differences between the groups occurred as concerns attachment. Furthermore, group A women showed a significantly higher degree of adequacy of social integration compared with group B. The majority of the couples could openly discuss sexual matters with their partners and were satisfied with their sexual life. More than half of the interviewed men reported an increase in sexual desire one year after their partners operation. Whereas about every third woman in both groups reported an increase in sexual desire. However, the frequency of intercourse did not change in any groups. In conclusion, this study underlines the importance of social factors in the assessment of the consequences of stress urinary incontinence and its treatment.

Adult↗
PubMed1996

Perceived parental rearing behaviour in patients with a schizophrenic disorder and its relationship to aspects of the course of the illness.

A total of 57 patients of both sexes (27 women and 30 men) with a definite diagnosis of a schizophrenic disorder completed the EMBU, a Swedish instrument designed to assess the experience of parental behaviour, that has been extensively used in cross-national studies. As in previous studies in different patient populations, three factors, 'rejection', 'emotional warmth' and 'overprotection', have been taken into account. The results obtained in the patient group were compared with those obtained in a control sample of healthy Swedish subjects. Schizophrenic patients rated both parents higher than controls on the factor 'rejection', and rated their mothers lower on the factor 'emotional warmth'. No correlation was found between EMBU score and age at the first hospitalization, or number of rehospitalizations within 1 year after discharge at the index episode. The present results cross-validate those obtained by other authors in other cultural settings, and suggest that negative experiences of parental rearing might be an important factor contributing to the development of 'vulnerability' in a person who will subsequently develop a schizophrenic disorder.

Adult↗
PubMed1994

Perception of spouse in relation to perception of self by semantic differentials in depressed patients and their spouses.

Several studies have shown correlations between personality types and affective disorders. To investigate the influence on personality assessment of the reporting individual's own schemata according to the cognitive theory of depression, we used an instrument of 29 items of semantic differentials. We obtained responses from 45 patients (18 men, 27 women) upon their recovery and from their spouses. Each of these 90 individuals indicated self-perception on one copy and his or her perception of spouse on another. Factor analysis yielded four factors. Self-perception and perception by spouse were significantly positively correlated for all these factors for the patients and their spouses, indicating lack of schemata influence. Anxiety scores were higher for patients and for women. There was negative correlation for extroversion within couples. Male (but not female) patients showed a negative correlation with their spouses for anxiety.

Adult↗
PubMed1994

Personality characteristics of stress incontinent women: a pilot study.

Personality traits were assessed by means of the Karolinska Scale of Personality (KSP) and the Eysenck Personality Inventory (EPI) in 45 genuine stress incontinent women and compared with a reference group of continent women in order to investigate the possible impact of this chronic condition on the personality. Women with stress incontinence of long duration scored significantly higher than controls on the KSP scales somatic anxiety, psychic anxiety, psychasthenia and suspicion and on the EPI lie-scale. These findings point to the importance of personality factors in chronic conditions such as urinary incontinence.

Adult↗
PubMed1993

Discriminative features of alcoholics classified according to family history.

By means of discriminant analysis, the frequently proposed distinction of alcoholics according to family history of alcoholism was tested. The most powerful discriminative factors were dysfunctional attitudes, some particular personality characteristics, and perceived parental rearing patterns. The results lend support to the assumption to regard alcoholics with a positive family history of alcoholism as a homogenous subgroup characterized by a specific etiopathogenesis.

Adult↗
PubMed1993

Muscle endurance, muscle tension and personality traits in patients with muscle or joint pain--a pilot study.

OBJECTIVE: To investigate the relationships between personality traits, depressive symptomatology and continuous muscle tension. METHODS: These were investigated by means of a visual analog scale and the presence of continuous muscle tension during repeated isokinetic shoulder flexions in patients with muscle or joint pain and controls. RESULTS: A significantly higher level of muscle tension between contractions was found in the patient groups in painful muscles. The patients with primary fibromyalgia and trapezius myalgia differed in degree of depressive symptomatology compared to controls. CONCLUSION: Inhibition of aggression correlated significantly with the tension level between contractions during the isokinetic test indicating interaction between psychological and somatic factors.

Adult↗
PubMed1992

Determinants of recall of parental rearing behavior. The influence of age or loss of parents by separation or death.

In a study of 562 psychiatric inpatients and 251 healthy controls, relationships between age of proband and related life events (divorce of parents, death of a parent) and the perceived parental rearing have been investigated. The inverse relationships obtained could be explained by the higher number of divorced parents among younger subjects with negatively experienced parental rearing practices on the one hand and an idealization of the parents who had died on the other hand. In psychiatric patients these relationships and differences were more pronounced pointing to the importance of parental rearing as a vulnerability factor for mental problems during adulthood. The necessity to control for age in studies of perceived parental rearing became obvious by the present results.

Adult↗
PubMed1991

Factors affecting physicians' decisions on caring for an incompetent elderly patient: an international study.

OBJECTIVES: To determine what treatment decisions physicians will make when faced with a hypothetical incompetent elderly patient with life-threatening gastrointestinal bleeding and to examine the relative importance of physician characteristics and factors (legal and ethical concerns, hospital costs, level of dementia, patient's age, physician's religion, patient's wishes and family's wishes) in making those decisions. DESIGN: Survey. SETTING: Family practice, medical and geriatrics rounds in academic medical centres and community hospitals in seven countries. PARTICIPANTS: Physicians who regularly cared for incompetent elderly patients. MAIN OUTCOME MEASURES: A self-administered questionnaire describing the elderly patient. Respondents were asked to choose one of four levels of care and to identify the level of importance factors had in making that decision. Older physicians, those less concerned about litigation, those for whom the level of dementia was important and those for whom the patient's age was important were expected to give less aggressive care than the other physicians. MAIN RESULTS: Supportive care was chosen by 8.1% of the respondents, limited therapeutic care by 41.5%, maximum therapeutic care without admission to the intensive care unit (ICU) by 32.2% and maximum care with admission to the ICU by 18.2%. The patient's wishes were reported by 91.0% as being extremely or very important in choosing the treatment. Stepwise logistic regression analysis revealed that the following variables independently predicted the level of treatment: level of dementia, country of residence, duration of practice, legal concerns, patient's age and ethical concerns. These factors were significantly correlated with the physicians' treatment choices (p less than 0.05). CONCLUSIONS: The importance that the physicians placed on the level of dementia was the strongest predictor of the level of care that would be provided. A societal consensus on the influence of cognitive function on the appropriate level of care as well as training of physicians in ethical issues are required.

Adult↗