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Biomedical subjects

R Kilian

Publications and source records attributed to R Kilian.

35 records · Page 2Linked to original sources
PubMed2001

[German adaptation of the client sociodemographic and service receipt inventory - an instrument for the cost of mental health care].

AIM: Psychiatric health services research has to consider health economic points of view more than before as a result of the present-day financial problems in our health care system. Therefore an instrument was developed, which is suitable for the evaluation of cost of mental health care in Germany. METHOD: The Client Sociodemographic and Service Receipt Inventory (CSSRI-EU), which was developed in the UK, was adapted to the German situation and for the first time used in a cost-effectiveness-analysis of mental health care. The adaptation process of the instrument and the practical application are explained and pros and cons considered. RESULTS: The German adaptation of the CSSRI-EU has proven effective in practical application. The instrument offers feasible solutions for many problems with the cost of mental health care. The instrument can be used for the calculation of direct and indirect costs and gives information about service utilization and medication profiles of the clients. CONCLUSION: The German adaptation of the CSSRI-EU is a feasible instrument for the evaluation of the cost of mental health care in Germany.

Cost-Benefit Analysis↗
PubMed2001

[The German adaptation of the Verona Service Satisfaction Scale: an instrument for patients' satisfaction with mental health care].

UNLABELLED: The German Adaptation of the Verona Service Satisfaction Scale: An Instrument for Patients' Satisfaction with Mental Health Care. AIM: Measuring effectiveness and quality of care became an important topic in psychiatry. Considering that objective criteria were not sufficient in the past, the subjective perspective gained growing interest. Client satisfaction is an important variable to evaluate psychiatric care. Patient satisfaction can influence treatment outcome as well as it determines the psychiatric system itself. METHOD: The Italian original version of the Verona Service Satisfaction Scale (VSSS-54) was translated and adapted to the German language. The instrument has been tested in the project "Cost-effectiveness of psychiatric service systems". The process of development, the psychometric testing and the practical application of the German version will be presented in this paper. Additional advantages and disadvantages are discussed. RESULTS: As psychometric properties of the instrument correspond to conventional standards, they are comparable with the results of an international study. The drop out of items cannot be controlled, therefore analysing the data is difficult. CONCLUSION: Although the VSSS shows various methodological limitations, it is at the moment an appropriate instrument for measuring patient satisfaction in the German language.

Cost-Benefit Analysis↗
PubMed2001

[The assessment of burden on relatives of mentally ill people: the German version of the involvement evaluation questionnaire (IEQ-EU)].

AIMS: The German Version of the Involvement Evaluation Questionnaire (IEQ-EU), developed for the assessment of burden on relatives of mentally ill people will be presented. Also the results of the reliability analysis will be presented. METHOD: After translation and adaptation of the Dutch version of the IEQ-EU into German, the instrument was tested in the study "Cost-effectiveness of psychiatric service systems". RESULTS: The internal consistency was tested on a sub-sample of 138 relatives and the Test-Retest-Reliability on a sub-sample of 37 relatives. The internal consistency (Cronbachs alpha) is moderate or good and slightly lower in comparison with the other European versions. With the exception of one subscale the results for the intraclass correlation coefficient are equal to the European versions. CONCLUSIONS: The IEQ-EU is an instrument with moderate or good psychometric properties. It covers all important domains, is easy to understand and not time-consuming.

Caregivers↗
PubMed2001

[The analysis of the cost structures of the treatment of schizophrenia by means of standardized assessment instruments].

OBJECTIVE: Aims of the study are the analysis oft the structures and influence factors causing direct costs of schizophrenic diseases by means of international standardized assessment instruments. METHOD: Annual costs of treatment were assessed for a sample of 258 patients with the diagnosis of schizophrenia (ICD-10 F20) by means of the German version of the CSSRI. For the analysis of cost variance a regression model was computed using functional level (GAF), symptoms (BPRS 4.0), needs for care (CAN), service satisfaction (VSSS) and subjective quality of life (LQoLP) as predictors. RESULTS: The average yearly treatment costs for the study sample were 12 726,- DM. Costs for sheltered accommodation and for psychiatric inpatient treatment were found to be the largest elements of the entire costs followed by the costs for ambulant medications. Results of the regression analysis show that illness history, the severity of symptoms and the need for care explain the greatest proportion of variance. CONCLUSIONS: The standardized instruments developed in the project enable a systematic and international comparable assessment of the costs in the treatment of schizophrenic diseases. Furthermore the instruments allow to explain 38 % of the cost variance. The impact of the severity of symptoms under statistical control of the functional impairment and the needs for care suggests that an effective reduction of symptoms could lead to savings in the entire treatment costs. However, the great influence of the illness history and, irrespective of the functional impairment, the need for care show that the possibilities for cost savings in the treatment of schizophrenia are generally low.

Adolescent↗
PubMed2001

Quality of life--as defined by schizophrenic patients and psychiatrists.

The aim of the study is to explore what schizophrenic patients understand by quality of life and what psychiatrists think quality of life may be like for schizophrenic patients. A survey was carried out among schizophrenic patients and psychiatrists from the whole of Germany. There are similarities and differences between the two: while both schizophrenic patients and psychiatrists recognised the importance of work, social relationships, family and independence for quality of life, patients thought about it more in terms of standard of living and lifestyle, whereas the psychiatrists' concept of quality of life was more illness-oriented encompassing the absence of handicaps and disabilities due to the illness and emphasising the importance of appropriate professional help and self-help. In order to facilitate the dialogue between psychiatrists and patients it is important to be aware of these differences.

Adult↗
PubMed2000

[Standardized documentation system for the complementary sector of psychiatric care. Development and trial in Saxony].

The necessity for a standardized documentation system for the complementary sector of psychiatric care is pointed out, and the goals and requirements to be met are debated. The test-version of such a documentation system (abbrev. BADO-K) is shown. It consists of modules for the assessment of client-centered data, and for the documentation of the treatment process in various facilities. Furthermore, a module of questionnaires and instruments for assessing outcome variables (e.g. quality of life) is integrated. The principles for using the paper-pencil-version and the EDP-version are outlined and discussed with regard to the legal regulations concerning the protection of personal data. Finally, possibilities and limitations of the presented documentation system are discussed. It is argued that the BADO-K is an useful instrument for evaluating the process and outcome of community psychiatric care.

Community Mental Health Services↗
PubMed1999

[Development of a standardized documentation system for outpatient non-hospital based psychiatric care].

An instrument documenting the care process in in-patient psychiatric services within the German mental health care system has been developed (BADO). This paper reports on the development of a documentation system for all non-hospital based mental health services (day centres, community mental health centres, supported accommodation, work rehabilitation services for general adult psychiatric patients and people with substance misuse). The development process and the instrument (PC and paper and pencil version) are described. The documentation system (BADO-K) could be an important prerequisite for quality assurance in non-hospital based mental health care, and its structure ensures compatibility with the corresponding hospital-based documentation system.

Adult↗
PubMed1998

Identification and characterization of photosystem II chlorophyll a/b binding proteins in Marchantia polymorpha L.

The minor chlorophyll a/b-binding (CAB) proteins of the liverwort Marchantia polymorpha L. were investigated in order to compare the antenna organization and the light-acclimation potential in lower and higher plants. Homologues to the minor CAB proteins CP24, CP26 and CP29 were identified by the following criteria: enrichment in photosystem II preparations, immunological cross-reactivities, spectroscopic properties and protein-fragment amino acid sequences. The high violaxanthin content of the minor CAB proteins in M. polymorpha indicates that their role in protection from high light is comparable in lower and higher plants. Considerably more-alkaline isoelectric points are found for the minor CAB proteins of M. polymorpha than for their higher-plant counterparts. This might be due to a higher content of basic amino acids. While the N-terminal sequence of angiosperm CP29 contains a threonine that becomes phosphorylated during cold stress, this amino acid is substituted by valine in M. polymorpha. Therefore, the regulatory properties of this protein could differ in lower and higher plants.

Amino Acid Sequence↗
PubMed1998

["Out of the picture"--self-evaluation of the occupational status of chronic schizophrenic patients in united Germany].

PURPOSE: This study is based of the documentation of drastic changes in the vocational life of chronically schizophrenic individuals in the New German Länder. With the political and economic transition since 1989, the employment rate of those suffering from chronic schizophrenia dropped from 50% to 7%. Currently most of them receive a disability pension. METHOD: Using a qualitative study design, we addressed the question as to what extent the disability pension can substitute for occupation of those in question. 45 chronically schizophrenic patients who are currently in outpatient treatment were interviewed to understand the role of work and disability pension in their lives. RESULTS: Positive and negative aspects of work and disability pension and their interaction as seen by the participants in our study are described. In a life of discontinuity disability pension offers a security which most of our interviewees would not like to give up. Other needs, however, especially the need for social integration, are not met by disability pension. A part-time job beyond sheltered facilities would offer them the possibility to benefit from the positive psycho-social function of work without challenging their security. Implications for vocational rehabilitation are discussed.

Adult↗
PubMed1995

[Can quality of life be measured? Problems of quantitative and possibilities for qualitative assessment of quality of life in psychiatry].

In a critical review of the theoretical background and recent empirical results of quality of life research in psychiatry the problems of a onesided quantitative methodological orientation will be discussed. For the surmounting of the theoretical difficulties a dynamic model of subjective quality of life in psychiatry will be presented and according to this model the necessity of a combination of quantitative and qualitative research methods will be suggested.

Adaptation, Psychological↗
PubMedDate not supplied

Quality of life in psychiatry as an ethical duty: from the clinical to the societal perspective.

It is the aim of this paper to discuss the ethical roots of the concept of quality of life and the historical background of its introduction into mental health service evaluation research. It will be argued that the original broad meaning of the quality of life concept has been brought closely in line with the clinical view, neglecting the ethical and the societal dimensions of this concept. In conclusion, expansion of the scope of quality of life research in psychiatry from a clinical to a societal perspective will be suggested. On the basis of this argument, seven research questions concerning the most important nonclinical factors influencing the quality of life of mentally ill patients will be formulated.

Chronic Disease↗