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  • 1995-1999  (4)
  • 1870-1879
  • Critically ill  (2)
  • Psychiatry  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Psychosomatische Grundversorgung auf der Grundlage des PLISSIT-Modells Entwicklung und Evaluation einer Weiterbildungskonzeption (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 54-63 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychosomatische Grundversorgung ; Fortbildung ; Hausärzte ; Beratung ; Psychiatrie ; Psychosomatik ; Key words Education ; Training program ; General practioners ; Psychosomatic medicine ; Psychiatry ; Primary care ; Continuous medical education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counceling approach of the „PLISSIT” approach: The GP helps in first step („permission”) the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP’s should develop preliminary strategies for change in the third step („coping strategies”, „symptom management”; „special suggestions”) and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education programm.
    Notes: Zusammenfassung Ausgehend von einer Analyse der Schwächen aktueller Ansätze der psychosomatischen Grundversorgung wird einerseits ein Ansatz vorgestellt, der störungsspezifisch im Rahmen eines Mehrebenenmodells pharmakologische und verbale Intervention aufeinander bezieht. Andererseits werden im Sinne eines zeitökonomisch abgestuften Vorgehens verschiedene Phasen durch das zugrundegelegte PLISSIT-Modell differenziert: In der Permission-Phase geht es um die Akzeptanzvermittlung und Problemanalyse hinsichtlich der vom Patienten geschilderten Beschwerden, in der Phase der „limited information” um die dialogische Erarbeitung eines Störungsmodells und den Aufbau einer aktiven Änderungsmotivation, in der Phase der „special suggestions” erfolgt eine konkrete Anleitung zur Selbstbeobachtung und -protokollierung des Problemverhaltens sowie die Vermittlung von Strategien zum Symptommanagement; in der letzten Phase der „intensive therapy” geht es um die Indikationsstellung und den Motivationsaufbau zur fachärztlichen bzw. fachpsychotherapeutischen Weiterbehandlung. Empirische Ergebnisse zur Evaluation des Weiterbildungskonzeptes an über 200 Teilnehmern werden referiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050400
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Stationäre Behandlung depressiver Patienten Konzeptuelle Überlegungen und Ergebnisse eines Pilotprojekts zur Qualitätssicherung in Baden-Württemberg (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 59-65 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Qualitätssicherung ; Strukturqualität ; Prozeßqualität ; Ergebnisqualität ; Psychiatrie ; Depressive Störungen ; Key words Quality assurance ; Structure quality ; Process quality ; Outcome quality ; Psychiatry ; Depressive disorder
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Quality-assurance activities will become more important in psychiatry during the next few years. In relation to other medical disciplines, some special aspects concerning structure, process and outcome quality as well as practical realization and methodologic aspects must be considered. These specific issues were the focus of a study dealing with the treatment of depressed inpatients. The experiences and results as well as considerations concerning future quality-assurance projects are discussed.
    Notes: Zusammenfassung Qualitätssicherungsmaßnahmen werden in den nächsten Jahren in der Psychiatrie zunehmend an Bedeutung gewinnen. Gegenüber anderen medizinischen Teildisziplinen zeichnen sie sich im Bereich der Psychiatrie durch eine Reihe von Besonderheiten aus und zwar sowohl im Hinblick auf die Struktur-, Prozeß- als auch Ergebnisqualität. Gleiches gilt auch für die Durchführung von Qualitätssicherungsprojekten aufgrund von methodischen Überlegungen. Diese speziellen konzeptuellen sowie methodischen Aspekte wurden versucht, bei der Durchführung eines Pilotprojekts zur stationären Behandlung depressiver Patienten zu berücksichtigen. Über Erfahrungen, Ergebnisse sowie weiterführende Überlegungen wird berichtet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050239
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Relations between the selenium status and the low T3 syndrome after major trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 575-581 
    Details
    ISSN: 1432-1238
    Keywords: Low T3 syndrome ; Selenium ; Deiodination ; Glutathione peroxidase ; Balance study ; Critically ill ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Thyroxine (T4) is deiodinated to triiodothyronine (T3) by the hepatic type I iodothyronine deiodinase, a selenoprotein that is sensitive to selenium (Se) deficiency. After severe injury, T4 deiodination is decreased, leading to the low T3 syndrome. Injury increases free radical production, which inactivates the iodothyronine deiodinase. The aims were to study the Se status after major trauma and to investigate its relation to the low T3 syndrome. Design Preliminary prospective descriptive study. Setting Intensive care unit at a university teaching hospital. Patients and methods 11 patients aged 41±4 years (mean±SEM), with severe multiple injuries (Injury Severity Score 29±2 points). A balance study was performed from day 1 to day 7. Serum and urine samples were collected from the time of admission until day 7, then on days 10, 15, 20, 25 and 30. Nonparametric tests and Pearson's correlation coefficients were used for analysis. Results Cumulated Se losses were 0.88±0.1 μmol/24h. Serum Se was decreased from admission to day 7. T3, free T3, and the T3/T4 ratio were low until day 5, being lowest on day 2; T4 and thyroid stimulating hormone were normal. Serum Se was correlated with T3 (r=0.55,p=0.0001), and with free T3 (r=0.35). Conclusion Se status is altered after trauma, with decreased Se serum levels upon admission to the ICU but with no major Se losses. Se is probably redistributed to the tissues. The correlation between Se and T3, along with the parallel decrease in T4 deiodination, indicates that reduced deiodination might be related to the transient decrease in serum Se.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01708099
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Relations between the selenium status and the low T3 syndrome after major trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 575-581 
    Details
    ISSN: 1432-1238
    Keywords: Key words Low T3 syndrome ; Selenium ; Deiodination ; Glutathione peroxidase ; Balance study ; Critically ill ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Thyroxine (T4) is deiodinated to triiodothyronine (T3) by the hepatic type I iodothyronine deiodinase, a selenoprotein that is sensitive to selenium (Se) deficiency. After severe injury, T4 deiodination is decreased, leading to the low T3 syndrome. Injury increases free radical production, which inactivates the iodothyronine deiodinase. The aims were to study the Se status after major trauma and to investigate its relation to the low T3 syndrome. Design: Preliminary prospective descriptive study. Setting: Intensive care unit at a university teaching hospital. Patients and methods: 11 patients aged 41±4 years (mean±SEM), with severe multiple injuries (Injury Severity Score 29±2 points). A balance study was performed from day 1 to day 7. Serum and urine samples were collected from the time of admission until day 7, then on days 10, 15, 20, 25 and 30. Non-parametric tests and Pearson‘s correlation coefficients were used for analysis. Results: Cumulated Se losses were 0.88±0.1 μmol/24 h. Serum Se was decreased from admission to day 7. T3, free T3, and the T3/T4 ratio were low until day 5, being lowest on day 2; T4 and thyroid stimulating hormone were normal. Serum Se was correlated with T3 (r=0.55, p=0.0001), and with free T3 (r=0.35). Conclusion: Se status is altered after trauma, with decreased Se serum levels upon admission to the ICU but with no major Se losses. Se is probably redistributed to the tissues. The correlation between Se and T3, along with the parallel decrease in T4 deiodination, indicates that reduced deiodination might be related to the transient decrease in serum Se.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01708099
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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