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  • 1
    Electronic Resource
    Electronic Resource
    Long-Term Morbidity Following Axillary Dissection in Breast Cancer Patients – Clinical Assessment, Significance for Life Quality and the Impact of Demographic, Oncologic and Therapeutic Factors (2000)
    Springer
    Breast cancer research and treatment 64 (2000), S. 275-286 
    Details
    ISSN: 1573-7217
    Keywords: axillary dissection ; breast cancer ; morbidity ; quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective. This study describes in detail the surgery-related symptoms following axillary lymph node dissection in breast cancer patients and considers both their significance for long term quality of life and the impact of possible influencing factors. Material and methods: Three hundred and ninety six patients were studied retrospectively using a self-report questionnaire and a clinical examination. The symptoms, numbness, pain, edema, arm strength and mobility were evaluated. The subjective assessment of the degree of symptom intensity was compared with objective measurements. The extent of surgery (number of resected nodes, level of dissection) as well as the influence of demographic, oncologic and adjuvant measures (age, time interval, number of involved nodes, chemotherapy) were evaluated. Results. Shoulder-arm morbidity and fear of cancer recurrence were the most important long-term sources of distress following breast cancer surgery in our study population. Demographic, oncologic and therapeutic measures including the extent of surgery had no influence on long-term morbidity. The intensity of all evaluated symptoms was reported to be more severe in patients' subjective statements than in the results of clinical assessment. Conclusion. Shoulder-arm morbidity following axillary dissection is a frustrating polysymptomatic disease that seems to be relatively unaffected by therapeutic measures. The surgical trauma necessary for adequate tumor staging (removal of 10 lymph nodes) seems decisive for the postsurgery syndrome following axillary dissection. For node-positive patients complete axillary clearing may improve tumor control without worsening long-term-morbidity. New techniques, such as the sentinel-node-biopsy, that selects patients with negative axillary status while preserving the integrity of axillary structures, may improve the overall morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026564723698
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  • 2
    Electronic Resource
    Electronic Resource
    Leitfaden zur psychodynamisch diagnostischen Untersuchung (1996)
    Springer
    Psychotherapeut 41 (1996), S. 297-304 
    Details
    ISSN: 0935-6185
    Keywords: Schlüsselwörter Psychodynamische Diagnostik ; psychoanalytische Interviewtechnik ; OPD ; ICD 10 ; Key words Psychoanalytic assessment interview ; Psychodynamic assessment interview ; Operationalized psychodynamic diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Psychology , Medicine
    Description / Table of Contents: Summary On the basis of existing models for psychodynamic diagnostic evaluation and psychoanalytic interview technique and of the theoretical concepts of the 5 axes of the OPD diagnosis, a new type of the psychodynamic assessment interview is presented. The examination is structured in 5 phases: the opening scene, exploration of specific examples for relationships, exploration of experience of self and others, of therapy motivation, and finally clarifying the preconditions for treatment and the ability for insight. The syndrome diagnosis according to ICD 10 is completed in a final phase. This psychodynamic-diagnostic assessment interview is recommended, apart from the use for OPD diagnosis, for use a clinical instrument.
    Notes: Zusammenfassung Auf der Grundlage der bisherigen Modelle zur psychodynamischen Diagnostik und der psychoanalytischen Interviewtechnik sowie den theoretischen Konzepten der fünf Achsen der OPD-Diagnostik wird eine psychodynamisch-diagnostische Untersuchung konzeptualisiert. Die Untersuchung ist in fünf Phasen strukturiert: Eröffnung, Ermittlung von Beziehungsepisoden, von Selbsterleben, von Objekterleben und der Psychotherapiemotivation sowie Behandlungsvoraussetzungen und Einsichtsfähigkeit. Die syndromale Diagnostik nach ICD 10 wird in einer abschließenden Phase ermittelt. Die entwickelte psychodynamisch-diagnostische Untersuchung kann als Erstinterview oder auch in späteren Phasen eingesetzt werden. Sie wird über die OPD-Diagnostik hinaus auch zur klinischen Anwendung empfohlen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002780050038
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    Paper (German National Licenses)
    Fulltext
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