1,720,966 research outputs found
Kommentar I zum Fall „Ablehnung eines Herzunterstützungssystems“: Behandlungsplanung, das gute Leben und die Frage nach der rechten Zeit
No full textFreedom caught in a dilemma
No full textZusammenfassung Zwanghafte und psychotische Symptome treten häufig zeitgleich oder aufeinanderfolgend auf, was verschiedene psychoanalytische Theorien auf mögliche funktionale Zusammenhänge von Zwang und Psychose zurückführen. Dieser Hypothese soll in einer systematischen Einzelfallstudie nachgegangen werden, in der qualitative und quantitative Daten aus der stationären Behandlung einer Patientin mit zwanghaften und paranoid-halluzinatorischen Symptomen gemäß dem Hermeneutic Single-Case Efficacy Design (HSCED) ausgewertet werden. Die Ergebnisse deuten auf einen Zusammenhang beider Symptomgruppen im Sinne einer gemeinsamen oder abwechselnden psychischen Triangulierungsfunktion hin: Zwang und psychotische Symptomatik können anscheinend, für sich genommen oder im Zusammenspiel, eine von der Patientin dringend benötigte dritte Position vorübergehend einführen – wenn auch unter massiven Kompromissen für die Lebensqualität der Patientin. Solche funktionalen Zusammenhänge haben Implikationen für die Beurteilung des Behandlungserfolgs. Wir diskutieren, dass bei solch komplexen Dynamiken in der Psychosentherapie die Notwendigkeit besteht, psychodynamische Konzepte von therapeutischer Entwicklung mit einem Modell von Personal Recovery zusammenzudenken.Abstract Obsessive-compulsive and psychotic symptoms often occur concurrently or in succession. Various psychoanalytic theories attribute this joint occurrence to functional interrelations between compulsion and psychosis. This hypothesis was investigated by means of a systematic single case study. We analyzed qualitative and quantitative data from the inpatient treatment of a young woman with obsessive-compulsive and paranoid hallucinatory symptoms according to the hermeneutic single-case efficacy design (HSCED). The results indicate an interrelationship between the two symptom groups in the sense of a joint or alternating psychological triangulation function: compulsive and psychotic symptoms on their own or in combination can apparently temporarily introduce a third position, which is urgently needed by the patient, even at the cost of massive compromises to the patient’s quality of life. Such functional relationships have implications for the assessment of treatment success. We discuss that in such complex dynamics in the therapy of psychosis there is a need to integrate psychodynamic concepts of therapeutic development into a model of personal recovery.Zusammenfassung Zwanghafte und psychotische Symptome treten häufig zeitgleich oder aufeinanderfolgend auf, was verschiedene psychoanalytische Theorien auf mögliche funktionale Zusammenhänge von Zwang und Psychose zurückführen. Dieser Hypothese soll in einer systematischen Einzelfallstudie nachgegangen werden, in der qualitative und quantitative Daten aus der stationären Behandlung einer Patientin mit zwanghaften und paranoid-halluzinatorischen Symptomen gemäß dem Hermeneutic Single-Case Efficacy Design (HSCED) ausgewertet werden. Die Ergebnisse deuten auf einen Zusammenhang beider Symptomgruppen im Sinne einer gemeinsamen oder abwechselnden psychischen Triangulierungsfunktion hin: Zwang und psychotische Symptomatik können anscheinend, für sich genommen oder im Zusammenspiel, eine von der Patientin dringend benötigte dritte Position vorübergehend einführen – wenn auch unter massiven Kompromissen für die Lebensqualität der Patientin. Solche funktionalen Zusammenhänge haben Implikationen für die Beurteilung des Behandlungserfolgs. Wir diskutieren, dass bei solch komplexen Dynamiken in der Psychosentherapie die Notwendigkeit besteht, psychodynamische Konzepte von therapeutischer Entwicklung mit einem Modell von Personal Recovery zusammenzudenken.Abstract Obsessive-compulsive and psychotic symptoms often occur concurrently or in succession. Various psychoanalytic theories attribute this joint occurrence to functional interrelations between compulsion and psychosis. This hypothesis was investigated by means of a systematic single case study. We analyzed qualitative and quantitative data from the inpatient treatment of a young woman with obsessive-compulsive and paranoid hallucinatory symptoms according to the hermeneutic single-case efficacy design (HSCED). The results indicate an interrelationship between the two symptom groups in the sense of a joint or alternating psychological triangulation function: compulsive and psychotic symptoms on their own or in combination can apparently temporarily introduce a third position, which is urgently needed by the patient, even at the cost of massive compromises to the patient’s quality of life. Such functional relationships have implications for the assessment of treatment success. We discuss that in such complex dynamics in the therapy of psychosis there is a need to integrate psychodynamic concepts of therapeutic development into a model of personal recovery
“That kind of changes things”: a meta-synthesis of the lived experiences of people with chronic heart disease
No full textAbstract Aims To explore the lived experiences of people with chronic heart disease (PCHD). Design Systematic meta-synthesis. Methods Following preregistration on PROSPERO, a systematic literature search was conducted in PubMed, PsycInfo, PsycArticles, and PSYNDEX between February 2023 and March 2024. Articles were assessed for eligibility based on predefined criteria and evaluated for methodological quality using a modified CASP tool. The results of the included primary studies were weighted according to their methodological quality and synthesized using Interpretative Phenomenological Analysis. The reporting adheres to PRISMA and ENTREQ guidelines. Results The analysis of 43 articles revealed an overarching theme: “The broken flow of life.” This theme illustrates the disruption of normalcy, as perceived by patients through distinct dimensions. These dimensions are represented by the four subthemes: (1) I no longer feel safe in my body, (2) Suddenly, I have less of a future, (3) My identity feels shattered, and (4) My disease strains my relationships. Conclusions The findings suggest that PCHD perceive their condition as a profound disruption of normalcy, affecting bodily, relational, and psychological dimensions that extend beyond established HRQOL measures. Implications The findings have direct implications for the assessment of HRQOL in medicine. To adequately evaluate holistic treatments, a deeper understanding of how the disease affects life planning and future perspectives is essential. Consequently, established HRQOL measures may need to be extended both in content and temporal scope to capture these broader impacts
"If You Look Closely, You Have Everything …": Ideas of a Good Life Among Middle-Aged Individuals With Heart Disease: An Interpretative Phenomenological Analysis
No full textHeart disease at an early or middle age is critical, especially when accompanied by an acute cardiac event with or without sudden cardiac arrest (SCA). Owing to this situation, patients describe changes in their health-related quality of life as well as in their future plans and goals. This study examined changes in ideas of a good life due to heart disease treated in an acute hospital. In our study, 16 patients aged 30-59 years were included. Among them, four had SCA, seven myocardial infarction, and five other serious cardiac conditions, such as cardiac arrhythmia. Advanced chronic heart failure was noted in five, and four had implantable cardioverter defibrillators. Phenomenological semi-structured interviews of 50-100 min each were conducted with a purposive sample and analyzed using interpretative phenomenological analysis. The ideas of a good life and changes in future lifestyle following a serious heart disease were reported by patients. These experiences were summarized into five superordinate themes: "My bodily trust is gone," "Simply living a modest life," "Actively shaping my life again," "Being more in contact with relevant people," and "Grateful for the gift of my new life." Living a more modest life and actively shaping life again are two new aspects of the ideas of a good life. Further studies should be conducted in cardiac patients with lower disease burden and young patients with congenital heart disease, with a focus on sex-specific issues
“I No Longer Felt Sick, I Always Felt Free”: Growing Up With Congenital Heart Disease and the Struggle for a Good Life—An Interpretative Phenomenological Analysis
No full textAdvancements in surgical, interventional, and intensive-care medicine have significantly increased the life expectancy of individuals born with congenital heart disease (CHD). As a result, growing numbers of affected children now reach adulthood. Despite medical progress, CHD remains a lifelong condition that influences how individuals perceive and shape their lives. This qualitative study explored ideas of a good life among 14 young adults aged 18–29 years living with CHD. Data were gathered through semi-structured phenomenological interviews and analyzed using interpretative phenomenological analysis. The pursuit of a “normal” life, characterized by equal developmental opportunities compared to peers without CHD, emerged as a central pattern. This experience was reflected in four key themes: “My Whole Life I Have to Fight for Normality,” “Being Treated Normally by Others Is Part of a Good Development,” “Normal Development Includes Lightheartedness,” and “I Need to Stand on My Own Two Feet.” These findings carry important implications for healthcare providers, particularly regarding the promotion of normality and autonomy among individuals with CHD. Patients should be supported in adopting this perspective—as should their parents, since they significantly shape the lives and well-being of patients during their formative years, playing a crucial role in laying the foundation for healthy development and a good life. At the same time, healthcare providers should avoid paternalistic attitudes that risk replicating patterns of parental overprotection. Finally, our findings point to the importance of future research exploring how gender and cultural background shape ideas of a good life with CHD.German Research Foundation 50110000165
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Promoting well-being in later life - a qualitative analysis of focus groups and individual interviews with older adults in Germany
No full textAbstract Background Medical decision-making for older adults is becoming increasingly complex due to chronic conditions, multimorbidity, and expanding medical options in old age. As the aging population grows, medical decision-making in old age will become an increasingly common issue. This study explores older adults’ perspectives on well-being and medical decision-making to inform patient-centered care practices in family medicine. Methods A qualitative study was conducted in Germany between August 2022 and August 2023, involving 35 participants aged 75 and older. Six focus group discussions and eight individual interviews were carried out. Focus groups were presented with two patient case histories involving medical decision dilemmas, while individual interviews used a guideline on personal history and experiences of medical care. Audio recordings were transcribed and analyzed using qualitative content analysis with MAXQDA software. Results Three main categories emerged as central to well-being in late life: autonomy, physical and cognitive abilities, and social integration. Autonomy was identified as crucial, encompassing independent decision-making and adaptation to changing circumstances. Physical and cognitive abilities, particularly mobility, were considered essential for maintaining autonomy. Participants demonstrated different attitudes toward medical intervention, with some taking significant risks to maintain mobility and others taking a more adaptive approach to age-related limitations. Social integration emerged as a key to well-being, with participants emphasizing the importance of maintaining social connections and engaging in meaningful activities. Family practitioners were recognized as playing a vital role in providing holistic, patient-centered geriatric care. Conclusions The study highlights the importance of understanding older adults’ perspectives on well-being to inform medical decision-making. Family practitioners can support the evolving needs of older adults by addressing both medical and psychosocial issues, facilitating social engagement, and building long-term relationships with patients. This approach can contribute to improved well-being and more patient-centered care practices in geriatric medicine. German Clinical Trials Register DRKS00027076, 05/11/2021
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