A heightened sensitivity towards negative emotional stimuli has been described for Borderline Personality Disorder (BPD). We investigated whether a faster and more accurate detection of negatively valent information in BPD can be confirmed by means of a visual search task which required subjects to detect a face with an incongruent emotional expression within a crowd of neutral faces. Twenty eight BPD patients and 28 nonpatients were asked to indicate whether a set of schematic neutral faces (3 × 3, 4 × 4 matrices) contained a happy or an angry face. Besides valence, the intensity of the target's emotion was varied in two steps. BPD patients and nonpatients both demonstrated an anger-superiority effect. However, no higher sensitivity towards negative stimuli was observed in BPD compared to nonpatients. BPD patients seem to rely to a stronger extent on controlled, i.e., serial, attention demanding processes when searching more subtle social-emotional information with positive valence.
ZusammenfassungEine bedürfnisorientierte psychoonkologische Unterstützung für Frauen, die an Brustkrebs erkrankt sind, ist v. a. in strukturschwachen Gebieten nicht genügend vorhanden. Moderne telemedizinische und webbasierte Angebote (eHealth) können einen wichtigen Mehrwert in der psychoonkologischen Versorgung darstellen, da sie im Rahmen des Selbstmanagements unabhängig von personellen Ressourcen, Zeit und Ort verfügbar sind. Bisher fehlen solche supportive psychoonkologische Angebote weitestgehend im deutschsprachigen Raum. Aus diesem Grund wurde ein psychoonkologisches Online-Programm entwickelt. Inhalte für die zeitgemäße webbasierte, bedürfnisorientierte, psychoonkologische Intervention wurden aus Literatur und eigenen Vorstudien entwickelt. Ein Manual für ein Skills- und Achtsamkeitstraining (Make It Training- Mindfulness and skills based distress reduction training in oncology) im Websetting wurde entworfen, programmiert und elektronisch umgesetzt. Diese Intervention beinhaltet insgesamt acht krankheitsbezogene Sitzungen mit Lehrvideos, Audiodateien, interaktiven Arbeitsblättern, persönlicher Skillsbox sowie daraus entstehendem Abschlussmaterial nach jeder Sitzung. Die hier vorgestellten Bausteine zur Psychoedukation und Vermittlung von verhaltenstherapeutischen Skills zu den Themen Emotionsmanagement, Ressourcen, Stressmanagement und Selbstzuwendung, sowie ein fortlaufendes Achtsamkeitsmodul wurden entwickelt. Eine Akzeptanzüberprüfung (N=35) ergab hohe Werte für Akzeptanz und Zufriedenheit seitens der Patientinnen. 87% der Patientinnen würden anderen betroffenen Frauen das Make It Training weiterempfehlen. Mit dem Make It Training steht ein Programm zur Verfügung, das effektive Bewältigungsstrategien und Fertigkeiten im Umgang mit psychischen Belastungen und Anforderungen, die durch eine Krebserkrankung entstehen, vermittelt. Das webbasierte psychoonkologische Selbstmanagementprogramm kann die Versorgung in einem gestuften Ansatz nicht zuletzt in strukturschwachen Regionen für Patienten mit onkologischen Erkrankungen verbessern.
BackgroundOver the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-based studies on the demands and needs in cancer-affected patients.ObjectiveThis cross-sectional study aimed to explore the cancer-affected women’s needs and wishes for psycho-oncological content topics in eHealth applications and whether women with cancer differ in their content topics and eHealth preferences regarding their experienced psychological burden.MethodsPatients were recruited via an electronic online survey through social media, special patient Internet platforms, and patient networks (both inpatients and outpatients, University Hospital Tuebingen, Germany). Participant demographics, preferences for eHealth and psycho-oncological content topics, and their experienced psychological burden of distress, quality of life, and need for psychosocial support were evaluated.ResultsOf the 1172 patients who responded, 716 were included in the study. The highest preference for psycho-oncological content topics reached anxiety, ability to cope, quality of life, depressive feelings, and adjustment toward a new life situation. eHealth applications such as Web-based applications, websites, blogs, info email, and consultation hotline were considered to be suitable to convey these content topics. Psychological burden did not influence the preference rates according to psycho-oncological content and eHealth applications.ConclusionsPsycho-oncological eHealth applications may be very beneficial for women with cancer, especially when they address psycho-oncological content topics like anxiety, ability to cope, depressive feelings, self-esteem, or adjustment to a new life situation. The findings of this study indicate that psycho-oncological eHealth applications are a promising medium to improve the psychosocial care and enhance individual disease management and engagement among women with cancer.
BACKGROUND Over the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-based studies on the demands and needs in cancer-affected patients. OBJECTIVE This cross-sectional study aimed to explore the cancer-affected women’s needs and wishes for psycho-oncological content topics in eHealth applications and whether women with cancer differ in their content topics and eHealth preferences regarding their experienced psychological burden. METHODS Patients were recruited via an electronic online survey through social media, special patient Internet platforms, and patient networks (both inpatients and outpatients, University Hospital Tuebingen, Germany). Participant demographics, preferences for eHealth and psycho-oncological content topics, and their experienced psychological burden of distress, quality of life, and need for psychosocial support were evaluated. RESULTS Of the 1172 patients who responded, 716 were included in the study. The highest preference for psycho-oncological content topics reached anxiety, ability to cope, quality of life, depressive feelings, and adjustment toward a new life situation. eHealth applications such as Web-based applications, websites, blogs, info email, and consultation hotline were considered to be suitable to convey these content topics. Psychological burden did not influence the preference rates according to psycho-oncological content and eHealth applications. CONCLUSIONS Psycho-oncological eHealth applications may be very beneficial for women with cancer, especially when they address psycho-oncological content topics like anxiety, ability to cope, depressive feelings, self-esteem, or adjustment to a new life situation. The findings of this study indicate that psycho-oncological eHealth applications are a promising medium to improve the psychosocial care and enhance individual disease management and engagement among women with cancer.
A 46-year-old man presented to the emergency department because of recurrent minor haemoptysis and marked shortness of breath when walking short distances or even at rest (equivalent to New York Heart Association Class III to IV). Two years earlier, he had experienced similar symptoms, but a full pulmonary evaluation did not reveal the aetiology. He had unin-tentionally lost 15 kg of body weight during the previous 5 months, but had no fever or night sweats. His past medical history was remarkable for hepatitis B and alcohol abuse. The patient was living alone, had a lower socioeconomic background, and had migrated from Eastern Europe to Switzerland more than 10 years ago.On admission, the patient's blood pressure was 127/77 mm Hg, heart rate was 97/min, and oxygen saturation was 98% while breathing ambient air. On physical examination, discrete wheezing on pulmonary auscultation and slight oedema of the legs were found.Cardiac auscultation was remarkable for a holosystolic murmur and a rumbling diastolic murmur, both best heard in the apex. The ECG showed sinus rhythm with right axis deviation, inferolateral early repolarisation pattern and a bifid p wave (fig. 1). Chest X-ray showed normal cardiac size and a diffuse interstitial SummaryOccasionally, cardiac disease may manifest acutely with extracardiac symptoms. we present a patient case with pulmonary haemorrhage as the first manifestation of rheumatic mitral stenosis, which resolved completely after mitral valve surgery, and discuss the pathophysiology and clinical management of this rare manifestation of rheumatic heart disease.
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