Claudia Spahn

Parental Distress: The Initial Phase of Hearing Aid and Cochlear Implant Fitting

The results of previous cross-section studies suggest that childhood hearing impairment may lead to parental psychosocial stress. The present study investigated whether modifications in parental psychic state can be ascertained in connection with the childs treatment events and the childs hearing and speech status, in a prospective study design. Data were available on 116 fathers and mothers regarding the pre—cochlear implant examination or hearing aid fitting of their child. In the course of the childs treatment, parental quality of life improved from a low to a normal level. Among children who were at the stage of pre-examination for a cochlear implant, better hearing and speech capacity was linked to more severe impairment of the parental state. It is emphasized that the parents whose children showed comparatively good language development at the time of pre-examination for a cochlear implant were especially subjected to stress.

A comparison between parents of children with cochlear implants and parents of children with hearing aids regarding parental distress and treatment expectations

OBJECTIVE The aim of the present study was to compare the parents of children with a hearing aid (HA) and children with a cochlear implant (CI) regarding their psychological distress, their expectations from treatment, their family climate, and the way they first obtained information on HA/CI. METHODS 154 parents (return quota 41%; 81 mothers and 73 fathers) of 90 children with a HA and 103 parents (return quota 59%; 57 mothers and 46 fathers) of 57 children with a CI were interviewed by means of a questionnaire. RESULTS Both groups of parents felt distressed, particularly at the time of diagnosis. Their psychological well-being was gradually stabilized in the further course of rehabilitation. Due to the operation associated with it, fitting with a CI brought on a phase of heightened parental psychological distress compared with less invasive treatment with a HA. Regarding family climate, more distress was found in parents of CI children than in parents of HA children. Expectations from therapy appeared realistic in both parental groups; however, after CI fitting, the parents of the CI children showed heightened expectations by comparison with the parents of the HA children. CONCLUSIONS The results of our study suggest that the parents of hearing impaired children fitted with a HA or a CI may be divided into two subgroups with divergent psychosocial parameters. For the counseling of the parents of hearing impaired children in clinical practice, it would seem important to take these specific differences into consideration.

Perceived medical school stress and the development of behavior and experience patterns in German medical students

Background: Longitudinal data about the development of health risks and resources in relation to the performance of medical students are limited. Aims: To evaluate the development of study-related experience and the correlation to performance. Method: Medical students in the first (2006), second (2008), and fifth years (2011) of their studies were surveyed with standard instruments for quality of life, study-related behavior and experience, perceived medical school stress, anxiety and depression, and grades in their first major exam. Results: The proportion of students with a healthy behavior and experience pattern decreased from 47.3% in the first year to 36.9% in the second year and 17.6% in the fifth year. This corresponded to an increase in the proportion of students at risk for burnout (7.1% first, 20% second, 19% fifth year). Students with a healthy behavior and experience pattern scored higher in self-perceived performance (p < 0.05) and objective grades. Stress and risk for burnout were important predictors for anxiety and depression. Conclusions: The decrease in health and the increase in risk patterns indicate a need for prevention and health promotion that should not only focus on individual behavior but also address the contextual factor of study organization within medical school.

Study-related health and behavior patterns of medical students: A longitudinal study

Background: Little is known about specific health risks and resources and their development influencing medical students’ stress. Aim: To evaluate the development of quality of life and study-related behavior and experience patterns among medical students. Methods: Data were collected in the first (n = 112 of 182 in 2006) and the fourth semesters (n = 164 of 176 in 2008). The instruments “Work-Related Behavior and Experience Patterns” (AVEM, including four main patterns: “Health”, “Unambitious,” “Overexertion,” “Burnout”) and “Short Form-12 Health Survey (SF-12)” were used at both points in time. Results: The medical students scored significantly lower on mental health compared with reference samples of young adults. The proportion of students with a healthy pattern decreased from 47.3% (95% CI 38.1–56.5%) in the first semester to 36.9% (29.4–44.4%) in the fourth semester. This corresponded to an increase in the proportion of students at risk for burnout from 7.1% (2.3–11.9%) to 20% (13.8–26.2%). At both time points, female students had a higher risk for overexertion and a lower prevalence of a healthy pattern than male students. Conclusion: Our data provide evidence for a decrease in the healthy pattern and an increase in the burnout pattern. Intervention is needed, especially for students at risk for burnout.

Psychische Belastung, Informiertheit und Behandlungserwartung von Eltern mit einem Cochlear Implant versorgten Kind

ZusammenfassungBisheriges Wissen zum Thema. Eine generell erhöhte psychosoziale Belastung der Eltern hörbehinderter Kinder ist aus der Literatur bekannt. Wissenschaftliche Fragestellung. Wie verändert sich die psychosoziale Situation der Eltern von mit einem Cochlear Implant (CI) versorgten Kindern im zeitlichen Verlauf der Rehabilitation? Ziel der Arbeit. Ziel war es darzustellen, wie die Eltern ihr eigenes psychisches Befinden während der Rehabilitation ihres Kindes retrospektiv einschätzen. Methoden und Arbeitsergebnisse. 87 Elternpaare wurden getrennt in einer postalischen Fragebogenerhebung befragt; 57 Mütter und 46 Väter antworteten (59% Rücklauf). Die Eltern gaben ab dem Zeitpunkt der Diagnosestellung eine subjektiv deutlich erhöhte Belastung an. 25% der Eltern waren auch im weiteren Verlauf der Rehabilitation anhand der Beurteilungskriterien des SCL-90-R in einem klinisch relevanten Ausmaß psychisch belastet. Die Erwartung der Eltern vor der Implantation war realistisch und stieg im Verlauf der Rehabilitation statistisch signifikant an. Schlussfolgerungen. Die starke psychische Belastung in der Selbsteinschätzung der Eltern von CI-Kindern in der Phase der Diagnosestellung bestätigt die Theorie und klinische Praxis, dass die Eltern in dieser kritischen Phase besonderer Betreuung bedürfen. Auch über die Phase des initialen Schocks hinaus scheinen die Eltern in einem Ausmaß psychisch belastet zu sein, welches eine gezielte zusätzliche psychologische Betreuung der Eltern erforderlich machen könnte.AbstractEstablished knowledge. It is known that parents of hard-of-hearing children suffer from an increase in psychosocial stress. Scientific question. How does the psychosocial situation of parents with children who have cochlear implants change during rehabilitation? Aim of study. It was the aim of this study to demonstrate how parents evaluate retrospectively their own psychological well-being during the process of rehabilitation. Methods and results. We interviewed 87 parents by questionnaire which were mailed to them. Fifty-seven mothers and 46 fathers responded (59% return rate). Parents reported a significant increase in stress, as perceived by themselves, after the time of diagnosis. Of the parents, 25% continued to suffer from psychic stress during rehabilitation as could be demonstrated by the SCL-90-R questionnaire criteria. The expectations by parents were realistic prior to implantation but thereafter increased significantly with time. Conclusions. The psychological state of parents during the critical phase, after a diagnosis of deafness has been made for their child, has to be considered. Even after an initial phase of shock, parents seemed to be stressed to an extent that required therapeutic intervention.

Work-related behaviour and experience patterns of nurses in different professional stages and settings compared to physicians in Germany

Working in a health-care profession is correlated with high levels of stress and potential burnout that are likely to increase over time. Few studies differentiate psychosocial stress between nurses in different clinical settings or professional stages. In this cross-sectional study, we compared the work-related behaviour and experience of nurses (n=389) and physicians (n=344) and of nurses across different career stages and clinical settings in Germany. Nurses had the lowest proportion of a healthy behaviour and experience pattern (11.6%) compared with student nurses (32.6%), senior nurses (25%), and physicians (16.7%). They also had the highest proportion of a burnout-related behaviour and experience pattern (32.8% vs 26.1% of student nurses, 18.3% of senior nurses, and 27.3% of physicians). In comparison with medical nurses, psychiatric nurses presented a significantly (P<0.01) lower proportion with a healthy (10.6% vs 21.8%) and burnout-related behaviour pattern (23.5% vs 29.6%), and a higher proportion showing a low commitment to work (61.4% vs 34.4%). Differences in health-related dimensions were primarily observed in the domains of professional commitment and stress resistance. The observed differences in behaviour and experience patterns as a function of health-care settings and career stages emphasize the need for specific interventions.

Psychic stress and quality of life in parents during decisive phases in the therapy of their hearing-impaired children.

Objective: This study was performed to analyze psychic stress and quality of life in the parents of children with hearing impairment in the course of various phases of treatment. Design: At three measuring points over a course of 12 months, the degree of parental stress and the quality of life was surveyed prospectively. In addition, the children’s hearing and speech status was surveyed. Parents whose children were treated with hearing aids or cochlear implants were the target of this survey. At the outset of the study, data of 123 parents were available. The average age of the children was 38 months. Results: It was not possible to demonstrate generally heightened psychic stress in any phase of treatment. Differentiation into subgroups must be performed, as parental stress depends on possible changes of treatment and the child’s speech status. Initially, quality of life was clearly reduced but gradually became statistically insignificant. Conclusions: The results point out the necessity of supporting the parents with counseling and psychosocial support, especially in the initial fitting phase and in the various decision and orientation phases.

[Religiosity, spirituality, health and work-related behaviour patterns in pastors of two free protestant denominations].

BACKGROUND Epidemiological data show psychosocial health risks of pastors. This study should therefore identify psychosocial risk factors and health resources including religiosity and spirituality in profession related behaviour and experience of pastors. Methods Pastors of two protestant denominations were surveyed with three standard instruments (AVEM, SF-12, BMMRS). RESULTS Only a small fraction of pastors presented a healthy behaviour and experience pattern (13.9% SDA; 10.1% FEG). A burnout-related risk pattern was found in 28.3% of SDA and 37.2% of FEG pastors. Pastors with a healthy pattern scored higher in physical and mental health and selected scales of religiosity/spirituality than those with a pattern in risk for burnout. CONCLUSIONS The results show distinct psychosocial strain patterns of pastors. Religiosity and spirituality may be an important resource.

Health locus of control and preventive behaviour among students of music

The present study investigated health locus of control, preventive behaviour and previous playing-related health problems of music students; 326 students of music (58% female, mean age 22 years) filled in the Locus of Control Inventory for Illness and Health (Lohaus and Schmitt, 1989) and the Epidemiological Questionnaire for Musicians (Spahn, 1998). It was shown that previous playing-related problems, being a string instrumentalist or a singer as well as high powerful others locus of control (LOC) and low external chance LOC, were predictive factors for the utilizing of preventive measures. It was not possible to confirm that a high internal LOC, in and of itself, furthers preventive behaviour. For prevention programmes at universities of music, it would seem important that previous health problems are actively ascertained at the commencement of the course of study, as they are an important point of departure for further, differentiated preventive counselling measures.

Music performance anxiety in young musicians: comparison of playing classical or popular music.

OBJECTIVES Music performance anxiety (MPA) is an issue frequently experienced by musicians. It occurs not only in experienced musicians but also in children and adolescents. Furthermore, most research on MPA has been done with musicians who specialized in classical music. This study investigated the development of MPA across the ages in young musicians focusing on the classical and popular genres. METHODS In a cross-sectional survey, 239 students at German music schools, aged between 7 and 20 yrs, were asked about their perceived MPA and musical background. The data were analyzed according to musical genre and age. Multiple regression analyses were performed to investigate the influences of musical experiences on MPA. RESULTS The analyses yielded high levels of MPA for classical musicians between 7 and 16 yrs, which was reduced in older students; for popular musicians, low MPA was seen in the younger (7-11 yrs) and high MPA in the older (16+ yrs) musicians. MPA was influenced by gender and the number of performances in the classical music group and only by gender and age in the popular music group. CONCLUSION The results showed clear different trends for the development of MPA between musical genres that should be taken into account for educational aspects in musical training.