carl eduard scheidt

 The communication skills of treating physicians can affect the psychological burden of cancer patients and the prevalence of mental illness among these patients. This study investigated the communication skills of physicians and their relationship to the psychological symptoms of cancer patients and their satisfaction with the treatment they received.

 This cross-sectional descriptive study was carried out in 2019. A total of 160 cancer patients who fulfilled the inclusion criteria and referred to Omid Hospital in Isfahan, Iran, and the Iranian Cancer Control Center (MACSA) took part in the study. Demographic information, including age, sex, marital status, education, and type and stage of the disease, was collected using the Demographic Information Questionnaire. The patients' psychological states and satisfaction were then measured using the Patient's Depression, Anxiety, and Stress Scale (DASS), the Short Assessment of Patient Satisfaction (SAPS), and the Communication Assessment Tool (CAT). Correlation coefficients and multiple linear regression were performed using the SPSS software to analyze data.

 There was a significant direct relationship between the two quantitative variables of CAT and SAPS scores (r = 0.752; P < 0.001). There was also a significant relationship between the depression (r = -0.318; P < 0.001) and stress (r = -0.303; P < 0.001) scores and the CAT score. The mean SAPS score in patients undergoing radiotherapy was significantly lower than in the stages of chemotherapy (beta (SE) = -3.14 (1.05); P = 0.003).

 It was found that physicians' communication skills play an essential role in patients' satisfaction and are directly correlated. We also showed that the physician communication skills score was inversely related to patients' depression.
 

Experienced bodily sensation with basic emotions seems to be a universal phenomenon, but cross-cultural differences are expected.

A cross-sectional study designed to determine the topographic map of changes across six basic emotions  and anxiety in 220 Iranians aged 16 -55 years .The Persian pencil and paper version of the emBODY application was used and validated during the study. The results were analyzed by SPSS software version 20 using generalized linear models (GLM) to determine the relationship between gender and emotion sensation in 5 main body areas and three main facial parts.

The findings supported implicit detection of all basic emotions by participants. Anxiety was the most common reported and anger, fear, sadness, joy, surprise and disgust, respectively were identified basic emotions in both sexes. GLMs were significant (P <0.05) for bodily sensation changes in head and neck, upper body, upper and lower limbs, and all three main facial parts. Results also showed a significant gender difference in lower limbs (P <0.05).

The results suggested the consistency of distinct emotion- triggered bodily sensation maps of Iranians with universal patterns.  Implication of the findings for quantification and documentation of the emotion-related similarities and differences of Iranians with the international communities are discussed.

job burnout, depression, and anxiety, which can affect the healthcare systems and societies. This has been intensified by the outbreak of the Covid-19 pandemic. Many of the caregivers’ problems are due to insufficient psychosocial competence and lack of suitable training for basic skills such as self-awareness, rapport, empathy, compassion, reasoning, decision-making, etc. The main purpose of this study was to design a psychosocial service package for caregivers to help them throughout their lives.

 Data gathering was performed by conducting 2 focus groups, searching for studies to identify urgent and important healthcare needs, and finding the best way to address their necessities through a proactive and sustainable method.

 The online “healers' healing” platform is designed with 3 general objectives. The first objective was to present practical and effective materials to support caregivers in order to improve their psychosocial competence. The second objective was to monitor the member's progress and measure the effectiveness of the program. Moreover, to make the members more active in training and their own health promotion, this platform leads and supports self-help groups for caregivers as the third purpose of this project. Furthermore, healers can be active in content development and community education in order to experience a more productive interaction within the communities of caregivers.
 

The Body Image Acceptance and Action Questionnaire (BI-AAQ) assesses cognitive flexibility and acceptance of body image.

This study was done to assess the validity and reliability of the Persian version of BI-AAQ, as an instrument to measure body image flexibility, in patients with somatic symptom and related disorders.

This descriptive psychometric study was done in 2017 on 357 patients with somatic symptom and related disorders selected through a convenient sampling method from Kashan University of Medical Sciences clinics. They responded to the BI-AAQ, Depression, Anxiety, and Stress Scale (DASS), Acceptance and Action Questionnaire-II (AAQ-II), and Freiburg Mindfulness Inventory (FMI). The reliability of the BI-AAQ was calculated using Cronbach’s alpha coefficient. To assess its validity, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed via SPSS-22 and Amos-22 software.

This version retained a one-factor structure, similar to the original version of the questionnaire, which explained 42.55% of the variance. It had high internal consistency (0.84), split-half method (0.77), and correlates with AAQ (0.45), mindfulness (0.39) and correlates contrastingly with stress (0.11), anxiety (0.36) and depression (0.43).

According to the results of the current research, the BI-AAQ is a reliable instrument with valid psychometric properties to measure the body image acceptance of individuals in Iranian patients with somatic symptom and related disorders.

To determine the effects of a bioenergy economy program on the severity of symptoms and quality of life of patients with myofascial pain syndrome

In this randomized clinical-trial, 30 patients with myofascial pain syndrome were assigned to two groups. Patients in the case group participated in a bioenergy economy program for 6 sessions. The data collection tools were the McGill Pain Questionnaire and the WHO Quality of Life -BREF Questionnaire. In addition, the Beck Depression Inventory and the Beck Anxiety Inventory were also applied to patients in both groups. Repeated measures analysis of variance was used to analysis of the changes between the two groups.

According to the analysis, the test of between-subject effect was not significant for pain, QOL, anxiety, and depression (p-value>0.05 for all variables) while the results of the test of within-subject effect were significant (p-value<0.05 for all variables). The effect of the time-group interaction was not significant for pain (P=0.139) and QOL (P=0.169) while it was significant for anxiety (P<0.001) and depression (P=0.026). The mean scores of anxiety and depression decreased during the measurement times in both groups although the decrease was more prominent in the intervention group.

The bioenergy economy program can effectively decrease the pain intensity, depression, and anxiety and improve the quality of life of patients with myofascial pain syndrome. This program can reduce the patients’ distress through modifying attention bias and improving the self-efficacy and acceptance in these patients.

Balint Work is getting introduced and Balint Group Trials are being held in Iran in recent years. This is the first study of a Balint group trial participated by Iranian General Practitioners (GPs). This was a qualitative study to explore the themes which feature the GPs' described experience of their participation. A phenomenological approach was applied to examine the GPs' experience of participation in a seven-session Balint-group-trial. The participants were eight Iranian GPs working in the primary health-care network of Natanz-Iran. A focus group and in-depth semi-structured interviews were applied and the transcribed.  Verbatim were analyzed through a phenomenological explorative and descriptive process by a three-membered research team. Three ground themes and four main-themes emerged as the main features through which the participant-GPs had explained their experience. The main themes were1) Improving the Skills and Wisdom of Doctor-Patient-Relationship, 2) Exceptional Training Method/Learning Experience, 3) Emotional healing for doctors, 4) Job Morality Inspirations. Iranian physicians described their participation in a Balint group trial as a missing, needed and valuable experience of different sort of a peer-discussion-group, an insight-inducing and skill-improving one and an emotionally-supportive one. Minor particularities and major similarities were found between the participation experience as portrayed by Iranian physicians and by physicians of other countries. The study also adds a demonstration of the trans-cultural nature of the Balint group experience. 

The current research investigated the effectiveness of Acceptance and Commitment Therapy (ACT) on psychosomatic symptoms and mindfulness in patients with psychosomatic disorders. A randomized clinical trial was conducted at Kashan University of Medical Sciences clinics in Kashan City, Iran, from December 1, 2017, to March 30, 2018. In total, 66 patients with psychosomatic disorders were selected by purposive sampling method. The selected patients were divided into three groups (each 22 samples which were selected randomly). The subjects had a medical record at Kashan Beheshti Hospital. The experimental group received ACT with medicinal treatment. The first control group received psychological interventions and the second control group received medicinal treatment without any psychological interventions. The results were obtained using the Freiburg Mindfulness Inventory (FMI)-short Form and Diagnostic Criteria for Psychosomatic Research in the Pre-test and Post-Test phases and the three-month follow-up. In the follow-up and Post-Test phases, mindfulness improved in the intervention group, compared to the active and neutral control groups (P<0.001). Moreover, the active control group demonstrated more ability to mindfulness than the neutral control group (P<0.001). Furthermore, the obtained results were similar for psychosomatic symptoms. ACT can improve psychosomatic symptoms and mindfulness level in patients with psychosomatic disorders.

Growth of cardiovascular disease (CVD), variation in provision of medical services, rising costs, and increasing information availability through the media are making patients more actively involved in decision-making process of their treatment. The aim of this study was to better understand the components of patient competence in the context of coronary artery disease (CAD) and to further evaluate their relations with medical, demographic, and psychosocial characteristics. In this cross-sectional study, 148 patients with at least one year diagnosis of acute coronary syndrome (ACS) were enrolled in the study from April to June 2014. Data on demographic characteristics, depression, anxiety, quality of life (QOL), social support, and drug adherence were collected from participants. Pearson correlation, one way analysis of variance (ANOVA), and multiple linear regression tests were performed for analyzing data. The mean age of patients was 53.63 ± 5.15. Of the participants, 58 (39.5%) and
61 cases (41.5%) were found to be depressed and anxious, respectively. Higher levels of self-regulation correlated with higher education years and social support, and also with lower depression and anxiety (P < 0.050). Stress management and confronting the threat were linked to education years, depression, anxiety, QOL, and social support (P < 0.050). The patients with CAD, in order to be involved in the proper treatment process and manage their emotions during this process, need to have the required competencies. Patient competence as a whole and its components have been related to medical, demographic, and psychosocial characteristics.

Psychosomatic medicine developed in Germany after the Second World War as a multifaceted system of inpatient, day-patient, and outpatient treatment. The conceptual roots of post war psychosomatic medicine in Germany were in internal medicine (Victor von Weizäcker and Thure von Uexkuell) and in the psychodynamic and psychoanalytic tradition of G. Engels, Franz Alexander, and others. The implementation of psychosomatic medicine as a speciality of medicine in addition to psychiatry supported an integration of psychotherapeutic methods and interventions in medicine. Consultation-liaison (CL) services have contributed to the dissemination of psychosocial skills and interventions in the medical setting. Psychosomatic basic care curricula have improved the diagnosis and treatment of psychosomatic problems and disorders in primary care.

Perinatal loss, especially in the advanced stages of pregnancy, is associated with severe psychological distress. Insufficient processing of the loss experience can result in a psychological disorder for some of those affected. This holds true especially for women who have suffered a pregnancy loss after the 20th week of pregnancy. Depressive disorders, symptoms of anxiety, post-traumatic stress disorders, and functional physical complaints can also be observed in the foreground. Following an evaluation of a current Cochrane review, the available studies on the evaluation of psychotherapeutic measures after perinatal loss provide no conclusive indicators for evidence-based approaches within the realm of secondary prevention. Health risks in women affected by the loss of a pregnancy have been alternatively proven by a number of studies. Thus, a noticeable desideratum of research exists with regards to empirically-controlled psychotherapeutic studies on evaluation of the treatment of grief reactions after the loss of a pregnancy.
 

Various psychodynamic processes may underlie the development of psychogenic pain disorder such as conversion, the displacement of affect, or narcissistic defenses. However, many of the processes suggested are related to a disorder of affect regulation. The term affect regulation in psychoanalytic literature refers to phenomena which are often described by the concept of alexithymia. Empirical observations suggest that alexithymia is correlated to insecure attachment, especially an insecure dismissing representation of attachment. Psychodynamic psychotherapy in psychogenic pain disorder should focus on the reintegration of split-off affects which may provoke intensive counter-transference and which in order to be used therapeutically must be linked to attachment experiences within and outside of the therapeutic relationship.

The aim was to translate and develop a patient competence (PC) questionnaire in the context of cardiology and test its validity and reliability. In total, 148 cardiac patients who have inclusion criteria of the study were completed cardiac PC (CPC) questionnaire. Hospital Anxiety and Depression Scale and self-administered instrument European quality of life 5-dimensions were used to further validate the CPC questionnaire. The CPC was translated according to the recommended methodology for translating questionnaires, and psychometric properties including internal consistency, factor analysis, discriminant validity, construct validity, and concurrent criterion validity were tested. Five domains in problem-focused task including search for information, self-regulation, being assertive, independent decision-making, and looking for social services, and three domains in emotion-focused task including stress management, confronting the threat, and avoidance were obtained by factor analysis. The standardized Cronbach’s α of all domains were statistically significant (P < 0.001) and internal consistency for all domains was acceptable. Significant intercorrelations of CPC domains also indicated good criterion validity. As there were no cross-loadings, the domains have demonstrated good construct validity and discriminant validity. The results of this study show that the Persian version of the CPC is a reliable and valid questionnaire. Although further improvement of this measure is clearly required, it suggests being a potential basis for investigating the determinants and health effects of CPC.

Despite a general acceptance of the biopsychosocial model, medical education and patient care are still largely biomedical in focus, and physicians have many deficiencies in biopsychosocial formulations and care. Education in medical schools puts more emphasis on providing biomedical education (BM) than biopsychosocial education (BPS); the initial knowledge formed in medical students is mainly with a biomedical approach. Therefore, it seems that psychosocial aspects play a minor role at this level and PSM knowledge will lag behind BM knowledge. However, it seems that the integration of biomedical and psychosocial-knowledge is crucial for a successful and efficient patient encounter. In this paper, based on the theory of medical expertise development, the steps through which biomedical reasoning transforms to psychosomatic reasoning will be discussed.

The influence of various psychological factors and coping mechanisms on quality of life (QOL) in cancer patients has been well established. We evaluated locus of control and attributional styles, and their association with coping styles and quality of life (QOL) among Iranian cancer patients.

This cross-sectional study was conducted on patients with breast cancer and patients with colorectal cancer in stage I to III. Patients were assessed for demographic and disease characteristics, cancer-related symptoms, locus of control, attributional styles, coping styles, and QOL.

From 140 invited patients, 100 patients participated in the study. Data of 55 patients with breast cancer and 22 patients with colorectal cancer were appropriate and included for analysis (mean age of 47.5 ± 7.9 years, 89.6% female). Factors positively associated with QOL included educational level, internal locus of control, overall hopefulness, and confrontive, optimistic, and self-reliant coping styles (r = 0.228 to 0.426). Factors negatively associated with QOL included age, symptoms severity, overall hopelessness, and fatalistic and emotive coping styles (r = -0.221 to -0.674). Internal locus of control and hopefulness were associated with confrontive/adaptive coping styles (r = 0.226 to 0.381), while external locus of control and hopelessness were associated with evasive/maladaptive coping styles (r = 0.208 to 0.381).

These results indicate that internal locus of control, hopefulness, and positive attributional styles are associated with more adaptive/confrontive coping strategies and better QOL in Iranian cancer patients. Further studies with more comprehensive psychosocial evaluation in a larger sample of cancer patients are warranted.