Konstanz, Univ., Diplomarb., 2004.

Zugl.: Köln, Univ., Diss., 2007.

Zugl.: Mainz, Univ., Diss., 2006

Thesis (doctoral)--Universität, Mainz, 2002.

Thesis (doctoral)--Universität, Tübingen, 2000.

Shared decision making (SDM) is a paradigm of patient-physician communication which aims at combining the physician s expertise and the patient s individual preferences regarding a treatment decision. Although most clinicians consider SDM the most appropriate communication style, neither a precise theoretical framework nor a convincing evaluation method has been proposed yet. Since SDM is especially indicated in situations without any clearly superior treatment alternative which is often due to the lack of reliable clinical evidence several different qualities of uncertainty have to be faced and negotiated to reach a consensual decision. These include medical considerations like valuing risks and harms of each treatment as well as questions e.g. about sense of life in view of limited lifetime or reliability of the partnership under life threatening conditions. Based on qualitative interviews with cancer patients using the Grounded Theory approach, a questionnaire has been derived addressing multiple qualities of uncertainty. The QUiCC (Qualities of Uncertainty in Chronic Conditions) has been validated in a multicenter study using multidimensional Rasch models and classical item analysis procedures providing strong evidence for its reliability and validity. Open negotiation of uncertainties will probably not result in their reduction. Even so, we feel that patients would benefit from negotiating various uncertainties with their physician. Transition of uncertainty to another state rather than its replacement with an illusive certainty can nevertheless empower the patient in his or her decision-making process.

Universiẗat, Diss.--Mainz, 2006.

Univ., Diss.--Mainz, 2002.

The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life. We argue that current clinical practice does not sufficiently account for the complex cognitive processes in this population. This is because widely applied pharmacological interventions only rarely account for the complexity of the underlying neuronal mechanisms and do not fit well into possibly powerful “individualized medicine” approaches. Novel treatment approaches targeting deficits in executive functions in seriously ill children could focus on neuronal oscillations, as these have some specific relations to different aspects of executive function. Importantly, such treatment approaches can be individually tailored to the individuals’ deficits and can be transferred into home-treatment or e-health solutions. These approaches are easy-to-use, can be easily integrated into daily life, and are becoming increasingly cost-effective.

Diabetes mellitus ist mit die häufigste Volkskrankheit auf der Welt. 371 Millionen Menschen sind weltweit erkrankt und bis zum Jahr 2030 wird die Zahl auf ca. 552 Millionen ansteigen. Doch wie erleben PatientInnen ihre Welt mit Diabetes und wie bewältigen sie ihren Alltag? Mit Hilfe der systematischen Metaphernanalyse untersuchte ich qualitativ die subjektive Welt von Typ–1 DiabetikerInnen und vor allem ihre Sprache. Mit dieser Methode wollte ich Einblicke in das Denken und Handeln von Betroffenen gewinnen und Rückschlüsse zur Bewältigung ziehen.