[The healing process following gynecologic laparoscopy: data on the significance of psychological factors]. / A gyógyulás folyamata nögyógyászati laparoscopiát követóen: adatok a pszichés tényezök jelentóségéhez.

It is known that patients undergoing laparoscopic surgery can be discharged from hospital sooner and their reconvalescence is achieved faster than after laparotomy. Beside the medical judgement of the healing process it is also important to assess the length of time needed for the patients to feel themselves completely cured and be free of complaints. The data on the subjective judgement of the healing process provided by 335 patients who underwent laparoscopic surgery are analyzed retrospectively here. The aim of the study was to assess how anxiety as a personality trait might influence the healing process and also if there is any connection between anxiety, clinical diagnosis and laparoscopic findings. Anxiety was measured by Spielberger's State-Trait Anxiety Inventory (STAI). The estimated average healing time is 29.8 days (appr. 4 weeks), but patients with diagnostic and/or operative laparoscopy felt themselves free of complaints after 18.9 days (appr. 3 weeks) on the average. The duration of the healing process is independent of the laparoscopic findings and the type of procedure. There is a strong correlation between the anxiety level and the healing process. The average level of anxiety trait was 47.99 +/- 9.50. Anxiety level was the highest in the group of patients operated on for pelvic pain (mean = 51.21). There was no serious organic alteration in the small pelvis in 37% of the cases. One year after the operation 11.3% of the patients did not feel themselves cured and 17.6% had complaints. These data emphasize the role of anxiety and that of psychological factors in the etiopathogenesis and treatment of gynecologic diseases, especially in chronic pelvic pain and infertility or sterility.

[The importance of gender in the gynecologist-patient relationship]. / A nem jelentösége nögyógyász és betege kapcsolatában.

One of the focal interest of medical psychology is the quality of doctor-patient relationship. The sex of physician and patient have an important impact on their interaction. From this point of view, the contact of gynaecologist and client has a proper character. The authors review the references of this topic. They list the differences between male and female physicians, they also list the factors which determine the patient's choice of one or an other gynaecologist, finally authors deal with the motivations to become a gynaecologist. Both the male and female gynaecologist apply psychological egodefence mechanisms to elaborate sexual-erotic impulses. The adequate relationship needs a convergent, complementer interaction between doctor and patient. According to observations, patients are more satisfied by the female gynaecologists. Obstetricians have to give up the traditional and rigid view of gender and doctor's role. Balint-groups could help to develop and maintain more adequate doctor-patient relationship.

Contents of childbirth-related fear among couples wishing the partner's presence at delivery.

In order to explore the contents of childbirth-related fears, a survey was carried out among 216 pairs of prospective parents who opted for the presence of the partner at delivery. Each couple took part in a three-class parentcraft course during the third trimester. During the first antenatal class, couples were asked to fill in a questionnaire with inquiries about specific contents of fear they might have in relation to pregnancy, childbirth and relationship with their partner after childbirth. Each item of the questionnaire called for an answer from a five-grade scale of fear such as 'absolutely not', 'slightly', 'quite', 'quite strongly' and 'very much'. Their worries were ranked according to the weighted average of the frequency of positive answers. More than 80% of both men and women had some fears relating to childbirth. Women were most worried about, in order of significance, having a malformed or injured baby, assisted or operative delivery, being lonely in a strange environment, doing something wrong, and facing the uncertainties of how the delivery was going to happen. The wife having severe pain and suffering, operative delivery, fetal birth injuries, helplessness, powerlessness and the wife's death in childbirth were the most significant subjects of men's fears. Eighty per cent of women and 76% of men felt that the presence of the partner at delivery would have no adverse effect on their future personal relationship.

[Grief related to perinatal loss]. / Perinatális gyászreakció.

Findings of the retrospective questionnaire survey with 45 mothers who experienced perinatal loss show fairly higher residual anxiety scores 1-2 years after the death than it can be experienced in the case of normal population. The results suggest that the Hungarian clinical practice hardly helps the mothers' requested grief work. More than the half of women satisfied with the support from the medical staff, but 17 mothers did not get any kind of advice with respect of the next pregnancy. Nineteen women saw her died baby, while this opportunity was not offered for the others. The risks from the strengthened self-accusation of the mothers and from the "replacement child" syndrome are argued as well.

[Psychosomatic aspects of sterility and assisted reproduction]. / A meddöség és az asszisztált reprodukció pszichoszomatikája.

The authors survey the literature of psychosomatic aspects of infertility, in-vitro-fertilization and embryo transfer. They emphasize the most important thesises of psychosocial and psychodynamical approaches. The changing of sexual and marital relationship of infertile couples are analysed as well. They call readers' attention to some critical points of doctor-patient and psychotherapeutical relationship.

[Anxiety and the presence of the father at childbirth]. / Az együttszülés és a szorongás.

The authors give a report of a follow-up the anxiety of 363 couples whereby the husband decided to be present at the childbirth and took part in the childbirth preparation courses. The anxiety state and anxiety trait in men was found to be significantly lower than in women. The data of women were compared to a matched control group consisting of 135 pregnant women. In cases where the husband was present at childbirth the anxiety state and anxiety trait of the women was considerably lower than in the control group. The degree of anxiety was found independent of age, educational level, occupation but depended of parity. During the childbirth preparation the anxiety state of the husbands reduced considerably, whereas in the women the trend of increasing anxiety state could be prevented. In the group where the husband was present at childbirth the authors did not find any close relationship between the degree of anxiety and the examined obstetrical parameters (gestational age at labour, outcome and duration of labour, and the birth-weight.

[Prevention of respiratory distress syndrome in pregnant diabetic women during labor]. / Die Steroidprophylaxe des Respirations-Distress-Syndroms bei schwangeren Diabetikerinnen während der Geburt.

In the period between 1973 and 1976, in order to prevent neonatal RDS, 24 insulin-dependent diabetic mothers were given Dexamethason before delivery. The treated group was compared with a control group comprising 26 women of the same gesational age, severity of diabetes and mode of delivery. Neonatal care was similar in both groups. In the group where steroid prophylaxis was applied, decrease of RDS morbidity and mortality was observed. The authors accentuate that Dexamethason given to the mother may have an unfavourable effect on carbohydrate metabolism. Therefore, it is recommended to perform 4-hour determinations of blood sugar, urinary sugar and acetone and accordingly, modification of therapy.