[Psychosocial Stress, Stress Perception and Stress Management of Students of Social Work: a Quantitative Study]. / Psychosoziale Belastungen, Stressempfinden und Stressbewältigung von Studierenden der Sozialen Arbeit: Ergebnisse einer quantitativen Studie.

In this quantitative study, data on 746 students of social work were collected regarding their current sense of stress, experience of psychosocial drain as well as their use of specific coping strategies. The Perceived Stress Scale (PSS) and the Trier Inventory of Chronic Stress (TICS) were used. The results show that one out of 3 students suffer from a lot of to extreme stress. One-fourth of the students report feeling overworked and socially overburdened. More than half of the students are exposed to psychosocial drain as a consequence of past events in their biography (e. g. death or mental illness of a close relative). Despite these obvious burdens, only one-fourth made use of professional aid or counseling. Students who are primarily using functional coping strategies have a lower sensibility to stress and feel less overworked than students primarily using dysfunctional coping strategies. In the university setting, the theoretically and empirically sound knowledge based on this report can be used profitably: The increasing implementation of seminars on coping with stress at universities itself suggests that learning and utilizing functional coping strategies can contribute to a reduction of stress and strain among students.

[Computer-based organization and documentation in orthopedics. A 5-year experience]. / EDV-gestützte Organisation und Dokumentation in der Orthopädie. Ein Erfahrungsbericht nach 5 Jahren Einsatz.

In the orthopedic department of the University Hospital Homburg/Saar, we use since 1993 a computer-based system for clinics organisation and documentation of operations. Hardware consists of DOS/Windows PC's in a Novell-network. Our software is a combination of database-system for managing patient-data and a special coding program for ICD and IKPM-digits. Our experience shows that computer assisted clinic-management is an effective tool to help the surgeon in planning and documentation. Until now, we used the system for 31,500 patients and 8500 operations. A flexible software can meet the requirements both of the surgeons and administration. Moreover, in the University hospital Homburg/Saar, the different departments are linked by an Intranet with connection to other scientific networks and the Internet.

[Management of case fees and special charges by using the coding system "do it"]. / Fallpauschalen und Sonderentgeltmanagement mit Hilfe des Verschlüsselungssystems "do it".

INTRODUCTION: With the German health care restructuring legislation ("Gesundheitsstrukturgesetz") the coding of diagnoses and operations according to ICD-9 and ICPM (OPS-301) was introduced for budget assignment ("Fallpauschalen/Sonderentgelte"). METHODS: Application of the structured coding system "do it" in orthopedics and traumatology in combination with a surgical documentation system. Results of 8,664 documented operative cases within three years. RESULTS: In total, 11,854 ICD-9 or ICD-10 and 20,178 ICPM (OPS-301) were coded. 2,914 "Fallpauschalen" and/or 3,456 "Sonderentgelte" were found. The System achieved high acceptance due to its userfriendliness and simple functionality. DISCUSSION: In comparison with text- or thesaurus-based coding systems the "do it" coding system does not require any knowledge of the ICD or ICPM (OPS-301). It can be adapted to individual clinical requirements by implementing frequent diagnoses and individual therapy concepts. In combination with a medical information system the coding system can be integrated seamlessly into routine documentation.

[Standardized computer-based documentation system for diagnoses and medical performance in orthopedics and traumatology. Development and initial application]. / Standardisiertes EDV-gestütztes Befundungs- und Leistungsdokumentationssystem für die Orthopädie bzw. Traumatologie. Entwicklung und erste Anwendung.

INTRODUCTION: Increasing demands on quality assurance und medical performance documentation require an immediate and evaluable documentation in the outpatients' department. Presentation of a new computer-based diagnostic system for reporting and medical performance documentation. METHODS: Development and initial application of the system in three big orthopedical or traumatological hospitals. Judgements about the feasibility of immediate documentation in outpatients' departments. RESULTS: Presentation of an outpatients' departments diagnostic system with textblock-oriented anamnesis or anatomy-related diagnosis through pre-structured examination checklists. Coding of ICD-9/-10 as well as AO-classification and AIS (abbreviated injury scale). Implementation of scorings. Medical performance documentation through forms including pre-defined billing codes. Presentation of the documentation flow and its transfer into other contexts. DISCUSSION: Pure text-based clinical results do not allow sufficient evaluation for quality assurance and medical performance documentation. However, a computer-based and immediate documentation in outpatients' departments should not mean a significantly increased workload for physicians.

Computer-based organisation and documentation in orthopaedics: 5 year's experience.

In the orthopedic department of the University Hospital Homburg/Saar, we use since 1993 a computer-based system for clinics organisation and documentation of operations. Hardware consists of DOS/Windows PC's in a Novell-network. Our software is a combination of datbase-system for managing patient-data and a special coding program for ICD and IKPM-digits. Our experience shows that computer assisted clinic-management is an effective tool to help the surgeon in planning and documentation. Until now, we used the system for 31 500 patients and 8500 operations. A flexible software can meet the requirements both of the surgeons and administration. Moreover, in the University hospital Homburg/Saar, the different departments are linked by an Intranet with connection to other scientific networks and the Internet.

Management of case fees and special charges with aid of the coding system "do it".

INTRODUCTION: With the German health care restructuring legislation ("Gesundheitsstrukturgesetz") the coding of diagnoses and operations according to ICD-9 and ICPM (OPS-301) was introduced for budget assignment ("Fallpauschalen/Sonderentgelte"). METHODS: Application of the structured coding system "do it" in orthopeadics and traumatology in combination with a surgical documentation system. Results of 8,664 documented operative cases within three years. RESULTS: In total, 11,854 ICD-9 or ICD-10 and 20,178 ICPM (OPS-301) were coded. 2,914 "Fallpauschalen" and/or 3,456 "Sonderentgelte" were found. The System achieved high acceptance due to its userfriendliness and simple functionality. DISCUSSION: In comparison with text- or thesaurus-based coding systems the "do it" coding system does not require any knowledge of the ICD or ICPM (OPS-301). It can be adapted to individual clinical requirements by implementing frequent diagnoses and individual therapy concepts. In combination with a medical information system the coding system can be integrated seamlessly into routine documentation.

Development of a standardised computer-based documentation system for diagnoses and medical performance in orthopeadics/traumatology.

INTRODUCTION: Increasing demands on quality assurance und medical performance documentation require an immedate and evaluable documentation in the outpatients' department. Presentation of a new computer-based diagnostic system for reporting and medical performance documentation. METHODS: Development and initial application of the system in three big orthopeadical or traumatological hospitals. Judegements about the feasibility of immediate documentation in outpatients' departments. RESULTS: Presentation of an outpatients' departments diagnostic system with textblock-oriented anamnesis or anatomy-related diagnosis through pre-structured examination checklists. Coding of ICD-9/-10 as well as AO-classification and AIS (abbreviated injury scale). Implementation of scorings. Medical performance documentation through forms including pre-defined billing codes. Presentation of the documentation flow and its transfer into other contexts. DISCUSSION: Pure text-based clinical results do not allow sufficient evalutation for quality assurance and medical performance documentation. However, a computer-based and immediate documentation in outpatients' departments should not mean a significantly increased workload for physicians.

[An ultrasound hip screening program--middle term results of flexion-abduction orthosis therapy]. / Aus einem hüftsonographischen Screeningprogramm--Mittelfristige Ergebnisse nach Spreizhosentherapie.

INTRODUCTION: Today the hip sonography is an established method to detect congenital hip maturation disturbances in the first days of life. Short-term follow-ups have showed that mature hip joints can be performed with an flexion-abduction bandage within a few months. METHODS: This prospective study reviews in a middle-term follow up 57 dysplastic hips at birth of 42 children after an average period of 7.8 years, who took part in an ultrasonic hip screening and were treated successfully with an abduction pant (33 hips type IIg, 16 hips type D, 8 hips type III according to Graf). RESULTS: There were only 3 cases (5%) who had slight limitations of motion clinically according to the classification of Tönnis. The radiographic control showed an average AC-angle of 11 degree, an average CE-angle of 28 degree and an average hip-score according to Tönnis of 8.5. Slight radiological deviations were found in 9% of the cases. Severe pathologic radiographic appearance or avascular necrosis of the femoral head were not observed. CONCLUSIONS: If DDH is detected in first day of life and immediately treated with abduction pants is physiological development of the hip probably.

[Simple and valid ICD9-/10- and IKPM coding using an electronic data-assisted coding system "do it"--experiences after one years use]. / Einfache und valide ICD9-/-10- und IKPM-Kodierung mit Hilfe des EDV-gestützten Verschlüsselungssystems "do it"--Erfahrungen nach einjähriger Anwendung.

UNLABELLED: Question by introducing "Fallpauschalen" and "Sonderentgelte" in German health system the coding of diagnoses and therapies gains a new momentum. Therefore, a new computer based coding-system for ICD- and ICPM- digits is presented. The physician gets enabled for simple and valid classification within his documentation routine. METHODS: Development of a hierarchic menue system, whose first part represents the anatomic region. The second part is reserved for the most common diagnosis rsp. therapies within its special anatomic region. By further sub-menues all other ICD numbers in the orthopedic and traumatologic field may be coded (selection related by frequency). This coding-system has been in clinical use since jan. 1st. 1995. RESULTS: Control of the efficiency of this coding-systems by 1316 patients with 1551 operations within one year. By using ICD-10, the representation of orthopedic-traumatologic diagnosis inhanced by factor 1.8 versus ICD-9. According to ICPM, 3560 therapies were coded, making it 2-3 actions per operation. "Fallpauschalen" were found in 21.9%, in 27.7% there were "Sonderentgelte". Within one year the coding error rate was reduced from 25% to 5%. CONCLUSIONS: Because of its easy handling the coding system "do it" represents a good alternative to conventional coding rsp. clear text analysis.

[Computer-assisted classification of ICD-9/10 and IKPM in compliance with the new federal health care regulation--practice-oriented solution for trauma surgery and orthopedics]. / Rechnergestützte Verschlüsselung der ICD-9/-10 und IKPM gemäss der neuen Bundespflegesatzverordnung--praxisorientierte Lösung für Unfallchirurgie und Orthopädie.

From the beginning of 1995, the German law on the health system structure prescribes that in all clinics the four-digit ICD code be supplied for each diagnosis and the ICPM code for each operation. This makes on-line access to diagnosis and therapy codes embedded in a clinic documentation system advisable. Since 1 February 1995, in one department of traumatologic surgery the ICD diagnosis and ICPM therapy coding is managed on-line by the doctors in the outpatient clinic and operation theatre, using the "do it" coding system in combination with the KAUZ system for clinic documentation. The user guidance supplied by a frequency-oriented menu and specialist traumatological terms makes it possible to determine the ICD and ICPM codes without any great expenditure of effort. Furthermore, the appropriate flat rates per case and special charges are displayed. Comparison of manual and computer-assisted coding of operations during 1 month (160 patients, 173 operations) showed that manual coding could be corrected or improved by the computerized system in 35% of cases. The ICD-10 system has already been integrated: it improves the recording of diagnoses and will simplify the change over to the coming new revision.

[Development assessment of a hip ultrasonographic screening program for the early diagnosis of congenital hip dysplasia at the orthopedic university department Homburg/Saar from 1986 to 1990]. / Verlaufsbeobachtung eines hüftsonographischen Screeningprogrammes zur Früherkennung angeborener Hüftreifungsstörungen an der Orthopädischen Universitätsklinik Homburg/Saar im Zeitraum von 1985 bis 1990.

The results of the hip ultrasound newborn screening at the orthopaedic department of the University Hospital Homburg/Saar underline the necessity of an early diagnosis of Hip dysplasia already during the first days of life. In the course of the following publication the benefit of using abduction-pants in case of physiological unripe and primary pathological hips is described closely. From October 1985 to December 1990 2317 newborns have been examined by ultrasound. The rate of Hip Dysplasia (type IID, IIg, IIIa) was at 104 hips (2.2%). Clinical striking facts were only found in 46.3% of all patients with primary pathological hips. After an precautionary broad swadling (Breitwickeln) or abduction-pants-treatment 331 (90.0%) hips of the 368 regular checked hips with type IIa developed with an average secondary anatomical healing of 2.5 months to Ia- or Ib-hips. After 3 months only just 12 hips corresponded to a diagnosis of type IIb according to Graf. A deterioration to a IIg or IIIa hip was only ascertained in two cases. With all 41 sufficiently controlled primary pathological hips an improvement to type Ia or Ib according to Graf achieved when treated with abduction pants (average duration of treatment: 4.3 months). None of the children had to undergo an operation because of instable hips.