Demand for psychosocial counselling of young wheelchair users.

Young persons tied to wheelchairs increasingly report fears and inhibitions in romantic attachments, irrespective of whether they are paraplegic or not. More frequently they complain about being gaped at and being pitied by healthy persons more than they would like. Being tied to the wheelchair had a significant relation to these results, but not gender, age and illness variables. A high demand for psychosocial counselling during rehabilitation is deduced from these results, in particular also for young people without paraplegia.

[Empirical results of adjustment to disability by adolescents with spina bifida and traumatic paraplegia]. / Empirische Ergebnisse zur Verarbeitung von Behinderung bei Jugendlichen mit Spina bifida und traumatischer Querschnittlähmung.

Between June 1991 and June 1992, a total of 39 rehabilitees aged 16 to 25 years were examined, i.e., 21 patients suffering from spina bifida and 18 patients suffering from traumatic paraplegia. Diagnostic instruments used were the Freiburg questionnaire on coping with illness (FKV 102), Goldberg et al's questionnaire for the evaluation of subjective wellbeing regarding health, and a self-constructed questionnaire for evaluating satisfaction with rehabilitation. Medical interviews on the present state of health and the present situation were held with each patient. The level of paralysis was taken as an indicator of the motor handicap present. The patients examined showed distinctly less confidence in doctors than adults do. From a subjective point of view, however, the confidence in doctors was good: among the coping strategies chosen, the compliance strategies ranked first and second, respectively, in the two groups. The coping strategy of "cognitive avoidance and dissimilation" is distinctly less common among spina bifida patients than among patients with traumatic paraplegia. They are less inclined to hope for a miracle, and take their handicap much more seriously than adolescents suffering from traumatic paraplegia. The higher the level of paraplegia, the more use is made of the coping strategy of "emotional control and social withdrawal". Regressive tendencies and depressive modes of coping were equally present in both groups. When investigating satisfaction with rehabilitation and with the own person, both groups showed very high satisfaction with the physical independence achieved and the possibilities of acting independently.(ABSTRACT TRUNCATED AT 250 WORDS)

[Extraosseous calcification in juvenile dermatomyositis. The ineffectiveness of EHDP]. / Extraossäre Calcifikationen bei juveniler Dermatomyositis. Unwirksamkeit von EHDP.

A now 20-year-old man was first diagnosed as having dermatomyositis when aged 12 years. At that time he had muscular weakness and heart failure followed a year later by heterotopic calcifications. For over seven years he was treated with corticoids, at times also with azathioprine or methotrexate. Nonetheless the calcifications progressed. Because of the extensive calcifications, predominantly of the extremities, he is severely disabled and has been confined to a wheel-chair. For one year he was treated with EHDP (1-hydroxyethylidenediphosphonate), up to 16 mg/dl per day. In addition he received prednisolone (10 mg/d) and azathioprine (100 mg/d). But radiologically there has been further slight progression of the calcifications, indicating that EHDP has been ineffective in this patient.

[From the care of cripples to the rehabilitation of the physically handicapped]. / Von der Krüppelfürsorge zur Rehabilitation Körperbehinderter.

Starting out from describing an orthopaedic institute with an orthopaedic-rehabilitative approach, established in 1780 by Venel in the Suisse canton of Waadt, a historical retrospective is given of the field of rehabilitation of the physically disabled, going back for some notable industrial and social medicine aspects to Graeco-Roman times. Reference is in particular made to the peculiarities of 19th century private, residential care, and the development of modern-day facilities for persons with a physical disability is outlined.

[Legal claim of integration (author's transl)]. / Rechtsanspruch auf Wiedereingliederung

For more than 100 years in different sectors the attempt has been made to define rehabilitation and to make it significant in the practice of rehabilitation. If you watch especially the past 70 years in Germany, then the legislature concerning the protection of health, the provident measures, the case of invalidity is so progressive and from year to year becoming more extensive, that there is actually always an area, in which there is a legal way to help the disabled. Nevertheless there are always gaps within a measure of rehabilitation which are necessary to be filled in common efforts. In the Federal Republic of Germany there is a legal clain of rehabilitative measures in a comprehensive way indeed, in which we think of the necessity of a federal rehabilitation law, since certain methods in the arrangement and exhausting of previous legislature for the disabled is often too difficult. In spite of best legal conditions, however, it has to be considered, and the dynamics in the accomplishment not only of the particular functions, but also of the special aims always will be significant for the understanding of a society. Legal claim of integration should therefore never be in doubt.