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Mambrey V, Loerbroks A. Psychosocial working conditions as determinants of slips and lapses, and poor social interactions with patients among medical assistants in Germany: A cohort study. PLoS One 2024; 19:e0296977. [PMID: 38625845 PMCID: PMC11020507 DOI: 10.1371/journal.pone.0296977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/21/2023] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE We sought to examine the relationship of unfavorable psychosocial working conditions with slips and lapses and poor patient interaction as well as potential intermediate factors among medical assistants (MAs) in Germany based on prospective data. METHODS We used data from 408 MAs from a 4-year cohort study (follow-up: 2021). At baseline, psychosocial working conditions were assessed by the established effort-reward-imbalance questionnaire and a MA-specific questionnaire with 7 subscales. Frequency of slips and lapses (e.g., pertaining to measurements and documentation) and the quality of patient interactions (e.g., unfriendliness or impatience) due to work stress were assessed at follow-up with three items each (potential score ranges = 3-15). Potential intermediate factors at baseline included work engagement (i.e., vitality and dedication (UWES)), work satisfaction (COPSOQ), anxiety (GAD-2), depressiveness (PHQ-2), and self-reported health. We ran multivariable linear regression using z-standardized exposures to estimate unstandardized coefficients (B) and 95% confidence intervals (CI). Potential intermediate factors were added separately to the regression models. Attenuation of the association between exposure and outcome toward the null value (B = 0) was interpreted as mediation. RESULTS High reward and lack of resources were weakly associated with the frequency of slips and lapses (the Bs were -0.18 and 0.23, respectively; p<0.05), with little evidence of mediation. With the exception of low recognition, all unfavorable psychosocial working conditions predicted a higher frequency of poor interactions with patients (p-values<0.01). These associations were attenuated by work engagement, work satisfaction, and health outcomes. CONCLUSION We found mostly non-significant associations between adverse psychosocial working conditions and the frequency of slips and lapses. However, unfavorable psychosocial working conditions among MAs predicted a higher frequency of poor interaction with patients due to stress.
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Affiliation(s)
- Viola Mambrey
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Elsässer A, Dreher A, Pietrowsky R, Flake F, Loerbroks A. Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study. BMC Emerg Med 2024; 24:62. [PMID: 38616266 PMCID: PMC11017549 DOI: 10.1186/s12873-024-00983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. METHODS For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). RESULTS The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. CONCLUSIONS Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.
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Affiliation(s)
- Antonia Elsässer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Frank Flake
- German Association of Emergency Medical Services (Deutscher Berufsverband Rettungsdienst e. V.), Lübeck, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
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Schmidt-Stiedenroth K, Mambrey V, Dreher A, Loerbroks A. Psychosocial working conditions and mental health among medical assistants in Germany: a scoping review. BMC Public Health 2024; 24:716. [PMID: 38448891 PMCID: PMC10916249 DOI: 10.1186/s12889-024-17798-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Medical assistants (MA) constitute one of the largest professions in outpatient health care in Germany. The psychosocial working conditions of health care staff are generally believed to be challenging and to thereby increase the risk of poor mental health. A review of MA's psychosocial working conditions and mental health is lacking, however. We aimed to systematically identify and summarize existing research on psychosocial working conditions and mental health of MA by addressing (1) Which methods, concepts, and instruments have been used to capture the psychosocial working conditions and mental health among MA in Germany? (2) What findings are available? and (3) What are the research gaps? METHODS We systematically searched Medline, Scopus, CCMed and Google Scholar. Using the Population Concept Context (PCC)-framework, we applied the following eligibility criteria: (a) Language: English or German, (b) publication between 2002-2022, (c) original study, (d) study population: mainly MA (i.e., ≥ 50% of the study population), (e) concept: psychosocial working conditions and/or mental health, and (f) context: Germany. Two reviewers extracted data independently, results were compared for accuracy and completeness. RESULTS Eight hundred twenty-seven sources were identified. We included 30 publications (19 quantitative, 10 qualitative, and one mixed methods study). Quantitative studies consistently reported high job satisfaction among MA. Quantitative and mixed methods studies frequently reported aspects related to job control as favorable working conditions, and aspects related to job rewards as moderate to unfavorable. Qualitative studies reported low job control in specific work areas, high demands in terms of workload, time pressure and job intensity, and a desire for greater recognition. Social interactions seemed to be important resources for MA. Few studies (n = 8) captured mental health, these reported inconspicuous mean values but high prevalences of anxiety, burnout, depression, and stress among MA. Studies suggested poorer psychosocial working conditions and mental health among MA during the COVID-19 pandemic. CONCLUSIONS Quantitative studies tend to suggest more favorable psychosocial working conditions among MA than qualitative studies. We suggest mixed methods to reconcile this alleged inconsistency. Future research should examine discrepancies between job satisfaction and unfavorable working conditions and if psychosocial working conditions and mental health remain changed after the COVID-19 pandemic.
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Affiliation(s)
- Kira Schmidt-Stiedenroth
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Viola Mambrey
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Malik E, Halling T, Dreher A, Marazia C, Esposito I, Loerbroks A, Hansson N. [Awards in pathology-a man's world?]. Pathologie (Heidelb) 2024; 45:59-66. [PMID: 37861701 PMCID: PMC10827953 DOI: 10.1007/s00292-023-01239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Awards provide their recipients with fame and recognition, and subsequently facilitate publications and acquisition of external funding through increased visibility. We hypothesize that despite increasing representation in pathology, women are underrepresented as awardees in the German Society of Pathology and consequently there is an associated imbalance between genders. MATERIAL AND METHODS Published data from the German Society of Pathology on female awardees during the period from 2000 to 2022 were examined. Only awards specifically dedicated to the field of pathology were considered. In addition, the publicly available data of the German Medical Association on gender and age distribution of pathologists in Germany were considered as reference material. RESULTS A total of six different awards were included in the analysis. Among the 143 awardees across 150 individual awards in the period from 2000 to 2022, 55 (38.4%) of the awardees were female compared to an average percentage of 31% of women working in the field of pathology in the 23-year period under consideration. Consequently, female awardees in pathology were not underrepresented when compared to the national figures on the proportion of women in the field of pathology. However, the distribution of female awardees across individual awards suggests that women were increasingly represented in less prestigious research and doctoral awards, while men made up a large proportion of awardees of honorary awards (0% women) and prestigious awards (17% women).
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Affiliation(s)
- Elisa Malik
- Institut für Geschichte, Theorie und Ethik der Medizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Thorsten Halling
- Institut für Geschichte, Theorie und Ethik der Medizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Annegret Dreher
- Institut für Arbeits-, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Chantal Marazia
- Institut für Geschichte, Theorie und Ethik der Medizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Irene Esposito
- Institut für Pathologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Adrian Loerbroks
- Institut für Arbeits-, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Nils Hansson
- Institut für Geschichte, Theorie und Ethik der Medizin, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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Salandi J, Hayden MC, Heinrichs K, Limbach M, Schultz K, Schwarzl G, Neumeister W, Loerbroks A. Can an educational intervention in the context of inpatient pulmonary rehabilitation improve asthma self-management at work? A study protocol of a randomized controlled trial. BMC Pulm Med 2024; 24:40. [PMID: 38233800 PMCID: PMC10795332 DOI: 10.1186/s12890-024-02847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Asthma self-management (e.g., trigger avoidance or correct medication use) is a cornerstone of therapy. Its successful implementation in everyday working life is determined by psychosocial working conditions, in particular by support from superiors and colleagues and the job decision latitude (i.e., when and how to carry out which tasks). To empower individuals with asthma to modify their working conditions, employees need to use certain communication skills and acquire specific knowledge. Both could be taught as part of patient education during pulmonary rehabilitation. Therefore, the aim of the planned study is the development and multicentre implementation of an education module for individuals with asthma during their rehabilitation and to generate evidence on its effectiveness. METHODS Participants (n ≥ 180) will be recruited, randomized into an intervention and a control group, trained and surveyed in two rehabilitation clinics. The intervention group will receive the supplementary patient education module "Asthma and Work" while the control group will participate in a program on " Eating behaviour" (both 2 × 50 min). The effectiveness of the intervention will be examined based on pre-post measurements (T1 and T2) and a 3-month follow-up (T3). We will consider behavioural intention (T2) and asthma self-management at work (T3) as primary outcomes. Secondary outcomes will include self-management-related knowledge, self-efficacy, number of sick days, number of exacerbations, asthma control (Asthma Control Test), asthma-related quality of life (Marks Asthma Quality of Life Questionnaire), and subjective employment prognosis (Brief Scale Measuring the Subjective Prognosis of Gainful Employment). The pre-post comparisons are to be evaluated using univariate analyses of covariance. DISCUSSION Improving asthma self-management at work could increase the work ability and social participation of employees with asthma. This could reduce costs, e.g. in terms of asthma-related sick leave. TRIAL REGISTRATION German Clinical Trials Register (ID: DRKS00031843).
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Markus C Hayden
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Limbach
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Konrad Schultz
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Gabriele Schwarzl
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | | | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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Mambrey V, Ritz-Timme S, Loerbroks A. Prevalence and correlates of workplace violence against medical assistants in Germany: a cross-sectional study. BMC Health Serv Res 2023; 23:350. [PMID: 37038136 PMCID: PMC10088275 DOI: 10.1186/s12913-023-09331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Workplace violence is widespread, but studies on workplace violence against health professions in outpatient settings are sparse. We aimed to examine, for the first time, the prevalence of workplace violence against medical assistants as well as potential sociodemographic, occupational and health-related correlates of the exposure to workplace violence. METHODS We used data from a survey (03-05/2021) among medical assistants in Germany (n = 424). We assessed the 12-month prevalence (yes/no) of verbal violence, physical violence, and sexual harassment as well as the types of perpetrators of workplace violence. Further, information was gathered on sociodemographic (e.g., age, educational level), occupational (e.g., years in job), and mental health-related factors (i.e., anxiety, depression). The 12-month prevalences of the different types of workplace violence were merged into a single variable ("any workplace violence" vs. none) for association analysis. We ran multivariable Poisson regression models to examine potential associations between sociodemographic and occupational correlates (i.e., independent variables) with any workplace violence as dependent variable and in addition between any workplace violence (independent variable) and dichotomized mental health as dependent variable. RESULTS Overall, 59.4% of the medical assistants reported verbal violence, 5.9% reported physical violence, 3.8% reported sexual harassment, and 60.1% reported any workplace violence in the previous 12 months. Patients were reported to be the main perpetrators, followed by patients' relatives. Younger age, being single, and working in a medical care center were sociodemographic and occupational correlates of workplace violence (PRs ≥ 1.27). Workplace violence was significantly associated with mental health variables (PRs ≥ 1.72). CONCLUSION Medical assistants experience workplace violence, in particular verbal violence. To devise preventive measures, prospective studies are needed to confirm the potential risk groups for workplace violence and the potential mental health sequels of workplace violence observed in our study.
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Affiliation(s)
- Viola Mambrey
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany.
| | - Stefanie Ritz-Timme
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
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Salandi J, Vu-Eickmann P, Apfelbacher C, Sheikh A, Loerbroks A. Implementing the Patient Needs in Asthma Treatment (NEAT) questionnaire in routine care: a qualitative study among patients and health professionals. BMC Pulm Med 2023; 23:21. [PMID: 36650461 PMCID: PMC9843883 DOI: 10.1186/s12890-022-02293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Many patients with asthma report unmet health care needs. The Patient Needs in Asthma Treatment (NEAT) questionnaire is a validated instrument to quantify these unmet needs. We explored how health professionals evaluated the instrument's utility as well as patients' and professionals' perspectives of how NEAT could be incorporated into routine clinical practice. METHODS Qualitative interviews were conducted by telephone between February and September 2021 with 19 patients with asthma and 21 health professionals (i.e., general practitioners, pneumologists, health professionals in pulmonary rehabilitation, and medical assistants). Interview recordings were transcribed verbatim and content-analyzed using both deductive and inductive approaches using MAXQDA. RESULTS Health professionals could see the potential value of using NEAT to inform clinical decisions. However, health professionals tended to be skeptical towards the routine use of NEAT in outpatient settings, mainly due to a lack of time. Implementation of NEAT was seen as more valuable in the context of patient education (i.e., in Disease Management Programs [DMPs] or pulmonary rehabilitation) by patients and health professionals alike, because it offered greater opportunities to address any unmet needs identified. Both patients and health professionals considered it more useful to use the questionnaire for the first time some time after the initial diagnosis has been made (e.g., when the treatment regime is found rather than at time of initial diagnosis). In the context of DMPs and pulmonary rehabilitation, NEAT could be used twice, i.e., before and after patient education to support patient-centered planning and evaluation. CONCLUSION Both patients and health professionals consider the use of the NEAT, in particular in educational programs (i.e., during DMPs or pulmonary rehabilitation), as feasible and useful. There is now a need to undertake a feasibility trial in routine care.
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Affiliation(s)
- Julia Salandi
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Patricia Vu-Eickmann
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Christian Apfelbacher
- grid.5807.a0000 0001 1018 4307Institute of Social Medicine and Health Systems Research (ISMHSR), Medical Faculty, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Asthma UK Centre for Applied Research, Usher Institute, Old Medical School, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG UK
| | - Adrian Loerbroks
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
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Braun P, Schwientek AK, Angerer P, Guthardt L, Icks A, Loerbroks A, Apolinário-Hagen J. Investigating information needs and preferences regarding digital mental health services among medical and psychology students in Germany: A qualitative study. Digit Health 2023; 9:20552076231173568. [PMID: 37256006 PMCID: PMC10226173 DOI: 10.1177/20552076231173568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Background Since 2020, physicians and psychotherapists in Germany can prescribe digital mental health services (dMHSs). However, even future healthcare professionals (HCPs), such as medical and psychology students, remain reluctant to use dMHSs, although they are a risk group for mental health issues themselves. Reasons include scepticism and lacking awareness of dMHSs, which can be addressed by acceptance-facilitating interventions (AFIs) such as information strategies. To date, though, little is known about their information needs. Methods Semi-structured interviews with n = 21 students were conducted between August and September 2021. Students of legal age studying psychology or medicine at a German university could participate. Interview recordings were transcribed verbatim and content-analyzed according to Mayring, using deductive and inductive coding. Results Most students reported having little experience with dMHSs. Digital health has barely been raised in their study, even though it was perceived as crucial for personal needs as well as in preparation for their work as HCPs. Students favoured receiving information on and recommendations for dMHSs from their university via, e.g. social media or seminars. Among others, information about data safety, scientific evidence base and application scope were preferred. Additionally, information on costs as well as user reviews seemed to be essential components of information strategies because students were concerned that high costs or low usability would hinder uptake. Conclusions The results give first insights on how future HCPs would like to be informed on dMHSs. Future research should focus on systematic variations of AFIs' components mimicking real-world decision scenarios to increase the adoption of dMHSs.
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Affiliation(s)
- Pia Braun
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Ann-Kathrin Schwientek
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital rechts der Isar, School of Medicine, Technical
University of Munich, Munchen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Lisa Guthardt
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research
and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Gao W, Strümpell C, Loerbroks A. Workplace stressors and their association with hair cortisol concentrations among ready-made garment workers in Bangladesh: A cross-sectional study. J Occup Health 2023; 65:e12426. [PMID: 37752694 PMCID: PMC10522888 DOI: 10.1002/1348-9585.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVES Psychosocial working conditions of ready-made garment (RMG) workers have been associated with poorer self-reported health outcomes. However, no such research has been done with respect to physiological markers that are considered to reflect stress. We consequently aimed to investigate associations of psychosocial working conditions with such a marker, that is, hair cortisol, among RMG workers in Bangladesh. METHODS We conducted semi-structured face-to-face interviews in labor colonies in the Mirpur area, Dhaka, Bangladesh, in February and March 2021 with individuals identifying as garment workers. The interview inquired after various workplace stressors and resources (i.e., workplace support, workplace bullying, vertical trust, beneficial leadership, work-family conflict, and financial issues including savings, debts, financial obligations, and financial support). In addition, hair samples of 2 cm length were collected from participants. Hair cortisol concentrations (HCC) were determined based on liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear regression models were run to detect possible associations of workplace stressors and resources with HCC. RESULTS In total, data of 576 participants were included in the analysis (71.9% female, mean age = 25.9 years). Mean HCC was 4.4 pg/mg (standard deviation = 2.1 pg/mg). The sole variable significantly associated with increased HCC was "having to keep your job to support your children or spouse financially" (β = 0.28 [95% confidence interval 0.02-0.55]). CONCLUSIONS The sole workplace stressor significantly associated with increased HCC was the necessity to keep one's job to support children or spouse financially. This observation can, however, barely be disentangled from the fact that one has children/a spouse.
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Affiliation(s)
- Annegret Dreher
- Faculty of Medicine, Institute of Occupational, Social, and Environmental Medicine, Centre for Health and SocietyHeinrich‐Heine‐University DüsseldorfDüsseldorfGermany
| | - Rita Yusuf
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD)Independent UniversityDhakaBangladesh
| | - Hasan Ashraf
- Department of AnthropologyJahangirnagar UniversityDhakaBangladesh
| | - Syed A. K. Shifat Ahmed
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD)Independent UniversityDhakaBangladesh
| | - Wei Gao
- Faculty of Psychology, Chair of Biological PsychologyTechnical University DresdenDresdenGermany
| | - Christian Strümpell
- Institute of Social and Cultural AnthropologyUniversity of HamburgHamburgGermany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social, and Environmental Medicine, Centre for Health and SocietyHeinrich‐Heine‐University DüsseldorfDüsseldorfGermany
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Wang L, Shi Y, Hu Z, Li Y, Ang Y, Jing P, Zhang B, Cao X, Loerbroks A, Li J, Zhang M. Longitudinal Associations of Work Stress with Changes in Quality of Life among Patients after Acute Coronary Syndrome: A Hospital-Based Study. Int J Environ Res Public Health 2022; 19:17018. [PMID: 36554897 PMCID: PMC9779479 DOI: 10.3390/ijerph192417018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Targeting a sample of Chinese employees in this study, the correlation of work stress with changes in quality of life (QoL) was explored subsequent to acute coronary syndrome (ACS). (2) Methods: Patients suffering from the first ACS episode, with regular paid work before ACS, were eligible for this one-year longitudinal study. Effort-reward imbalance (ERI), together with job strain (JS) models, were employed to evaluate work stress before discharge, and QoL prior to discharge (baseline), as well as at 1, 6, and 12 months following discharge, were measured using the 8-Items Short Form (SF-8), in addition to the Seattle Angina Questionnaire (SAQ). Moreover, generalized estimating equations were used to determine the relationship of work stress to longitudinal QoL variations. (3) Results: After adjusting for covariates, high work stress at the baseline measured by JS was associated with the slow recovery of both mental health (p < 0.01) and physical health (p < 0.05) in SF-8, while ERI-measured work stress was related to slower improvement in SF-8 physical health (p < 0.001), SAQ-angina stability (AS) (p < 0.05), SF-8 mental health (p < 0.001), and SAQ-angina frequency (AF) (p < 0.05). After mutual adjustment for JS and ERI, high work stress as assessed by JS displayed no correlation with any QoL alteration (all p > 0.05), whereas ERI-determined work stress at a high level still presented a relationship to slow improvement in SF-8 physical health, SAQ-AS, SF-8 mental health, and SAQ-AF (all p < 0.05). (4) Conclusion: Work stress was associated with slow recovery of QoL in patients with ACS across one year. For ACS patients, ERI was a stronger predictor of QoL variations than JS.
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Affiliation(s)
- Luqiao Wang
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yunke Shi
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Zhao Hu
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yanyan Li
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Yan Ang
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Pan Jing
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Bangying Zhang
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Xingyu Cao
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
- School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Min Zhang
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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11
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Mambrey V, Angerer P, Loerbroks A. Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study. BMC Health Serv Res 2022; 22:1501. [PMID: 36494848 PMCID: PMC9733172 DOI: 10.1186/s12913-022-08895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We sought to examine the association of psychosocial working conditions with concerns to have made important medical errors and to identify possible intermediate factors in this relationship. METHODS We used data from 408 medical assistants (MAs) in Germany who participated in a 4-year prospective cohort study (follow-up period: 03-05/2021). Psychosocial working conditions were assessed at baseline by the effort-reward imbalance questionnaire and by a MA-specific questionnaire with seven subscales. MAs reported at follow-up whether they are concerned to have made an important medical error throughout the last 3 months, 12 months or since baseline (yes/no). These variables were merged into a single variable (any affirmative response vs. none) for primary analyses. Potential intermediate factors measured at baseline included work engagement (i.e., vigor and dedication, assessed by the UWES), work satisfaction (COPSOQ), depression (PHQ-2), anxiety (GAD-2) and self-rated health. We ran Poisson regression models with a log-link function to estimate relative risks (RRs) and 95% confidence intervals (CIs). Doing so, we employed the psychosocial working condition scales as continuous variables (i.e. z-scores) in the primary analyses. Potential intermediate factors were added separately to the regression models. RESULTS Poor collaboration was the only working condition, which was significantly predictive of the concern of having made an important medical error (RR = 1.26, 95%CI = 1.00-1.57, p = 0.049). Partial intermediate factors in this association were vigor, depression and anxiety. CONCLUSION We found weak and mostly statistically non-significant associations. The only exception was poor collaboration whose association with concerns to have made an important medical error was partially explained by vigor and poor mental health.
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Affiliation(s)
- Viola Mambrey
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Peter Angerer
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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12
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Strümpell C, Loerbroks A. Work-family conflict, financial issues and their association with self-reported health complaints among ready-made garment workers in Bangladesh: a cross-sectional study. Int Arch Occup Environ Health 2022; 96:483-496. [PMID: 36480083 PMCID: PMC9734729 DOI: 10.1007/s00420-022-01942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aims to quantify the degree of work-family conflict (WFC) and financial issues among ready-made garment (RMG) workers in Bangladesh and to investigate their potential associations with self-reported health outcomes. METHODS We conducted a cross-sectional survey among 1118 RMG workers in labor colonies in Dhaka, Bangladesh, in February and March 2021. Descriptive analyses were performed to characterize WFC (i.e., family life disturbing the job or facing problems in family due to the job) and financial issues (i.e., savings, debt, financial obligations, financial support). We ran multivariable Poisson regression models to examine possible associations between WFC and financial issues and workers' health (self-reported general health and 10 specific health complaints). RESULTS We found low levels of WFC, low levels of savings, moderate levels of debt, and high levels of financial obligations: virtually all workers agreed they had to keep their job to financially support their spouse, children or other relatives. Only about a third of workers expected they would be able to receive financial support in case of a job loss. Work-family conflict was positively associated with poor health but not consistently with specific symptoms. Financial support was negatively associated, whereas being indebted was weakly positively associated with poor health. CONCLUSIONS Our findings suggest low levels of WFC among RMG workers but high levels of financial obligations. Work-family conflict was positively associated with poor health, but not consistently with specific symptoms. Being indebted was weakly positively associated with poor health. Future prospective studies are needed to confirm these findings.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Rita Yusuf
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Dhaka, Bangladesh
| | - Hasan Ashraf
- Department of Anthropology, Jahangirnagar University, Dhaka, Bangladesh
| | - Syed A K Shifat Ahmed
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Dhaka, Bangladesh
| | - Christian Strümpell
- Institute of Social and Cultural Anthropology, University of Hamburg, Hamburg, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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13
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Dreher A, Mambrey V, Loerbroks A. Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study. BMC Prim Care 2022; 23:273. [PMID: 36329407 PMCID: PMC9632591 DOI: 10.1186/s12875-022-01880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
Background In Germany, general practices are usually contacted first by patients with health complaints, including symptoms characteristic of SARS-CoV-2. Within general practices, medical assistants (MAs) are the first contact person for patients and perform various tasks in close physical patient contact. Working conditions of MAs have been characterized as challenging, e.g., due to low salaries, a high workload, time pressure and frequent interruptions. The potential changes of working conditions and job-related challenges experienced by MAs due to the SARS-CoV-2 pandemic have not been fully explored. We aimed to address this knowledge gap among MAs working in general practices in Germany. Methods Semi-structured telephone interviews were conducted between March and April 2021 with 24 MAs. Medical assistants of legal age, who worked in general practices in Germany, and who were continuously employed and without change of employer in 2020 were eligible for participation. Interview recordings were transcribed verbatim and content-analyzed using MAXQDA, using deductive and inductive coding. Results The SARS-CoV-2 pandemic posed great challenges for MAs, including a dramatic increase in workload, changes in occupational tasks, increased hygiene measures, rearrangements of work organization, childcare issues, and structural and personnel challenges within their practice. Participants described both improved but also worsened collaboration with their employers and colleagues due to the pandemic. Many MAs complained about issues regarding SARS-CoV-2-related billing processes and an increase in unpleasant patient behavior, including disregard of practice rules or frequent verbal insults. Many also did not feel adequately appreciated by politics, media, or society for their efforts during the pandemic. Positive changes were perceived to be the expansion of digital communication channels and a growing social cohesiveness of practice teams. Conclusions Our study suggests that the SARS-CoV-2 pandemic posed great challenges for MAs. The pandemic seems to have worsened MAs’ working conditions, which had been described as challenging already prior to the pandemic. In order to improve job satisfaction and to prevent loss of healthcare personnel, measures must be taken to improve working conditions of MAs in general practices. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01880-y.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
| | - Viola Mambrey
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany
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14
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Loerbroks A, Winkler J, Vu-Eickmann P, Muth T. [Potential improvements of psychosocial working conditions in general practices: Development of a discussion guide for medical assistants for staff appraisals]. Z Evid Fortbild Qual Gesundhwes 2022; 174:82-89. [PMID: 36175331 DOI: 10.1016/j.zefq.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Staff appraisals can provide employees and their supervisors with the opportunity to improve their communication and collaboration. However, one can assume that staff appraisals are not yet common instruments for human resources management in physician practices. The aim of this study was to develop a discussion guide for medical assistants (MAs) in general practices to support MAs in preparing, carrying out and documenting staff appraisals. METHODS MAs were recruited through their professional organization [Verband medizinischer Fachberufe e. V.] and social media (06/2020-10/2020). An early draft of the discussion guide was devised comprising an introduction, a checklist for logistic preparation, a documentation sheet and a section to prepare the content of the meeting. The discussion guide was revised based on interviews with MAs who also rated the instrument. Data collection, analyses and the revision of the guide were carried out in an iterative process to the point where no further significant suggestions for improvement were made. RESULTS In total, 20 interviews were conducted. Revisions were based on recommendations pertaining to a) how to interact with the supervisor (e. g., raising awareness of and responding to changes of the topic; anticipating counterarguments, scheduling of follow-up meetings), b) the choice of topics, c) additional measures to respond to MAs' needs (e. g., rotation to distribute tasks), and d) the preparation of the staff appraisal (e. g., rehearsals with an experienced colleague). Both the likelihood to use the guide in the future and its usefulness for staff appraisals were considered to be high. DISCUSSION AND CONCLUSION We developed a discussion guide for and with MAs in general practices which can be helpful in preparing, conducting and documenting staff appraisals. This serves the purpose of bringing one's psychosocial working conditions to the supervisor's attention and to possibly improve them. To further improve the tool, future research should explore the experiences of MAs and physicians who actually use the discussion guide.
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Affiliation(s)
- Adrian Loerbroks
- Institut für Arbeits-, Sozial- und Umweltmedizin, centre for health and society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
| | - Julia Winkler
- Institut für Arbeits-, Sozial- und Umweltmedizin, centre for health and society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Patricia Vu-Eickmann
- Institut für Arbeits-, Sozial- und Umweltmedizin, centre for health and society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Thomas Muth
- Institut für Arbeits-, Sozial- und Umweltmedizin, centre for health and society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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15
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Braun P, Schwientek AK, Loerbroks A, Apolinário-Hagen J. How to design information strategies on e-mental health services for prospective healthcare providers. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Among prospective healthcare providers (HCPs) such as medical students, mental health problems are prevalent, but they seem reluctant to seek help. Barriers include fear of stigmatization or limited resources of counseling centers. Electronic mental health services (eMHSs) seem to be promising low-threshold and evidence-based tools for increasing treatment availability. However, uptake rates remain low. Reasons include skepticism and lacking awareness, which can be addressed through acceptance-facilitating interventions (AFIs) such as multi-attributes information strategies. To date little is known about how to design AFIs to meet prospect HCPs’ information needs and preferences.
Methods
Between August 2021 and June 2022, n = 21 semi-structured online interviews and n = 3 co-design workshops were conducted with medical and psychology students across Germany to define attributes and levels of information strategies. Interviews were recorded, transcribed and content-analyzed using MAXQDA.
Results
Most students reported having little knowledge about eMHSs but would have liked to be informed at the beginning of their studies or as an integral part of their study program. We identified 5 attributes that information strategies should consist of: information source (e.g., student counseling center), information path (e.g., flyer), timing (e.g., during freshman week), recommendation (e.g., from HCPs), and quality criterion (e.g., evidence-base). Attributes included 4 to 6 levels. Concerning design preferences, students favored green or blue as colors, and short texts with images.
Conclusions
For a comprehensive dissemination of eMHSs into the healthcare system, prospective HCPs need to be educated on eMHSs. This study gives first insight into how AFIs should be designed to inform prospective HCPs. Future research should focus on systematic variations of AFIs’ attributes and their levels mimicking real-world decision scenarios through discrete choice experiments.
Key messages
• Through tailored AFIs, prospective HCPs can be informed about eMHSs for both personal and professional needs.
• Our results give student counseling centers with limited resources clear guidelines on how to inform prospective HCPs on low-threshold eMHSs.
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Affiliation(s)
- P Braun
- Medical Faculty, Heinrich Heine University Dusseldorf , Dusseldorf, Germany
| | - A-K Schwientek
- Medical Faculty, Heinrich Heine University Dusseldorf , Dusseldorf, Germany
- Department of Psychiatry and Psychotherapy, Technical University of Munich , Munich, Germany
| | - A Loerbroks
- Medical Faculty, Heinrich Heine University Dusseldorf , Dusseldorf, Germany
| | - J Apolinário-Hagen
- Medical Faculty, Heinrich Heine University Dusseldorf , Dusseldorf, Germany
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16
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Halling T, Dreher A, Mambrey V, Marazia C, Loerbroks A, Hansson N. Prize trends in rheumatology: the Gender Award Gap. Lancet Rheumatol 2022; 4:e655-e656. [PMID: 38265960 DOI: 10.1016/s2665-9913(22)00184-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 01/26/2024]
Affiliation(s)
- Thorsten Halling
- Heinrich-Heine-University, Medical Faculty, Centre for Health and Society, Department of History, Philosophy and Ethics of Medicine, 40225 Düsseldorf, Germany
| | - Annegret Dreher
- Department of Occupational, Social and Environmental Medicine, 40225 Düsseldorf, Germany
| | - Viola Mambrey
- Department of Occupational, Social and Environmental Medicine, 40225 Düsseldorf, Germany
| | - Chantal Marazia
- Heinrich-Heine-University, Medical Faculty, Centre for Health and Society, Department of History, Philosophy and Ethics of Medicine, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- Department of Occupational, Social and Environmental Medicine, 40225 Düsseldorf, Germany
| | - Nils Hansson
- Heinrich-Heine-University, Medical Faculty, Centre for Health and Society, Department of History, Philosophy and Ethics of Medicine, 40225 Düsseldorf, Germany.
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17
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Strümpell C, Loerbroks A. Social stressors and social resources at work and their association with self-reported health complaints among ready-made garment workers in Bangladesh: a cross-sectional study. BMC Public Health 2022; 22:1793. [PMID: 36131265 PMCID: PMC9492303 DOI: 10.1186/s12889-022-14173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bangladesh is one of the world's largest garment exporters. Physical working conditions of garment workers are precarious and known to largely affect their health. Research on garment workers' psychosocial working conditions, however, is scarce. We aimed to quantify psychosocial working conditions of garment workers and possible associations with workers' health. METHODS We conducted a cross-sectional survey among 1,118 ready-made garment (RMG) workers in labor colonies in Dhaka, Bangladesh, in February 2021. Descriptive analyses were performed to characterize social stressors (e.g., being bullied at work, poor leadership) and social resources at work (e.g., receiving support at work, vertical trust between management and employees, beneficial leadership) and workers' health (self-reported overall health and 10 specific health complaints). To examine links of social stressors and social resources with self-reported health outcomes we ran multivariable Poisson regression models yielding prevalence ratios (PR) and 95% confidence intervals (CI). RESULTS We found low to moderate levels of workplace bullying and high levels of poor leadership (i.e., supervisors not caring about workers' problems). We also found high levels of social support, vertical trust and beneficial leadership (i.e., supervisors taking decisions free of bias). Garment workers frequently suffered from health complaints, first and foremost headache (68.3%), cold (55.3%), and back pain (50.7%). Health outcomes were poorer among workers who reported to be bullied at work versus not bullied (e.g., PR 1.55 [95% CI 1.32-1.92] for poor self-reported health when bullied by colleagues) and health was better among those reporting to feel supported versus unsupported (e.g., PR 0.61 [0.52-0.71] for poor self-reported health when supported by supervisor). Perceived vertical trust between workers and management was weakly associated with better health. Leadership behavior did not display a consistent pattern. CONCLUSIONS Our findings suggest that working conditions of RMG workers are rather good (e.g., characterized by low levels of bullying and high levels of support, vertical trust and beneficial leadership). The majority of workers reported good or very good health, although health complaints were frequently mentioned, first and foremost headache, cold, and back pain. Associations between psychosocial working conditions and health indicate worse working conditions being associated with poorer health.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rita Yusuf
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Plot #16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka, 1229, Bangladesh
| | - Hasan Ashraf
- Department of Anthropology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Syed A K Shifat Ahmed
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Plot #16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka, 1229, Bangladesh
| | - Christian Strümpell
- Institute of Social and Cultural Anthropology, University of Hamburg, Edmund-Siemers-Allee 1, West, 20146, Hamburg, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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18
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Scharf J, Loerbroks A, Angerer P. Rückkehr an den Arbeitsplatz von Beschäftigten nach einer psychischen Erkrankung. Zbl Arbeitsmed 2022; 72:228-235. [PMID: 35729896 PMCID: PMC9188830 DOI: 10.1007/s40664-022-00471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 10/30/2022]
Abstract
Zusammenfassung
Zielstellungen
Die Rückkehr an den Arbeitsplatz scheitert häufig an widersprüchlichen Erwartungen und Zielen der beteiligten Akteure. Aufgrund ihrer medizinischen Expertise und arbeitsplatzbezogenen Kenntnisse könnten Betriebsärzte bzw. Betriebsärztinnen gegenseitiges Verständnis und Zusammenarbeit der Beteiligten effektiv fördern. Es soll ein Leitfaden und eine Schulung zu dessen Anwendung entwickelt werden, die Betriebsärzte bzw. Betriebsärztinnen unterstützen, eine vermittelnde Rolle bei der Eingliederung psychisch erkrankter Beschäftigter einzunehmen.
Methoden
Basierend auf einer Literaturrecherche sowie umfangreichen qualitativen Vorarbeiten zu den Erwartungen der Akteure, wurden in mehreren konsekutiven Schritten ein Leitfaden und Schulungsmaterialien partizipativ mit Arbeitsmedizinerinnen und Arbeitsmedizinern und anderen Experten bzw. Expertinnen entwickelt, diskutiert und überarbeitet. Schließlich wurden Betriebsärzte und Betriebsärztinnen in Weiterbildungskursen in der Anwendung des Leitfadens geschult, um ihn anschließend im Arbeitsalltag auf Praktikabilität zu überprüfen.
Ergebnisse
Der Leitfaden informiert über die potenziell unterschiedlichen Erwartungen der Akteure bzw. Akteurinnen an den Rückkehrprozess und bietet umfassende Handlungshilfen für die vermittelnde Arbeit des Betriebsarztes/der Betriebsärztin. Nach der etwa zweistündigen manualisierten Schulung setzten innerhalb von 4 Monaten 9 von 37 Teilnehmern den Leitfaden für Rückkehrgespräche ein, 6 von 9 bewerteten ihn als hilfreich.
Schlussfolgerung
Die ersten positiven Anwendungserfahrungen des mit der Zielgruppe entwickelten Materials rechtfertigt eine größere Interventionsstudie, um den zu vermutenden positiven Effekt auf den Wiedereingliederungserfolg zu untersuchen.
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19
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Mambrey V, Ritz-Timme S, Loerbroks A. Gewalterfahrungen am Arbeitsplatz unter Medizinischen
Fachangestellten in Deutschland – eine
Querschnittsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- V Mambrey
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Universität
Düsseldorf, Düsseldorf, Deutschland
| | - S Ritz-Timme
- Heinrich-Heine-Universität Düsseldorf, Institut
für Rechtsmedizin, Universität Düsseldorf,
Düsseldorf, Deutschland
| | - A Loerbroks
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Universität
Düsseldorf, Düsseldorf, Deutschland
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20
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Strümpell C, Loerbroks A. Der Zusammenhang zwischen sozialen Stressoren und sozialen Ressourcen
am Arbeitsplatz sowie Work-Family-Conflict mit schlechter Gesundheit bei
Beschäftigen in Textilfabriken in Bangladesch: Eine
Querschnittsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Dreher
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Düsseldorf,
Deutschland
| | - R Yusuf
- Independent University, International Center for Biotechnology and
Health (ICBH), Center for Health Population and Development (CHPD), Dhaka,
Bangladesch
| | - H Ashraf
- Jahangirnagar University, Department of Anthropology, Dhaka,
Bangladesch
| | - SAKS Ahmed
- Independent University, International Center for Biotechnology and
Health (ICBH), Center for Health Population and Development (CHPD), Dhaka,
Bangladesch
| | - C Strümpell
- Universität Hamburg, Institut für Ethnologie, Hamburg,
Deutschland
| | - A Loerbroks
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Düsseldorf,
Deutschland
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21
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Mambrey V, Angerer P, Loerbroks A. Psychosoziale Arbeitsbedingungen als Determinanten der Sorge, einen
wichtigen medizinischen Fehler gemacht zu haben und mögliche
intermediäre Faktoren dieses Zusammenhangs – eine Kohortenstudie
unter Medizinischen Fachangestellten. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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22
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Braun P, Schwientek AK, Guthardt L, Loerbroks A, Apolinário-Hagen J. How to raise awareness about electronic mental health services among prospect healthcare providers: a qualitative study on information preferences. Eur Psychiatry 2022. [PMCID: PMC9565538 DOI: 10.1192/j.eurpsy.2022.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Since fall 2020, electronic mental health services (eMHSs) like apps can be prescribed by physicians and psychotherapists in Germany. However, future healthcare providers such as medical and psychology students remain reluctant to adopt eMHSs, even though they represent a vulnerable group with respect to developing mental health problems themselves. Reasons include scepticism and lacking awareness, which can be addressed by tailored multi-component information material. However, to date little is known about the most important information attributes to educate prospect healthcare providers on eMHSs.
Objectives
The objective of this study is to explore information preferences on eMHSs among medical and psychology students.
Methods
A total of 21 semi-structured interviews were conducted (n=16 medical and n=5 psychology students) across Germany based on a topic guide. Interviews were recorded, transcribed and content-analyzed using MAXQDA.
Results
Most students reported having little knowledge about eMHSs and that the issue of digital health has never been raised in their study, even though it is perceived as important. Concerning information design preferences, students favored light, neutral colors and a combination of short, compressible texts with matching images. Regarding the content, information about data protection, the underlying evidence base and the match with personal needs were perceived as important for utilization intentions, while there was little interest in tailored information focusing exclusively on psychology or medical students.
Conclusions
This study provides first insights into eMHS information preferences among prospect healthcare providers. In a next step, a discrete-choice conjoint experiment will be conducted to test the relevant information features on eMHSs.
Disclosure
No significant relationships.
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Loerbroks A, Vu-Eickmann P, Dreher A, Mambrey V, Scharf J, Angerer P. The Relationship of Medical Assistants' Work Engagement with Their Concerns of Having Made an Important Medical Error: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:ijerph19116690. [PMID: 35682274 PMCID: PMC9180158 DOI: 10.3390/ijerph19116690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022]
Abstract
Objectives: We aimed to examine associations of work engagement with self-reported concerns of having made medical errors among medical assistants. Methods: We used cross-sectional questionnaire data from 424 medical assistants in Germany (collected between March and May 2021). The nine-item Utrecht Work Engagement Scale assessed the subdimensions vigor, dedication, and absorption. Participants further reported whether they were concerned that they had made an important medical error in the last three months. Work engagement scores were used both as categorized variables (i.e., highest tertile vs. remaining tertiles) and continuous variables (i.e., z-scores) and their associations with concerns to have made an important medical error were examined using multivariable logistic regression to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: High vigor (versus low vigor) and high dedication (versus low dedication) were associated with substantially reduced odds of expressing concerns to have made an important medical error (OR = 0.19, 95%CI = 0.04–0.85 and OR = 0.25, 95%CI = 0.07–0.88, respectively), but absorption was not (OR = 1.10, 95%CI = 0.43–2.86). Analyses with z-scores confirmed this pattern of associations for vigor and absorption, but less so for dedication (OR = 0.72, 95%CI = 0.47–1.11). Conclusions: Vigor and possibly also dedication are inversely related to concerns of having made an important medical error. Our findings may suggest that promotion of these subdimensions of work engagement may improve patient safety.
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Affiliation(s)
- Adrian Loerbroks
- Correspondence: ; Tel.: +49-(0)-211-81-08032; Fax: +49-(0)-211-81-18586
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24
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Scharf J, Vu-Eickmann P, Angerer P, Müller A, in der Schmitten J, Loerbroks A. Work-Related Intervention Needs of Medical Assistants and How to Potentially Address Them according to Supervising General Practitioners: A Qualitative Study. Int J Environ Res Public Health 2022; 19:ijerph19031359. [PMID: 35162382 PMCID: PMC8835399 DOI: 10.3390/ijerph19031359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
Work stress is common among health care professionals and this observation also holds true for general practitioners (GPs) and their medical assistance staff in Germany. Therefore, prior studies have examined the work-related intervention needs of medical assistants (MAs). We sought to explore potential interventions that may help to address these needs according to GPs’ views. Between December 2018 and April 2019 GPs were recruited via physician networks and through personal visits in general practices. Information on the nature and prevalence of 20 work-related intervention needs of MAs was presented to GPs. GPs then participated in a qualitative interview to reflect on the MAs’ needs. Qualitative content analysis according to Mayring was carried out using MAXQDA. A total of 21 GPs participated and perceived many of the needs as justified. The least understanding was expressed for requests of MA related to occupational aspects that were already known prior to hiring. The responsibility to address needs was often assigned to the German health policy. GPs expressed though that they considered addressing the need for better leadership style as their own responsibility as supervisors. Furthermore, professional training was discussed as one opportunity to raise the recognition and remuneration of MAs. Measures to address the work-related intervention needs of MAs and to thereby improve the working conditions of MAs were discussed with GPs.
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Affiliation(s)
- Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141 Essen, Germany;
| | - Jürgen in der Schmitten
- Institute of General Practice, University of Duisburg-Essen, Pelmanstr. 81, 45131 Essen, Germany;
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
- Correspondence: ; Tel.: +49-211-81-08032
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25
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Braun P, Schwientek AK, Guthardt L, Loerbroks A, Apolinário-Hagen J. Insights into the needs and preferences for eMental health information among prospect healthcare providers: a qualitative study. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Heinrichs K, Hermülheim V, Pilz González L, Loerbroks A. When in Doubt … Career Indecision, Mental Wellbeing, and Consultation-Seeking Behaviour-A Qualitative Interview Study among Students and Counsellors. Int J Environ Res Public Health 2021; 18:ijerph182312604. [PMID: 34886330 PMCID: PMC8656489 DOI: 10.3390/ijerph182312604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/01/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
University dropout is often preceded by a phase of doubt whether to continue studying, either in general or just the given subject. Mental health problems might be interrelated with this phase of doubt. Counselling services at German universities could provide help, but do not seem to reach students in need. To explore the phase of doubt and possible (inter-)relationships with mental wellbeing among university students in Germany as well as their consultation-seeking behaviour, a qualitative interview study was conducted (2017–2018). Participants were students casting doubts on their studies (n = 14) and counsellors (n = 16) working with this target group. Examples of reasons for doubts were insufficient information, unfulfilled expectations concerning the subject, subjectively poor study conditions, performance problems, and lacking future perspectives. Mental health problems were subjectively intertwined with doubts, considered as both cause and effect. Counselling services were evaluated as hardly helpful by students and as being in need of improvement by counsellors. Suggestions as how to improve such services comprise a more specific and proactive way to approach students. By considering the phase of doubt before dropout, German universities can improve their support services to be more responsive to students and, thus, prevent dropout and mental health problems.
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Affiliation(s)
- Katherina Heinrichs
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
- Correspondence:
| | - Victoria Hermülheim
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany; (V.H.); (A.L.)
| | - Laura Pilz González
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany; (V.H.); (A.L.)
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Heilbronner U, Streit F, Vogl T, Senner F, Schaupp SK, Reich-Erkelenz D, Papiol S, Kohshour MO, Klöhn-Saghatolislam F, Kalman JL, Heilbronner M, Gade K, Comes AL, Budde M, Andlauer TFM, Anderson-Schmidt H, Adorjan K, Stürmer T, Loerbroks A, Amelang M, Poisel E, Foo J, Heilmann-Heimbach S, Forstner AJ, Degenhardt F, Zimmermann J, Wiltfang J, von Hagen M, Spitzer C, Schmauss M, Reininghaus E, Reimer J, Konrad C, Juckel G, Lang FU, Jäger M, Figge C, Fallgatter AJ, Dietrich DE, Dannlowski U, Baune BT, Arolt V, Anghelescu IG, Nöthen MM, Witt SH, Andreassen OA, Chen CH, Falkai P, Rietschel M, Schulze TG, Schulte EC. Interplay between the Genetics of Personality Traits, severe Psychiatric Disorders, and COVID-19 Host Genetics in the Susceptibility to SARS-CoV-2 Infection - ADDENDUM. BJPsych Open 2021; 7:e206. [PMID: 34789355 PMCID: PMC8632373 DOI: 10.1192/bjo.2021.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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28
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Heilbronner U, Streit F, Vogl T, Senner F, Schaupp SK, Reich-Erkelenz D, Papiol S, Oraki Kohshour M, Klöhn-Saghatolislam F, Kalman JL, Heilbronner M, Gade K, Comes AL, Budde M, Andlauer TFM, Anderson-Schmidt H, Adorjan K, Stürmer T, Loerbroks A, Amelang M, Poisel E, Foo J, Heilmann-Heimbach S, Forstner AJ, Degenhardt F, Zimmermann J, Wiltfang J, von Hagen M, Spitzer C, Schmauss M, Reininghaus E, Reimer J, Konrad C, Juckel G, Lang FU, Jäger M, Figge C, Fallgatter AJ, Dietrich DE, Dannlowski U, Baune BT, Arolt V, Anghelescu IG, Nöthen MM, Witt SH, Andreassen OA, Chen CH, Falkai P, Rietschel M, Schulze TG, Schulte EC. Interplay between the genetics of personality traits, severe psychiatric disorders and COVID-19 host genetics in the susceptibility to SARS-CoV-2 infection. BJPsych Open 2021; 7:e188. [PMID: 34659794 PMCID: PMC8503053 DOI: 10.1192/bjo.2021.1030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behaviour and, therefore, the risk of contracting the virus. AIMS We examined overlapping genetic underpinnings between major psychiatric disorders, personality traits and susceptibility to SARS-CoV-2 infection. METHOD Linkage disequilibrium score regression was used to explore the genetic correlations of coronavirus disease 2019 (COVID-19) susceptibility with psychiatric disorders and personality traits based on data from the largest available respective genome-wide association studies (GWAS). In two cohorts (the PsyCourse (n = 1346) and the HeiDE (n = 3266) study), polygenic risk scores were used to analyse if a genetic association between, psychiatric disorders, personality traits and COVID-19 susceptibility exists in individual-level data. RESULTS We observed no significant genetic correlations of COVID-19 susceptibility with psychiatric disorders. For personality traits, there was a significant genetic correlation for COVID-19 susceptibility with extraversion (P = 1.47 × 10-5; genetic correlation 0.284). Yet, this was not reflected in individual-level data from the PsyCourse and HeiDE studies. CONCLUSIONS We identified no significant correlation between genetic risk factors for severe psychiatric disorders and genetic risk for COVID-19 susceptibility. Among the personality traits, extraversion showed evidence for a positive genetic association with COVID-19 susceptibility, in one but not in another setting. Overall, these findings highlight a complex contribution of genetic and non-genetic components in the interaction between COVID-19 susceptibility and personality traits or mental disorders.
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Affiliation(s)
- Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Farahnaz Klöhn-Saghatolislam
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | | | - Eric Poisel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Jerome Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | | | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany; and Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany; and Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Germany
| | - Max Schmauss
- Department of Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Tübingen, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Germany; and Center for Systems Neuroscience Hannover, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Bernhardt T Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; and The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Germany
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Ole A Andreassen
- NORMENT Centre and KG Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Chi-Hua Chen
- Department of Radiology, University of California, USA
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA; and Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany; and Institute of Virology, Technical University Munich/Helmholtz Zentrum München, Germany
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Dreher A, Pietrowsky R, Loerbroks A. Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study. BMJ Open 2021; 11:e045881. [PMID: 34526331 PMCID: PMC8449838 DOI: 10.1136/bmjopen-2020-045881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact and involvement in various high-risk dental procedures. This study aimed to investigate attitudes, stressors and work outcomes among DAs from all over Germany at the peak of cases in spring 2020. DESIGN Cross-sectional study. Descriptive analysis and logistic regression. SETTING Dental, maxillofacial surgery and orthodontic practices across Germany, April 2020. PARTICIPANTS Participants aged 18 years and above and currently working as DAs in Germany. PRIMARY AND SECONDARY OUTCOME MEASURES A self-devised online questionnaire was employed comprising questions on SARS-CoV-2-related attitudes, stressors and work outcomes. Validated scales assessed symptoms of depression and anxiety. RESULTS Among 1481 participating DAs (median age 35 years, 98.4% female, 91.8% working in dental practices), major stressors were uncertainty about the pandemic's temporal scope (97.9% agreement, n=1450), uncertainty about one's financial situation (87.8%, n=1301), uncertainty about how to act correctly (87.6%, n=1298) and thoughts about a possible infection during work (83.8%, n=1241). Forty-two per cent of DAs (n=622) felt sufficiently prepared for dealing with patients with SARS-CoV-2. Only 17.5% (n=259) agreed that material for personal protection was sufficiently available. Multivariable logistic regression analyses suggested that working in a dental practice, compared with orthodontic and maxillofacial surgery practices, was significantly associated with uncertainty about one's financial situation (OR 2.13 (95% CI 1.33 to 3.44)) and with the reported availability of personal protective equipment (PPE) (0.55 (0.36 to 0.84)). CONCLUSIONS Training about correct behaviour of DAs during future infectious disease outbreaks is needed, especially for DAs working in dental practices. In the future, it will also be necessary to strengthen supply chains to ensure that PPE is sufficiently available in a timely manner.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Dusseldorf, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Dusseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Dusseldorf, Germany
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30
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Mambrey V, Vu-Eickmann P, Angerer P, Loerbroks A. Associations between psychosocial working conditions and quality of care (i.e., careless errors, perceived social interactions with patients) – a cross-sectional study among medical assistants. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- V Mambrey
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich Heine Universität Düsseldorf
| | - P Vu-Eickmann
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich Heine Universität Düsseldorf
| | - P Angerer
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich Heine Universität Düsseldorf
| | - A Loerbroks
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich Heine Universität Düsseldorf
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31
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Dreher A, Pietrowsky R, Loerbroks A. Attitudes, Stressors and Work Outcomes related to the COVID-19 Pandemic among Dental Assistants in Germany: a cross-sectional Study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1731992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Dreher
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich-Heine- Universität Düsseldorf
| | - R Pietrowsky
- Institut für experimentelle Psychologie, Abteilung klinische Psychologie, Heinrich-Heine- Universität Düsseldorf
| | - A Loerbroks
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich-Heine- Universität Düsseldorf
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Loerbroks A, Dreher A, Scharf J, Mambrey V, Vu-Eickmann P, Angerer P. The Relationship of Workplace Bullying with Health Outcomes, the Intention to Leave the Profession and Medical Errors: A Cross-sectional Study among Medical Assistants in Germany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
| | - A Dreher
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
| | - J Scharf
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
| | - V Mambrey
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
| | - P Vu-Eickmann
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
| | - P Angerer
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf
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Heinrichs K, Schultz K, Hummel S, Jütjens O, Angerer P, Loerbroks A. Mögliche Interventionen zur Verbesserung von Asthma-Selbstmanagement am Arbeitsplatz. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Heinrichs
- Institut für Gesundheits- und Pflegewissenschaft, Charité - Universitätsmedizin Berlin
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich-Heine-Universität Düsseldorf
| | - K Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd
| | | | - O Jütjens
- Nordseeklinik Borkum der DRV Rheinland
| | - P Angerer
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich-Heine-Universität Düsseldorf
| | - A Loerbroks
- Institut für Arbeits-, Sozial- und Umweltmedizin, Heinrich-Heine-Universität Düsseldorf
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Dreher A, Yusuf R, Ashraf H, Shifat Ahmed SA, Strümpell C, Loerbroks A. Psychosocial stressors among Bangladesh’s ready-made garment workers: a pilot study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Dreher
- Institute of Occupational, Social, and Environmental Medicine, University of Düsseldorf
| | - R Yusuf
- School of Life Sciences, Independent University Bangladesh
| | - H Ashraf
- Department of Anthropology, Jahangirnagar University
| | | | - C Strümpell
- Institute of Social and Cultural Anthropology, University of Hamburg
| | - A Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, University of Düsseldorf
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Dreher A, Flake F, Pietrowsky R, Loerbroks A. Attitudes and stressors related to the SARS-CoV-2 pandemic among emergency medical services workers in Germany: a cross-sectional study. BMC Health Serv Res 2021; 21:851. [PMID: 34419024 PMCID: PMC8380100 DOI: 10.1186/s12913-021-06779-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim was to investigate attitudes and stressors related to the SARS-CoV-2 outbreak among emergency medical services (EMS) workers in Germany. We further aimed to detect possible changes within a 5-week period and potential determinants of attitudes and stressors. METHODS We conducted two cross-sectional studies using an online questionnaire in early April 2020 (i.e., the first peak of the SARS-CoV-2 outbreak in Germany) and five weeks later. The study instrument comprised sociodemographic items, self-devised items on pandemic-related attitudes, stressors and work outcomes, and established instruments assessing depressive symptoms and symptoms of anxiety. Logistic regression was performed to identify possible determinants. RESULTS Data of 1537 participants was included in the analysis (April: n = 1124, May: n = 413, 83.1% male, median age 32). Most participants agreed that their personal risk of infection was higher compared to the general population (April: 87.0% agreement, May: 78.9%). The greatest stressor was uncertainty about the pandemic's temporal scope (82.0 and 80.9%, respectively). Most participants (69.9, 79.7%) felt sufficiently prepared for the pandemic and only few felt burdened by their financial situation (18.8, 13.3%). Agreement to all stressors decreased from April to May except related to the childcare situation. Regression analysis identified subgroups to be burdened more frequently such as older employees, those with SARS-CoV-2 cases among their colleagues, and those with lower paramedic training levels. CONCLUSIONS We identified key SARS-CoV-2-related stressors whose levels generally decreased within a 5-week period. Our results indicate that EMS workers are less affected by existential fears and rather worry about their personal infection risk.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Frank Flake
- German Association of Emergency Medical Service, Luebeck, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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Apolinário-Hagen J, Harrer M, Dederichs M, Fritsche L, Wopperer J, Wals F, Loerbroks A, Lehr D, Salewski C, Angerer P, Ebert DD. Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students: Four-group randomized controlled trial. PLoS One 2021; 16:e0252012. [PMID: 34038455 PMCID: PMC8153476 DOI: 10.1371/journal.pone.0252012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/09/2021] [Indexed: 11/18/2022] Open
Abstract
Electronic mental health services (eMHSs) offer additional options for the dissemination of psychological interventions for university students. Still, many university students are reluctant to use eMHSs. Narrative messages may help increase the awareness and acceptance of quality-approved programs. However, little is known about the usefulness of narrative messages to improve attitudes towards eMHSs. In this experiment, we thus aimed to explore in how far different ways of targeting information to students affect their attitudes towards eMHSs for stress prevention and therapy, and to identify potential determinants of attitude change. N = 451 students (Mean = 32.6 years, SD = 10.2, 75% female, 7% with eMHS experience) were randomly assigned to one of four study arms involving information designed to induce different levels of perceived similarity. While the active control condition only received general information (arm 1, “information only”, n = 116), the other experimental arms were additionally exposed to testimonials on specific eMHSs either addressing an unspecified audience (arm 2, n = 112), employees (arm 3, n = 115) or working university students (arm 4, n = 108). Two-way ANOVA revealed no impact of information on the alteration of attitudes towards eMHSs for stress coping (d = 0.20). Only a small effect of target-group specific testimonials on attitudes towards online therapies was identified at post-intervention (d = 0.29). Regression analyses demonstrated significant influences of source credibility and perceived similarity on attitudes for preventative eMHSs (ps<0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicated no meaningful impact of information on attitudes and limited evidence for benefits of tailored narrative messages. Since attitudes were already positive at baseline, further research with a representative student sample mimicking real-world decision scenarios is needed to gain an in-depth understanding of acceptance-facilitating message features that may contribute to promote the adoption of evidence-based eMHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Melina Dederichs
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Jeannette Wopperer
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Frank Wals
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Christel Salewski
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Peter Angerer
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Daniel Ebert
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Heinrichs K, Schultz K, Hummel S, Jütjens O, Loerbroks A. Asthma self-management at work, asthma morbidity, and the subjective prognosis of gainful employment - the role of work engagement and overcommitment: a cross-sectional study. J Asthma 2021; 59:719-729. [PMID: 33600726 DOI: 10.1080/02770903.2021.1892751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Work engagement is considered a constructive and satisfying state of mind promoting well-being, whereas overcommitment contributes to ill-health. We investigated if these psychosocial factors are related to asthma self-management at the workplace (i.e. physical activity, trigger avoidance, acute symptom management, communication), asthma control, asthma-specific quality of life, and the subjective prognosis of gainful employment among employees with asthma. METHODS Questionnaires were distributed in three pulmonary rehabilitation clinics (10/2017-05/2018) in Germany. Work engagement was measured by three items from the Copenhagen Psychosocial Questionnaire and overcommitment by six items from the effort-reward imbalance questionnaire. Asthma self-management was mainly assessed by self-developed items, asthma morbidity by the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire, and the subjective prognosis of gainful employment by a validated three-item scale. After dichotomization of all variables we ran Poisson regression analyses to calculate multivariable prevalence ratios with 95% confidence intervals. RESULTS The sample comprised 221 individuals with asthma. Low work engagement was related to physical inactivity. Low work engagement and high overcommitment were associated with inadequate trigger avoidance and acute symptom management, reduced asthma-specific quality of life, and a poor prognosis of gainful employment. No relationships were observed with communication or asthma control. CONCLUSIONS Our findings highlight the potential contribution of high levels of work engagement to adequate asthma self-management, good quality of life, and a positive subjective prognosis of gainful employment among employees with asthma. Overcommitment shows associations with those outcomes in the opposite direction, which suggests a detrimental role in asthma.
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Affiliation(s)
- Katherina Heinrichs
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.,Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd, Bad Reichenhall, Germany
| | | | - Olaf Jütjens
- Nordseeklinik Borkum der DRV Rheinland, Borkum, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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Heilbronner U, Papiol S, Budde M, Andlauer TFM, Strohmaier J, Streit F, Frank J, Degenhardt F, Heilmann-Heimbach S, Witt SH, Forstner AJ, Loerbroks A, Amelang M, Stürmer T, Müller-Myhsok B, Nöthen MM, Rietschel M, Schulze TG. "The Heidelberg Five" personality dimensions: Genome-wide associations, polygenic risk for neuroticism, and psychopathology 20 years after assessment. Am J Med Genet B Neuropsychiatr Genet 2021; 186:77-89. [PMID: 33590662 DOI: 10.1002/ajmg.b.32837] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/11/2022]
Abstract
HeiDE is a longitudinal population-based study that started in the 1990s and, at baseline, assessed an array of health-related personality questionnaires in 5133 individuals. Five latent personality dimensions (The Heidelberg Five) were identified and interpreted as Emotional Lability (ELAB), Lack of Behavioral Control (LBCN), Type A Behavior (TYAB), Locus of Control over Disease (LOCC), and Psychoticism (PSYC). At follow-up, 3268 HeiDE participants (post-QC) were genotyped on single nucleotide polymorphism (SNP) arrays. To further characterize The Heidelberg Five, we analyzed genomic underpinnings, their relations to the genetic basis of the Big Five trait Neuroticism, and longitudinal associations with psychiatric symptoms at follow-up. SNP-based heritability was significant for ELAB (34%) and LBCN (29%). A genome-wide association study for each personality dimension was conducted; only the phenotype PSYC yielded a genome-wide significant finding (p < 5 × 10-8 , top SNP rs138223660). Gene-based analyses identified significant findings for ELAB, TYAB, and PSYC. Polygenic risk scores for Neuroticism were only associated with ELAB. Each of The Heidelberg Five was related to depressive symptoms at follow-up. ELAB, LBCN, and PSYC were also associated with lifetime anxiety symptoms. These results highlight the clinical importance of health-related personality traits and identify LBCN as a heritable "executive function" personality trait.
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Affiliation(s)
- Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany.,Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany.,Centre for Human Genetics, University of Marburg, Marburg, Germany.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Manfred Amelang
- Department of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Til Stürmer
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Bertram Müller-Myhsok
- Department of Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Behavioral Sciences, Upstate University Hospital, Syracuse, New York, USA
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Loerbroks A, Scharf J, Angerer P, Spanier K, Bethge M. The Prevalence and Determinants of Being Offered and Accepting Operational Management Services-A Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph18042158. [PMID: 33672121 PMCID: PMC7927052 DOI: 10.3390/ijerph18042158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/22/2022]
Abstract
In Germany, employers are obliged to offer “operational integration management” (OIM) services to employees returning from long-term sick leave. OIM aims to improve employees’ workability and to prevent future sick leave or early retirement. This study examined (i) to what extent OIM services are offered to eligible employees, (ii) to what extent offers are accepted and (iii) the determinants of both outcomes. We used data from a cohort of employees eligible for OIM. Thirty-four potential determinants were assessed in 2013 (i.e., the baseline) using participant reports. In 2015 (i.e., the follow-up), participants were asked (a) whether they had ever been offered OIM services by their employer, and (b) whether they had accepted that offer (i.e., the outcomes). We estimated relative risks by multivariable binomial regression to identify predictors based on backward elimination. In total, 36.0% of the participants were offered OIM services and 77.2% of them accepted that offer. The likelihood of an OIM offer at follow-up was elevated in participants with mental impairment, cancer or long-term absenteeism and increased with organizational justice, neuroticism, and company size. The likelihood of accepting that OIM offer was positively associated with mental impairment and decreased with increasing company size.
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Affiliation(s)
- Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany; (J.S.); (P.A.)
- Correspondence: ; Tel.: +49-(0)-211-81-08032; Fax: +49-(0)-211-81-18586
| | - Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany; (J.S.); (P.A.)
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany; (J.S.); (P.A.)
| | - Katja Spanier
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (K.S.); (M.B.)
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (K.S.); (M.B.)
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Dreher A, Pietrowsky R, Loerbroks A. Pandemic-related attitudes, stressors and work outcomes among medical assistants during the SARS-CoV-2 ("Coronavirus") pandemic in Germany: A cross-sectional Study. PLoS One 2021; 16:e0245473. [PMID: 33444419 PMCID: PMC7808691 DOI: 10.1371/journal.pone.0245473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants. Methods The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants. Results 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one’s financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one’s financial situation was significantly associated with working in specialist practices (1.32 [1.08–1.62]), caring for children (1.51 [1.22–1.87]), depression (1.28 [1.01–1.62]), and anxiety disorder (1.93 [1.55–2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07–1.64]), caring for children (1.33 [1.07–1.66]), depression (1.54 [1.18–2.00]), and anxiety (4.71 [3.71–5.98]). Conclusions This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
- * E-mail:
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Salandi J, Icks A, Gholami J, Hummel S, Schultz K, Apfelbacher C, Sheikh A, Loerbroks A. Impact of pulmonary rehabilitation on patients' health care needs and asthma control: a quasi-experimental study. BMC Pulm Med 2020; 20:267. [PMID: 33059650 PMCID: PMC7559596 DOI: 10.1186/s12890-020-01301-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary rehabilitation offers potential benefits to people with asthma. It is however unknown if rehabilitation favourably affects patients' health care needs. We therefore examined if rehabilitation reduced needs and, in addition, if it improved asthma control. METHODS One hundred fifty patients with asthma were surveyed in three rehabilitation clinics at admission and at discharge. Additionally, we surveyed 78 participants with asthma twice 4 weeks apart. The latter sample (i.e. the control group) was recruited through other pathways than rehabilitation clinics. The Patient Needs in Asthma Treatment (NEAT) questionnaire and the Asthma Control Test (ACT) were completed at baseline and follow-up. Differences between baseline and follow-up and between rehabilitation and control group were examined by t-tests and chi-squared-tests. Univariate ANCOVAS were used to examine if NEAT and ACT follow-up scores differed significantly between groups. Within the rehabilitation group, linear regressions were used to examine if self-reported utilization of more interventions that addressed needs were associated with NEAT scores at follow-up. RESULTS At baseline, there were no differences between the rehabilitation and the control group regarding needs and asthma control. At follow-up, the rehabilitation group showed reduced needs (t(149) = 10.33, p < 0.01) and increased asthma control (t(130) = -6.67, p < 0.01), whereas members of the control group exhibited no changes. Univariate ANCOVAS showed that unmet follow-up needs (F(1, 212) = 36.46, p < 0.001) and follow-up asthma control (F(1, 195) = 6.97, p = 0.009) differed significantly between groups. In the rehabilitation group, self-reported utilization of more interventions was associated with reduced needs (β = 0.21; p = 0.03). CONCLUSIONS This study provides preliminary evidence suggestion that pulmonary rehabilitation in adults with asthma may reduce asthma-related needs and confirms previous findings that rehabilitation may improve asthma control.
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- Institute of Health Services Research and Health Economics, German Diabetes Center, Medical Faculty, University of Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland, Bubertstraße 4, 26757, Borkum, Germany
| | - Stefan Hummel
- MEDIAN Klinik Heiligendamm, Kinderstrand 1, 18209, Bad Doberan, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd, Salzburger Str. 8-11, 83435, Bad Reichenhall, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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Dederichs M, Weber J, Muth T, Angerer P, Loerbroks A. Students' perspectives on interventions to reduce stress in medical school: A qualitative study. PLoS One 2020; 15:e0240587. [PMID: 33057431 PMCID: PMC7561099 DOI: 10.1371/journal.pone.0240587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022] Open
Abstract
The mental health of medical students remains to be a matter of concern. Numerous setting-based and individual-based interventions for student mental health have been proposed in the literature. However, the student perspective on those interventions has been largely neglected. This study aims to explore how medical students perceive different interventions and if they desire any additional changes with regard to their studies. Eight focus groups with 71 participants were conducted at a large German medical school. Focus groups were recorded, transcribed and content-analyzed using MAXQDA 18. We found that medical students prefer setting-based interventions. Most proposed interventions were on a setting-based level. For instance, students asked for more information on the university's psychosocial counseling services and for better information management regarding contact persons. Interventions proposed in the literature received mixed reactions: Several participants did not favour a pass/fail grading system. Students considered a peer-to-peer mentoring program for freshmen very helpful. Students had diverse attitudes towards Balint groups. They approved of several self-management courses, most of them being related to time or stress management. Interestingly, the most urgently wanted interventions appear to be rather easy to implement (e.g. a mentoring program). This study explored the medical student perspective on student mental health interventions. Additionally, our study illustrates the benefit and feasibility of involving students early on in the conception of interventions. Further research with a representative sample is needed to obtain broader information on the acceptance of the suggested interventions.
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Affiliation(s)
- Melina Dederichs
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Jeannette Weber
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Thomas Muth
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Peter Angerer
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Adrian Loerbroks
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
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Tiwari I, Herr RM, Loerbroks A, Yamamoto SS. Household Air Pollution and Angina Pectoris in Low- and Middle-Income Countries: Cross-Sectional Evidence from the World Health Survey 2002-2003. Int J Environ Res Public Health 2020; 17:ijerph17165802. [PMID: 32796570 PMCID: PMC7460098 DOI: 10.3390/ijerph17165802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/03/2022]
Abstract
The evidence regarding the effects of household air pollution on angina pectoris is limited in low-and middle-income countries (LMICs). We sought to examine the association between household air pollution and angina pectoris across several countries. We analyzed data of individuals from 46 selected countries participating in the cross-sectional World Health Survey (WHS) 2002–2003. Pooled and stratified (sex, continent) logistic regression with sampling weights was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to quantify associations between the use of different household fuels with angina pectoris. In the pooled sample, we observed lower odds of angina pectoris with electricity use (OR: 0.68, 95% CI: 0.56–0.83) compared to those households reporting the use of gas as a household fuel. Increased odds of angina pectoris were observed with the use of agriculture/dung/shrub/other (OR: 1.65, 95% CI: 1.30–2.09), mixed (solid and non-solid fuels) (OR: 1.31, 95% CI: 1.09–1.56), and mixed solid fuel use (OR: 1.59, 95% CI: 1.12–2.25). Higher odds of angina pectoris were observed mainly with solid fuel use. The results highlight the importance of addressing these issues, especially in regions with a high proportion of solid fuel users and increasing levels of cardiovascular disease.
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Affiliation(s)
- Ishwar Tiwari
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
- Correspondence:
| | - Raphael M. Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany;
| | - Shelby S. Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
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Hilger-Kolb J, Loerbroks A, Diehl K. ‘When I have time pressure, sport is the first thing that is cancelled’: A mixed-methods study on barriers to physical activity among university students in Germany. J Sports Sci 2020; 38:2479-2488. [DOI: 10.1080/02640414.2020.1792159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jennifer Hilger-Kolb
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Brandes V, Terris D, Fischer C, Loerbroks A, Jarczok M, Ottowitz G, Titscher G, Fischer J, Thayer J. FC10-04 - Efficacy of auditory stimulation programs for the treatment of depression, dysthymia and symptoms of burnout - RCT results. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73571-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Depression is a prevalent, often chronic and disabling disease. Current psychosocial and antidepressant treatments result in similar response rates with mostly symptom reduction, but not complete remission. Poor treatment adherence complicates depression management and prevention of recurrent episodes. Therefore, new therapies must be developed urgently, that alone or combined with present treatments, can significantly improve therapy outcomes.Depression is potentially associated with decreased heart rate variability (HRV). Based on our previous studies' results which demonstrated HRV increase following auditory stimulation, we developed two interventions based on specifically for depression treatment composed and arranged music and tested the efficacy in a waiting list and placebo controlled double-blind study with depressed outpatients.Depression status was assessed at the beginning of T1 and T2 using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS-D) and by a composite (COMP) scale based on HAM-D, BDI and HADS-D z-scores. Changes in depressive symptoms between T1 and T2 (5 week period) were assessed based on COMP and on HAM-D, BDI and HADS-D scores alone. Compared to the control arm, a significant, positive effect in COMP was observed for MT1 at T2. Both MT1 and MT2 were associated with significant positive effects (HAM-D and HADS-D scores). MT2 resulted in positive effects on BDI scores. No significant change in any depression score was detected in the placebo arm. Treatment continuation was associated with an effect increase (mean HAM-D score reduction of 60%) after 10 to 15 weeks of treatment.
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Li J, Wege N, Loerbroks A, Riedel N. Does cognitive function predict changes in perception of stressful working conditions? Ind Health 2020; 58:72-77. [PMID: 31155520 PMCID: PMC6997721 DOI: 10.2486/indhealth.2019-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
Cognitive health is a key resource for individuals to nurture their employability. We studied the longitudinal association of cognitive function with changes in stressful working conditions, testing a possible reversed causation. We used a sample of employees (N=1,355) participating in two surveys (2006 and 2011) within a German national representative study (GSOEP). Cognitive function was captured by perceptual speed (Symbol Digit Test) and word fluency (Animal Naming Test). Stressful working conditions were measured by the validated short version of the effort-reward imbalance questionnaire. Multivariate linear regression models assessed the impact of perceptual speed and verbal fluency in 2006 on changes in participants' perceptions of effort, reward, effort-reward ratio, and over-commitment between 2006 and 2011, adjusting for socio-demography, behaviours, physical and mental health at baseline. Neither perceptual speed nor verbal fluency was significantly related to changes in perceived working conditions. Our findings did not support the notion of reversed causation.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, USA
| | - Natalia Wege
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | - Natalie Riedel
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Germany
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Bergmann C, Muth T, Loerbroks A. Medical students' perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study. Med Educ Online 2019; 24:1603526. [PMID: 31007152 PMCID: PMC6493308 DOI: 10.1080/10872981.2019.1603526] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Medical students have been found to experience considerable stress due to their academic studies. The high demands associated with academic studies may interfere with demands in other domains of life. Conversely, demands in those other domains of life may conflict with academic studies. OBJECTIVE We aimed to better understand the potential inter-relationships between the demands related to academic studies and in other domains of life. DESIGN A total of 68 medical students from a medical school in Germany participate in eight focus groups. Sessions were structured by a topic guide and were recorded, transcribed and content-analyzed. RESULTS Embarking on one's medical studies was perceived to be associated with important personal challenges, such as living alone for the first time and finding a new social role in one's peer group. Permanent stress was perceived to result in emotional exhaustion, which spilled over in other domains of life. Students reported to feel guilty if they did not spend their limited spare time on learning. Consequently, they felt to have little time for leisure time activities and a healthy lifestyle. Feelings of social isolation, especially during exam phases, were reported. Leisure activities were perceived to facilitate recovery from academic stress. Social ties were subjectively able to reduce stress, but also to increase stress due to demands. Side jobs were perceived to increase stress and to be time-consuming and were thus perceived to result in poorer academic performance. Certain personality characteristics seemed to amplify those perceptions. For instance, high levels of conscientiousness were felt to relate to higher expectations regarding one's academic performance and thus increased stress. CONCLUSION The demands associated with medical studies, the demands in private life, lacking resources for recovery and certain personal traits as well as interactions between those domains can contribute to stress among medical students and reduce well-being.
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Affiliation(s)
- Christin Bergmann
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Thomas Muth
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Heidelberg, Germany
- CONTACT Adrian Loerbroks Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225Düsseldorf, Germany
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Heinrichs K, Hummel S, Gholami J, Schultz K, Wild B, Li J, Sheikh A, Loerbroks A. Psychosocial working conditions and the subjective prognosis of gainful employment among employees with asthma: a cross-sectional study. Disabil Rehabil 2019; 43:1299-1306. [PMID: 31522569 DOI: 10.1080/09638288.2019.1662496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE The present study set out to examine whether low job decision latitude (JDL, i.e., limited work autonomy) and low social support at work are related to a poor subjective prognosis of gainful employment (SPE) among working rehabilitants with asthma. METHODS JDL and support were assessed by the Copenhagen Psychosocial Questionnaire. The SPE was measured by a validated three-item scale. Separate logistic regression analyses were conducted for all variables to calculate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Among the 221 participants (response rate = 29.3%), those reporting low JDL or low support had more than doubled odds of being unsure that they would be working until retirement age (OR = 2.28; 95% CI = 1.19-4.37; OR = 2.78; 95% CI = 1.43-5.40, respectively) and of considering their work ability permanently at risk due to ill-health (OR = 3.89; 95% CI = 2.03-7.46; OR = 2.05; 95% CI = 1.08-3.90, respectively) compared to those with good working conditions. The associations of JDL or support were weaker with one's consideration to apply for premature pension (OR = 1.54; 95% CI = 0.60-3.98; OR = 2.18; 95% CI = 0.83-5.77, respectively). Additional analyses identified job satisfaction as a possible explanatory factor for the observed relationships. CONCLUSIONS Adverse psychosocial working conditions are related to a poor SPE, and low job satisfaction may explain those relationships. Future prospective research is needed to confirm our findings.Implications for rehabilitationEarlier research suggested that asthma increases the risk of disability retirement and thus causes high direct and indirect costs.Prior findings showed that adverse psychosocial working conditions are related to poorer asthma self-management and increased asthma morbidity among rehabilitants with asthma.Consistent with earlier work the present study found that job decision latitude and social support at work are associated with the subjective prognosis of gainful employment among working rehabilitants with asthma.If the reported findings are confirmed by prospective studies, interventions could be developed to improve the working conditions for rehabilitants with asthma and to thereby reduce their risk of disability retirement.
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Affiliation(s)
- Katherina Heinrichs
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | | | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland*, Borkum, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd*, Bad Reichenhall, Germany
| | - Burkhard Wild
- refonet - Rehabilitations-Forschungsnetzwerk der DRV Rheinland*, Bad Neuenahr, Germany
| | - Jian Li
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.,Department of Environmental Health Sciences, Fielding School of Public Health; School of Nursing, University of California, Los Angeles, USA
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, UK
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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49
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Weber J, Skodda S, Muth T, Angerer P, Loerbroks A. Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study. BMC Med Educ 2019; 19:312. [PMID: 31429744 PMCID: PMC6701044 DOI: 10.1186/s12909-019-1747-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/06/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND Prior evidence suggests that medical students' mental health is poor and deteriorates during the course of academic studies. This qualitative study therefore aims to improve our understanding of medical students' perceptions of i) stressors related to their academic studies, ii) resources that may facilitate coping with those stressors and iii) suggestions to potentially reduce stress. METHODS Eight focus groups were conducted with medical students enrolled at a medical school in Germany until thematic saturation was reached. A topic guide was used to facilitate the discussion. Subsequently, focus group discussions were transcribed and content-analyzed using MaxQDA. RESULTS Organizational factors especially related to inadequate information flow as well as exams (e.g. repeat exams, scheduling, perceived unfair grading), poor theoretical and practical teaching quality, time and performance pressure, social interactions and individual characteristics (e.g. self-expectations, fear of failure) emerged as major contributors to stress. Resources perceived to facilitate coping with those stressors pertained to some other organizational aspects (e.g. flexibility, availability of contact persons), career prospects, practical training, social support, personal characteristics (e.g. knowledge base, past experience) and leisure time. Suggestions for improvement related primarily to organizational measures rather than individual-level measures. CONCLUSIONS Besides well-known stressors (e.g. exams and high performance pressure), some new aspects emerged from our study including stress related to organizational factors and repeat exams. Accordingly, students' wishes for organizational-level interventions, including better information systems and better interweaving of practical and theoretical education, could be first target areas for improvement.
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Affiliation(s)
- Jeannette Weber
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Stefanie Skodda
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Thomas Muth
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
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50
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Riedel N, Köckler H, Scheiner J, van Kamp I, Erbel R, Loerbroks A, Claßen T, Bolte G. Urban road traffic noise and noise annoyance-a study on perceived noise control and its value among the elderly. Eur J Public Health 2019; 29:377-379. [PMID: 30052879 DOI: 10.1093/eurpub/cky141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Noise annoyance may reflect a pro-participatory attitude towards public information and consultation according to the European Environmental Noise Directive. However, noise annoyance is also indicative of a stress response to perceived uncontrollable noise exposure. Using cross-sectional data on a sample of elderly citizens (n = 1772), we investigated whether the value residents ascribed to being able to control noise exposure at home moderated the potential indirect effect of road traffic noise on annoyance through perceived noise control. Our results confirmed the presence of such a moderated mediation, which may justify studying the impact of residents' valuing perceived noise control on participation readiness.
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Affiliation(s)
- Natalie Riedel
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.,Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Heike Köckler
- Department of Community Health, Hochschule für Gesundheit Bochum (University of Applied Science), Bochum, Germany
| | - Joachim Scheiner
- Department of Transport Planning, Faculty of Spatial Planning, TU Dortmund University, Dortmund, Germany
| | - Irene van Kamp
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Raimund Erbel
- Institute of Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Thomas Claßen
- Section "Health Assessments and Forecasting", Centre for Health NRW (North Rhine-Westphalia), Bochum, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
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