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Morbach C, Gelbrich G, Tiffe T, Eichner FA, Christa M, Mattern R, Breunig M, Cejka V, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Prevalence and determinants of the precursor stages of heart failure: results from the population-based STAAB cohort study. Eur J Prev Cardiol 2020; 28:924-934. [DOI: 10.1177/2047487320922636] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/08/2020] [Indexed: 12/16/2022]
Abstract
Abstract
Aims
Prevention of heart failure relies on the early identification and control of risk factors. We aimed to identify the frequency and characteristics of individuals at risk of heart failure in the general population.
Methods and Results
We report cross-sectional data from the prospective Characteristics and Course of Heart Failure Stages A–B and Determinants of Progression (STAAB) cohort study investigating a representative sample of residents of Würzburg, Germany. Sampling was stratified 1:1 for sex and 10:27:27:27:10 for age groups of 30–39/40–49/50–59/60–69/70–79 years. Heart failure precursor stages were defined according to American College of Cardiology/American Heart Association: stage A (risk factors for heart failure), stage B (asymptomatic cardiac dysfunction). The main results were internally validated in the second half of the participants. The derivation sample comprised 2473 participants (51% women) with a distribution of 10%/28%/25%/27%/10% in respective age groups. Stages A and B were prevalent in 42% and 17% of subjects, respectively. Of stage B subjects, 31% had no risk factor qualifying for stage A (group ‘B-not-A’). Compared to individuals in stage B with A criteria, B-not-A were younger, more often women, and had left ventricular dilation as the predominant B qualifying criterion (all P < 0.001). These results were confirmed in the validation sample (n = 2492).
Conclusion
We identified a hitherto undescribed group of asymptomatic individuals with cardiac dysfunction predisposing to heart failure, who lacked established heart failure risk factors and therefore would have been missed by conventional primary prevention. Further studies need to replicate this finding in independent cohorts and characterise their genetic and -omic profile and the inception of clinically overt heart failure in subjects of group B-not-A.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Götz Gelbrich
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Germany
| | - Theresa Tiffe
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Felizitas A Eichner
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Martin Christa
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Renate Mattern
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Margret Breunig
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Vladimir Cejka
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Martin Wagner
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Peter U Heuschmann
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
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2
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Goettler D, Wagner M, Faller H, Kotseva K, Wood D, Leyh R, Ertl G, Karmann W, Heuschmann PU, Störk S. Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey. BMC Cardiovasc Disord 2020; 20:152. [PMID: 32228474 PMCID: PMC7106891 DOI: 10.1186/s12872-020-01429-w] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background Tobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD. Methods The fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview. Results Out of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002). Discussion Attending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention.
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Affiliation(s)
- D Goettler
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany
| | - M Wagner
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - H Faller
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - K Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,Imperial College Healthcare NHS Trust, London, UK
| | - D Wood
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - R Leyh
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - G Ertl
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Department of Internal Medicine I, University and University Hospital of Würzburg, Würzburg, Germany
| | - W Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany
| | - P U Heuschmann
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Clinical Trial Center, University Hospital of Würzburg, Würzburg, Germany
| | - S Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany. .,Department of Internal Medicine I, University and University Hospital of Würzburg, Würzburg, Germany.
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3
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Salchow J, Mann J, Koch B, von Grundherr J, Jensen W, Elmers S, Straub LA, Vettorazzi E, Escherich G, Rutkowski S, Dwinger S, Bergelt C, Sokalska-Duhme M, Bielack S, Calaminus G, Baust K, Classen CF, Rössig C, Faber J, Faller H, Hilgendorf I, Gebauer J, Langer T, Metzler M, Schuster S, Niemeyer C, Puzik A, Reinhardt D, Dirksen U, Sander A, Köhler M, Habermann JK, Bokemeyer C, Stein A. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors - presentation of the CARE for CAYA-Program study protocol and associated literature review. BMC Cancer 2020; 20:16. [PMID: 31906955 PMCID: PMC6945396 DOI: 10.1186/s12885-019-6492-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 03/25/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Improved, multimodal treatment strategies have been shown to increase cure rates in cancer patients. Those who survive cancer as a child, adolescent or young adult (CAYA), are at a higher risk for therapy-, or disease-related, late or long-term effects. The CARE for CAYA-Program has been developed to comprehensively assess any potential future problems, to offer need-based preventative interventions and thus to improve long-term outcomes in this particularly vulnerable population. Methods The trial is designed as an adaptive trial with an annual comprehensive assessment followed by needs stratified, modular interventions, currently including physical activity, nutrition and psycho-oncology, all aimed at improving the lifestyle and/or the psychosocial situation of the patients. Patients, aged 15–39 years old, with a prior cancer diagnosis, who have completed tumour therapy and are in follow-up care, and who are tumour free, will be included. At baseline (and subsequently on an annual basis) the current medical and psychosocial situation and lifestyle of the participants will be assessed using a survey compiled of various validated questionnaires (e.g. EORTC QLQ C30, NCCN distress thermometer, PHQ-4, BSA, nutrition protocol) and objective parameters (e.g. BMI, WHR, co-morbidities like hyperlipidaemia, hypertension, diabetes), followed by basic care (psychological and lifestyle consultation). Depending on their needs, CAYAs will be allocated to preventative interventions in the above-mentioned modules over a 12-month period. After 1 year, the assessment will be repeated, and further interventions may be applied as needed. During the initial trial phase, the efficacy of this approach will be compared to standard care (waiting list with intervention in the following year) in a randomized study. During this phase, 530 CAYAs will be included and 320 eligible CAYAs who are willing to participate in the interventions will be randomly allocated to an intervention. Overall, 1500 CAYAs will be included and assessed. The programme is financed by the innovation fund of the German Federal Joint Committee and will be conducted at 14 German sites. Recruitment began in January 2018. Discussion CAYAs are at high risk for long-term sequelae. Providing structured interventions to improve lifestyle and psychological situation may counteract against these risk factors. The programme serves to establish uniform regular comprehensive assessments and need-based interventions to improve long-term outcome in CAYA survivors. Trial registration Registered at the German Clinical Trial Register (ID: DRKS00012504, registration date: 19th January 2018).
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Affiliation(s)
- J Salchow
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Mann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Koch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J von Grundherr
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Jensen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Elmers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Straub
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Dwinger
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - S Bielack
- Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | | | - K Baust
- University Hospital Bonn, Bonn, Germany
| | - C F Classen
- University Hospital Rostock, Rostock, Germany
| | - C Rössig
- University Children's Hospital Münster, Münster, Germany
| | - J Faber
- Mainz University Medical Center, Mainz, Germany
| | - H Faller
- University Hospital Würzburg, Würzburg, Germany
| | | | - J Gebauer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Metzler
- University Hospital Erlangen, Erlangen, Germany
| | - S Schuster
- University Hospital Erlangen, Erlangen, Germany
| | - C Niemeyer
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Puzik
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Reinhardt
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - U Dirksen
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - A Sander
- Hannover Medical School, Hannover, Germany
| | - M Köhler
- Medical Faculty University Hospital Magdeburg, Magdeburg, Germany
| | | | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Musekamp G, Gerlich C, Ehlebracht-Kï Nig I, Dorn M, Hï Fter A, Tomiak C, Schlittenhardt D, Faller H, Reusch A. Evaluation of a self-management patient education programme for fibromyalgia-results of a cluster-RCT in inpatient rehabilitation. Health Educ Res 2019; 34:209-222. [PMID: 30689860 DOI: 10.1093/her/cyy055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/01/2019] [Indexed: 06/09/2023]
Abstract
The objective was to evaluate the effectiveness of a self-management patient education programme for fibromyalgia syndrome (FMS) as compared with usual care education in inpatient rehabilitation. In a multicentre cluster-randomized controlled trial, 583 inpatients in 3 rehabilitation centres received an advanced self-management patient education programme or usual care education. Patients completed questionnaires at admission, discharge and after 6 and 12 months. Primary outcomes were disease- and treatment-specific knowledge at discharge, and self-management-competencies after 6 months. Secondary outcomes included satisfaction, attitudes, coping competencies, psychological distress and health impairment. We found a medium-sized effect on disease- and treatment-specific knowledge at discharge (P < 0.05, Cohen's d = 0.45, 95% CI = 0.27-0.63), and small effects for subjective knowledge, pain-related control, self-monitoring and insight, communication about disease, action planning for physical activity and treatment satisfaction (all P < 0.05). Only the effect on knowledge persisted for 6 and 12 months. This advanced education programme seemed to be more effective in the short term than usual education. However, intermediate- and long-term effects did not emerge. While superior long-term effects on knowledge as well as short-term effects on self-management skills may suggest implementation, additional long-term effects on other patient-relevant outcomes would be desirable. Trial registration: German Clinical Trials Register, DRKS00008782, Registered 8 July 2015.
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Affiliation(s)
- G Musekamp
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Julius-Maximilians-University of W�rzburg, W�rzburg, Germany
| | - C Gerlich
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Julius-Maximilians-University of W�rzburg, W�rzburg, Germany
| | | | - M Dorn
- Rehabilitation Centre Bad Eilsen, Bad Eilsen, Germany
| | - A Hï Fter
- Rehabilitation Centre Bad Aibling, Clinic Wendelstein, Bad Aibling, Germany
| | - C Tomiak
- Rehabilitation Centre Bad Aibling, Clinic Wendelstein, Bad Aibling, Germany
| | - D Schlittenhardt
- Rehabilitation Clinic Bad S�ckingen GmbH, Bad S�ckingen, Germany
| | - H Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Julius-Maximilians-University of W�rzburg, W�rzburg, Germany
| | - A Reusch
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Julius-Maximilians-University of W�rzburg, W�rzburg, Germany
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5
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Morbach C, Gelbrich G, Tiffe T, Eichner F, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Variations in cardiovascular risk factors in people with and without migration background in Germany - Results from the STAAB cohort study. Int J Cardiol 2018; 286:186-189. [PMID: 30420145 DOI: 10.1016/j.ijcard.2018.10.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 06/27/2018] [Revised: 10/02/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND About 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). METHODS We report data of the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of inhabitants of the City of Würzburg, Germany, aged 30 to 79 years. Individuals without migration background were defined as follows: German as native language, no other native language, and/or born in Germany. All other participants were defined as individuals with migration background. RESULTS Of 2473 subjects (51% female, mean age 54 ± 12 years), 291 (12%) reported a migration background: n = 107 (37%) from a country within the EU, n = 117 (40%) from Russia, and n = 67 (23%) from other countries. Prevalence of hypertension, atherosclerotic disease, and diabetes mellitus was similar in individuals with and without migration background. By contrast, prevalence of obesity and metabolic syndrome was significantly higher in individuals with migration background, with the least favourable profile apparent in individuals from Russia (individuals without vs. with migration background: obesity 19 vs. 24%, p < 0.05; odds ratio: EU: 1.6, Russia: 2.2*, other countries: 0.6; metabolic syndrome 18 vs. 21%, p < 0.05; odds ratio: EU: 1.2, Russia: 1.7*, other countries: 1.5; *p < 0.05). CONCLUSION Individuals with migration background in Germany might exhibit a higher CVRF burden due to a higher prevalence of obesity and metabolic syndrome. Strategies for primary prevention of heart failure may benefit from deliberately considering the migration background.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Theresa Tiffe
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Felizitas Eichner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Martin Wagner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Comprehensive Heart Failure Center, and Clinical Trial Center, University of Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany.
| | | | - S Frantz
- Dept. of Medicine I, Div. of Cardiology, University Hospital Würzburg, Germany
| | - C Maack
- Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Germany
| | - G Ertl
- University Hospital Würzburg, Germany
| | - M Fassnacht
- Dept. of Medicine I, Div. of Endocrinology, University Hospital Würzburg, Germany
| | - C Wanner
- Dept. of Medicine I, University Hospital Würzburg, Germany
| | - R Leyh
- Dept. of Cardiovascular Surgery, University Hospital Würzburg, Germany
| | - J Volkmann
- Dept. of Neurology, University Hospital Würzburg, Germany
| | - J Deckert
- Dept. of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Germany
| | - H Faller
- Dept. of Medical Psychology, University of Würzburg, Germany
| | - R Jahns
- Interdisciplinary Bank of Biomaterials and Data Würzburg, University Hospital Würzburg, Germany
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6
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Sindlinger K, Meng K, Dorn M, Faller H, Schuler M. Illness representations, pain and physical function in patients with rheumatic disorders: between- and within-person associations. Psychol Health 2018; 34:200-215. [PMID: 30358411 DOI: 10.1080/08870446.2018.1523406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Rehabilitation for patients with rheumatic diseases improves both illness representations (IR) and clinical outcomes such as pain and physical functioning (PF). However, it is unclear whether IR may affect and, in turn, are affected by pain and PF. In this study, we examined both between-person associations and within-person associations between IR and pain/PF over time on three measurement occasions. Furthermore, cross-lagged relationships were examined. DESIGN AND MAIN OUTCOME MEASURES This secondary analysis is based on data from N = 186 patients with rheumatic diseases. Data on pain, PF and IR were assessed using self-report questionnaires at the beginning, the end and three months after a 3-week inpatient rehabilitation. METHODS To separate between- and within-person level, data were analysed using random-intercept cross-lagged panel models. RESULTS On both the between-person level (r = |0.21| - |0.44|) and the within-person level (r = |0.15| - |0.46|), pain and PF were related to cognitive and emotional IR. In addition, we found within-person bidirectional cross-lagged effects between emotional IR and PF. CONCLUSION IR show complex relationships with pain and PF. Improving PF might improve subsequent illness-related emotional distress and vice versa.
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Affiliation(s)
- K Sindlinger
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - K Meng
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - M Dorn
- b Rehabilitation Center Bad Eilsen , Bad Eilsen , Germany
| | - H Faller
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - M Schuler
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
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7
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Esser P, Glaesmer H, Wittchen HU, Faller H, Koch U, Härter M, Schulz H, Wegscheider K, Weis J, Mehnert A. Posttraumatische Belastungsstörung bei Krebspatienten: Ergebnisse einer epidemiologischen Studie aus Deutschland. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667921] [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: 10/28/2022]
Affiliation(s)
- P Esser
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - H Glaesmer
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | | | | | | | | | | | | | - A Mehnert
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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Heß V, Schuler M, Meng K, Schulte T, Bengel J, Faller H. Psychosoziale Bedürfnisse und Belastungen bei onkologischen Rehabilitanden: Warum werden sie im Aufnahmegespräch nicht geäußert bzw. erkannt? Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667991] [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: 10/28/2022]
Affiliation(s)
- V Heß
- Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Würzburg, Deutschland
| | - M Schuler
- Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Würzburg, Deutschland
| | - K Meng
- Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Würzburg, Deutschland
| | - T Schulte
- Klinik Bad Oexen, Bad Oeynhausen, Deutschland
| | - J Bengel
- Universität Freiburg, Abteilung für Rehabilitationspsychologie und Psychotherapie, Freiburg, Deutschland
| | - H Faller
- Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Würzburg, Deutschland
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Szentes B, Schwarzkopf L, Lehbert N, Wittmann M, Wagner R, Nowak D, Faller H, Schuler M, Schultz K. Is EQ-5D suited to assess quality of life aspects in pulmonary rehabilitation in bronchial asthma. Pneumologie 2018. [DOI: 10.1055/s-0037-1619413] [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: 10/28/2022]
Affiliation(s)
- B Szentes
- Deutsches Foschungszentrum für Gesundheit und Umwelt, Helmholtz Zentrum München
| | - L Schwarzkopf
- Deutsches Foschungszentrum für Gesundheit und Umwelt, Helmholtz Zentrum München
| | - N Lehbert
- Zentrum für Rehabilitation, Klinik Bad Reichenhall der DRV Bayern Süd
| | - M Wittmann
- Zentrum für Rehabilitation, Klinik Bad Reichenhall der DRV Bayern Süd
| | - R Wagner
- Zentrum für Rehabilitation, Klinik Bad Reichenhall der DRV Bayern Süd
| | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
| | - H Faller
- Abteilung für Medizinische Psychologie und Psychotherapie, Universität Würzburg
| | - M Schuler
- Abteilung für Medizinische Psychologie und Psychotherapie, Universität Würzburg
| | - K Schultz
- Zentrum für Rehabilitation, Klinik Bad Reichenhall der DRV Bayern Süd
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Schultz K, Wittmann M, Wagner R, Schwarzkopf L, Nowak D, Faller H, Schuler M. Stimmt der Asthmakontrolltest (ACT) mit den überarbeiteten GINA-Kriterien der Asthmasymptomkontrolle (ASC) überein? Pneumologie 2018. [DOI: 10.1055/s-0037-1619163] [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: 10/28/2022]
Affiliation(s)
- K Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd
| | - M Wittmann
- Klinik Bad Reichenhall der DRV Bayern Süd
| | - R Wagner
- Klinik Bad Reichenhall der DRV Bayern Süd
| | - L Schwarzkopf
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Neuehrberg
| | - D Nowak
- Comprehensive Pneumology Center, Institut und Poliklinik für Arbeits-, Sozial- Und Umweltmedizin; Klinikum der LMU München
| | - H Faller
- Abteilung für Medizinische Psychologie und Psychotherapie; Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - M Schuler
- Abteilung für Medizinische Psychologie und Psychotherapie; Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
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Riegler C, Teismann H, Baune B, Faller H, Störk S, Heuschmann P. Inter-Rater-Reliabilität einer deutschsprachigen Variante des Functioning Assessment Short Test (FAST). Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605907] [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: 10/18/2022]
Affiliation(s)
- C Riegler
- Julius-Maximilians-Universität Würzburg, Institut für klinische Epidemiologie und Biometrie (IKE-B), Würzburg
| | - H Teismann
- Westfälische Wilhelms-Universität Münster, Institut für Epidemiologie und Sozialmedizin (IfES), Münster
| | - B Baune
- University of Adelaide, Discipline of Psychiatry, Adelaide
| | - H Faller
- Julius-Maximilians-Universität Würzburg, Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Würzburg
| | - S Störk
- Universitätsklinikum Würzburg, Medizinische Klinik 1, Würzburg
- Julius-Maximilians-Universität Würzburg, Deutsches Zentrum für Herzinsuffizienz, Würzburg
| | - P Heuschmann
- Julius-Maximilians-Universität Würzburg, Institut für klinische Epidemiologie und Biometrie (IKE-B), Würzburg
- Julius-Maximilians-Universität Würzburg, Deutsches Zentrum für Herzinsuffizienz, Würzburg
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12
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Mehnert A, Hartung T, Friedrich M, Vehling S, Brähler E, Härter M, Keller M, Schulz H, Wegscheider K, Weis J, Koch U, Faller H. One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology 2017; 27:75-82. [DOI: 10.1002/pon.4464] [Citation(s) in RCA: 243] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 01/09/2023]
Affiliation(s)
- A. Mehnert
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - T.J. Hartung
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - M. Friedrich
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - S. Vehling
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - E. Brähler
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Psychosomatic Medicine and Psychotherapy; Universal Medical Center Mainz; Mainz Germany
| | - M. Härter
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M. Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine; University Hospital Heidelberg; Heidelberg Germany
| | - H. Schulz
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - K. Wegscheider
- Department of Medical Biometry and Epidemiology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - J. Weis
- Department of Psychooncology; UKF Reha gGmbh University Clinic Center Freiburg; Freiburg im Breisgau Germany
| | - U. Koch
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Deanery; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - H. Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken; University of Würzburg; Würzburg Germany
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13
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Schuler M, Jelusic D, Wittmann M, Wagner R, Seidl H, Nowak D, Faller H, Schultz K. Sind bereits vor Beginn einer bewilligten stationären pneumologischen Rehabilitation bei Patienten mit unkontrolloiertem Asthma gesundheitsrelevante Veränderungen eingetreten? Pneumologie 2017. [DOI: 10.1055/s-0037-1598585] [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)
- M Schuler
- Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - D Jelusic
- Klinik Bad Reichenhall der Drv Bayern Süd
| | - M Wittmann
- Klinik Bad Reichenhall der Drv Bayern Süd
| | - R Wagner
- Zentrum für Rehabilitation, Pneumologie und Orthopädie, Klinik Bad Reichenhall der Drv Bayern Süd
| | - H Seidl
- Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Helmholtz Zentrum München (Gmbh)
| | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München, Comprehensive Pneumology Center
| | | | - K Schultz
- Klinik Bad Reichenhall der Drv Bayern Süd
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14
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Schultz K, Jelusic D, Wittmann M, Wagner R, Seidl H, Nowak D, Faller H, Schuler M. Die nummerische Ratingskala des EQ-5D als Outcomeparameter der Rehabilitation von Patienten mit unkontrolliertem Asthma. Pneumologie 2017. [DOI: 10.1055/s-0037-1598261] [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 Schultz
- Klinik Bad Reichenhall der Drv Bayern Süd
| | - D Jelusic
- Klinik Bad Reichenhall der Drv Bayern Süd
| | - M Wittmann
- Klinik Bad Reichenhall der Drv Bayern Süd
| | - R Wagner
- Zentrum für Rehabilitation, Pneumologie und Orthopädie, Klinik Bad Reichenhall der Drv Bayern Süd
| | - H Seidl
- Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Helmholtz Zentrum München (GmbH)
| | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München, Comprehensive Pneumology Center
| | | | - M Schuler
- Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
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15
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Hartung TJ, Brähler E, Faller H, Härter M, Hinz A, Johansen C, Keller M, Koch U, Schulz H, Weis J, Mehnert A. The risk of being depressed is significantly higher in cancer patients than in the general population: Prevalence and severity of depressive symptoms across major cancer types. Eur J Cancer 2016; 72:46-53. [PMID: 28024266 DOI: 10.1016/j.ejca.2016.11.017] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer incidence and a comparison group consisting of 5018 participants. Both groups reported depressive symptoms by filling in the Patient Health Questionnaire (PHQ-9). In multivariate analyses adjusted for age and sex, we calculated the odds of being depressed. RESULTS Out of 5818 eligible patients, 69% participated (51% women, mean age = 58 years). We estimated that one in four cancer patients (24%) is depressed (PHQ-9 ≥ 10). The odds of being depressed among cancer patients were more than five times higher than in the general population (OR, 5.4; 95% CI, 4.6-6.2). Patients with pancreatic (M = 8.0, SD = 5.0), thyroid (M = 7.8, SD = 6.3) and brain tumours (M = 7.6, SD = 4.9) showed the highest prevalence, whereas patients with prostate cancer (M = 4.3, SD = 3.8) and malignant melanoma (M = 5.3, SD = 4.3) had the lowest levels of depressive symptoms. CONCLUSION Our results help clinicians identify cancer patients in need of psychosocial support when navigating in the growing survivor population.
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Affiliation(s)
- T J Hartung
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany.
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - H Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - M Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Hinz
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - C Johansen
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany; Oncology Clinic, 5073 Rigshospitalet, University of Copenhagen, Denmark; Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - M Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - U Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Deanery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Weis
- Department of Psychooncology, UKF Reha gGmbh University Clinic Center Freiburg, Freiburg, Germany
| | - A Mehnert
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
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Reusch A, Weiland R, Gerlich C, Dreger K, Derra C, Mainos D, Tuschhoff T, Berding A, Witte C, Kaltz B, Faller H. Self-management education for rehabilitation inpatients suffering from inflammatory bowel disease: a cluster-randomized controlled trial. Health Educ Res 2016; 31:782-791. [PMID: 27651394 DOI: 10.1093/her/cyw042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
Although inflammatory bowel disease (IBD) affects patients' psychological well-being, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group-based psychoeducational program that combined provision of both medical information and psychological self-management skills, delivered in an interactive manner, and evaluated it in a large, cluster-randomized trial. We assigned 540 rehabilitation inpatients suffering from IBD (mean age 43 years, 66% female) to either the new intervention or a control group comprising the same overall intensity and the same medical information, but only general psychosocial information. The primary outcome was patient-reported IBD-related concerns. Secondary outcomes included disease knowledge, coping, self-management skills, fear of progression, anxiety, depression and quality of life. Assessments took place at baseline, end of rehabilitation and after 3 and 12 months.The psychoeducational self-management program did not prove superior to the control group regarding primary and secondary outcomes. However, positive changes over time occurred in both groups regarding most outcomes. The superior effectiveness of the newly developed psychoeducational program could not be demonstrated. Since the intervention and control groups may have been too similar, this trial may have been too conservative to produce between-group effects.
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Affiliation(s)
- A Reusch
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
| | - R Weiland
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
| | - C Gerlich
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
| | - K Dreger
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
- Rehabilitation Centre Bad Mergentheim, Clinic Taubertal, Bad Mergentheim, 97980, Germany
| | - C Derra
- Rehabilitation Centre Bad Mergentheim, Clinic Taubertal, Bad Mergentheim, 97980, Germany
| | - D Mainos
- Rehabilitation Centre Bad Mergentheim, Clinic Taubertal, Bad Mergentheim, 97980, Germany
| | - T Tuschhoff
- Rehabilitation Centre Bad Mergentheim, Clinic Taubertal, Bad Mergentheim, 97980, Germany
| | - A Berding
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
- German Crohn's and Colitis Association (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung, DCCV e.V.), Berlin, 10179, Germany
| | - C Witte
- German Crohn's and Colitis Association (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung, DCCV e.V.), Berlin, 10179, Germany
| | - B Kaltz
- German Crohn's and Colitis Association (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung, DCCV e.V.), Berlin, 10179, Germany
| | - H Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, Würzburg, D 97070, Germany
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Peters S, Schwab M, Faller H, Meng K. Wie sind die Voraussetzungen und Erwartungen von Hausärzten und Therapeuten hinsichtlich eines Schulungsangebots zur Bewegungsförderung. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586551] [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: 10/21/2022]
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Abstract
Due to the chronic course, rheumatic diseases may be associated with both long-lasting pain and movement limitations. Those afflicted by these disorders thus face continuous challenges regarding both adapting to their illness as well as changing their lifestyle habits, for example increasing the physical activity levels. However, patient education may provide patients with the competencies they need to cope with their illness and modify their behavior. Therefore, patient education programs are core elements of rehabilitation in rheumatology. The German Society for Rheumatology has performed pioneering work concerning conceptualization and evaluation of standardized educational programs. In this article some more recent developments and up to date standards for contents and didactics of self-management programs are presented. Empowerment may be considered the overriding aim of these programs, i.e. enabling patients to make informed decisions in situations where their health is involved. Patient-centered didactic methods as used in state of the art concepts mirror the empowerment approach. To foster sustainability of lifestyle changes, detailed planning of behavioral modifications is recommended, thus increasing the chance of transferring changes adopted during rehabilitation into everyday living. Such methods have been proven to be effective and are employed in the updated education concept for patients with fibromyalgia syndrome, which is described here as an example. The Centre for Patient Education offers support in updating and evaluating patient education concepts.
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Affiliation(s)
- H Faller
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg, Klinikstr. 3, 97070, Würzburg, Deutschland,
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Kleinert S, Marx A, Faller H, Tony HP, Feuchtenberger M, Kneitz C, Lehmann S, Angermann C, Ertl G, Störk S, Breunig M. FRI0150 Depression, Inflammation and Mortality in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2473] [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: 11/04/2022]
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Meng K, Peters S, Schultze A, Pfeifer K, Faller H. Der Einfluss von 2 Implementierungsinterventionen auf die Implementierungsgüte einer standardisierten Rückenschulung in der orthopädischen Rehabilitation. REHABILITATION 2015; 54:325-31. [DOI: 10.1055/s-0035-1555911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- K. Meng
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - S. Peters
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - A. Schultze
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - K. Pfeifer
- Institut für Sportwissenschaft und Sport, Arbeitsbereich Bewegung und Gesundheit, Universität Erlangen-Nürnberg
| | - H. Faller
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
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Vogel H, Blöcher A, Wegmann U, Berger H, Faller H. Nachbefragung von Rehabilitanden zum Reha- und Entlassungsmanagement als Baustein der Qualitätssicherung in der Medizinischen Rehabilitation. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563232] [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: 10/23/2022]
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Neusser S, Biermann J, Meng K, Faller H, Wasem J, Neumann A. Kosteneffektivität eines neuen standardisierten Schulungsprogramms in der Rehabilitation von Patienten mit chronischem Rückenschmerz. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563009] [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: 10/23/2022]
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Gutt S, Bergelt C, Faller H, Krischak G, Spyra K, Uhlmann A, Mau W. [Development of a Set of Rehabilitation Related Multiple-choice-questions in Medical Education]. REHABILITATION 2015; 54:259-65. [PMID: 26080058 DOI: 10.1055/s-0035-1545362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the rehabilitation related teaching as in other subjects of the medical training multiple choice (MC) examinations are the most frequent type of examinations. Compared to other subjects only a few MC questions are available for the interdisciplinary subject Rehabilitation. Therefore an internet-based online platform "Pool of rehabilitation related MC questions" was developed to assist teachers regarding the provision, design and organization of high-quality rehabilitation related MC questions. A total of 502 existing MC questions were collected from 12 German Medical Faculties. After removal of 59 questions not suitable for formal and content reasons a total of 443 questions were presented to 6 reviewers for triple reviews (a total of 1 329 expert reviews received). Of the 502 questions 335 (67%) were included in the final pool including short cases with 46 case studies. The questions refer to the following learning objectives: principles of rehabilitation (40%), rehabilitative interventions (20%), diagnosis and assessment (18%), initiation and control of the rehabilitation process (12%) and methods/quality of rehabilitative interventions (10%). The use of the online platform modules resp. the questions are for free for lecturers. This includes the compilation and output of complete examinations, the statistical evaluation, and other audit-related materials. This examination pool counteracts the current lack of quality-assured rehabilitation-related MC questions and contributes to set common standards for the Medical Faculties to rehabilitation related examinations.
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Affiliation(s)
- S Gutt
- Institut für Rehabilitationsmedizin, Martin-Luther-Universität, Halle-Wittenberg
| | - C Bergelt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf
| | - H Faller
- Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
| | - G Krischak
- Institut für Rehabilitationsmedizinische Forschung, Universität Ulm
| | - K Spyra
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité Universitätsmedizin Berlin
| | - A Uhlmann
- Institut für Qualitätsmanagement und Sozialmedizin, Universitätsklinikum Freiburg
| | - W Mau
- Institut für Rehabilitationsmedizin, Martin-Luther-Universität, Halle-Wittenberg
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Peters S, Schultze A, Pfeifer K, Faller H, Meng K. [Acceptance of the Implementation of Standardised Patient Education Programmes by the Multidisciplinary Rehabilitation Team Using the Example of a Back School - A Qualitative Study]. Gesundheitswesen 2014; 78:148-55. [PMID: 25531158 DOI: 10.1055/s-0034-1390445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM The transfer of standardised patient education programmes into practice is a complex process with a multitude of influencing factors. Determinants relate among others to the organisation and individuals (e. g., practitioner, patient). Knowledge about individual factors regarding the trainers of patient education programmes in the German rehabilitation system is scarce. The aim of this study is to explore the acceptance of trainers concerning the implementation of a standardised back school and to derive facilitators and barriers to the implementation of patient education programmes. METHODS Semi-structured guideline-based interviews were conducted in 10 rehabilitation clinics. The sample consisted of 46 trainers (25 women): 11 physicians, 11 psychologists, 21 physio-/exercise therapists and 3 occupational therapists with a mean age of 41. The opinions of the trainers regarding the central components of back schools in general, their opinions about the new curriculum, their expectations on its implementation, anticipated difficulties with implementation and requests to the project team were explored as indicators for acceptance. The data were analysed with a multi-step qualitative content analysis. RESULTS 6 main categories comprising 136 subcategories were created and 729 quotations coded. Regarding the central components that should be covered by back schools, back-friendly behaviour was addressed most often. Opinions regarding the new curriculum were mostly positive. Trainers' approval of content and methods was highlighted and the similarity with existing offers in the clinics as well as the structure of the programme were rated positively. The trainers expected an increased patient orientation and personal development as well as a common, coherent language and interdisciplinarity. Difficulties were anticipated regarding time and personnel as well as therapy and appointment planning and also regarding the motivation/acceptance of patients. A wish for communication, education of trainers and feedback was directed at the project team. CONCLUSION The study demonstrates high acceptance of programme implementation and central components of modern patient education programmes among trainers. The basis of individual facilitators and barriers has been investigated and might contribute to further development of implementation interventions. Communication and education considering those factors play a central role.
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Affiliation(s)
- S Peters
- Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - A Schultze
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Julius-Maximilians-Universität Würzburg, Würzburg
| | - K Pfeifer
- Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - H Faller
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Julius-Maximilians-Universität Würzburg, Würzburg
| | - K Meng
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Julius-Maximilians-Universität Würzburg, Würzburg
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Vogel H, Braun C, Escher C, Reuss-Borst M, Faller H. Wie wünschen sich die Rehabilitand(inn)en den Reha-Entlassungsbericht? Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1387055] [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: 10/24/2022]
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26
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Schuler M, Musekamp G, Bengel J, Schwarze M, Spanier K, Gutenbrunner C, Ehlebracht-König I, Nolte S, Osborne RH, Faller H. Measurement of stable changes of self-management skills after rehabilitation: a latent state-trait analysis of the Health Education Impact Questionnaire (heiQ™). Qual Life Res 2014; 23:2531-43. [PMID: 24777867 DOI: 10.1007/s11136-014-0693-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess stable effects of self-management programs, measurement instruments should primarily capture the attributes of interest, for example, the self-management skills of the measured persons. However, measurements of psychological constructs are always influenced by both aspects of the situation (states) and aspects of the person (traits). This study tests whether the Health Education Impact Questionnaire (heiQ™), an instrument assessing a wide range of proximal outcomes of self-management programs, is primarily influenced by person factors instead of situational factors. Furthermore, measurement invariance over time, changes in traits and predictors of change for each heiQ™ scale were examined. METHODS Subjects were N = 580 patients with rheumatism, asthma, orthopedic conditions or inflammatory bowel disease, who filled out the heiQ™ at the beginning, the end of and 3 months after a disease-specific inpatient rehabilitation program in Germany. Structural equation modeling techniques were used to estimate latent trait-change models and test for measurement invariance in each heiQ™ scale. Coefficients of consistency, occasion specificity and reliability were computed. RESULTS All scales showed scalar invariance over time. Reliability coefficients were high (0.80-0.94), and consistency coefficients (0.49-0.79) were always substantially higher than occasion specificity coefficients (0.14-0.38), indicating that the heiQ™ scales primarily capture person factors. Trait-changes with small to medium effect sizes were shown in five scales and were affected by sex, age and diagnostic group. CONCLUSION The heiQ™ can be used to assess stable effects in important outcomes of self-management programs over time, e.g., changes in self-management skills or emotional well-being.
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Affiliation(s)
- M Schuler
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, 97070, Würzburg, Germany,
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Hammer F, Stauffenberg S, Faller H, Ertl G, Stoerk S, Angermann C. Iron deficiency is associated with impaired quality of life in non-anaemic patients hospitalized for acute decompensated heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1728] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Seekatz B, Haug G, Mosler G, Schwaab B, Altstidl R, Worringen U, Faller H, Meng K. [Development and short-term effects of a standardized patient education program for in-patient cardiologic rehabilitation]. REHABILITATION 2013; 52:344-51. [PMID: 23749622 DOI: 10.1055/s-0032-1327727] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patient education is an essential part in the treatment of coronary heart disease in medical rehabilitation. In the German-speaking area, no standardized and evaluated patient education program for coronary heart disease is available so far. In this paper, we demonstrate the development of a quality assured patient education program based on a health-education program of the German statutory pension insurance scheme. METHODS In a multi-level approach, an existing program was modified concerning treatment evidence, practical guidelines, theories of health and illness behavior and quality criteria for patient education as well as clinical experience and thereafter manualized. In a formative evaluation, feasibility and patient acceptance of this modified program were assessed using evaluation questionnaires of patients and trainers. Afterwards, effects of the patient education program as compared to a traditional education program were assessed on a short-term (at discharge), medium-term (6-month follow-up) and long-term (12-month follow-up) basis in a multicenter quasi-experimental control group study of patients with coronary heart disease (n=434). RESULTS Results of the formative evaluation demonstrate an overall good acceptance and a good feasibility of the manualized program. Short-term results show a significant small treatment effect in the primary outcome variable patients' knowledge (p=0.001, η2 =0.028). Furthermore, small effects were also observed among some secondary outcomes, such as attitude towards medication, planning of physical activity, psychological quality of life and satisfaction with the education program. CONCLUSION A standardized education program for patients with coronary heart disease has been developed in a systematic process based on established quality standards. Depending on the outstanding medium and long-term effects, the program may be recommended for general use in medical rehabilitation. The manual provides the prerequisites allowing for a successful transfer into clinical practice.
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Affiliation(s)
- B Seekatz
- Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg
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Reusch A, Schug M, Küffner R, Vogel H, Faller H. [Medical rehabilitation group-programmes concerning health promotion, patient education and psychoeducation - a 2010 national survey]. REHABILITATION 2013; 52:226-33. [PMID: 23749620 DOI: 10.1055/s-0032-1327688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE High quality demands are being placed on concepts of educational group programmes in medical rehabilitation as well as the related trainer qualifications. A nationwide survey of German medical rehabilitation clinics in 2005 had revealed a need for improving educational practice according to these quality criteria. An updated investigation was performed in 2010 aiming at describing group programmes used in medical rehabilitation. METHOD 1 473 inpatient and outpatient medical rehabilitation clinics were invited to participate. 908 clinics reported on their training programmes. Data from clinics caring for patients with somatic disorders could be compared to the 2005 survey. Data from clinics for both psychosomatic and substance abuse disorders was collected for the first time in 2010. RESULTS Overall, psychologists and physicians were reported to be the most frequent conductors of educative programmes. In somatic clinics, psychologists, dieticians and occupational therapists or physiotherapists were the most common conductors. Two-thirds of the institutions reported no training prerequisites for staff members to perform patient education. 80% of the education programmes were categorized post hoc into 3 classes: "generic health education", "disorder-specific patient education", and "psychoeducational group programmes". Almost two-thirds of all programmes were carried out with 8-15 participants, and many used several interactive didactic methods. Programmes conducted in small groups (<8 participants) used significantly more interactive methods than those conducted in larger groups did (>15 participants). Only half of the programmes were manualized. Significantly more interactive methods were used in completely manualized programmes. Only about half of the programmes were evaluated, and only very few evaluation studies were published. The institutions wished additional support by workshops especially concerning qualification of their staff and concerning educational concepts. CONCLUSIONS A need for further improvement and support exists relative to the training of educators and the development of manuals as well as evaluation and publication of the programmes.
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Affiliation(s)
- A Reusch
- Arbeitsbereich Rehabilitationswissenschaften, Universität Würzburg.
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Ströbl V, Knisel W, Landgraf U, Faller H. A combined planning and telephone aftercare intervention for obese patients: Effects on physical activity and body weight after one year. J Rehabil Med 2013; 45:198-205. [DOI: 10.2340/16501977-1095] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Patient education programmes, i. e. standardized, manualized, interactive group programmes aiming to increase self-management and empowerment, are a core element of medical rehabilitation for chronic conditions. In an update of the evidence of the effectiveness of patient education, its effectiveness was proven for a broad spectrum of chronic disorders, such as diabetes mellitus, chronic low back pain, rheumatoid arthritis, coronary heart disease, chronic heart failure, bronchial asthma, COPD, and cancer, as well as for the modification of health behaviours, such as diet and exercise. To sustain effects, aftercare interventions, such as support provided by phone, were found to be successful. Interventions targeted to particular patient groups according to gender, age, or migration background are also being developed more frequently. When evaluating educational interventions not only distal outcomes, such as quality of life and participation, should be used but also proximal outcomes such as self-management skills. A recent survey of patient education practice in medical rehabilitation revealed a continuing potential for optimization relative to manualization, evaluation and didactics. However, the dissemination of innovative programmes into rehabilitation routine presents a major challenge.
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Affiliation(s)
- H Faller
- Institut für Psychotherapie und Medizinische Psychologie, Universität Würzburg, Klinikstraße 3, 97070
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Goebel S, Baumann B, Steinert A, Reppenhagen S, Faller H. [Elevated postoperative pain levels following orthopedic surgery. Depression as a strong predictor]. Schmerz 2010; 24:54-61. [PMID: 20143100 DOI: 10.1007/s00482-009-0883-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of this study was to examine whether depression is a strong predictor of elevated postoperative pain levels following orthopedic surgery and whether the implementation of standardized pain management is more beneficial for patients with depression. We performed a non-randomized, prospective study with two different groups of patients who underwent orthopedic surgery. Group 1 (n=249) received non-standardized pain therapy whereas group 2 (n = 243) was treated with a standardized pain management concept. Effects of the treatment were monitored with a VAS-based pain assessment protocol. Depression was measured preoperatively with the self-reported Patient Health Questionnaire (PHQ-9). Patients with the probable diagnosis of a current episode of major depression showed significantly higher postoperative pain than patients without a depressive episode. On the other hand, patients with depression benefited from the implementation of standardized pain management. Our data suggest a predictive value of depression for severe postoperative pain. Patients with depression benefited from standardized postoperative pain therapy, but were still suffering from significantly higher postoperative pain.
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Affiliation(s)
- S Goebel
- Orthopädische Klinik König-Ludwig-Haus, Universität Würzburg, Brettreichstr. 11, 97074, Würzburg.
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Meng K, Seekatz B, Roßband H, Worringen U, Faller H, Vogel H. Entwicklung eines standardisierten Rückenschulungsprogramms für die orthopädische Rehabilitation. REHABILITATION 2010; 48:335-44. [DOI: 10.1055/s-0029-1239575] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ströbl V, Küffner R, Müller J, Reusch A, Vogel H, Faller H. Patientenschulung: Qualitätskriterien der Schulungsumsetzung. REHABILITATION 2009; 48:166-73. [DOI: 10.1055/s-0029-1220749] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Störk S, Faller H, Schowalter M, Ertl G, Angermann C. Evidenz-basiertes Krankheitsmanagement bei Herzinsuffizienz (HeartNetCare-HF©Würzburg). Dtsch Med Wochenschr 2009; 134:773-6. [DOI: 10.1055/s-0029-1220230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Krannich JH, Herzog M, Weyers P, Lueger S, Faller H, Bohrer T, Lange V, Elert O, Leyh R. Patients' Needs during Hospitalization in a Cardiac Surgery Unit before and after Coronary Artery Bypass Graft Surgery. Thorac Cardiovasc Surg 2009; 57:22-4. [DOI: 10.1055/s-2008-1038725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schmidt H, Faller H, Sütterlin M. Immobilisation bei drohender Frühgeburt – Belastungen und Bewältigung. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-2008-1039244] [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: 10/21/2022] Open
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Krannich JH, Weyers P, Lueger S, Faller H, Schimmer C, Deeg P, Elert O, Leyh R. Die kurz- und langfristigen motivationalen Effekte eines Patientenschulungsprogramms für Herzbypasspatienten. REHABILITATION 2008; 47:219-25. [DOI: 10.1055/s-2007-1004598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kirchhof R, Schwarze M, Ehlebracht-König I, Gutenbrunner C, Schuler M, Musekamp G, Faller H. Erfassung von Selbstmanagementkompetenzen zur Bewertung von Patientenschulungen – der generische Fragebogen heiQ. Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086407] [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: 10/21/2022]
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Schwarze M, Kirchhof R, Schuler M, Musekamp G, Nolte S, Jordan J, Osborne R, Ehlebracht-König I, Faller H, Gutenbrunner C. Ein Blick Down Under. Z Rheumatol 2008; 67:189-98. [DOI: 10.1007/s00393-008-0278-5] [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: 10/22/2022]
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Hillert A, Koch S, Faller H. Bericht zum 2. Reha-Symposium des Netzwerkes Rehabilitationsforschung in Bayern e. V. im Oktober 2007 in Prien zum Thema „Chronische Erkrankung und berufliche Realität - Neues zur medizinisch-beruflichen Rehabilitation”. REHABILITATION 2008; 47:131-2. [DOI: 10.1055/s-2007-1004597] [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: 10/22/2022]
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Faller H, Reusch A, Ströbl V, Vogel H. Patientenschulung als Element der Patientenorientierung in der Rehabilitation. REHABILITATION 2008; 47:77-83. [DOI: 10.1055/s-2008-1042444] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wollmerstedt N, Glatzel M, Kirschner S, Schneider J, Faller H, König A. Vergleichende Analyse des patientenzentrierten Outcome nach totalendoprothetischem Ersatz von Hüft- und Kniegelenk. ACTA ACUST UNITED AC 2006; 144:464-71. [PMID: 16991061 DOI: 10.1055/s-2006-942241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM The aim of the present study was a comparative investigation of the functional improvement reported by patients suffering from primary osteoarthritis of the knee or hip undergoing total joint replacement and assessed at 3 months. METHOD In a prospective, controlled clinical trial, 56 patients with primary osteoarthritis of the hip and 59 patients with primary osteoarthritis of the knee undergoing total joint replacement were assessed at two measuring times (day of admission = t1 and 3-month follow-up = t2) using the XSMFA-D (Extra Short Musculoskeletal Function Assessment Questionnaire--German version), WOMAC (Western Ontario and McMasters Universities) arthrosis index and FFb-H OA (Function Assessment Questionnaire Hannover Osteoarthritis). The statistical analysis included effect sizes as standardised response mean, t-test and covariance analysis. RESULTS Both groups of patients demonstrated significant improvements of the musculoskeletal functions measured. The effect sizes between baseline scores and 3-month follow-up scores range from 0.4 to 2.0 and can be considered as large effects. The covariance analysis showed significant differences between patients with osteoarthritis of the hip and knee for almost every score examined. Patients with hip replacement showed large improvements. A significant influence of the presurgery baseline score on the 3-month score was found consistently. Further analysis showed that patients with medium or strong degrees of disability according to the Function index of the XSMFA-D showed the strongest effects of change at 3 months. However, their scores at t2 were less than the scores of the less disabled patients at t1. CONCLUSION We conclude that patients with hip replacement show more improvement 3 months after the surgery than patients with knee replacement. Furthermore, it was seen that patients who were more disabled before surgery achieved more improvement than the less-disabled patients. However, they did not achieve the level of the less disabled patients. Thus, the recommendation that total joint replacement should be performed as late as possible should be reviewed.
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MESH Headings
- Adult
- Aged
- Arthroplasty, Replacement, Hip/statistics & numerical data
- Arthroplasty, Replacement, Knee/statistics & numerical data
- Female
- Germany/epidemiology
- Humans
- Male
- Middle Aged
- Osteoarthritis, Hip/diagnosis
- Osteoarthritis, Hip/epidemiology
- Osteoarthritis, Hip/surgery
- Osteoarthritis, Knee/diagnosis
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Knee/surgery
- Outcome Assessment, Health Care
- Prognosis
- Recovery of Function
- Treatment Outcome
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Igl W, Zwingmann C, Faller H. Änderungssensitivität von Fragebogen zur Erfassung der subjektiven Gesundheit - Ergebnisse einer prospektiven vergleichenden Studie. REHABILITATION 2006; 45:232-42. [PMID: 16874580 DOI: 10.1055/s-2005-915451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Questionnaires measuring patients' subjective health or health-related quality of life are indispensable tools for the evaluation of effects revealed by intervention studies in the field of medical rehabilitation. These patient-reported outcomes should appropriately reflect change over time. Unfortunately, "sensitivity to change" has so far not been adequately examined for German health-related quality of life questionnaires, especially not in a comparative way. Therefore, indices of sensitivity to change for three widespread generic assessment tools have been determined: IRES-3, SF-36, scales of the SCL-90-R. METHODS A prospective comparative study was conducted in n = 1145 inpatients with orthopaedic/rheumatologic and cardiac diseases from 16 rehabilitation clinics. All patients received usual care. Their subjective health-status was assessed at two to four weeks before admission (t0), admission (t1), discharge (t2), and three months after discharge (t3). At each time point, they completed the IRES-3, SF-36, and relevant scales of the SCL-90-R. For the time interval t1-t2, Guyatt's responsiveness index (GRI) was calculated and compared across scales and instruments. RESULTS Virtually all GRI coefficients for scales and aggregated scores, respectively, reached statistical significance. With respect to the GRI distributions of the diagnostic groups, most coefficients were located in a middle to upper range. While the results for the scales do not clearly indicate which assessment instrument should be preferred, GRI coefficients for higher aggregated scores suggest the IRES-3 to be most sensitive to change. CONCLUSION These results can be helpful in selecting a health-related quality of life instrument or certain subscales for evaluation studies in the field of medical rehabilitation.
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Affiliation(s)
- W Igl
- Institut für Psychotherapie und Medizinische Psychologie der Universität Würzburg, Arbeitsbereich Rehabilitationswissenschaften.
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Wollmerstedt N, Faller H, Ackermann H, Schneider J, Glatzel M, Kirschner S, König A. Evaluierung des XSMFA-D an Patienten mit Erkrankungen des Bewegungsapparates und operativer oder konservativer stationärer Therapie. REHABILITATION 2006; 45:78-87. [PMID: 16575713 DOI: 10.1055/s-2005-915337] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM The present study had the objective of evaluating the psychometric characteristics of the shortened 16-item version of the German Short Musculoskeletal Function Assessment questionnaire (XSMFA-D), which was designed for routine assessment of functional capacity in patients with various orthopaedic disorders treated either surgically or medically. METHODS A total of 382 patients from seven different samples with either osteoarthritis of the knee, osteoarthritis of the hip, rheumatoid arthritis or rotator cuff tear treated either in surgical hospitals or rehabilitation settings were assessed both before and after treatment. The XSMFA-D was compared with both questionnaires measuring similar constructs and widely accepted indicators of health status in musculoskeletal disorders. Psychometric characteristics were computed. RESULTS The internal consistency (Cronbach's alpha) exceeded 0.90 in most cases for the function index and was between 0.80 and 0.90 in most cases for the bother index of the XSMFA-D. Retest-reliability was between 0.80 and 0.95 for the function index and between 0.60 and 0.92 for the bother index. Correlations between the XSMFA-D subscales and the other questionnaires were substantial, showing construct validity. Criterion validity was also demonstrated as significant relationships with accepted external parameters such as function tests, judgements by physicians, pain self-ratings by patients and disease severity scores were found. Sensitivity to change was as high as for the other assessment instruments used in this study. CONCLUSIONS The XSMFA-D, a very short assessment instrument, proved to be practical, reliable, valid and sensitive to change among the various patient samples studied. It may be recommended for the assessment of patients' state as well as the evaluation of treatments.
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Igl W, Zwingmann C, Faller H, Beutel M, Beyer W, Bischoff C, Fritschka E, Gustson D, Hillert A, Knickenberg R, Kühn A, Kulick B, Lamprecht F, Nübling R, Rief W, Schmidt J, Schmitz B, Vauth R, Vogel H, Wagner R, Wallesch CW, Wittmann M. Änderungssensitivität von generischen Patientenfragebogen - Ergebnisse einer verbundübergreifenden Reanalyse. Phys Rehab Kur Med 2006. [DOI: 10.1055/s-2005-915386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Patient education is considered to be a major feature of medical rehabilitation in chronic disorders. The rehabilitation sciences research programme funded by the German Pension Insurance scheme and the Federal Ministry of Education and Research comprises a considerable number of evaluation studies carried out with methodological rigor. Over two funding periods, patient education programmes were developed and evaluated with respect to their medical, psychosocial, occupational and economic effects. In this article, a conceptual definition of patient education is presented. Then, the aims and results of ten patient education studies of the funding programme as well as of several implementation projects are described. When integrating these results into previous research taking both a national and international perspective, it can be concluded that patient education programmes are effective regarding medical psychosocial and socio-economic outcomes, although effects sizes may vary. However, in some disorders the state of the research is still unsatisfactory and results are either scarce or heterogeneous. In particular, it is unclear whether such programmes are widely used in medical rehabilitation on a routine basis. Several education programmes provide train-the-trainer opportunities, others are still in the process of development or evaluation. Implementation projects such as those described in the article are aimed at closing these gaps and disseminating research results into the practice of rehabilitation.
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Affiliation(s)
- H Faller
- Institut für Psychotherapie und Medizinische Psychologie der Universität Würzburg, Arbeitsbereich Rehabilitationswissenschaften, Würzburg.
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