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Straßburger C, Hieber D, Karthan M, Jüster M, Schobel J. Return to work after Post-COVID: describing affected employees' perceptions of personal resources, organizational offerings and care pathways. Front Public Health 2023; 11:1282507. [PMID: 38089028 PMCID: PMC10715408 DOI: 10.3389/fpubh.2023.1282507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023] Open
Abstract
Background Most individuals recover from the acute phase of infection with the SARS-CoV-2 virus, however, some encounter prolonged effects, referred to as the Post-COVID syndrome. Evidence exists that such persistent symptoms can significantly impact patients' ability to return to work. This paper gives a comprehensive overview of different care pathways and resources, both personal and external, that aim to support Post-COVID patients during their work-life reintegration process. By describing the current situation of Post-COVID patients pertaining their transition back to the workplace, this paper provides valuable insights into their needs. Methods A quantitative research design was applied using an online questionnaire as an instrument. Participants were recruited via Post-COVID outpatients, rehab facilities, general practitioners, support groups, and other healthcare facilities. Results The analyses of 184 data sets of Post-COVID affected produced three key findings: (1) The evaluation of different types of personal resources that may lead to a successful return to work found that particularly the individuals' ability to cope with their situation (measured with the FERUS questionnaire), produced significant differences between participants that had returned to work and those that had not been able to return so far (F = 4.913, p = 0.001). (2) In terms of organizational provisions to facilitate successful reintegration into work-life, predominantly structural changes (i.e., modification of the workplace, working hours, and task) were rated as helpful or very helpful on average (meanworkplace 2.55/SD = 0.83, meanworking hours 2.44/SD = 0.80; meantasks 2.55/SD = 0.83), while the remaining offerings (i.e., job coaching or health courses) were rated as less helpful or not helpful at all. (3) No significant correlation was found between different care pathways and a successful return to work. Conclusion The results of the in-depth descriptive analysis allows to suggests that the level of ability to cope with the Post-COVID syndrome and its associated complaints, as well as the structural adaptation of the workplace to meet the needs and demands of patients better, might be important determinants of a successful return. While the latter might be addressed by employers directly, it might be helpful to integrate training on coping behavior early in care pathways and treatment plans for Post-COVID patients to strengthen their coping abilities aiming to support their successful return to work at an early stage.
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Affiliation(s)
- Claudia Straßburger
- Department of Tourism Management, Kempten University of Applied Sciences, Kempten, Germany
| | - Daniel Hieber
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Department of Pathology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Maximilian Karthan
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Markus Jüster
- Department of Tourism Management, Kempten University of Applied Sciences, Kempten, Germany
| | - Johannes Schobel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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Digitale Gesundheitsanwendungen in der
Rehabilitation: Eine Forschungsagenda. DIE REHABILITATION 2022. [DOI: 10.1055/a-1898-4717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
„Für alles gibt es scheinbar eine App“Wenn es um den Begriff „Gesundheit“ geht, richtet sich unser Blick
zunehmend auf Digitalisierungspotenziale, welche vielfältig in Form von
webbasierten Informationsangeboten im Internet oder auch in Form von mobilen
Anwendungen (Apps) zur eigenen Gesunderhaltung oder Kontrolle der eigenen Gesundheit
eingesetzt werden können. Diese Angebote sind jederzeit bzw. nahezu
ständig und von überall aus verfügbar und können
problemlos auf mobilen und auf anderen geeigneten Endgeräten installiert
werden 1. Aufgrund ihrer Flexibilität
und Individualisierbarkeit erfahren sie intensiviertes Interesse,
größere Aufmerksamkeit und eine immer weitere Verbreitung im
Gesundheitsmarkt.
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Stoppok P, Teufel M, Jahre L, Rometsch C, Müßgens D, Bingel U, Skoda EM, Bäuerle A. Determining the Influencing Factors on Acceptance of eHealth Pain Management Interventions Among Patients With Chronic Pain Using the Unified Theory of Acceptance and Use of Technology: Cross-sectional Study. JMIR Form Res 2022; 6:e37682. [PMID: 35976199 PMCID: PMC9434396 DOI: 10.2196/37682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/13/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Chronic pain is a complex disease with high prevalence rates, and many individuals who are affected do not receive adequate treatment. As a complement to conventional therapies, eHealth interventions could provide many benefits to a multimodal treatment approach for patients with chronic pain, whereby future use is associated with the acceptance of these interventions. Objective This study aims to assess the acceptance of eHealth pain management interventions among patients with chronic pain and identify the influencing factors on acceptance. A further objective of the study is to evaluate the viability of the Unified Theory of Acceptance and Use of Technology (UTAUT) model and compare it with its extended version in terms of explained variance of acceptance. Methods We performed a cross-sectional web-based study. In total, 307 participants with chronic pain, as defined according to the International Association for the Study of Pain criteria, were recruited through flyers, posters, and web-based inquiries between December 2020 and July 2021. In addition to sociodemographic and medical data, the assessment included validated psychometric instruments and an extended version of the well-established UTAUT model. For statistical analyses, group comparisons and multiple hierarchical regression analyses were performed. Results The acceptance of eHealth pain management interventions among patients with chronic pain was overall moderate to high (mean 3.67, SD 0.89). There was significant difference in acceptance among age groups (W=9674.0; r=0.156; P=.04). Effort expectancy (β=.37; P<.001), performance expectancy (β=.33; P<.001), and social influence (β=.34; P<.001) proved to be the most important predictors of acceptance. The extended UTAUT (including the original UTAUT factors as well as sociodemographic, medical, and eHealth-related factors) model explained 66.4% of the variance in acceptance, thus supporting the viability of the model. Compared with the original UTAUT model (performance expectancy, effort expectancy, and social influence), the extended model explained significantly more variance (F25,278=1.74; P=.02). Conclusions Given the association between acceptance and future use, the knowledge of the influencing factors on acceptance should be used in the development and promotion of eHealth pain management interventions. Overall, the acceptance of eHealth pain management interventions was moderate to high. In total, 8 predictors proved to be significant predictors of acceptance. The UTAUT model is a valuable instrument for determining acceptance as well as the factors that influence acceptance of eHealth pain management interventions among patients with chronic pain. The extended UTAUT model provided the greatest predictive value for acceptance.
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Affiliation(s)
- Paula Stoppok
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Lisa Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Caroline Rometsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Diana Müßgens
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany
| | - Ulrike Bingel
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
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de la Coba P, Rodríguez-Valverde M, Hernández-López M. Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment. Internet Interv 2022; 29:100561. [PMID: 35855947 PMCID: PMC9287477 DOI: 10.1016/j.invent.2022.100561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/28/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Acceptance and commitment therapy (ACT) is an effective treatment for chronic pain conditions. ACT seeks to produce clinical change by enhancing Psychological Flexibility (PF). This exploratory (feasibility and preliminary effectiveness) study presents a pilot application of an online ACT group intervention for fibromyalgia (FM) with an extensive Experiential Sampling (ES) assessment of outcome and process variables via smartphone. METHOD 5-weekly ACT online group sessions were applied to 9 female FM patients. Questionnaire-based assessments of several clinical outcomes and PF processes were conducted pre- and post-intervention, and at 6-month follow-up. Extensive (6 weeks pre- and 6 weeks post-intervention) smartphone-delivered ES was implemented to gather process and outcome data in the patients' usual contexts. Clinically significant change was evaluated both at the group level and individually. RESULTS This treatment format appears to be feasible and acceptable to participants, with good adoption and completion rates (75 %) and excellent rates of treatment completion and clinical adherence (100 %). Participants showed significant reductions in affective pain, distress and biopsychosocial impact of FM both post-intervention and at 6-month follow-up (as measured with questionnaires), as well as significant improvements in satisfaction with actions and emotional discomfort (as measured through ES). Multilevel regression analyses indicated that PF-related processes assessed through ES had a significant impact on clinical outcomes and predicted the impact of FM at the 6-month follow-up. CONCLUSIONS A brief online group ACT intervention for FM was both feasible and acceptable to participants. Also, there was preliminary evidence of effectiveness in enhancing pain-related PF and producing clinical benefits in FM.
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Affiliation(s)
- Pablo de la Coba
- Corresponding author at: Departamento de Psicología, Universidad de Jaén, 23071 Jaén, Spain.
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Knauer J, Terhorst Y, Philippi P, Kallinger S, Eiler S, Kilian R, Waldmann T, Moshagen M, Bader M, Baumeister H. Effectiveness and cost-effectiveness of a web-based routine assessment with integrated recommendations for action for depression and anxiety (RehaCAT+): protocol for a cluster randomised controlled trial for patients with elevated depressive symptoms in rehabilitation facilities. BMJ Open 2022; 12:e061259. [PMID: 35738644 PMCID: PMC9226881 DOI: 10.1136/bmjopen-2022-061259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The integration of a web-based computer-adaptive patient-reported outcome test (CAT) platform with persuasive design optimised features including recommendations for action into routine healthcare could provide a promising way to translate reliable diagnostic results into action. This study aims to evaluate the effectiveness and cost-effectiveness of such a platform for depression and anxiety (RehaCAT+) compared with the standard diagnostic system (RehaCAT) in cardiological and orthopaedic health clinics in routine care. METHODS AND ANALYSIS A two-arm, pragmatic, cluster-randomised controlled trial will be conducted. Twelve participating rehabilitation clinics in Germany will be randomly assigned to a control (RehaCAT) or experimental group (RehaCAT+) in a 1:1 design. A total sample of 1848 participants will be recruited across all clinics. The primary outcome, depression severity at 12 months follow-up (T3), will be assessed using the CAT Patient-Reported Outcome Measurement Information System Emotional Distress-Depression Item set. Secondary outcomes are depression at discharge (T1) and 6 months follow-up (T2) as well as anxiety, satisfaction with participation in social roles and activities, pain impairment, fatigue, sleep, health-related quality of life, self-efficacy, physical functioning, alcohol, personality and health economic-specific general quality of life and socioeconomic cost and benefits at T1-3. User behaviour, acceptance, facilitating and hindering factors will be assessed with semistructured qualitative interviews. Additionally, a smart sensing substudy will be conducted, with daily ecological momentary assessments and passive collection of smartphone usage variables. Data analysis will follow the intention-to-treat principle with additional per-protocol analyses. Cost-effectiveness analyses will be conducted from a societal perspective and the perspective of the statutory pension insurance. ETHICS AND DISSEMINATION The study will be conducted according to the Declaration of Helsinki. The Ethics Committee of Ulm University, has approved the study (on 24 February 2021 ref. 509/20). Written informed consent will be obtained for all participants. Results will be published via peer-reviewed journals. TRIAL REGISTRATION NUMBER DRKS00027447.
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Affiliation(s)
- Johannes Knauer
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Paula Philippi
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Selina Kallinger
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sandro Eiler
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Tamara Waldmann
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Morten Moshagen
- Department of Psychological Research Methods, Ulm University, Ulm, Germany
| | - Martina Bader
- Department of Psychological Research Methods, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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Stolz I, Weber E, Vreuls R, Anneken V. Rehabilitation Through Physical Activity and Sport in Light of the International Classification of Functioning, Disability, and Health–Current Research Perspectives. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:840850. [PMID: 36188984 PMCID: PMC9397674 DOI: 10.3389/fresc.2022.840850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022]
Abstract
The implementation of functioning by the World Health Organization (WHO) as the third global health indicator, along with mortality and morbidity, represents a promising advancement for a comprehensive assessment of international health systems and health strategies. The description of a person's health state operationalized by both biological and lived health via functioning provides a holistic picture of an individual's life situation and proved to be successful in building a framework for formulating therapy goals, achievable activities, and participational aspects against the background of an individual's life situation. Furthermore, improving an individual's functional ability and wellbeing could potentially affect the health indicators of morbidity and mortality and will be codable beyond the ICF in ICD-11. This methodological perspective emphasizes the use of ICF applications on the wider and narrower level of international rehabilitation systems and highlights the incorporation of the term functioning in rehabilitation through physical activity and sport. Current research perspectives in applying the ICF and functioning in clinical and rehabilitation practices are discussed and a current explorative study is presented, which applies the holistic orientation of functioning and the biopsychosocial model to the specific case by an individualized sports coaching intervention in rehabilitation. Subsequently, a unifying ICF- oriented language in rehabilitation is considered as a powerful foundation for a consistent international research strategy concerning increased international collaborations and future research perspectives.
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Affiliation(s)
- Isabel Stolz
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
- Institute for Movement-and Neurosciences, German Sport University Cologne, Cologne, Germany
- *Correspondence: Isabel Stolz
| | - Elisa Weber
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
| | - Ruud Vreuls
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
| | - Volker Anneken
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
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Philippi P, Baumeister H, Apolinário-Hagen J, Ebert DD, Hennemann S, Kott L, Lin J, Messner EM, Terhorst Y. Acceptance towards digital health interventions - Model validation and further development of the Unified Theory of Acceptance and Use of Technology. Internet Interv 2021; 26:100459. [PMID: 34603973 PMCID: PMC8463857 DOI: 10.1016/j.invent.2021.100459] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/23/2022] Open
Abstract
Internet- and mobile-based interventions (IMI) offer an effective way to complement health care. Acceptance of IMI, a key facilitator of their implementation in routine care, is often low. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT), this study validates and adapts the UTAUT to digital health care. Following a systematic literature search, 10 UTAUT-grounded original studies (N = 1588) assessing patients' and health professionals' acceptance of IMI for different somatic and mental health conditions were included. All included studies assessed Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions and acceptance as well as age, gender, internet experience, and internet anxiety via self-report questionnaires. For the model validation primary data was obtained and analyzed using structural equation modeling. The best fitting model (RMSEA = 0.035, SRMR = 0.029) replicated the basic structure of UTAUT's core predictors of acceptance. Performance Expectancy was the strongest predictor (γ = 0.68, p < .001). Internet anxiety was identified as an additional determinant of acceptance (γ = -0.07, p < .05) and moderated the effects of Social Influence (γ = 0.07, p < .05) and Effort Expectancy (γ = -0.05, p < .05). Age, gender and experience had no moderating effects. Acceptance is a fundamental prerequisite for harnessing the full potential of IMI. The adapted UTAUT provides a powerful model identifying important factors - primarily Performance Expectancy - to increase the acceptance across patient populations and health professionals.
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Affiliation(s)
- Paula Philippi
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Jennifer Apolinário-Hagen
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine, Heinrich Heine University Düsseldorf, Germany
| | - David Daniel Ebert
- Department of Sport and Health Science, Technical University Munich, Germany
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes-Gutenberg-University Mainz, Germany
| | - Leonie Kott
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Jiaxi Lin
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
- Department of Research Methods, Institute of Psychology and Education, Ulm University, Germany
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Systemische Therapie goes online. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00544-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dederichs M, Weber J, Pischke CR, Angerer P, Apolinário-Hagen J. Exploring medical students' views on digital mental health interventions: A qualitative study. Internet Interv 2021; 25:100398. [PMID: 34026567 PMCID: PMC8122007 DOI: 10.1016/j.invent.2021.100398] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Medical students show a relatively high prevalence for common mental disorders. Only few of those in need for treatment seek professional help. Therefore, easily accessible interventions are required. While several evidence-based internet- and mobile-based interventions (IMIs) have been proposed, little is known about medical students' attitudes towards using them. OBJECTIVE We aimed to explore the views of medical students on IMIs as well as facilitators and barriers to use them and gain first insights into their preferences for tailored IMIs. METHODS We conducted four focus groups with 26 medical students enrolled at a German medical school in March 2020. Focus groups were audio-recorded, transcribed and analyzed following established approaches for qualitative content analysis. RESULTS Medical students valued IMIs for their low-threshold and flexible access, their potential to bridge waiting times and as a first step towards face-to-face-therapy. However, medical students preferred face-to-face interventions in case of severe mental health problems. The main disadvantages named by students included difficulties to find or decide on suitable IMIs based on clear quality criteria, fear of a misdiagnosis and lack of personalisation and human interaction. Some students also questioned the effectiveness of IMIs. Easy handling, flexible use, data safety and easily understandable terms of use were believed to facilitate the uptake of IMIs, whereas technical problems, frequent notifications, required internet access, need to register, lack of anonymity, high time expenditure and costs were reported to hinder their use. Most students did not prefer IMIs tailored to medical students but rather wanted to use IMIs suitable for students of all disciplines. CONCLUSION Our results suggest overall positive views regarding IMIs for mental health promotion but concerns regarding their use for severe mental disorders and acute crises. Our findings indicate that IMIs may represent promising tools for stress prevention and early interventions for medical students. Students explicitly stated to prefer quality-approved IMIs recommended and provided by their university.
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Affiliation(s)
- Melina Dederichs
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, North Rhine-Westphalia, Germany
| | - Jeannette Weber
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, North Rhine-Westphalia, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, North Rhine-Westphalia, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, North Rhine-Westphalia, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, North Rhine-Westphalia, Germany
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Mayer A, Tsiouris A, Nölke C, Schwinn T, Wiltink J, Beutel ME, Zwerenz R. [Development of a Psychosocial Online Self-Help Program for Cancer Patients: A Patient-Oriented Approach]. REHABILITATION 2021; 60:132-141. [PMID: 33858022 DOI: 10.1055/a-1361-4993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM OF THE STUDY Involving potential end users in the development process of digital interventions makes it possible to ensure that these programs meet the needs, requirements and expectations of future users, which in turn has a positive impact on acceptance and adherence. This contribution presents a participatory development approach for the patient-centered design of the psycho-oncological online self-help epos, which aims to provide support in coping with cancer. METHODS Patients were involved in the developmental process at two points. At an early stage of development, semi-standardized in-depth interviews were conducted with patients diagnosed by different types of cancer (N=10) and were qualitatively evaluated with regard to their view of (1) the cancer disease and (2) the design of an online self-help on the content, structural and design levels. At a later stage, a prototype of the online self-help was evaluated in a pilot phase. RESULTS The qualitative analysis of the interviews with a total of N=742 codings resulted in five main content categories (changes in everyday life and future experience, changes in social relationships, processing mechanisms, loss of control, difficult emotions), which provide information about the central challenges and burdens of people with cancer. Participants showed particularly strong emotions around interpersonal concerns, so in addition to the emotion-based focus, the online self-help also included a focus on social relationships. Structural and design implications for development related primarily to clarity and user-friendliness. The pilot phase allowed evaluating whether the requirements for the online self-help that were described by cancer patients at an early stage of development were met. CONCLUSION Patient participation in the development process of the digital online self-help epos provided information for the design at various levels. Involving potential end users in several development phases can ensure that the requirements and suggestions have been sufficiently considered not only from the perspective of the developers, but also from the perspective of future users. These findings confirm the importance of a patient-centered approach in the development of digital offerings.
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Affiliation(s)
- Anna Mayer
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Angeliki Tsiouris
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Charlotte Nölke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Tamara Schwinn
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Jörg Wiltink
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Manfred E Beutel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Rüdiger Zwerenz
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
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Baumeister H, Terhorst Y, Grässle C, Freudenstein M, Nübling R, Ebert DD. Impact of an acceptance facilitating intervention on psychotherapists' acceptance of blended therapy. PLoS One 2020; 15:e0236995. [PMID: 32785245 PMCID: PMC7423074 DOI: 10.1371/journal.pone.0236995] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/17/2020] [Indexed: 11/19/2022] Open
Abstract
Blended therapy is a new approach combining advantages of face-to-face psychotherapy and Internet- and mobile-based interventions. Acceptance is a fundamental precondition for its implementation. The aim of this study was to assess 1) the acceptance of psychotherapists towards blended therapy, 2) the effectiveness of an acceptance facilitating intervention (AFI) on psychotherapists' acceptance towards blended therapy and 3) to identify potential effect moderators. Psychotherapists (N = 284) were randomly assigned to a control (CG) or an intervention group (IG). The IG received a short video showing an example of blended therapy, the CG an attention placebo video. Both groups received a reliable online questionnaire assessing acceptance, effort expectancy, performance expectancy, facilitating conditions, social influence and internet anxiety. Between group differences were examined using t-tests and Mann-Whitney tests. Exploratory analysis was conducted to identify moderators. Psychotherapists in CG showed mixed baseline acceptance towards blended therapy (low = 40%, moderate = 33%, high = 27%). IG showed significantly higher acceptance compared to CG (d = .27, pone-sided = .029; low = 24%, moderate = 47%, high = 30%). Bootstrapped confidence intervals were overlapping. Performance expectancy (d = .35), effort expectancy (d = .44) and facilitating conditions (d = .28) were significantly increased (p < .05). No effects on social influence and internet anxiety were found (p>.05). Exploratory analysis indicated psychodynamic oriented psychotherapists profiting particularly from the AFI. Blended therapy is a promising approach to improve healthcare. Psychotherapists show mixed acceptance, which might be improvable by AFIs, particularly in subpopulations of initially rather skeptical psychotherapists. Forthcoming studies should extend the present study by shifting focus from attitudes to the impact of different forms of AFIs on uptake.
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Affiliation(s)
- Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Cora Grässle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Maren Freudenstein
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Rüdiger Nübling
- Chamber of Psychotherapists Baden-Württemberg, Stuttgart, Germany
| | - David Daniel Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, VU Amsterdam, Amsterdam, The Netherlands
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Fromberger P, Schröder S, Bauer L, Siegel B, Tozdan S, Briken P, Buntrock C, Etzler S, Rettenberger M, Leha A, Müller JL. @myTabu-A Placebo Controlled Randomized Trial of a Guided Web-Based Intervention for Individuals Who Sexually Abused Children and Individuals Who Consumed Child Sexual Exploitation Material: A Clinical Study Protocol. Front Psychiatry 2020; 11:575464. [PMID: 33488416 PMCID: PMC7820175 DOI: 10.3389/fpsyt.2020.575464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background: There is a high demand for evidence-based and cost-effective treatment concepts for convicted individuals who sexually abused children (ISAC) and individuals who consumed child sexual exploitation material (ICCSEM) under community supervision (CS). The @myTabu-consortium developed a guided web-based intervention for convicted ISAC and ICCSEM under CS consisting of six online modules targeting psychological meaningful risk factors. The study aims to evaluate the effectiveness of this guided web-based intervention in reducing dynamic risk factors and the risk to re-offend compared to a placebo condition. Furthermore, these dynamic risk factors are measured before and after every module to evaluate their individual effectiveness to reduce the respective risk factor as well as risk to re-offend. This clinical trial protocol describes the planned methods as well as the intervention concept. Methods: The methodological design is a placebo controlled randomized add-on trial (N = 582) with follow-ups at 8 points in time. The placebo condition controls for attention and expectation effects and comprises the same amount of modules with a comparable temporal effort as the experimental intervention. The trial is conducted as an add-on to community supervision as usually done. Primary outcomes are dynamic risk factors assessed by self-report risk assessment tools and officially recorded re-offenses. Discussion: To the best of our knowledge, the study is the first to compare the (cost-) effectiveness of a guided web-based intervention for convicted ISAC and ICCSEM under community supervision against a placebo condition. Methodological limitations (e.g., potential ceiling- or volunteers-effects) are discussed. Clinical Trial Registration: German Clinical Trial Register (DRKS 00021256). Prospectively registered: 24.04.2020.
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Affiliation(s)
- Peter Fromberger
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Sonja Schröder
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Louisa Bauer
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Bruno Siegel
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Safiye Tozdan
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Andreas Leha
- Department of Medical Statistics, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Jürgen L Müller
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, University Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
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Zwerenz R, Baumgarten C, Dahn I, Labitzke N, Schwarting A, Rudolph M, Ferdinand P, Dederichs-Masius U, Beutel ME. Implementation of a Web-Based Work-Related Psychological Aftercare Program Into Clinical Routine: Results of a Longitudinal Observational Study. J Med Internet Res 2019; 21:e12285. [PMID: 31215515 PMCID: PMC6604507 DOI: 10.2196/12285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/20/2019] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. However, previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants. OBJECTIVE The aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic Web-based aftercare program GSA (Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace])-Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus, and to determine helpfulness of the intervention and satisfaction of the participants as well as improvement in quality of life and mental health status of the regular users of GSA-Online plus. METHODS GSA-Online plus was prescribed by physicians at termination of orthopedic psychosomatic inpatient rehabilitation. Participants' use of the program, work-related attitudes, distress, and quality of life were assessed on the Web. RESULTS In 2 rehabilitation centers, 4.4% (112/2562) of rehabilitants got a recommendation for GSA-Online plus during inpatient rehabilitation. Compared with usual person aftercare, the Web-based aftercare program was rarely recommended by physicians. Recommendations were made more frequently in psychosomatic (69/1172, 5.9%) than orthopedic (43/1389, 3.1%) rehabilitation (χ21=11.845, P=.001, Cramér V=-0.068) and to younger patients (P=.004, d=0.28) with longer inpatient treatment duration (P<.001, r=-0.12) and extended sick leaves before inpatient medical rehabilitation (P=.004; Cramér V=0.072). Following recommendation, 77% (86/112) of rehabilitants participated in Web-based aftercare. Completers (50/86, 58%) reported statistically significant improvements between discharge of inpatient treatment and the end of the aftercare program for subjective work ability (P=.02, d=0.41), perceived stress (P=.01, d=-0.38), functioning (P=.002, d=-0.60), and life satisfaction (P=.008, d=0.42). CONCLUSIONS Physicians' recommendations of Web-based aftercare are well accepted by patients who derive considerable benefits from participation. However, a low rate of prescription compared with other usual aftercare options points to barriers among physicians to prescribing Web-based aftercare.
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Affiliation(s)
- Rüdiger Zwerenz
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Carlotta Baumgarten
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Ingo Dahn
- Knowledge Media Institute, University of Koblenz-Landau, Koblenz, Germany
| | - Nicole Labitzke
- Center for Audiovisual Production, Johannes Gutenberg-University, Mainz, Germany
| | - Andreas Schwarting
- Center of Rheumatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Matthias Rudolph
- Mittelrhein-Klinik, German Statutory Pension Insurance Rhineland-Palatinate, Boppard, Bad Salzig, Germany
| | - Peter Ferdinand
- Knowledge Media Institute, University of Koblenz-Landau, Koblenz, Germany
| | - Ute Dederichs-Masius
- Drei-Burgen-Klinik, German Statutory Pension Insurance Rhineland-Palatinate, Bad Kreuznach, Germany
| | - Manfred E Beutel
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
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Apolinário-Hagen J, Harrer M, Kählke F, Fritsche L, Salewski C, Ebert DD. Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study. JMIR Ment Health 2018; 5:e10735. [PMID: 29764797 PMCID: PMC5974457 DOI: 10.2196/10735] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Internet interventions have been proposed to improve the accessibility and use of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their use. OBJECTIVE This study aimed to (1) determine attitudes toward guided internet interventions, (2) assess its acceptability compared with other internet-based formats, and (3) explore predictors of acceptance. METHODS A convenience-sample Web-based survey (N=646) assessed attitudes toward guided internet therapies (ie, perceived usefulness and helpfulness, and advantage relative to face-to-face therapy), preferences for delivery modes (ie, e-preference: guided internet interventions, unguided internet interventions, or videoconferencing psychotherapy), and potential predictors of attitudes and preferences: sociodemographics, help-seeking-related variables, attachment style, and perceived stress. RESULTS Although most participants perceived internet interventions as useful or helpful (426/646, 65.9%), a few indicated their advantage relative to face-to-face therapy (56/646, 8.7%). Most participants preferred guided internet interventions (252/646, 39.0%) over videoconferencing psychotherapy (147/646, 22.8%), unguided internet interventions (124/646, 19.2%), and not using internet interventions (121/646, 18.8%; missing data: 1/646, 0.2%). Attachment avoidance and stress were related to e-preference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals who were aware of internet-based treatment (χ26=12.8; P=.046). CONCLUSIONS Participants assessed therapist-guided internet interventions as helpful, but not equivalent to face-to-face therapies. The vast majority (523/646, 81.0%) of the participants were potentially willing to use internet-based approaches. In lieu of providing patients with only one specific low-intensity treatment, implementation concepts should offer several options, including guided internet interventions, but not limited to them. Conversely, our results also indicate that efforts should focus on increasing public knowledge about internet interventions, including information about their effectiveness, to promote acceptance and uptake.
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Affiliation(s)
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Fanny Kählke
- Department of Clinical Psychology and Psychotherapy, Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Lara Fritsche
- Institute of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Christel Salewski
- Institute of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - David Daniel Ebert
- Department of Clinical Psychology and Psychotherapy, Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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15
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Lin J, Baumeister H. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:208-209. [PMID: 29642992 PMCID: PMC5963602 DOI: 10.3238/arztebl.2018.0208b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jiaxi Lin
- *King’s College London, Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | - Harald Baumeister
- **Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education Science, University of Ulm, German
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Xu Y, Guo Y, Song Y, Zhang K, Zhang Y, Li Q, Hong S, Liu Y, Guo Y. A New Theory for Acupuncture: Promoting Robust Regulation. J Acupunct Meridian Stud 2018; 11:39-43. [DOI: 10.1016/j.jams.2017.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/24/2022] Open
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