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Scherff AD, Feldmann L, Piechaczek C, Pehl V, Wagenbüchler P, Wermuth I, Ghotbi N, Allgaier AK, Freisleder FJ, Beins EC, Forstner AJ, Nöthen MM, Czamara D, Rex-Haffner M, Ising M, Binder E, Greimel E, Schulte-Körne G. Cohort profile: BioMD-Y (biopsychosocial factors of major depression in youth) - a biobank study on the molecular genetics and environmental factors of depression in children and adolescents in Munich. BMJ Open 2024; 14:e074925. [PMID: 38485175 PMCID: PMC10941147 DOI: 10.1136/bmjopen-2023-074925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024] Open
Abstract
PURPOSE BioMD-Y is a comprehensive biobank study of children and adolescents with major depression (MD) and their healthy peers in Germany, collecting a host of both biological and psychosocial information from the participants and their parents with the aim of exploring genetic and environmental risk and protective factors for MD in children and adolescents. PARTICIPANTS Children and adolescents aged 8-18 years are recruited to either the clinical case group (MD, diagnosis of MD disorder) or the typically developing control group (absence of any psychiatric condition). FINDINGS TO DATE To date, four publications on both genetic and environmental risk and resilience factors (including FKBP5, glucocorticoid receptor activation, polygenic risk scores, psychosocial and sociodemographic risk and resilience factors) have been published based on the BioMD-Y sample. FUTURE PLANS Data collection is currently scheduled to continue into 2026. Research questions will be further addressed using available measures.
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Affiliation(s)
- Aline Doreen Scherff
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa Feldmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Charlotte Piechaczek
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Verena Pehl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Petra Wagenbüchler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Neda Ghotbi
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Antje-Kathrin Allgaier
- Department of Human Sciences, Institute of Psychology, University of the Bundeswehr Munich, Munich, Germany
| | | | - Eva C Beins
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Darina Czamara
- Department Genes and Environment, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Monika Rex-Haffner
- Department Genes and Environment, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Marcus Ising
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth Binder
- Department Genes and Environment, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Ellen Greimel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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Hieronimi A, O'Reilly F, Schneider M, Wermuth I, Schulte-Körne G, Lagally L, Bose-O'Reilly S, Danay E. A Germany-wide survey of caregiving professionals on climate change and mental health of children and adolescents - factors influencing their relevance rating of extreme weather event associated mental health impairments. BMC Public Health 2024; 24:120. [PMID: 38191355 PMCID: PMC10775442 DOI: 10.1186/s12889-023-17576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Climate change presents a significant risk for the mental and physical health of young people. In order to identify and properly care for potential mental health impairments from extreme weather events, the relevance of these impairments must be assessed as high by the professional groups providing care for children and adolescents. This raises the question of which factors influence the individual relevance assessment of caretaking professionals? METHODS Data was collected creating and conducting a Germany-wide online questionnaire via LimeSurvey. The questionnaire was addressed to professionals providing care for children and adolescents, in this case medical and therapeutic personnel as well as school and pedagogical personnel. Professional associations, chief physicians and school principals were contacted as multipliers and asked to forward the questionnaire to their members and staff. The data was analyzed using the R statistical software, and multiple linear regressions were performed to test the hypotheses. RESULTS Overall, 648 questionnaires were taken into analysis. Approximately 70% of the participants considered climate change-induced impacts on the mental health of children and adolescents due to extreme weather events as relevant. Experiencing heat, storm, heavy precipitation, flood/flooding, and/or avalanches/mudflows made a modest yet significant contribution to explaining higher relevance assessments. In contrast, there was no evidence to suggest that an urban working environment increases the relevance assessment. CONCLUSION The described influence of experiencing extreme weather events should not be regarded as the sole factor leading to higher relevance ratings. A more comprehensive understanding of the factors influencing relevance assessments is necessary to address key aspects of risk communication and increase risk awareness.
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Affiliation(s)
- Annika Hieronimi
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
| | - Fiona O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Michael Schneider
- Institute of Sociology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lena Lagally
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, Medical Informatics and Technology, UMIT University of Health Sciences, Hall in Tirol, Austria
| | - Erik Danay
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, Medical Informatics and Technology, UMIT University of Health Sciences, Hall in Tirol, Austria
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Löchner J, Platt B, Starman-Wöhrle K, Takano K, Engelmann L, Voggt A, Loy F, Bley M, Winogradow D, Hämmerle S, Neumeier E, Wermuth I, Schmitt K, Oort F, Schulte-Körne G. A randomized controlled trial of a preventive intervention for the children of parents with depression: mid-term effects, mediators and moderators. BMC Psychiatry 2023; 23:455. [PMID: 37344778 DOI: 10.1186/s12888-023-04926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND In a parallel randomized controlled trial the effectiveness of the family- and group-based cognitive-behavioural "Gug-Auf" intervention in preventing depression in children of depressed parents was evaluated. We hypothesized that the intervention would be associated with reduced incidence of depression at 15 months as well as with reduced symptom severity at 6, 9, and 15 months. We also explored the role of a number of mediators and moderators. METHODS Families were included if a parent (n = 100, mean age = 46.06, 61% female) had experienced depression and children (n = 135, aged 8-17 years, 53% female) had no mental illness. Families (91.5% German) were randomly allocated (50:50 block-wise; stratified by child age and parental depression) to the 12-session "GuG-Auf" intervention or no intervention. Outcomes were assessed (on an intention-to-treat basis) at 0-(T1), 6-(T2), 9-(T3) and 15-months (T4) after baseline. Primary outcome (onset of depression; T4) was assessed with standardized (blinded) clinical interviews. Secondary (unblinded) outcome was risk of depression (at T2-T4) indicated by self- and parent-reported symptoms of internalizing, externalizing and depressive disorder. Potential mediators were emotion regulation, attributional style, knowledge of depression and parenting style. Potential moderators were parental depression severity and negative life events. RESULTS None of the children who received the intervention developed depression, whereas two of those in the control group did. The intervention significantly reduced depression risk (indicated by severity of self-reported internalizing symptoms) at T3 (p = .027, d = -0.45) and T4 (p = .035, d = -0.44). Both groups showed reduced depressive symptoms (p = .029, d = -0.44). Cognitive problem-solving and negative parenting emerged as mediators. There was no evidence that the intervention was associated with parent-reported internalizing symptoms or externalizing symptoms. No adverse events were observed. CONCLUSIONS Children of parents with depression showed an increase in self-reported (but not parent-reported) internalizing symptoms over time. This increase was not present in children who received the GuG-Auf intervention. The intervention was not associated with changes in externalizing symptoms. Conclusions regarding prevention of the onset of depression were not possible. Despite some limitations in the generalizability, these findings contribute to reducing the burden of youth depression. REGISTRATION The trial was registered on 16/04/2014 at ClinicalTrials.gov ( NCT02115880 ) and study protocol published in BMC Psychiatry ( https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-014-0263-2 ).
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Affiliation(s)
- Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Department of Child and Adolescent Psychiatry, University Hospital, Eberhard-Karls-University, Tübingen, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Kornelija Starman-Wöhrle
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Human Informatics and Interaction Research Institute (HIIRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Lina Engelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alessandra Voggt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fabian Loy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Mirjam Bley
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Dana Winogradow
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Stephanie Hämmerle
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Esther Neumeier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Schmitt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Frans Oort
- Faculty of Social and Behavioral Sciences, Universiteit van Amsterdam, Amsterdam, Netherlands
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Hieronimi A, Elbel J, Schneider M, Wermuth I, Schulte-Körne G, Nowak D, Bose-O’Reilly S. A Qualitative Study to Explain the Factors Influencing Mental Health after a Flooding. Int J Environ Res Public Health 2022; 20:134. [PMID: 36612497 PMCID: PMC9819052 DOI: 10.3390/ijerph20010134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Background: Children and adolescents are considered to be particularly vulnerable to the psychological effects of climate change, such as extreme weather events. What are the protective factors and stressors for the mental health of the young population after extreme weather events in Germany? Methods: Nine semi-structured interviews with representatives of occupational groups providing care to children, adolescents, and political stakeholders were conducted in Simbach am Inn, a German town affected by flooding in 2016. The interviews were analyzed using qualitative content analysis according to Mayring. Results: The interviews show that the parents' dealing with what they had experienced and the concern for their relatives were the most influential stressors for children and adolescents. As protective factors, they felt that conversations with familiar people and restoring a certain "normality" were particularly important. The interviewees described both, the time of the flooding, and the time after the initial state of shock had subsided, as particularly stressful. Consequently, the experts reported on children and adolescents acutely complaining of fear, helplessness, and extreme tension. Nevertheless, the demand for psychological care increased only slightly after the flooding in Simbach am Inn. Conclusion: The social environment of children and adolescents is essential for their psychological well-being after an extreme weather event. Research, especially on children and adolescents who have already been affected, must increase in order to be able to describe influencing factors even more precisely, to protect individuals from adverse mental health effects, and to identify healthcare requirements.
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Affiliation(s)
- Annika Hieronimi
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
| | - Johanna Elbel
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
| | - Michael Schneider
- Institute of Sociology, Ludwig-Maximilians-University Munich, 80801 Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
| | - Stephan Bose-O’Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
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Hvidt NC, Curlin F, Büssing A, Baumann K, Frick E, Søndergaard J, Nielsen JB, Lawrence R, Lucchetti G, Ramakrishnan P, Wermuth I, Hefti R, Lee E, Kørup AK. The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description. J Relig Health 2022; 61:2605-2630. [PMID: 34599478 DOI: 10.1007/s10943-021-01428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!
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Affiliation(s)
- Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
| | - Farr Curlin
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC, USA
| | - Arndt Büssing
- Faculty of Medicine, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University, Freiburg im Breisgau, Germany
| | - Eckhard Frick
- Department of Psychosomatic Medicine and Psychotherapy, Research Centre Spiritual Care, The University Hospital Klinikum Rechts der Isar, Langerstr. 3, 81675, Munich, Germany
- Forschungsstelle Spiritual Care, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Munich School of Philosophy, Kaulbachstr. 31, 80539, Munich, Germany
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ryan Lawrence
- Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Giancarlo Lucchetti
- Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n - Aeroporto, Juiz de Fora, MG, 36038330, Brazil
| | | | - Inga Wermuth
- Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany
| | - René Hefti
- Medical Faculty, University of Bern, Bern, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University Center for Social Cohesion, Daegu Catholic University, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-Si, Gyeongbuk, 38430, Republic of Korea
| | - Alex Kappel Kørup
- Research Unit of General Practice, Department of Mental Health Kolding-Vejle, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Frey M, Wermuth I. [Anorexia nervosa - diagnostics and therapy]. MMW Fortschr Med 2022; 164:54-59. [PMID: 35274268 DOI: 10.1007/s15006-022-0775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Michael Frey
- Fakultät Angewandte -Gesundheitswissenschaften, Technische Hochschule -Deggendorf, Dieter-Görlitz-Platz 1, 94469, Deggendorf, Germany.
| | - Inga Wermuth
- Klinik für Kinder- und -Jugendpsychiatrie, Psychosomatik und Psychotherapie, LMU, Nußbaumstraße 5a, 80336, München, Germany
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Kørup AK, Søndergaard J, Lucchetti G, Ramakrishnan P, Baumann K, Lee E, Frick E, Büssing A, Alyousefi NA, Karimah A, Schouten E, Wermuth I, Hefti R, de Diego-Cordero R, Menegatti-Chequini MC, Hvidt NC. Physicians' religious/spiritual characteristics and their behavior regarding religiosity and spirituality in clinical practice: A meta-analysis of individual participant data. Medicine (Baltimore) 2021; 100:e27750. [PMID: 34967347 PMCID: PMC8718206 DOI: 10.1097/md.0000000000027750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/27/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Religiosity and/or spirituality (R/S) of physicians have been reported to inform behavior regarding religiosity and spirituality in clinical practice (R/S-B). Our aim was to study this association. METHODS Building upon a large international data pool of physician values we performed network and systematic literature searches using Google Scholar, Web of Science, Embase, Medline, and PsycInfo. Measures for R/S and R/S-B were selected for comparability with existing research. We performed a two-stage IPDMA using R/S coefficients from sample-wise multiple regression analyses as summary measures. We controlled for age, gender, and medical specialty. An additional sub-analysis compared psychiatrists to non-psychiatrists. RESULTS We found 11 eligible surveys from 8 countries (n = 3159). We found a positive association between R/S and R/S-B with an overall R/S coefficient of 0.65 (0.48-0.83). All samples revealed a positive association between R/S and R/S-B. Only 2 out of the 11 samples differed from the overall confidence interval. Psychiatrists had a higher degree of R/S-B, but associations with R/S did not differ compared to non-psychiatrists. CONCLUSIONS We confirmed a significant association between R/S and R/S-B in this study. Despite large cultural differences between samples, coefficients remained almost constant when controlling for confounders, indicating a cultural independent effect of R/S on R/S-B, which to our knowledge has not been documented before.Such interaction can constitute both facilitators and barriers for high quality health care and should be considered in all aspects of patient and relationship-centered medicine.
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Affiliation(s)
- Alex K. Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
- Department of Mental Healtmaxh Service, Vejle, Region of Southern Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n-Aeroporto, Juiz de Fora, MG, Brazil
| | - Parameshwaran Ramakrishnan
- Graduate Theological Union-University of California, Berkeley, 2400 Ridge Rd, Berkeley, CA
- AdiBhat Foundation, New Delhi, India
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, Freiburg, Germany
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, Freiburg, Germany
| | - Eckhard Frick
- Research Centre Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, The University Hospital Klinikum rechts der Isar, Langerstr, 3, Munich, Germany
- Munich School of Philosophy, Kaulbachstr, 31, Munich, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, Germany
| | - Nada A. Alyousefi
- Department of Family and Community Medicine, College of Medicine, King Saud University (KSU), Riyadh, Saudi Arabia
| | - Azimatul Karimah
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Esther Schouten
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15, Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Germany
| | - René Hefti
- Research Institute for Spirituality and Health, Weissensteinstrasse 30, Langenthal, Switzerland
- Medical Faculty, University of Bern and Basel, Switzerland
| | | | | | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense C, Denmark
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Kørup A, Søndergaard J, Alyousefi NA, Lucchetti G, Baumann K, Lee E, Karimah A, Ramakrishnan P, Frick E, Büssing A, Schouten E, Butcher W, Hefti R, Wermuth I, de Diego-Cordero R, Menegatti-Chequini MC, Hvidt NC. Health professionals' attitudes toward religiosity and spirituality: a NERSH Data Pool based on 23 surveys from six continents. F1000Res 2021; 10:446. [PMID: 34868556 PMCID: PMC8607302 DOI: 10.12688/f1000research.52512.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 01/15/2023] Open
Abstract
Background In order to facilitate better international and cross-cultural comparisons of health professionals (HPs) attitudes towards Religiosity and/or Spirituality (R/S) using individual participant data meta-analysis we updated the NERSH Data Pool. Methods We performed both a network search, a citation search and systematic literature searches to find new surveys. Results We found six new surveys (N=1,068), and the complete data pool ended up comprising 7,323 observations, including 4,070 females and 3,253 males. Most physicians (83%, N=3,700) believed that R/S had “some” influence on their patients’ health (CI95%) (81.8%–84.2%). Similarly, nurses (94%, N=1,020) shared such a belief (92.5%–95.5%). Across all samples 649 (16%; 14.9%–17.1%) physicians reported to have undergone formal R/S-training, compared with nurses where this was 264 (23%; 20.6%–25.4%). Conclusions Preliminary analysis indicates that HPs believe R/S to be important for patient health but lack formal R/S-training. Findings are discussed. We find the data pool suitable as a base for future cross-cultural comparisons using individual participant data meta-analysis.
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Affiliation(s)
- Alex Kørup
- Research Unit of General Practice, University of Southern Denmark, Odense, 5000, Denmark.,Department of Mental Health Kolding-Vejle, University of Southern Denmark, Vejle, Region of Southern Denmark, 7000, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, University of Southern Denmark, Odense, 5000, Denmark
| | - Nada A Alyousefi
- College of Medicine, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Klaus Baumann
- Faculty of Theology, Albert-Ludwig-University, Freiburg, D-79085, Germany
| | - Eunmi Lee
- Faculty of Theology, Albert-Ludwig-University, Freiburg, D-79085, Germany.,Center for Social Cohesion, Catholic University of Daegu, Daegu, South Korea
| | - Azimatul Karimah
- Department of Psychiatry, Airlangga University, Surabaya, Indonesia
| | | | - Eckhard Frick
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, 81675, Germany.,Munich School of Philosophy, Munich, 80539, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, University Witten/Herdecke, Herdecke, 58313, Germany
| | - Esther Schouten
- Department of Neonatology, University Hospital Munich, Munich, 80366, Germany
| | - Wyatt Butcher
- School of Divinity, King's College, University of Aberdeen, Aberdeen, UK
| | - René Hefti
- Research Institute for Spirituality and Health, University of Bern, Bern, Switzerland
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Munich, 80336, Germany
| | - Rocio de Diego-Cordero
- Research Group CTS 969 Innovation in Health Care and Social Determinants of Health, University of Seville, Seville, 41009, Spain
| | | | - Niels Christian Hvidt
- Research Unit of General Practice, University of Southern Denmark, Odense, 5000, Denmark.,Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, 5000, Denmark
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9
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Löchner J, Starman-Wöhrle K, Takano K, Engelmann L, Voggt A, Loy F, Bley M, Winogradow D, Hämmerle S, Neumeier E, Wermuth I, Schmitt K, Oort F, Schulte-Körne G, Platt B. A randomised controlled trial of a family-group cognitive-behavioural (FGCB) preventive intervention for the children of parents with depression: short-term effects on symptoms and possible mechanisms. Child Adolesc Psychiatry Ment Health 2021; 15:54. [PMID: 34598737 PMCID: PMC8487152 DOI: 10.1186/s13034-021-00394-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 08/09/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Parental depression is one of the biggest risk factors for youth depression. This parallel randomized controlled trial evaluates the effectiveness of the German version of the family-group-cognitive-behavioral (FGCB) preventive intervention for children of depressed parents. METHODS Families with (i) a parent who has experienced depression and (ii) a healthy child aged 8-17 years (mean = 11.63; 53% female) were randomly allocated (blockwise; stratified by child age and parental depression) to the 12-session intervention (EG; n = 50) or no intervention (CG; usual care; n = 50). Self-reported (unblinded) outcomes were assessed immediately after the intervention (6 months). We hypothesized that CG children would show a greater increase in self-reported symptoms of depression (DIKJ) and internalising/externalising disorder (YSR/CBCL) over time compared to the EG. Intervention effects on secondary outcome variables emotion regulation (FEEL-KJ), attributional style (ASF-KJ), knowledge of depression and parenting style (ESI) were also expected. Study protocol (Belinda Platt, Pietsch, Krick, Oort, & Schulte-Körne, 2014) and trial registration (NCT02115880) reported elsewhere. RESULTS We found significant intervention effects on self-reported internalising ([Formula: see text] = 0.05) and externalising ([Formula: see text] = 0.08) symptoms but did not detect depressive symptoms or parent-reported psychopathology. Parental depression severity did not modify these effects. Both groups showed equally improved knowledge of depression ([Formula: see text] = 0.06). There were no intervention effects on emotion regulation, attributional style or parenting style. CONCLUSION The German version of the FGCB intervention is effective in reducing symptoms of general psychopathology. There was no evidence that the mechanisms targeted in the intervention changed within the intervention period.
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Affiliation(s)
- Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany. .,German Youth Institute (Deutsches Jugendinstitut E.V.), Munich, Germany.
| | - Kornelija Starman-Wöhrle
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Keisuke Takano
- grid.5252.00000 0004 1936 973XDepartment of Clinical Psychology and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lina Engelmann
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Alessandra Voggt
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Fabian Loy
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Mirjam Bley
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Dana Winogradow
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Stephanie Hämmerle
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Esther Neumeier
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany ,grid.417840.e0000 0001 1017 4547Institut für Therapieforschung, Munich, Germany
| | - Inga Wermuth
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Schmitt
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Frans Oort
- grid.7177.60000000084992262Faculty of Social and Behavioral Sciences, Universiteit Van Amsterdam, Amsterdam, The Netherlands
| | - Gerd Schulte-Körne
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Belinda Platt
- grid.5252.00000 0004 1936 973XDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Munich, Germany
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10
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Kørup AK, Søndergaard J, Alyousefi NA, Lucchetti G, Baumann K, Lee E, Karimah A, Ramakrishnan P, Frick E, Büssing A, Schouten E, Butcher W, Hefti R, Wermuth I, Hvidt NC. The International NERSH Data Pool of Health Professionals' Attitudes Toward Religiosity and Spirituality in 12 Countries. J Relig Health 2021; 60:596-619. [PMID: 32776266 DOI: 10.1007/s10943-020-01077-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The amount of research concerned with the values of health professionals (HPs) is steadily growing. Around the world HPs face similar challenges when patients express their existential and spiritual views. How HPs engage these views, and the degree of embedment into consultations, differ across cultures. Today, more than ever before, researchers in this field need to share experiences and build new knowledge upon local findings. To meet this demand, we founded the international collaboration "Network for Research on Spirituality and Health" ( https://NERSH.org ). One of the central projects of our network has been to build a large international data pool of health professionals' attitudes toward religiosity and spirituality. Today the data pool hosts answers from more than 6,000 health professionals from 17 separate surveys derived from 12 countries. Data were gathered by either the questionnaire "Religion and Spirituality in Medicine, Perspectives of Physicians" (RSMPP) or its successor 'NERSH Questionnaire'. In this article we describe the methodology behind the construction of the data pool. We also present an overview of five available scales related to HP religiosity and spirituality, including a description of scale reliability and dimensionality.
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Affiliation(s)
- Alex Kappel Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, C 5000, Odense, Denmark.
- Department of Mental Health Kolding-Vejle, University of Southern Denmark, 7100, Vejle, Denmark.
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, C 5000, Odense, Denmark
| | - Nada A Alyousefi
- College of Medicine, King Saud University (KSU), Riyadh, 11461, Saudi Arabia
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n-Aeroporto, Juiz de Fora, MG, 36038330, Brazil
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085, Freiburg, Germany
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085, Freiburg, Germany
- Center for Social Cohesion, Catholic University of Daegu, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-si, Gyeongbuk, Republic of Korea, 38430
| | - Azimatul Karimah
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Parameshwaran Ramakrishnan
- Harvard Divinity School, Harvard University, Cambridge, MA, 02138, USA
- AdiBhat Foundation, New Delhi, 110048, India
| | - Eckhard Frick
- Department of Psychosomatic Medicine and Psychotherapy, Research Centre Spiritual Care, The University Hospital, Klinikum Rechts Der Isar, Klinikum rechts der Isar, Langerstr. 3, 81675, Munich, Germany
- Munich School of Philosophy, Kaulbachstr. 31, 80539, Munich, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, 58313, Witten, Germany
| | - Esther Schouten
- Medical Faculty, Ludwig Maximilian University of Munich, 81377, München, Germany
| | - Wyatt Butcher
- School of Divinity, King's College, University of Aberdeen, 81377, München, Germany
| | - René Hefti
- Research Institute for Spirituality and Health, Weissensteinstrasse 30, 4900, Langenthal, Switzerland
- Medical Faculty, University of Bern, Basel, Switzerland
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, 81377, München, Germany
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, C 5000, Odense, Denmark
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11
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Frey M, Pietsch K, Weninger L, Brockhaus M, Loy F, Claus N, Wagenbüchler P, Kornbichler S, Kroboth J, Georgii B, Wermuth I, Kititsina A, Heiser K, Schulte-Körne G, Platt B. The adaptation and evaluation of a CBT-based manual for the inpatient treatment of youth depression: a pilot study. Pilot Feasibility Stud 2020; 6:30. [PMID: 32123572 PMCID: PMC7038626 DOI: 10.1186/s40814-020-00573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 02/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background Although there is good evidence to support the effectiveness of cognitive behavioral therapy (CBT) for the outpatient treatment of adolescent major depressive disorder (MDD), evidence-based manuals for the inpatient setting are lacking. This pilot study sought to (i) adapt an existing CBT manual (treatment of adolescent depression; TADS) to an inpatient setting (TADS-in), (ii) test its effectiveness at symptom reduction and remission of MDD in a pre-post design, and (iii) assess the strengths and limitations of the manual via a focus-group with clinicians. Methods Twenty nine adolescents aged 12–17 years with a primary ICD-10 diagnosis of MDD being treated as inpatients at a psychiatric clinic were included. Embedded in the regular inpatient treatment course (8 weeks), patients received 12 sessions of the TADS-in manual. Quantitative assessment of symptom reduction and remission of MDD was conducted using a non-controlled pre-post design. The quantitative results were supplemented by a focus group with participating psychotherapists. Results Of the 29 patients included in the study at the beginning, 19 (65.5%) remained in the study at week 8. Symptoms of depression were statistically significantly lower at the end of treatment than at baseline according to self- (d = 1.38; mean change = 19.88; 95% CI = 12.48–27.28) and other reports (d = 0.64, mean change = 0.35; 95% CI = 0.08–0.62). Clinicians ratings of improvement (CGI-I) suggested that at the end of treatment, 15.8% were very much improved, 68.4% much improved, and 15.8% were minimally improved. According to diagnostic interviews with patients conducted at the end of treatment, 73.3% were in remission. The qualitative analysis showed that on the whole, the TADS-in manual is suitable for the inpatient setting. However, clinicians believed the effectiveness of TADS-in was limited by patient comorbidity and the fact that the inpatients were unable to practice incorporating techniques learnt into everyday life. Conclusions This study is the first to adapt the TADS manual to the inpatient setting. The sample of depressed adolescents showed reduced symptomology following treatment, although these findings require replicating in a randomized controlled trial before effects can be attributed to the TADS-in manual specifically. This pilot study informs further development of the manual as well as representing an important first step in the evaluation of the inpatient treatment of adolescent depression. The study was retrospectively registered (DRKS00017308) and received no external funding.
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Affiliation(s)
- Michael Frey
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Kathrin Pietsch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Laura Weninger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Matthias Brockhaus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fabian Loy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nathalie Claus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Petra Wagenbüchler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Selina Kornbichler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jana Kroboth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Beatrice Georgii
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anna Kititsina
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Heiser
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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12
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Kørup AK, Søndergaard J, Christensen RD, Nielsen CT, Lucchetti G, Ramakrishnan P, Baumann K, Lee E, Frick E, Büssing A, Alyousefi NA, Karimah A, Schouten E, Schulze A, Wermuth I, Hvidt NC. Religious Values in Clinical Practice are Here to Stay. J Relig Health 2020; 59:188-194. [PMID: 30328542 PMCID: PMC6976554 DOI: 10.1007/s10943-018-0715-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians' right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.
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Affiliation(s)
- Alex Kappel Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
- Department of Mental Health Service, University of Southern Denmark, Vejle, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
| | - René dePont Christensen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
| | | | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n-Aeroporto, Juiz de Fora, 36038330 MG Brazil
| | - Parameshwaran Ramakrishnan
- Graduate Theological, Union-University of California, 2400 Ridge Rd, Berkeley, CA 94709 USA
- AdiBhat Foundation, New Delhi, 110048 India
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085 Freiburg, Germany
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085 Freiburg, Germany
| | - Eckhard Frick
- Research Centre Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, The University Hospital Klinikum rechts der Isar, Langerstr. 3, Munich, 81675 Germany
- Munich School of Philosophy, Kaulbachstr. 31, Munich, 80539 Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, 58313 Germany
| | - Nada A. Alyousefi
- College of Medicine, King Saud University (KSU), Riyadh, 11461 Saudi Arabia
| | - Azimatul Karimah
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Esther Schouten
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15, 80366 Munich, Germany
| | - Andreas Schulze
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15, 80366 Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000 Odense, Denmark
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13
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Claus N, Marzano L, Loechner J, Starman K, Voggt A, Loy F, Wermuth I, Haemmerle S, Engelmann L, Bley M, Schulte-Koerne G, Platt B. Qualitative evaluation of a preventive intervention for the offspring of parents with a history of depression. BMC Psychiatry 2019; 19:290. [PMID: 31533676 PMCID: PMC6751651 DOI: 10.1186/s12888-019-2273-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meta-analyses of randomised controlled trials suggest that psychological interventions to reduce children's risk of depression are effective. Nevertheless, these effects are modest and diminish over time. The Medical Research Council recommends a mixed-methods approach to the evaluation of complex interventions. By gaining a more thorough understanding of participants' perspectives, qualitative evaluations of preventive interventions could improve their efficacy, longevity and transfer into clinical practice. METHODS 18 parents and 22 children who had received a 12-session family- and group-based cognitive-behavioural intervention to prevent youth depression as part of a randomised controlled trial took part in semi-structured interviews or a focus group about aspects which had been perceived as helpful, elements they were still using after the intervention had ended, and suggestions they had for improving the intervention. RESULTS The chance to openly share and discuss their experiences of depression within and between families was considered helpful by both children and parents. Children benefitted the most from learning coping strategies for dealing with stress and many still used them in everyday life. Parents profited mostly from increasing positive family time, but noted that maintaining new routines after the end of the intervention proved difficult. Participants were generally content with the intervention but commented on how tiring and time consuming it was. CONCLUSIONS Managing parents' expectations of family-based interventions in terms of their own mental health needs (versus those of their children) and leaving more room for open discussions may result in interventions which are more appealing to participating families. Increasing intervals between sessions may be one means of improving the longevity of interventions. TRIAL REGISTRATION The original RCT this evaluation is a part of was registered under NCT02115880 .
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Affiliation(s)
- Nathalie Claus
- Department of Psychology, Clinical Psychology and Psychotherapy, Ludwig-Maximilians-Universität München, Leopoldstr. 13, 80802, Munich, Germany. .,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336, Munich, Germany.
| | - Lisa Marzano
- 0000 0001 0710 330Xgrid.15822.3cDepartment of Psychology, Middlesex University London, The Burroughs, Hendon, London, NW4 4BT UK
| | - Johanna Loechner
- 0000 0004 1936 973Xgrid.5252.0Department of Psychology, Clinical Psychology and Psychotherapy, Ludwig-Maximilians-Universität München, Leopoldstr. 13, 80802 Munich, Germany ,0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Kornelija Starman
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Alessandra Voggt
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Fabian Loy
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Inga Wermuth
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Stephanie Haemmerle
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Lina Engelmann
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Mirjam Bley
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Gerd Schulte-Koerne
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
| | - Belinda Platt
- 0000 0004 0477 2585grid.411095.8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Nussbaumstr. 5a, 80336 Munich, Germany
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14
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Kørup AK, Søndergaard J, Lucchetti G, Ramakrishnan P, Baumann K, Lee E, Frick E, Büssing A, Alyousefi NA, Karimah A, Schouten E, Wermuth I, Hvidt NC. Religious values of physicians affect their clinical practice: A meta-analysis of individual participant data from 7 countries. Medicine (Baltimore) 2019; 98:e17265. [PMID: 31568003 PMCID: PMC6756708 DOI: 10.1097/md.0000000000017265] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design. METHODS Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale "Religiosity of Health Professionals"; and a dichotomized value of the question "My religious beliefs influence my practice of medicine." Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders. RESULTS Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96-9.96]) compared with the Asian samples India (10.46 [9.82-10.21]) and Indonesia (12.52 [12.19-12.84]), whereas Brazil (9.76 [9.54-9.99]) and USA (10.02 [9.82-10.21]) were placed in between. The proportion of the European physicians who agreed to the statement "My religious beliefs influence my practice of medicine" (95% CI) was 42% (26%-59%) compared with Brazil (36% [29%-43%]), USA (57% [54%-60%]), India (58% [52%-63%]), and Indonesia (91% [84%-95%]). CONCLUSIONS Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.
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Affiliation(s)
- Alex Kappel Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C
- Department of Mental Health Service, Vejle, Region of Southern Denmark, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n-Aeroporto, Juiz de Fora, MG, Brazil
| | | | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University D-79085, Freiburg, Baden-Württemberg
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University D-79085, Freiburg, Baden-Württemberg
| | - Eckhard Frick
- Research Centre Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, The University Hospital Klinikum rechts der Isar, Langerstr
- Munich School of Philosophy, Kaulbachstr., Munich
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, Germany
| | - Nada A. Alyousefi
- College of Medicine, King Saud University (KSU), Riyadh, Saudi Arabia
| | - Azimatul Karimah
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Esther Schouten
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Munich
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense C, Denmark
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Mambrey V, Wermuth I, Böse-O'Reilly S. [Extreme weather events and their impact on the mental health of children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:599-604. [PMID: 30976819 DOI: 10.1007/s00103-019-02937-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Indexed: 11/26/2022]
Abstract
As part of climate change, a rise in meteorological extreme weather events (EWE) like heavy precipitation and flooding can be observed in Germany. Severe extreme events can evoke great fear and pose a risk for traumatization. These traumas and the sustained stress caused by the event may result in adverse psychological health effects. Children and adolescents represent a vulnerable group due to the fact that they hold less coping strategies than adults and are strongly dependent on their environment.This narrative overview intends to summarise the prevalence of mental illness after an EWE and the related risk factors in order to draw meaningful conclusions about the mental health of children and adolescents in Germany. Therefore, existing literature from the WHO European region and from countries with a similar income level (e.g. Canada, Australia, USA) was taken into account. Since floods and heavy precipitation are the most frequent EWE in Germany, the focus was placed on them.An increase in anxiety disorders, depression symptoms, posttraumatic stress and behavioural disorders can be observed in children and adolescents after an EWE. The literature provides little information on the prevalence of such mental health effects as a result of EWEs and their effects, and which risk factors are of importance. There is thus still considerable need for research internationally and especially in Germany.
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Affiliation(s)
- Viola Mambrey
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, LMU München, Ziemssenstr. 1, 80336, München, Deutschland.
| | - Inga Wermuth
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Stephan Böse-O'Reilly
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, LMU München, Ziemssenstr. 1, 80336, München, Deutschland
- Institut für Public Health, Medical Decision Making und Health Technology Assessment, Department Public Health, Versorgungsforschung und Health Technology Assessment, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik GmbH, Hall i.T., Österreich
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Schoierer J, Lob-Corzilius T, Wermuth I, Nowak D, Böse-O'Reilly S. [Does the Prevention Act Improve Prevention in Pediatric Outpatient Settings!?]. Gesundheitswesen 2016; 79:174-178. [PMID: 26990613 DOI: 10.1055/s-0042-102340] [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: 10/22/2022]
Abstract
Aim of the study: The Prevention Act was adopted by the German Federal Parliament on 18.06.2015. The paediatric practice is an important place from which to reach out to children and teenagers and to positively influence them through targeted prevention services in their health-related behaviour. It is therefore an important setting for the implementation of the Prevention Act. Could the delegation of prevention services to qualified medical assistants promote the successful implementation of the Prevention Act? Since 2003, medical assistants have qualified as "Prevention Assistants" after completing training courses and offered support in preventive services to children and teenagers in the paediatrician's office. The aim of this study was to improve the effectiveness of the training to increase the competence of the participants, expansion of preventive services for children and teenagers in the paediatrician's office and reduction of physician workload. Methodology: Training was accompanied by ongoing evaluation; there were two extensive studies in 2009 and 2011, respectively. Between 2003 and 2006 (n=126, after 75% response rate) and in 2011 (n=119 after 24% response rate), participants were assessed with standardized questionnaires, and in the survey of 2011, their employers also were interviewed, (n=76, after 22% response rate). Results: The prevention assistants assess their learning successes as good and are able to take over delegated tasks in the paediatrician's office. The involvement of a trained prevention assistant contributed to the transformation and re-establishment of prevention offers in paediatrician's offices and reduced physician workload. 44% of physicians felt that the time saved by prevention assistant was very good or good, 80% of physicians surveyed also indicated that prevention assistants carried out preventive consultations in the doctor's office. Conclusion: In light of the paediatricians' workload and their own wishes and demands, and for a targeted implementation of the Prevention Act, it is necessary to delegate preventive services to trained personnel. It is also possible to accomplish this task. It is necessary to introduce billing numbers in the fee schedule for doctors similar to the billing numbers for dental health prophylaxis.
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Affiliation(s)
- J Schoierer
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München, München
| | - T Lob-Corzilius
- Christliches Kinderhospital Osnabrück, Pädiatrische Pneumologie und Allergologie, Osnabrück
| | - I Wermuth
- Deutsche Akademie für Prävention und Gesundheitsförderung im Kindes- und Jugendalter, DAPG, Bochum
| | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München, München
| | - S Böse-O'Reilly
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München, München
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Schmidt B, Roberts RS, Davis PG, Doyle LW, Asztalos EV, Opie G, Bairam A, Solimano A, Arnon S, Sauve RS, Cairnie J, Dix J, Adams BA, Warriner E, Marie Kim MH, Anderson P, Davis P, Doyle L, Argus B, Callanan C, Davis N, Duff J, McDonald M, Asztalos E, Hohn D, Lacy M, Haslam R, Barnett C, Goodchild L, Lontis RM, Fraser S, Keng J, Saunders K, Opie G, Kelly E, Woods H, Marchant E, Turner AM, Davis N, Magrath E, Williamson A, Bairam A, Bélanger S, Fraser A, Blayney M, Lemyre B, Frank J, Solimano A, Synnes A, Grunau RE, Hubber-Richard P, Rogers M, Mackay M, Petrie-Thomas J, Butt A, van Wassenaer A, Nuytemans D, Houtzager B, van Sonderen L, Regev R, Itzchack N, Arnon S, Chalaf A, Ohlsson A, O'Brien K, Hamilton AM, Chan ML, Sankaran K, Proctor P, Golan A, Goldsch-Lerman E, Reynolds G, Dromgool B, Meskell S, Parr V, Maher C, Broom M, Kecskes Z, Ringland C, McMillan D, Spellen E, Sauve RS, Christianson H, Anseeuw-Deeks D, Creighton D, Heath J, Alvaro R, Chiu A, Porter C, Turner G, Moddemann D, Granke N, Penner K, Bow J, Mulder A, Wassenberg R, van der Hoeven M, Clarke M, Parfitt J, Parker K, Nwaesei C, Ryan H, Saunders C, Schulze A, Wermuth I, Hilgendorff A, Flemmer AW, Herlenius E, Legnevall L, Lagercrantz H, Matthew D, Amos W, Tulsiani S, Tan-Dy C, Turner M, Phelan C, Shinwell ES, Levine M, Juster-Reicher A, Khairy M, Grier P, Vachon J, Perepolkin L, Barrington KJ, Sinha SK, Tin W, Fritz S, Walti H, Royer D, Halliday H, Millar D, Mayes C, McCusker C, McLaughlin O, Fahnenstich H, Tillmann B, Weber P, Wariyar U, Embleton N, Swamy R, Bucher HU, Fauchere JC, Dietz V, Harikumar C, Tin W, Fritz S, Schmidt B, Anderson PJ, Asztalos EV, Barrington KJ, Davis PG, Dewey D, Doyle LW, Grunau RE, Moddemann D, Ohlsson A, Roberts RS, Solimano A, Tin W, Gent M, Fraser W, Hey E, Perlman M, Thorpe K, Gray S, Roberts RS, Chambers C, Costantini L, Yacura W, McGean E, Scapinello L. Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants. J Pediatr 2015; 167:982-6.e2. [PMID: 26318030 DOI: 10.1016/j.jpeds.2015.07.067] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [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: 05/17/2015] [Revised: 07/08/2015] [Accepted: 07/30/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate bronchopulmonary dysplasia (BPD), serious brain injury, and severe retinopathy of prematurity (ROP) as predictors of poor long-term outcome in very low birth weight infants. STUDY DESIGN We examined the associations between counts of the 3 morbidities and long-term outcomes in 1514 of 1791 (85%) infants with birth weights of 500-1250 g who were enrolled in the Caffeine for Apnea of Prematurity trial from October 1999, to October 2004, had complete morbidity data, and were alive at 36 weeks postmenstrual age (PMA). BPD was defined as use of supplemental oxygen at 36 weeks PMA. Serious brain injury on cranial ultrasound included grade 3 and 4 hemorrhage, cystic periventricular leucomalacia, porencephalic cysts, or ventriculomegaly of any cause. Poor long-term outcome was death after 36 weeks PMA or survival to 5 years with 1 or more of the following disabilities: motor impairment, cognitive impairment, behavior problems, poor general health, deafness, and blindness. RESULTS BPD, serious brain injury, and severe ROP occurred in 43%, 13%, and 6% of the infants, respectively. Each of the 3 morbidities was similarly and independently correlated with poor 5-year outcome. Rates of death or disability (95% CI) in children with none, any 1, any 2, and all 3 morbidities were 11.2% (9.0%-13.7%), 22.9% (19.6%-26.5%), 43.9% (35.5%-52.6%), and 61.5% (40.6%-79.8%), respectively. CONCLUSIONS In very low birth weight infants who survive to 36 weeks PMA, a count of BPD, serious brain injury, and severe ROP predicts the risk of a late death or survival with disability at 5 years.
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Affiliation(s)
- Barbara Schmidt
- Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
| | - Robin S Roberts
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Peter G Davis
- Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | | | | | - Aida Bairam
- Department of Pediatrics, Laval University, Quebec City, Quebec, Canada
| | - Alfonso Solimano
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reginald S Sauve
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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Böse-O'Reilly S, Wermuth I, Hellmann J, Siebert U, Lob-Corzilius T. [Promotion of breast feeding in paediatric outpatient settings]. Gesundheitswesen 2008; 70 Suppl 1:S34-6. [PMID: 18368654 DOI: 10.1055/s-2008-1042412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
With some data and examples it can be shown that the competence and the knowledge of paediatric doctor's assistants and paediatric nurses can and should be improved. The training courses to become a "prevention assistant" have been very positively accepted by doctor's assistants and paediatric nurses, and it seems an appropriate method to reach these aims. Prevention and especially promotion of breast feeding is possible in paediatric outpatient settings. The immediate contact between infants, parents, paediatric doctor's assistants, paediatric nurses, and doctors offers a unique opportunity to promote the health of children, mainly due to the high acceptance of regular check-ups. So why not introduce the promotion of breast feeding in paediatric outpatient settings with specially trained doctor's assistants and paediatric nurses?
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Affiliation(s)
- S Böse-O'Reilly
- Institute of Public Health, UMIT - Universität für Health Sciences, Medical Informatics and Technology, Hall i.T., Osterreich.
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Hilgendorff A, Wermuth I, Letzgus A, Flemmer AW, Schulze A. Standardisiertes neurologisches Follow-up sehr kleiner Frühgeborener im Alter von 24 Monaten mit den Bayley Scales of Infant Development – Erfahrungen am Perinatalzentrum Großhadern. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078830] [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
Involvement of the family in decisions to withhold or withdraw intensive care and parental involvement in care planning for terminally ill infants does not aggravate or prolong parents' grief responses, their feelings of guilt, or the incidence of pathological grief responses. Effective physical pain and symptom management is critically important. Compassionate care plans, however, need to implement a number of other and equally important components. Parents are not uniform in their perceived needs to make various kinds of contacts with their dying infant. They should be allowed to make their individual choices regarding contact with their baby during that time. The perinatal loss of a twin infant appears to evoke no less serious stress and risks to parents' compared to the loss of a singleton. The disruption of family life during a perinatal loss affects siblings of the baby, and their specific needs should be acknowledged. Post-death or post-autopsy meetings with the family should routinely be scheduled a few weeks after death, and bereavement support should actively be offered. Parents need to be informed about differences to be expected between maternal and paternal grief responses. The risk of pathological grief variants and chronic grief should be mentioned to parents because professional help is required in such occurrence.
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Affiliation(s)
- A Schulze
- Neonatologie, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Standort Grosshadern, Ludwig-Maximilians-Universität, München, Germany.
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Wermuth I, Schulze A. Analyse der Bedürfnisse und Trauerreaktionen der Eltern bei Tod ihres Neugeborenen auf einer neonatologischen Intensivstation. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-871467] [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: 10/19/2022]
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Wermuth I, Schulze A. Analyse der Bedürfnisse und Trauerreaktionen der Eltern bei Tod ihres Neugeborenen auf einer neonatologischen Intensivstation. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-923132] [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: 10/18/2022]
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