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Nordmeyer L, Leikert C, Sannemann L, Keller K, Leminski C, Meixner A, Peltzer S, Werner B, Kuntz L, Pfaff H, Schulz-Nieswandt F, Jessen F, Albus C. Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study. BMC Psychol 2024; 12:288. [PMID: 38783365 PMCID: PMC11112883 DOI: 10.1186/s40359-024-01693-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/28/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is often associated with mental disorders (MDs). Comorbid MDs reduce the quality of life and increase cardiac morbidity and mortality. Nevertheless, there is little and inconsistent research on the management of MDs in CHD patients. To bridge this gap, this study aims to gain insight into the long-term course of MD-related health care for patients with CHD, in order to identify opportunities for care improvement. METHODS In this prospective cohort study, we investigated whether CHD patients with or without expert-rated MD at baseline (N = 364) received different MD-related health care from either their general practitioner (GP) or cardiologist at follow-up, M = 2.7 [2.0-4.0] years later. In the follow-up assessment, N = 131 CHD patients participated and received questionnaires capturing sociodemographic, mental health, and MD-related health care characteristics. Descriptive statistics, t-tests and chi-squared tests were used for analyses. RESULTS We found significant differences in MD-related health care. CHD patients with MD were more likely to be examined psychologically/psychiatrically (MD 55.9%, non-MD 16.7%, p = < .001) and diagnosed with MD (MD 55.9%, non-MD 13.5%, p = .020) by their GP or cardiologist. Recommendations for and responses to requests for psychotherapy were more likely in MD patients compared to non-MD patients (MD 38.7%, non-MD 11.8%, p = .012 and MD 38.5%, non-MD 11.8%, p = .031, respectively). No significant differences were found concerning physicians' active demand for patients' mental health, referral to a specialist for additional diagnostics, provision of information about the diagnosed MD and further treatment options, response to the patients' request for psychopharmacotherapy, help received in finding psychotherapy or psychopharmacotherapy, and actual receipt of these treatments. CONCLUSIONS The results indicate differences in MD-related health care of CHD patients with and without comorbid MD. However, they still highlight the need to further encourage primary care physicians treating CHD to adequately address MDs, provide further diagnostics, support, and information to affected patients. To address this, physicians may benefit from awareness training on the association between CHD and MDs and on appropriate communication with MD patients. TRIAL REGISTRATION German clinical trials register (Deutsches Register Klinischer Studien, DRKS) Registration Number: ID DRKS00022154, date of registration: 02.11.2021.
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Affiliation(s)
- Laura Nordmeyer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Charlotte Leikert
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Lena Sannemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Kai Keller
- Chair of Quality Development and Evaluation in Rehabilitation, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute for Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Christin Leminski
- Chair of Quality Development and Evaluation in Rehabilitation, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute for Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Adriana Meixner
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Samia Peltzer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
| | - Belinda Werner
- Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology (ISS), University of Cologne, Cologne, Germany
| | - Ludwig Kuntz
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
- Centre for Health Services Research Cologne (ZVFK), University of Cologne, Cologne, Germany
| | - Holger Pfaff
- Chair of Quality Development and Evaluation in Rehabilitation, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute for Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
- Centre for Health Services Research Cologne (ZVFK), University of Cologne, Cologne, Germany
| | - Frank Schulz-Nieswandt
- Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology (ISS), University of Cologne, Cologne, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Cologne, Germany.
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Grasmann L, Morawa E, Adler W, Schug C, Borho A, Geiser F, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Mogwitz S, Baranowski AM, Erim Y. Depression and anxiety among nurses during the COVID-19 pandemic: Longitudinal results over 2 years from the multicentre VOICE-EgePan study. J Clin Nurs 2024. [PMID: 38519850 DOI: 10.1111/jocn.17079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/19/2024] [Accepted: 02/11/2024] [Indexed: 03/25/2024]
Abstract
AIMS To examine symptoms of depression and generalised anxiety among nurses over 2 years during the pandemic and compare them to the general population. BACKGROUND The COVID-19 pandemic has led to a significant increase in mental stress among the population worldwide. Nursing staff have been identified as being under remarkable strain. DESIGN A multicentre prospective longitudinal study. METHODS Symptoms of depression and generalised anxiety in 507 nurses were examined at four different time points (T1: April-July 2020, T2: November 2020-January 2021, T3: May-July 2021, T4: February-May 2022). Results were compared with values of the German general population, presence of gender-specific differences was analysed and frequencies of clinically relevant levels of depression and anxiety were determined. RESULTS Throughout the study (T1-T4), a significant increase in depressive and anxiety symptoms was observed. At all four measurement time points, nurses showed significantly higher prevalence for depression and anxiety compared to the German general population. No significant gender differences were found. Frequencies for probable depression and generalised anxiety disorder among nurses were: 21.6% and 18.5% (T1), 31.4% and 29.2% (T2), 29.5% and 26.2% (T3), 33.7% and 26.4% (T4). CONCLUSION During the pandemic, symptoms of depression and generalised anxiety among nurses increased significantly and remained elevated. Their symptom levels were permanently higher than in the general population. These findings strongly suggest that the circumstances of the pandemic severely affected nurses´ mental health. RELEVANCE TO CLINICAL PRACTICE The COVID-19 pandemic caused a great mental strain on caregivers. This study was able to demonstrate the significant increase in depression and anxiety among nurses during the pandemic. It highlights the urgent need for prevention, screening and support systems in hospitals. IMPLICATIONS FOR THE PROFESSION Supportive programmes and preventive services should be developed, not least to prevent the growing shortage of nurses in the health care systems. REPORTING METHOD The study adhered to relevant EQUATOR guidelines. The STROBE checklist for cohort study was used as the reporting method. PATIENT CONTRIBUTION Five hundred and seven nurses completed the questionnaire and provided data for analysis. TRIAL AND PROTOCOL REGISTRATION The study was registered with the German Clinical Trials Register (https://drks.de/search/en) under the following ID: DRKS00021268.
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Affiliation(s)
- Lenja Grasmann
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Werner Adler
- Institute of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Christophsbad Hospital, Göppingen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andreas M Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Culmann AC, Baranowski AM, Matthias JK, Tüttenberg SC, Belschner W, Erim Y, Morawa E, Beschoner P, Jerg-Bretzke L, Albus C, Steudte-Schmiedgen S, Reuter M, Geiser F. Spirituality and anxiety in pastoral care workers and physicians in the first wave of the COVID-19 pandemic. Front Psychiatry 2024; 15:1354044. [PMID: 38528972 PMCID: PMC10961463 DOI: 10.3389/fpsyt.2024.1354044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
Background The COVID-19 pandemic had serious impact on the well-being of health care workers and highlighted the need for resources to help hospital staff to cope with psychologically negative consequences. The purpose of this study was to investigate the potentially protective effect of spirituality, as measured by the construct of transpersonal trust, against anxiety in physicians and in hospital pastoral care workers. In addition, transpersonal trust was compared to the effects of other potential resources, namely sense of coherence, optimism, and resilience. We also explored the relationship between transpersonal trust and anxiety and how it was moderated by sense of coherence and expected a significant effect. Method The sample included N = 405 participants (n = 151 pastoral care workers and n = 254 physicians) who completed an online survey during the first wave of the COVID-19 pandemic between 20th April and 05th July, 2020, that comprised established questionnaires assessing anxiety, transpersonal trust, sense of coherence, and resilience. Results There was no statistically significant negative relationship between transpersonal trust and anxiety in either profession or broken down by occupational group. Multiple regression analysis revealed that sense of coherence inversely predicted generalized anxiety, while transpersonal trust, resilience, and optimism did not. As hypothesized, the association between transpersonal trust and anxiety was moderated by sense of coherence. However, we could not confirm our hypothesis of a protective effect of transpersonal trust against anxiety. Conclusion Our results point to the significant role of sense of coherence as a protective factor against anxiety and highlight the complexity of the relationship among spirituality, transpersonal trust, and anxiety.
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Affiliation(s)
- Anna C. Culmann
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Andreas M. Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Julia-K. Matthias
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Simone C. Tüttenberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Wilfried Belschner
- Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Hospital Christophsbad, Göppingen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Martin Reuter
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
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Albus C. Low socio-economic status: how can we prevent its negative impact on cardiovascular disease incidence and prognosis? Eur J Prev Cardiol 2024; 31:38-39. [PMID: 37725917 DOI: 10.1093/eurjpc/zwad308] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Kerpenerstr. 62, Köln D-50924, Germany
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5
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Goerling U, Albus C, Bergelt C, Erim Y, Faller H, Geiser F, Hönig K, Hornemann B, Maatouk I, Stein B, Teufel M, Wickert M, Weis J. Predictors of cancer patients' utilization of psychooncological support: Examining patient´s attitude and physician´s recommendation. J Cancer Res Clin Oncol 2023; 149:17997-18004. [PMID: 37978060 PMCID: PMC10725332 DOI: 10.1007/s00432-023-05507-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Patients with cancer suffer from a wide range of psychological distress. Nevertheless, in the literature low utilization rates of psychooncological services are reported. Various factors may influence the utilization of professional support during inpatient care. Up to now it is unclear to what extent patients' attitude towards psychooncological support and physicians' recommendation for psychooncological care may influence the utilization. METHODS In a multicenter longitudinal observational study in Comprehensive Cancer Centers Germany, 1398 patients with mixed cancer diagnoses were assessed at baseline during their hospital stay with respect to psychooncological distress and the need for and use of psychooncological services. RESULTS Psychooncological support was used by almost 28.4% of patients up to this time. A positive attitude towards psychooncological support was reported by 41.6%. A recommendation of psychooncological support by a physician was received by 16.2%. These patients reported a significant higher level of distress compared to patients who did not received a recommendation. Multivariable logistic regression detected that the utilization rate was 3.79 times higher among patients with positive attitude towards psychooncological support (OR, 3.79; 95% CI 2.51-5.73, p < 0.001). Utilization was 4.21 times more likely among patients who received a physician´s recommendation (OR, 4.21; 95% CI 2.98-5.95, p < 0.001). CONCLUSION The results of the study provide evidence of the relevance of giving more attention to psychooncological distress and attitudes towards psychooncological care. To reduce reservations, patients need low-threshold information about the psychooncological services offered.
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Affiliation(s)
- Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany.
| | - Christian Albus
- Department of Psychosomatic and Psychotherapy, Medical Faculty and University Clinic, University of Cologne, Cologne, Germany
| | - Corinna Bergelt
- Institute of Medical Psychology, Greifswald University Medicine, Greifswald, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Erlangen, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University Bonn, Bonn, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Clinic, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Centre Dresden, Dresden, Germany
| | - Imad Maatouk
- Division of Medical Psychosomatics, University Hospital Würzburg, Würzburg, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Wickert
- Comprehensive Cancer Centre, University Clinic Centre Tübingen, Tübingen, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department of Self-Help Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Stolz M, Albus C, Beutel ME, Deter HC, Fritzsche K, Herrmann-Lingen C, Michal M, Petrowski K, Ronel J, Schultz JH, Söllner W, Weber C, de Zwaan M, Krauth C. Assessment of health-related quality of life in individuals with depressive symptoms: validity and responsiveness of the EQ-5D-3L and the SF-6D. Eur J Health Econ 2023; 24:1297-1307. [PMID: 36385438 PMCID: PMC10533591 DOI: 10.1007/s10198-022-01543-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The EQ-5D and the SF-6D are examples of commonly used generic preference-based instruments for assessing health-related quality of life (HRQoL). However, their suitability for mental disorders has been repeatedly questioned. OBJECTIVE To assess the responsiveness and convergent validity of the EQ-5D-3L and SF-6D in patients with depressive symptoms. METHODS The data analyzed were from cardiac patients with depressive symptoms and were collected as part of the SPIRR-CAD (Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease) trial. The EQ-5D-3L and SF-6D were compared with the HADS (Hospital Anxiety and Depression Scale) and PHQ-9 (Patient Health Questionnaire) as disease-specific instruments. Convergent validity was assessed using Spearman's rank correlation. Effect sizes were calculated and ROC analysis was performed to determine responsiveness. RESULTS Data from 566 patients were analysed. The SF-6D correlated considerably better with the disease-specific instruments (|rs|= 0.63-0.68) than the EQ-5D-3L (|rs|= 0.51-0.56). The internal responsiveness of the SF-6D was in the upper range of a small effect (ES: - 0.44 and - 0.47), while no effect could be determined for the EQ-5D-3L. Neither the SF-6D nor the EQ-5D-3L showed acceptable external responsiveness for classifying patients' depressive symptoms as improved or not improved. The ability to detect patients whose condition has deteriorated was only acceptable for the EQ-5D-3L. CONCLUSION Overall, both the convergent validity and responsiveness of the SF-6D are better than those of the EQ-5D-3L in patients with depressive symptoms. The SF-6D appears, therefore, more recommendable for use in studies to evaluate interventions for this population.
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Affiliation(s)
- Maike Stolz
- Institute of Epidemiology Social Medicine and Health System Research, Hannover Medical School, Hanover, Germany.
- Center for Health Economics Research Hanover (CHERH), Hanover, Germany.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Hans-Christian Deter
- Department of Psychosomatics and Psychotherapy, Charité Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Kurt Fritzsche
- Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Katja Petrowski
- Department of Psychotherapy and Psychosomatics, Technical University of Dresden, Dresden, Germany
| | - Joram Ronel
- Department of Psychosomatic Medicine and Psychotherapy, Clinic Barmelweid, Barmelweid, Switzerland
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts Der Isar, Technische Universitaet München, Munich, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Cora Weber
- Department of Psychosomatic Medicine and Psychotherapy, Oberhavel Clinic, Clinic Hennigsdorf, Hennigsdorf, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Christian Krauth
- Institute of Epidemiology Social Medicine and Health System Research, Hannover Medical School, Hanover, Germany
- Center for Health Economics Research Hanover (CHERH), Hanover, Germany
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Morawa E, Adler W, Schug C, Geiser F, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Baranowski AM, Erim Y. Depressive and anxiety symptoms in the course of the COVID-19 pandemic among physicians in hospitals: results of the longitudinal, multicenter VOICE-EgePan survey over two years. BMC Psychol 2023; 11:327. [PMID: 37817222 PMCID: PMC10566070 DOI: 10.1186/s40359-023-01354-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/21/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND This longitudinal, multicenter web-based study explored the trajectories of depressive and anxiety symptoms during the COVID-19 pandemic among physicians over two years. METHODS At four measurement points between 4/2020 and 5/2022 depressive (Patient Health Questionnaire-2, PHQ-2) and anxiety symptoms (Generalized Anxiety Disorder Scale-2, GAD-2) among physicians in German hospitals were assessed. Time, gender and age effects were analyzed with linear mixed regression models. Comparisons with norm values for the German population during the COVID-19 pandemic were also performed and frequencies of probable depression and anxiety are reported. RESULTS The physicians (N = 340) showed a significant increase of depressive symptoms from T1 (M = 1.35, SD = 1.33) to T4 (M = 1.64, SD = 1.34) (p < .001) and of anxiety symptoms from T1 (M = 1.35, SD = 1.42) to T2 (M = 1.59, SD = 1.43) (p = .024). The main effect of gender was only significant for anxiety symptoms (p = .001): women demonstrated higher scores than men. A significant age class difference was observed only for depressive symptoms: the youngest age group (18-40 years) revealed higher values than the oldest group (> 50 years, p = .003). As compared to the general population, the physicians reported significantly elevated PHQ-2 (T1: M = 1.35, SD = 1.33; T2: M = 1.53, SD = 1.37; T3: M = 1.55, SD = 1.40; T4: M = 1.64, SD = 1.34) and GAD-2 scores (T1: M = 1.35, SD = 1.42; T2: M = 1.59, SD = 1.43; T3: M = 1.61, SD = 1.57; T4: M = 1.49, SD = 1.46) for all measurement points (all p < .001). The frequencies of probable depression (PHQ-2 ≥ 3) and anxiety (GAD-2 ≥ 3) were: 14.1% and 17.0% (T1), 16.5% and 21.9% (T2), 17.8% and 22.6% (T3) and 18.5% and 17.3% (T4), respectively. CONCLUSIONS Mental distress of physicians in German hospitals has increased in the course of the COVID-19 pandemic with gender and age-related differences. Possible causes should be explored and regular monitoring of mental health and prevention programmes for physicians should be established. TRIAL REGISTRATION The study was registered on ClinicalTrials (DRKS-ID: DRKS00021268) on 9.4.2020.
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Affiliation(s)
- Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, Erlangen, 91054, Germany.
| | - Werner Adler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, Erlangen, 91054, Germany
- Institute of Medical Informatics, Biometry, and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, Erlangen, 91054, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty, University Hospital of Cologne, Cologne, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andreas M Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, Erlangen, 91054, Germany
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Petrowski K, Mekschrat L, Bührer S, Siepmann M, Albus C, Schmalbach B. Effects of Post-awakening Light Exposure on Heart Rate Variability in Healthy Male Individuals. Appl Psychophysiol Biofeedback 2023; 48:311-321. [PMID: 36971985 PMCID: PMC10412670 DOI: 10.1007/s10484-023-09581-7] [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] [Accepted: 02/07/2023] [Indexed: 03/29/2023]
Abstract
Light-induced effects on the autonomic nervous system (ANS) are assumed to be mediated by retinal projections to the hypothalamic suprachiasmatic nucleus (SCN) via different routes. Light information for the circadian system is detected by a subset of intrinsically photosensitive retinal ganglion cells (ipRGCs), however, inconsistency exists in research concerning the effects of light exposure on heart rate variability (HRV). Two within-subject experiments were conducted in a standardized sleep laboratory to investigate effects of light intensity (study I, n = 29: 2 days dim vs. bright light) and spectral composition (study II, n = 24: 3 days using red vs. blue vs. green light) on HRV parameters (RMSSD, LF, HF-HRV, LF/HF ratio). Light exposure was conducted for one-hour in the post-awakening phase at 5:00 AM. Results revealed no significant light intensity effect comparing dim light versus bright white light on HRV parameters. Light color of different wavelengths significantly influenced all HRV parameters except the low frequency, with moderate to large effect sizes. RMSSD values were elevated for all three colors compared to norm values, indicating stronger parasympathetic activation. LED light of different spectral compositions demonstrated bidirectional effects on spectral components of the HRV. Red light decreased the LF/HF ratio within 30 min, whereas with blue light, LF/HF ratio consistently increased across 40 min of light exposure.
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Affiliation(s)
- Katja Petrowski
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg - University Mainz, University Medicine Mainz, Duesbergweg 6, 55128, Mainz, Germany.
| | - Liza Mekschrat
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg - University Mainz, University Medicine Mainz, Duesbergweg 6, 55128, Mainz, Germany
| | - Stefan Bührer
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg - University Mainz, University Medicine Mainz, Duesbergweg 6, 55128, Mainz, Germany
| | - Martin Siepmann
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of University Cologne, Cologne, Germany
| | - Bjarne Schmalbach
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg - University Mainz, University Medicine Mainz, Duesbergweg 6, 55128, Mainz, Germany
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Markser A, Blaschke K, Meyer I, Jessen F, Schubert I, Albus C. Claims data analysis of the health care utilization for patients with coronary heart disease and mental comorbidity. J Psychosom Res 2023; 172:111430. [PMID: 37421747 DOI: 10.1016/j.jpsychores.2023.111430] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/24/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Mental disorders (MD) are a common comorbidity in patients with coronary heart disease (CHD) and have a significant impact on morbidity and mortality. The aim of this study was to determine to what extent mental disorders are diagnosed as comorbidity in patients with CHD and whether adequate therapeutic measures are taken. METHODS Claims data from 4435 Cologne citizens with diagnosed CHD and a hospital stay due to CHD in 2015 were examined through a longitudinal analysis. The data were analyzed descriptively with regard to mental disorders, investigating diagnostic examinations performed, prescriptions for psychotropic drugs, and utilization of psychotherapy. We differentiated between pre-existing MD, existing in the year before the CHD-related hospital stay, and incident MD with new onset during or within six months after hospitalization. RESULTS Psychodiagnostic examinations for mental disorders occurred very rarely during cardiological hospitalization (0.04%) and psychiatric/psychosomatic consultation sessions rarely (5%). The longitudinal analysis showed a high rate of pre-existing MDs (56%, n = 2490) and a new diagnosis of mental disorders in 7% (n = 302) of the patients. Within one year after inpatient treatment for CHD, psychotropic medication was prescribed in 64-67% of patients with newly diagnosed affective or neurotic, adjustment/somatoform disorder and 10-13% received outpatient psychotherapy. CONCLUSION The results indicate low rates of inpatient diagnostic examinations and low rates of adequate treatment of mental disorders in patients from Cologne with CHD and new onset mental disorders. The rate of prescriptions of psychopharmacotherapy after hospitalization due to CHD exceeds that of the utilization of outpatient psychotherapy.
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Affiliation(s)
- Anna Markser
- Dept. of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Germany.
| | - Katja Blaschke
- PMV research group, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany.
| | - Ingo Meyer
- PMV research group, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany.
| | - Frank Jessen
- Dept. of Psychiatry and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, North Rhine-Westphalia, Germany.
| | - Ingrid Schubert
- PMV research group, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany.
| | - Christian Albus
- Dept. of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Germany.
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Beschoner P, Jerg-Bretzke L, Erim Y, Geiser F, Baranowski AM, Weidner K, Albus C, Schug C, Limbrecht-Ecklundt K, Weimer K, Jarczok MN, Kempf M, Gündel H, Morawa E. The prevalence of effort-reward imbalance and its associations with working conditions, psychosocial resources and burden among health care workers during the COVID-19 pandemic: Results of the egePan-Voice study. PLoS One 2023; 18:e0287509. [PMID: 37590290 PMCID: PMC10434884 DOI: 10.1371/journal.pone.0287509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 06/06/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE The association between a measure of effort-reward imbalance (ERI) and profession as well as gender in a sample of health care workers (HCW) during the first wave of the COVID-19 pandemic in Germany using the egePan-Voice study. In addition, we examined, which factors are associated with an effort-reward imbalance ratio (ERI ratio) >1. METHODS In a large sample of HCW (N = 6174) we assessed occupational stress with the short version of the effort-reward imbalance (ERI) questionnaire, working conditions, COVID-19-related problems and psychosocial resources (ENRICHD Social Support Inventory, ESSI; Sense of Coherence Scale, SOC-3 and optimism, SOP2). RESULTS The prevalence of a ERI ratio >1 among HCW was 50.9%. The prevalence's of an ERI ratio >1 were statistically significant different between gender as well as the occupational profession. The proportion of women (51.8%) with ERI ratio >1 was significantly higher than among men (47.8%). The highest ERI imbalance was found among nurses (62.8%), followed by medical technical assistants (MTA) (58.8%), while psychologists/psychotherapists revealed the lowest value (37.8%), followed by physicians (41.8%). In the total sample, most essential factors reported at this time for increased ERI ratio were: insufficient staff for the current work load, insufficient recovery, feeling insufficiently protected by measures taken by the hospital/the employer, high occupancy rate of the wards, insufficient trust in colleagues and being a nurse as compared with being a physician. CONCLUSION The findings indicate a high proportion of HCW with effort-reward imbalance and substantial profession-related differences. Preventive interventions should be offered to vulnerable groups among the HCW to decrease the imbalance measured by work stress.
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Affiliation(s)
- Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Andreas M. Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Maximilian Kempf
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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11
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Doering S, Herpertz S, Pape M, Hofmann T, Rose M, Imbierowicz K, Geiser F, Bierling AL, Weidner K, Rademacher J, Michalek S, Morawa E, Erim Y, Teigelack P, Teufel M, Hartmann A, Lahmann C, Peters EMJ, Kruse J, von Boetticher D, Herrmann-Lingen C, Nöhre M, de Zwaan M, Dinger U, Friederich HC, Niecke A, Albus C, Zwerenz R, Beutel M, Sattel HC, Henningsen P, Stein B, Waller C, Hake K, Spitzer C, Stengel A, Zipfel S, Weimer K, Gündel H, Kessler H. The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany. Front Psychiatry 2023; 14:1155582. [PMID: 37608994 PMCID: PMC10440687 DOI: 10.3389/fpsyt.2023.1155582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Reliable outcome data of psychosomatic inpatient and day hospital treatment with a focus on psychotherapy are important to strengthen ecological validity by assessing the reality of mental health care in the field. This study aims to evaluate the effectiveness of inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy in a prospective, naturalistic, multicenter design including structured assessments. Methods Structured interviews were used to diagnose mental disorders according to ICD-10 and DSM-IV at baseline. Depression, anxiety, somatization, eating disorder and posttraumatic stress disorder (PTSD) symptoms, as well as personality functioning were assessed by means of questionnaires on admission and at discharge. Results 2,094 patients recruited by 19 participating university hospitals consented to participation in the study. Effect sizes for each of the outcome criteria were calculated for 4-5 sub-groups per outcome domain with differing severity at baseline. Pre-post effect sizes for patients with moderate and high symptom severity at baseline ranged from d = 0.78 to d = 3.61 with symptoms of PTSD, depression, and anxiety showing the largest and somatization as well as personality functioning showing somewhat smaller effects. Conclusions Inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy is effective under field conditions. Clinical trial registration https://drks.de/search/de/trial/DRKS00016412, identifier: DRKS00016412.
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Affiliation(s)
- Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Comprehensive Clinical Center for Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Tobias Hofmann
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Rose
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katrin Imbierowicz
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Antonie Louise Bierling
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany
- Institute for Material Science and Nanotechnology, Technical University of Dresden, Dresden, Germany
- Department of Clinical Psychology, Friedrich-Schiller University, Jena, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany
| | - Jörg Rademacher
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Silke Michalek
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Per Teigelack
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva Milena Johanne Peters
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Dirk von Boetticher
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ulrike Dinger
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heribert Christian Sattel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Karsten Hake
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Andreas Stengel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, University of Marburg, Marburg, Germany
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Fugmann D, Richter P, Karger A, Ernstmann N, Hönig K, Bergelt C, Faller H, Maatouk I, Hornemann B, Stein B, Teufel M, Goerling U, Erim Y, Geiser F, Albus C, Senf B, Wickert M, Weis J. Caring for dependent children impacts practical and emotional problems and need for support, but not perceived distress among cancer patients. Psychooncology 2023; 32:1231-1239. [PMID: 37277899 DOI: 10.1002/pon.6173] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/26/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE More than one in 10 cancer patients care for dependent children. It is unclear whether this status makes a difference in terms of the distress and associated problems they experience, or whether it is linked to differences in the need for or utilization of psychosocial support. METHODS Secondary analysis of a cross-sectional German study in National Comprehensive Cancer Centers using self-report standardized questionnaires administered to inpatients. Patients living with dependent children (n = 161) were matched by age and sex with a subsample of 161 cancer patients not living with dependent children. The resulting sample was tested for between-group differences in Distress Thermometer (DT) scores and the corresponding DT Problem List. Additionally, between-group differences in measures of the need for and utilization of psychosocial support were examined. RESULTS More than 50% of all patients suffered from clinically relevant distress. Patients living with dependent children reported significantly more practical (p < 0.001, η2 p = 0.04), family (p < 0.001, η2 p = 0.03), and emotional problems (p < 0.001, η2 p = 0.01). Although reporting a greater need for psychological support, parents with cancer were not found to more frequently utilize any type of psychosocial support. CONCLUSIONS The specific problems and needs of parents with cancer who care for dependent children are currently not sufficiently addressed in the clinical care pathways. All families should be helped to establish open and honest communication as well as understand the available support systems and what they can provide. Tailored interventions should be implemented for highly distressed families.
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Affiliation(s)
- Dominik Fugmann
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Peter Richter
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - André Karger
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nicole Ernstmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, Greifswald Medical School, Greifswald, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Imad Maatouk
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, University of Duisburg-Essen, Essen, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine, University Clinic Center Erlangen, Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine, University Clinic Center Bonn, Bonn, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine & Center Psychooncology (CePO), University Clinic Center Cologne, Cologne, Germany
| | - Bianca Senf
- University Clinic Center Frankfurt University Cancer Center, Frankfurt, Germany
| | - Martin Wickert
- Comprehensive Cancer Center, University Clinic Center Tübingen, Tübingen, Germany
| | - Joachim Weis
- Department of Self-Help Research, Faculty of Medicine and Medical Center, Comprehensive Cancer Center, University of Freiburg, Freiburg, Germany
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13
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Zelenak C, Nagel J, Bersch K, Derendorf L, Doyle F, Friede T, Herbeck Belnap B, Kohlmann S, Skou ST, Velasco CA, Albus C, Asendorf T, Bang CA, Beresnevaite M, Bruun NE, Burg MM, Buhl SF, Gæde PH, Lühmann D, Markser A, Nagy KV, Rafanelli C, Rasmussen S, Søndergaard J, Sørensen J, Stauder A, Stock S, Urbinati S, Riva DD, Wachter R, Walker F, Pedersen SS, Herrmann‐Lingen C. Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study. ESC Heart Fail 2023; 10:2051-2065. [PMID: 36907651 PMCID: PMC10192276 DOI: 10.1002/ehf2.14294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 03/13/2023] Open
Abstract
ESCAPE Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients. THERAPEUTIC AREA Healthcare interventions for the management of older patients with multiple morbidities. AIMS Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies. This comprehensive cohort study with embedded randomized controlled trial tests an integrated biopsychosocial care model for multimorbid elderly patients. HYPOTHESIS A holistic, patient-centred pro-active 9-month intervention based on the blended collaborative care (BCC) approach and enhanced by information and communication technologies can improve health-related quality of life (HRQoL) and disease outcomes as compared with usual care at 9 months. METHODS Across six European countries, ESCAPE is recruiting patients with heart failure, mental distress/disorder plus ≥2 medical co-morbidities into an observational cohort study. Within the cohort study, 300 patients will be included in a randomized controlled assessor-blinded two-arm parallel group interventional clinical trial (RCT). In the intervention, trained care managers (CMs) regularly support patients and informal carers in managing their multiple health problems. Supervised by a clinical specialist team, CMs remotely support patients in implementing the treatment plan-customized to the patients' individual needs and preferences-into their daily lives and liaise with patients' healthcare providers. An eHealth platform with an integrated patient registry guides the intervention and helps to empower patients and informal carers. HRQoL measured with the EQ-5D-5L as primary endpoint, and secondary outcomes, that is, medical and patient-reported outcomes, healthcare costs, cost-effectiveness, and informal carer burden, will be assessed at 9 and ≥18 months. CONCLUSIONS If proven effective, the ESCAPE BCC intervention can be implemented in routine care for older patients with multiple morbidities across the participating countries and beyond.
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Affiliation(s)
- Christine Zelenak
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
| | - Jonas Nagel
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
| | - Kristina Bersch
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | - Lisa Derendorf
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical EpidemiologyUniversity of CologneCologneGermany
| | - Frank Doyle
- Royal College of Surgeons in IrelandDublinIreland
| | - Tim Friede
- Department of Medical StatisticsUniversity of Göttingen Medical CentreGöttingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
| | - Birgit Herbeck Belnap
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
- Center for Behavioral Health, Media, and Technology, Division of General Internal MedicineUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Sebastian Kohlmann
- Clinic for Psychosomatic Medicine and PsychotherapyUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Søren T. Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational TherapyNæstved‐Slagelse‐Ringsted Hospitals, Region ZealandSlagelseDenmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | - Carlos A. Velasco
- Fraunhofer Institute for Applied Information Technology FITSchloss BirlinghovenSankt AugustinGermany
| | - Christian Albus
- Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and PsychotherapyUniversity of CologneCologneGermany
| | - Thomas Asendorf
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | | | - Margarita Beresnevaite
- Laboratory of Clinical Cardiology, Institute of CardiologyLithuanian University of Health SciencesKaunasLithuania
| | - Niels Eske Bruun
- Department of CardiologyZealand University HospitalRoskildeDenmark
- Clinical InstitutesCopenhagen and Aalborg UniversitiesCopenhagenDenmark
| | | | - Sussi Friis Buhl
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Peter H. Gæde
- Department of Cardiology and EndocrinologySlagelse HospitalSlagelseDenmark
- Institute of Regional HealthUniversity of Southern DenmarkOdenseDenmark
| | | | - Anna Markser
- Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and PsychotherapyUniversity of CologneCologneGermany
| | | | | | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Jan Sørensen
- Healthcare Outcomes Research CentreDublinIreland
| | - Adrienne Stauder
- Institute of Behavioural SciencesSemmelweis UniversityBudapestHungary
| | - Stephanie Stock
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical EpidemiologyUniversity of CologneCologneGermany
| | | | | | | | - Florian Walker
- Clinical Trial Unit of the University Medical Center GöttingenGöttingenGermany
| | - Susanne S. Pedersen
- Department of PsychologyUniversity of Southern DenmarkOdenseDenmark
- Department of CardiologyOdense University HospitalOdenseDenmark
| | - Christoph Herrmann‐Lingen
- Department of Psychosomatic Medicine and PsychotherapyUniversity of Göttingen Medical CentreGöttingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
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14
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Sannemann L, Bach L, Hower KI, Ihle P, Keller K, Leikert C, Leminski C, Meixner A, Meyer I, Nordmeyer L, Peltzer S, Peter S, Werner B, Kuntz L, Pfaff H, Schulz-Nieswandt F, Albus C, Jessen F. Effects of a Primary Care-Based Intervention on the Identification and Management of Patients with Coronary Heart Disease and Mental or Cognitive Comorbidity-A Study Protocol. Int J Environ Res Public Health 2023; 20:ijerph20105814. [PMID: 37239541 DOI: 10.3390/ijerph20105814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/27/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Mental and cognitive disorders (MCD) negatively affect the incidence and prognosis of coronary heart disease (CHD). Medical guidelines recommend the appropriate management of comorbid MCD in patients with CHD, yet there is evidence that the implementation in primary care is not always adequate. We present the protocol for a pilot study that aims to develop a minimally invasive intervention and evaluate its feasibility in the primary care setting to improve the identification and management of comorbid MCD in patients with CHD. The study consists of two consecutive parts and will be carried out in Cologne, Germany. Part 1 comprises the development and tailoring of the intervention, which is guided by qualitative interviews with primary care physicians (PCPs, n = 10), patients with CHD and MCD and patient representatives (n = 10). Part II focuses on the implementation and evaluation of the intervention in n = 10 PCP offices. Changes in PCP behaviour will be analysed by comparing routine data in the practice management system six months before and six months after study participation. In addition, we will explore the influence of organisational characteristics and perform a socio-economic impact assessment. The outcomes of this mixed-method study will inform the feasibility of a PCP-based intervention to improve quality of care in patients with CHD and comorbid MCD.
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Affiliation(s)
- Lena Sannemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
| | - Lisa Bach
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Kira Isabel Hower
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Peter Ihle
- PMV Research Group, Faculty of Medicine and Cologne University Hospital, University of Cologne, Herderstraße 52, 50931 Cologne, Germany
| | - Kai Keller
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Charlotte Leikert
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Weyertal 76, 50931 Cologne, Germany
| | - Christin Leminski
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Adriana Meixner
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Ingo Meyer
- PMV Research Group, Faculty of Medicine and Cologne University Hospital, University of Cologne, Herderstraße 52, 50931 Cologne, Germany
| | - Laura Nordmeyer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Weyertal 76, 50931 Cologne, Germany
| | - Samia Peltzer
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Weyertal 76, 50931 Cologne, Germany
| | - Sophie Peter
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
- Chair of General Practice II and Patient-Centredness in Primary Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany
| | - Belinda Werner
- Institute of Sociology and Social Psychology (ISS), Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Ludwig Kuntz
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus-Magnus-Platz, 50923 Cologne, Germany
- Centre for Health Services Research Cologne (ZVFK), University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Holger Pfaff
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
- Centre for Health Services Research Cologne (ZVFK), University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Frank Schulz-Nieswandt
- Institute of Sociology and Social Psychology (ISS), Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Weyertal 76, 50931 Cologne, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and Cologne University Hospital, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Str. 26, 50931 Cologne, Germany
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15
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Mogwitz S, Albus C, Beschoner P, Erim Y, Geiser F, Jerg-Bretzke L, Morawa E, Steudte-Schmiedgen S, Wintermann GB, Weidner K. Mental distress of physicians in the outpatient care throughout the COVID-19 pandemic: emotional and supportive human relations matter - Cross-sectional results of the VOICE-study. BMC Health Serv Res 2023; 23:481. [PMID: 37173735 PMCID: PMC10180613 DOI: 10.1186/s12913-023-09361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/01/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of this cross-sectional study was to evaluate the course of self-reported mental distress and quality of life (QoL) of physicians, working in the outpatient care (POC). Outcomes were compared with a control group of physicians working in the inpatient care (PIC), throughout the Corona Virus Disease (COVID)-19 pandemic. The impact of risk and protective factors in terms of emotional and supportive human relations on mental distress and perceived QoL of POC were of primary interest. METHODS Within the largest prospective, multi-center survey on mental health of health care workers (HCW), conducted during the first (T1) and second (T2) wave of the COVID-19 pandemic in Europe, we investigated the course of current burden (CB), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2) and QoL, cross-sectionally, in n = 848 POC (T1: n = 536, T2: n = 312). The primary outcomes were compared with an age- and gender-matchted control group of n = 458 PIC (T1: n = 262, T2: n = 196). COVID-19-, work-related, social risk and protective factors were examined. RESULTS At T1, POC showed no significant differences with respect to CB, depression, anxiety, and QoL, after Bonferroni correction. Whereas at T2, POC exhibited higher scores of CB (Cohen´s d/ Cd = .934, p < .001), depression (Cd = 1.648, p < 001), anxiety (Cd = 1.745, p < .001), work-family conflict (Cd = 4.170, p < .001) and lower QoL (Cd = .891, p = .002) compared with PIC. Nearly all assessed parameters of burden increased from T1 to T2 within the cohort of POC (e.g. depression: CD = 1.580, p < .001). Risk factors for mental distress of POC throughout the pandemic were: increased work-family conflict (CB: ß = .254, p < .001, 95% CI: .23, .28; PHQ-2: ß = .139, p = .011, 95% CI: .09, .19; GAD-2: ß = .207, p < .001, 95% CI: .16, .26), worrying about the patients´ security (CB: ß = .144, p = .007, 95% CI: .07, .22; PHQ-2: ß = .150, p = .006, 95% CI: .00, .30), fear of triage situations (GAD-2: ß = .132, p = .010, 95% CI: -.04, .31) and burden through restricted social contact in spare time (CB: ß = .146, p = .003, 95% CI: .07, .22; PHQ-2: ß = .187, p < .001, 95% CI: .03, .34; GAD-2: ß = .156, p = .003, 95% CI: -.01, .32). Protective factors for mental distress and QoL were the perceived protection by local authorities (CB: ß = -.302, p < .001, 95% CI: -.39, -.22; PHQ-2: ß = -.190, p < . 001, 95% CI: -.36, -.02; GAD-2: ß = -.211, p < .001, 95% CI: -.40, -.03; QoL: ß = .273, p < .001, 95% CI: .18, .36), trust in colleagues (PHQ-2: ß = -.181, p < .001, 95% CI: -.34, -.02; GAD-2: ß = -.199, p < .001, 95% CI: -.37, -.02; QoL: ß = .124, p = .017, 95% CI: .04, .21) and social support (PHQ-2: ß = -.180, p < .001, 95% CI: -.22, -.14; GAD-2: ß = -.127, p = .014, 95% CI: -.17, -.08; QoL: ß = .211, p < .001, 95% CI: .19, .23). CONCLUSIONS During the pandemic, the protective role of emotional and supportive human relations on the mental distress and quality of life of POC should be taken into account more thoroughly, both in practice and future research.
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Affiliation(s)
- Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Maximiliansplatz 2, 91054, Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Maximiliansplatz 2, 91054, Erlangen, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany.
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
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16
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Kulzer B, Albus C, Herpertz S, Kruse J, Lange K, Lederbogen F, Petrak F. Psychosocial Factors and Diabetes. Exp Clin Endocrinol Diabetes 2023; 131:94-109. [PMID: 36731492 DOI: 10.1055/a-1946-3863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Bernhard Kulzer
- Diabetes Center Bad Mergentheim, Research Institute of the Diabetes Academy (Forschungsinstitut der Diabetes Akademie - FIDAM), Mergentheim, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Cologne, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital of the Ruhr-University Bochum, Bochum, Germany
| | - Johannes Kruse
- Department of Psychosomatics and Psychotherapy of the Justus-Liebig-University Giessen and Philipps University Marburg, Marburg, Germany
| | - Karin Lange
- Research and Teaching Unit of Medical Psychology, Medical School, Hannover, Germany
| | | | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital of the Ruhr-University Bochum, Bochum, Germany
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17
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Beutner C, Schmitt J, Worm M, Wagenmann M, Albus C, Buhl T. Lack of Harmonized Adherence Criteria in Allergen Immunotherapy Prevents Comparison of Dosing and Application Strategies: A Scoping Review. J Allergy Clin Immunol Pract 2023; 11:439-448.e6. [PMID: 36272717 DOI: 10.1016/j.jaip.2022.10.005] [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: 08/16/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
Allergen immunotherapy (AIT) involves the application of increasing doses of allergen extract (as oral, sublingual, or subcutaneous immunotherapy) until immunologic tolerance is reached. Successful AIT relies on the consistent administration of allergen extract; therefore, adherence to these treatments is vital for compelling long-term results. Our review discusses the current terminology from adherence research in general, summarizes 25 current studies on adherence research in AIT in a scoping literature review, and delineates recommendations for tools and parameters for adherence research, aiming to improve outcomes in AIT. Almost every adherence study in AIT published to date used different tools, parameters, and data sources for measuring adherence and persistence rates. Unfortunately, an easily accessible, objective parameter or biomarker for monitoring treatment adherence and success has not yet been established for AIT. This situation calls for the development of an international core outcomes set for AIT that defines what is exactly meant by AIT adherence and how AIT adherence should be consistently measured. Therefore, we exemplarily present results and conclusions from adherence research in chronic diseases other than allergology. We aim to facilitate the development of advanced methods, considering the challenging disease specificities of these parameters in a routine care setting of AIT.
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Affiliation(s)
- Caroline Beutner
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
| | - Jochen Schmitt
- TU Dresden, Medizinische Fakultät Carl Gustav Carus, Center for Evidence-Based Healthcare, Dresden, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology, and Allergology, Charité University Hospital Berlin, Berlin, Germany
| | - Martin Wagenmann
- Clinic of Otorhinolaryngology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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18
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Doering S, Herpertz S, Hofmann T, Rose M, Imbierowicz K, Geiser F, Croy I, Weidner K, Rademacher J, Michalek S, Morawa E, Erim Y, Teigelack P, Teufel M, Hartmann A, Lahmann C, Johanne Peters EM, Kruse J, von Boetticher D, Herrmann-Lingen C, Nöhre M, de Zwaan M, Dinger U, Friederich HC, Niecke A, Albus C, Zwerenz R, Beutel M, Roenneberg C, Henningsen P, Stein B, Waller C, Hake K, Spitzer C, Stengel A, Zipfel S, Weimer K, Gündel H, Kessler H. What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany? Psychother Psychosom 2023; 92:49-54. [PMID: 36516807 DOI: 10.1159/000527881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/28/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. OBJECTIVE This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. METHODS Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. RESULTS 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of "complex patients" with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. CONCLUSIONS Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction.
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Affiliation(s)
- Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Tobias Hofmann
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Rose
- Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katrin Imbierowicz
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany.,Department of Clinical Psychology, Friedrich-Schiller University, Jena, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany
| | - Jörg Rademacher
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Silke Michalek
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Per Teigelack
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva Milena Johanne Peters
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Germany and Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Germany and Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Dirk von Boetticher
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ulrike Dinger
- Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Casper Roenneberg
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Karsten Hake
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Andreas Stengel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, University of Marburg, Marburg, Germany
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19
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Salzmann S, Laferton J, Shedden-Mora M, Horn N, Gärtner L, Schröder L, Rau J, Schade-Brittinger C, Murmann K, Rastan A, Andrási T, Böning A, Salzmann-Djufri M, Löwe B, Brickwedel J, Albus C, Wahlers T, Hamm A, Hilker L, Albert W, Zimmermann T, Ismail I, Strauß B, Doenst T, Schedlowski M, Moosdorf R, Rief W. Pre-surgery Optimization of Patients’ Expectations to Improve Outcome in Heart Surgery: Study Protocol of the Randomized Controlled Multicenter PSY-HEART-II Trial. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- S. Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Deutschland
| | - J. Laferton
- Department of Medicine, Health and Medical University, Potsdam, Deutschland
| | - M. Shedden-Mora
- Department of Psychology, Medical School Hamburg, Hamburg, Deutschland
| | - N. Horn
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Deutschland
| | - L. Gärtner
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Deutschland
| | - L. Schröder
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Deutschland
| | - J. Rau
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Deutschland
| | - C. Schade-Brittinger
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Deutschland
| | - K. Murmann
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Deutschland
| | - A. Rastan
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Deutschland
| | - T. Andrási
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Deutschland
| | - A. Böning
- Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Deutschland
| | - M. Salzmann-Djufri
- Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Deutschland
| | - B. Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg, Hamburg, Deutschland
| | - J. Brickwedel
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - C. Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, Cologne, Deutschland
| | - T. Wahlers
- Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Deutschland
| | - A. Hamm
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Greifswald, Deutschland
| | - L. Hilker
- Department of Cardiovascular Surgery, Clinic Karlsburg, Heart and Diabetes Center, Karlsburg, Deutschland
| | - W. Albert
- Psychosomatics, German Heart Center Berlin, Berlin, Deutschland
| | - T. Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Deutschland
| | - I. Ismail
- Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Deutschland
| | - B. Strauß
- Institute of Psychosocial Medicine, Psychotherapy, and Psychooncology, University Hospital Jena, Jena, Deutschland
| | - T. Doenst
- Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Deutschland
| | - M. Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Essen, Essen, Deutschland
| | - R. Moosdorf
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Deutschland
| | - W. Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Deutschland
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20
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Brinkmann C, Hof H, Gysan DB, Albus C, Millentrup S, Bjarnason-Wehrens B, Latsch J, Herold G, Wegscheider K, Heming C, Seyfarth M, Predel HG. Lifestyle intervention reduces risk score for cardiovascular mortality in company employees with pre-diabetes or diabetes mellitus - A secondary analysis of the PreFord randomized controlled trial with 3 years of follow-up. Front Endocrinol (Lausanne) 2023; 14:1106334. [PMID: 36909345 PMCID: PMC9992873 DOI: 10.3389/fendo.2023.1106334] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
AIM To evaluate the effects of a multimodal intervention (including exercise training, psychosocial interventions, nutrition coaching, smoking cessation program, medical care) on the health and long-term cardiovascular disease (CVD) mortality risk of company employees with pre-diabetes or diabetes mellitus (DM) at high CVD risk. METHODS In the PreFord study, German company employees (n=4196) participated in a free-of-charge CVD mortality risk screening at their workplace. Based on their European Society of Cardiology - Systematic Coronary Risk Evaluation score (ESC-SCORE), they were subdivided into three risk groups. High-risk patients (ESC-SCORE≥5%) were randomly assigned to a 15-week lifestyle intervention or usual care control group. Data from patients with pre-DM/DM were analyzed intention-to-treat (ITT: n=110 versus n=96) and per protocol (PP: n=60 versus n=52). RESULTS Body mass index, glycated hemoglobin, total cholesterol, low-density lipoprotein, triglyceride levels as well as systolic and diastolic blood pressure improved through the intervention (ITT, PP: p<0.001). The ESC-SCORE markedly decreased from pre- to post-intervention (ITT, PP: p<0.001). ESC-SCORE changes from baseline differed significantly between the groups, with the intervention group achieving more favorable results in all follow-up visits 6, 12, 24 and 36 months later (at each time point: ITT: p<0.001; PP: p ≤ 0.010). CONCLUSION The study demonstrates the feasibility of attracting employees with pre-DM/DM at high CVD mortality risk to participate in a multimodal lifestyle program following a free CVD mortality risk screening at their workplace. The lifestyle intervention used in the PreFord study shows high potential for improving health of company employees with pre-DM/DM in the long term. ISRCTN23536103.
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Affiliation(s)
- Christian Brinkmann
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany
- *Correspondence: Christian Brinkmann,
| | - Hannah Hof
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Detlef-Bernd Gysan
- Medical Center for Cardiology, Angiology, Pneumology and Rehabilitation Medicine, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany
| | - Stefanie Millentrup
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Birna Bjarnason-Wehrens
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Joachim Latsch
- Fresenius University of Applied Sciences, Cologne, Germany
| | - Gerd Herold
- Health Service of the Ford Motor Company GmbH, Cologne, Germany
| | - Karl Wegscheider
- Institute of Medical Biometry and Epidemiology, University of Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Heming
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Melchior Seyfarth
- HELIOS University Hospital Wuppertal, Wuppertal, Germany
- Witten/Herdecke University, Witten, Germany
| | - Hans-Georg Predel
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
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21
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Salzmann S, Laferton JAC, Shedden-Mora MC, Horn N, Gärtner L, Schröder L, Rau J, Schade-Brittinger C, Murmann K, Rastan A, Andrási TB, Böning A, Salzmann-Djufri M, Löwe B, Brickwedel J, Albus C, Wahlers T, Hamm A, Hilker L, Albert W, Falk V, Zimmermann T, Ismail I, Strauß B, Doenst T, Schedlowski M, Moosdorf R, Rief W. Pre-surgery optimization of patients' expectations to improve outcome in heart surgery: Study protocol of the randomized controlled multi-center PSY-HEART-II trial. Am Heart J 2022; 254:1-11. [PMID: 35940247 DOI: 10.1016/j.ahj.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
The PSY-HEART-I trial indicated that a brief expectation-focused intervention prior to heart surgery improves disability and quality of life 6 months after coronary artery bypass graft surgery (CABG). However, to investigate the clinical utility of such an intervention, a large multi-center trial is needed to generalize the results and their implications for the health care system. The PSY-HEART-II study aims to examine whether a preoperative psychological intervention targeting patients' expectations (EXPECT) can improve outcomes 6 months after CABG (with or without heart valve replacement). EXPECT will be compared to Standard of Care (SOC) and an intervention providing emotional support without targeting expectations (SUPPORT). In a 3-arm multi-center randomized, controlled, prospective trial (RCT), N = 567 patients scheduled for CABG surgery will be randomized to either SOC alone or SOC and EXPECT or SOC and SUPPORT. Patients will be randomized with a fixed unbalanced ratio of 3:3:1 (EXPECT: SUPPORT: SOC) to compare EXPECT to SOC and EXPECT to SUPPORT. Both psychological interventions consist of 2 in-person sessions (à 50 minute), 2 phone consultations (à 20 minute) during the week prior to surgery, and 1 booster phone consultation post-surgery 6 weeks later. Assessment will occur at baseline approx. 3-10 days before surgery, preoperatively the day before surgery, 4-6 days later, and 6 months after surgery. The study's primary end point will be patients' illness-related disability 6 months after surgery. Secondary outcomes will be patients' expectations, subjective illness beliefs, quality of life, length of hospital stay and blood sample parameters (eg, inflammatory parameters such as IL-6, IL-8, CRP). This large multi-center trial has the potential to corroborate and generalize the promising results of the PSY-HEART-I trial for routine care of cardiac surgery patients, and to stimulate revisions of treatment guidelines in heart surgery.
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Affiliation(s)
- Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany.
| | | | - Meike C Shedden-Mora
- Department of Psychology, Medical School Hamburg, Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Horn
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Laura Gärtner
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Lara Schröder
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Jörn Rau
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Germany
| | | | - Kirsten Murmann
- Coordination Center for Clinical Trials (KKS), University of Marburg, Marburg, Germany
| | - Ardawan Rastan
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Térezia B Andrási
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Andreas Böning
- Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany
| | | | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Brickwedel
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Germany
| | - Alfons Hamm
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Lutz Hilker
- Department of Cardiovascular Surgery, Clinic Karlsburg, Heart and Diabetes Center Mecklenburg-Western Pommerania, Karlsburg, Germany
| | | | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Issam Ismail
- Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy, and Psychooncology, University Hospital Jena, Germany
| | - Torsten Doenst
- Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Essen, Essen, Germany, and Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rainer Moosdorf
- Department for Cardiovascular Surgery, Heart Center, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
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Peltzer S, Köstler U, Müller H, Scholten N, Schulz-Nieswandt F, Jessen F, Albus C. The psychological consequences of living with coronary heart disease: Are patients' psychological needs served? A mixed-method study in Germany. Health Expect 2022; 25:2746-2761. [PMID: 36269637 DOI: 10.1111/hex.13467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/13/2022] [Accepted: 02/19/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION This mixed-method study explores psychological needs, access and barriers in coronary heart disease (CHD) patients with and without mental health issues (MHI) within the German healthcare system. METHODS This study was conducted in three different healthcare settings: two hospitals, two rehabilitation clinics and three cardiology practices in Cologne, Germany. Patients were screened for angiographically documented CHD and other inclusion criteria. In total, 364 CHD patients took part in this study. It consisted of two parts: In the first part, participants filled in a newly developed questionnaire about their psychological needs, access and barriers within the healthcare system and their contact with their doctor in these matters. Then, patients were screened for MHIs with the help of the Hospital Anxiety and Depression Scale (HADS). When a score above seven was scored on the HADS, patients were additionally screened for specific MHIs using the Structured Clinical Interview for DSM-IV Axis I Disorders. In the second part, 20 participants were subsequently interviewed in a semi-structured interview to generate more in-depth findings. RESULTS The interviews show that CHD patients with and without MHI experienced a cardiac event as life-changing and had an urgent need to talk about CHD with their doctor, mostly the general practitioner (GP). When the GP spoke to the patient shortly after the cardiac event, patients experienced relief and were better able to cope with their illness. Only 9.1% reported being aided in their search for psychotherapeutic treatment or drug treatment (4.1%). CONCLUSION The needs of CHD patients with and without MHI were not adequately satisfied within our sample. Psychological measures are necessary for sufficient improvement, such as training of doctors in doctor-patient communication (e.g., better support in coping with MHI/CHD), improvements in the procedure (more time for conversations during doctor contacts), and improvement of structural requirements (referring patients faster to psychotherapists). PATIENT OR PUBLIC CONTRIBUTION We received input from patients during pretests and used the feedback to tailor our questionnaire and the interview guidelines. Afterwards, we disseminated the main results for the patient and public involvement (e.g., public lectures, leaflets for self-help groups, etc.).
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Affiliation(s)
- Samia Peltzer
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Ursula Köstler
- Department of Social Policy and Methods of Qualitative Social Research, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Hendrik Müller
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Medicine and University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Frank Schulz-Nieswandt
- Department of Social Policy and Methods of Qualitative Social Research, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
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Kulzer B, Albus C, Herpertz S, Kruse J, Lange K, Lederbogen F, Petrak F. Psychosoziales und Diabetes. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1916-2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Bernhard Kulzer
- Diabetes-Zentrum Bad Mergentheim, Forschungsinstitut der Diabetes Akademie (FIDAM), Mergentheim, Deutschland
| | - Christian Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universität Köln, Köln, Deutschland
| | - Stephan Herpertz
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Deutschland
| | - Johannes Kruse
- Klinik für Psychosomatik und Psychotherapie der Justus-Liebig-Universität Gießen und Philipps-Universität Marburg, Marburg, Deutschland
| | - Karin Lange
- Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule, Hannover, Deutschland
| | - Florian Lederbogen
- Gemeinschaftspraxis Weimer/Tabakhtory-Fard, Marburg, Heidelberg, Deutschland
| | - Frank Petrak
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Deutschland
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Niecke A, Peters KM, Alayli A, Lüngen M, Pfaff H, Albus C, Samel C. Health‐related quality of life after 50 years in individuals with thalidomide embryopathy: Evidence from a German cross‐sectional survey. Birth Defects Res 2022; 114:714-724. [DOI: 10.1002/bdr2.2051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/25/2022] [Accepted: 05/09/2022] [Indexed: 01/30/2023]
Affiliation(s)
- Alexander Niecke
- Department of Psychosomatic Medicine and Psychotherapy Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Klaus M. Peters
- Department of Orthopedics and Osteology Dr. Becker Rhein‐Sieg‐Klinik Nümbrecht Germany
| | - Adrienne Alayli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Markus Lüngen
- Faculty of Business Management and Social Sciences Osnabrück University of Applied Sciences Osnabrück Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science University of Cologne Cologne Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy Faculty of Medicine and University Hospital Cologne Cologne Germany
| | - Christina Samel
- Institute of Medical Statistics and Computational Biology University of Cologne Cologne Germany
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25
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van den Houdt S, Albus C, Herrmann-Lingen C, Widdershoven J, Kupper N. Validity of a multidimensional comprehensive psychosocial screening instrument based on the ESC cardiovascular prevention guidelines - Evidence from the general and cardiovascular patient population. J Psychosom Res 2022; 157:110791. [PMID: 35398675 DOI: 10.1016/j.jpsychores.2022.110791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/24/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the psychometric properties and validity of the updated version of the Dutch multidimensional Comprehensive Psychosocial Screening Instrument in patients with coronary heart disease and the general population, based upon guideline recommendations from the European Society for Cardiology. METHOD 678 participants (Mage = 48.2, SD = 16.8; 46% male) of the Dutch general population and 312 cardiac patients (Mage = 65.9, SD = 9.9; 77% male) who recently received percutaneous coronary intervention completed the Comprehensive Psychosocial Screening Instrument and validated questionnaires for depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), hostility (CMHS), anger (STAS-T), trauma (SRIP), and chronic work and family stress (ERI, MMQ-6). RESULTS Confirmatory factor analysis (CFA) confirmed that the eight screened risk factors were best measured as separate entities, rather than broader indications of distress. Inter-instrument agreement, assessed with the intraclass coefficient (ICC) and the screening accuracy indicators (receiving operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) were good for most screened risk factors. PPV was low in low prevalence risk factors like anxiety, trauma, and depression. CONCLUSION Overall, the current version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance in both populations, with a fair to excellent level of agreement with established full questionnaires. Besides a few suggestions for further refinement, the screener may be implemented in primary care and cardiological practice.
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Affiliation(s)
- Sophie van den Houdt
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital of Cologne, Germany.
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Germany.
| | - Jos Widdershoven
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden Hospital, the Netherlands
| | - Nina Kupper
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
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26
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Albus C, Geiser F. Liebe Kolleginnen, liebe Kollegen,. Psychother Psychosom Med Psychol 2022. [PMID: 35605604 DOI: 10.1055/a-1798-4381] [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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Borusiak P, Mazheika Y, Bauer S, Haberlandt E, Krois I, Fricke C, Simon L, Beschoner P, Jerg-Bretzke L, Geiser F, Hiebel N, Weidner K, Albus C, Morawa E, Erim Y. The impact of the COVID-19 pandemic on pediatric developmental services: a cross-sectional study on overall burden and mental health status. Arch Public Health 2022; 80:113. [PMID: 35395839 PMCID: PMC8990278 DOI: 10.1186/s13690-022-00876-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers, even those who have not been directly involved in the care of acutely ill patients. The aims of this study were to identify the overall burden and mental health status of healthcare workers in pediatric developmental services under the influence of the COVID-19 pandemic, and to identify the risk and protective factors associated with mental health. METHODS This cross-sectional web-based study was part of a large multicenter VOICE study conducted among employees ((neuro-)pediatricians, psychologists, speech therapists, occupational therapists, etc.) from various pediatric developmental services between June and July 2020. A total of 1291 questionnaires regarding overall burden, mental health status (depression, generalized anxiety disorder and emotional exhaustion) and risk and protective factors for mental health (working conditions, potential problems during the COVID-19 pandemic and psychological resources) were analyzed. Descriptive statistics and multiple linear regression were used for data analysis. RESULTS A total of 44.5% (574/1291) participants felt a high or very high overall burden during the COVID-19 pandemic. Of all the participants, 14.6% (171/1173) reported clinically significant levels of depressive symptoms, 17.0% (199/1173) reported generalized anxiety disorder symptoms and 44.6% (532/1192) reported emotional exhaustion. Multiple linear regression analyses identified several common risk and protective factors for mental health status variables. The burden of an increase in the quantity of work, fear of work and fear of becoming infected showed the strongest negative associations, whereas psychological resources and sufficient relaxation in leisure time exhibited the strongest positive associations. CONCLUSION Employees who were not directly involved in the care of acutely ill patients were also exposed to considerable stress, some of which was not different from that experienced by professionals who were directly affected. These employees should not be lost sight of and must be offered appropriate support.
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Affiliation(s)
- Peter Borusiak
- Witten/Herdecke University, Witten, Germany. .,Wagener-Foundation for Social Pediatrics, Emsdetten, Germany.
| | - Yuliya Mazheika
- Wagener-Foundation for Social Pediatrics, Emsdetten, Germany
| | - Susanne Bauer
- Aks - Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz, Austria
| | - Edda Haberlandt
- Aks - Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz, Austria.,Kinderklinik Dornbirn, Dornbirn, Austria
| | | | - Christian Fricke
- VIFF - Vereinigung für Interdisziplinäre Frühförderung - Bundesvereinigung, Hamburg, Germany.,Hochschule Nordhausen - University of Applied Sciences (UAS), Nordhausen, Germany
| | - Liane Simon
- VIFF - Vereinigung für Interdisziplinäre Frühförderung - Bundesvereinigung, Hamburg, Germany.,MSH Medical School Hamburg, Hamburg, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Spüntrup C, Banerjee M, Piana J, Hellmich M, Bojahr J, Bojahr B, Albus C, Noé G. The influence of persistent bleeding after supracervical hysterectomy on depressive and anxious symptoms: a prospective bicenter study. Arch Gynecol Obstet 2022; 306:127-132. [PMID: 35229204 DOI: 10.1007/s00404-022-06446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/09/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Postoperative spotting is a frequent adverse symptom after laparoscopic supracervical hysterectomy (LSH). The conical excision (eLSH) reduces the postoperative spotting rate, but data in a larger collective are still rare and inconsistent. The influence of persistent bleeding on the anxious and depressive symptoms has not been analyzed yet. METHODS 311 patients, who underwent a laparoscopic supracervical hysterectomy with conical excision (n = 163), or with straight cervical resection (n = 148) were included. Anxious and depressive symptoms and postoperative spotting were recorded before operation, at 3 month follow-up and at 1 year follow-up in both operative groups using a validated questionnaire (German version of Hospital Anxiety and Depression Scale, HADS-D) and additional questions concerning the frequency and impact of bleeding. Statistical analysis included the impairment of bleeding as well as its impact on depressive and anxious symptoms for both groups. RESULTS 11.5% after eLSH and 15.5% after LSH reported spotting after 1 year. Supracervical hysterectomy significantly improves depressive and anxious symptoms at 3 and at 12 month follow-up for both groups (p < 0.001) independent on residual spotting. Patients with a preoperative continuous bleeding showed a maximum benefit independent on operative method. CONCLUSION Laparoscopic supracervical hysterectomy has a positive effect on anxious and depressive symptoms in the short-term and intermediate-term follow-up. The conical excision of the cervical stump reduces postoperative spotting rate, but has no explicit advantage on symptoms of depression or anxiety, irrespective of residual postoperative spotting.
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Affiliation(s)
- Carolin Spüntrup
- Department of Obstetrics and Gynecology, Rheinlandklinikum Dormagen, Dormagen, Germany.
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Homburg, Germany.
- Pelvic School Saarbrücken, Hohe Wacht 77, Saarbrücken, Germany.
| | - M Banerjee
- Department of Orthopedic Surgery and Sports Traumatology, Atos Media Park Clinic, Cologne, Germany
- University of Witten/Herdecke, Witten, Germany
| | - J Piana
- Department of Obstetrics and Gynecology, Rheinlandklinikum Dormagen, Dormagen, Germany
| | - M Hellmich
- Institute for Medical Statistics and Epidemiology, University of Cologne, Cologne, Germany
| | | | | | - C Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - G Noé
- Department of Obstetrics and Gynecology, Rheinlandklinikum Dormagen, Dormagen, Germany
- University of Witten/Herdecke, Witten, Germany
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Hannemann J, Abdalrahman A, Erim Y, Morawa E, Jerg-Bretzke L, Beschoner P, Geiser F, Hiebel N, Weidner K, Steudte-Schmiedgen S, Albus C. The impact of the COVID-19 pandemic on the mental health of medical staff considering the interplay of pandemic burden and psychosocial resources-A rapid systematic review. PLoS One 2022; 17:e0264290. [PMID: 35192662 PMCID: PMC8863237 DOI: 10.1371/journal.pone.0264290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/08/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In times of the global corona pandemic health care workers (HCWs) fight the disease at the frontline of healthcare services and are confronted with an exacerbated load of pandemic burden. Psychosocial resources are thought to buffer adverse effects of pandemic stressors on mental health. This rapid review summarizes evidence on the specific interplay of pandemic burden and psychosocial resources with regard to the mental health of HCWs during the COVID-19 pandemic. The goal was to derive potential starting points for supportive interventions. METHODS We conducted a rapid systematic review following the recommendations of the Cochrane Rapid Reviews Methods Group. We searched 7 databases in February 2021 and included peer-reviewed quantitative studies, that reported related data on pandemic stressors, psychosocial resources, and mental health of HCWs. RESULTS 46 reports were finally included in the review and reported data on all three outcomes at hand. Most studies (n = 41) applied a cross-sectional design. Our results suggest that there are several statistically significant pandemic risk factors for mental health problems in HCWs such as high risk and fear of infection, while resilience, active and emotion-focused coping strategies as well as social support can be considered beneficial when protecting different aspects of mental health in HCWs during the COVID-19 pandemic. Evidence for patterns of interaction between outcomes were found in the context of coping style when facing specific pandemic stressors. CONCLUSIONS Our results indicate that several psychosocial resources may play an important role in buffering adverse effects of pandemic burden on the mental health of HCWs in the context of the COVID-19 pandemic. Nevertheless, causal interpretations of mentioned associations are inadequate due to the overall low study quality and the dominance of cross-sectional study designs. Prospective longitudinal studies are required to elucidate the missing links.
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Affiliation(s)
- Julian Hannemann
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Alan Abdalrahman
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department for Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department for Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
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Schug C, Geiser F, Hiebel N, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Morawa E, Erim Y. Sick Leave and Intention to Quit the Job among Nursing Staff in German Hospitals during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph19041947. [PMID: 35206136 PMCID: PMC8872054 DOI: 10.3390/ijerph19041947] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 02/01/2023]
Abstract
Background: Sick leave and turnover of nurses exacerbate an already existing nursing shortage during the COVID-19 pandemic in Germany and other countries. Frequency and associated factors of sick leave and intention to quit among nurses need to be examined to maintain healthcare. Methods: An online survey among nursing staff (N = 757) in German hospitals was conducted between May and July 2021. Sick leave days, intention to quit, working conditions, depression, anxiety and sleep disorder symptoms, effort-reward imbalance (ERI), COVID-19-related and sociodemographic variables were measured. Regression analyses were performed. Results: The intention to quit was present in 18.9%. One third (32.5%) reported sick leave of ≥10 and 12.3% more than 25 days in 12 months. Significant predictors for ≥10 sick leave days were infection with SARS-CoV-2, a pre-existing illness, exhaustion, trust in colleagues and fear of becoming infected. Higher ERI reward levels, perception of sufficient staff and contact with infected patients were associated with lower odds for ≥10 sick leave days. Lower reward levels, having changed work departments during the pandemic, working part-time and higher depression levels significantly predicted turnover intention. Conclusion: Alarmingly, many nurses intend to quit working in healthcare. Perceived reward seems to buffer both sick leave and turnover intention. Enhancing protection from COVID-19 and reducing workload might also prevent sick leave. Depression prevention, improved change management and support of part-time workers could contribute to reducing turnover intention among nurses.
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Affiliation(s)
- Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
- Correspondence:
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, 53127 Bonn, Germany; (F.G.); (N.H.)
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, 53127 Bonn, Germany; (F.G.); (N.H.)
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (P.B.); (L.J.-B.)
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (P.B.); (L.J.-B.)
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, 50931 Cologne, Germany;
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany;
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
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Weber C, Fangauf SV, Michal M, Ronel J, Herrmann-Lingen C, Ladwig KH, Beutel M, Albus C, Söllner W, Perschel FH, de Zwaan M, Fritzsche K, Deter HC. Cortisol Awakening Reaction and Anxiety in Depressed Coronary Artery Disease Patients. J Clin Med 2022; 11:jcm11020374. [PMID: 35054071 PMCID: PMC8779785 DOI: 10.3390/jcm11020374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/19/2021] [Accepted: 01/07/2022] [Indexed: 11/16/2022] Open
Abstract
Disturbances of HPA axis functioning as represented by cortisol awakening reaction (CAR) belong to the mediating pathways linking psychosocial distress and cardiovascular risk. Both depression and anxiety have been confirmed as independent risk factors for coronary artery disease (CAD). However, data on anxiety and cortisol output in CAD patients are scarce. Based on previous data, we hypothesized that anxiety would be associated with higher cortisol output and a more pronounced morning increase in moderately depressed CAD patients. 77 patients (60 y, 79% male) underwent saliva sampling (+0, +30, +45, +60 min after awakening, midday and late-night sample). Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS) and patients were grouped into anxious versus non anxious subjects based upon the recommended score (≥11). A repeated measures ANOVA yielded a significant time and quadratic time effect referring to the typical CAR. Anxious patients showed a significantly steeper 30 min increase, higher AUCi, lower waking and late-night cortisol levels. The steeper cortisol increase in the anxious group is in line with previous data and may be interpreted as a biological substrate of affect regulation. The lower basal and late-night levels coupled with greater AUCi mirror a more dynamic reactivity pattern compared to depressed subjects without anxiety.
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Affiliation(s)
- Cora Weber
- Department of Psychosomatic Medicine and Psychotherapy, Clinic Hennigsdorf, Oberhavel Clinic, 16761 Hennigsdorf, Germany
- Department of Psychosomatics and Psychotherapy, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany;
- Correspondence:
| | - Stella V. Fangauf
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, 37075 Göttingen, Germany; (S.V.F.); (C.H.-L.)
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany; (M.M.); (M.B.)
| | - Joram Ronel
- Department of Psychosomatic Medicine, Klinik Barmelweid, 5017 Barmelweid, Switzerland;
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, 37075 Göttingen, Germany; (S.V.F.); (C.H.-L.)
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany;
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany; (M.M.); (M.B.)
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, 50937 Cologne, Germany;
| | - Wolfgang Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg Medical Hospital, 90419 Nuremberg, Germany;
| | - Frank Holger Perschel
- Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany;
- Labor Berlin, Charité Vivantes GmbH, 13353 Berlin, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, 79104 Freiburg, Germany;
| | - Hans-Christian Deter
- Department of Psychosomatics and Psychotherapy, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany;
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Spüntrup C, Banerjee M, Bordelius M, Hellmich M, Bojahr J, Bojahr B, Albus C, Noé G. The influence of conventional and extended supracervical hysterectomy on sexuality and quality of life parameters: a prospective bi-center study with a special focus on postoperative spotting. Arch Gynecol Obstet 2022; 305:1079-1088. [DOI: 10.1007/s00404-021-06376-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/20/2021] [Indexed: 11/02/2022]
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Schug C, Erim Y, Geiser F, Hiebel N, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Steudte-Schmiedgen S, Borho A, Lieb M, Morawa E. [Vaccination willingness against COVID-19 among healthcare workers in Germany : Results from a University Medicine Network survey between November 2020 and January 2021]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:74-85. [PMID: 34554277 PMCID: PMC8458789 DOI: 10.1007/s00103-021-03418-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic is a continuing burden on society and the health system. The vaccination willingness among healthcare workers is of particular interest, as these groups play a key role in the pandemic response. OBJECTIVES The present study investigated how the willingness of healthcare workers in Germany to get vaccinated depends on sociodemographic, occupational, and COVID-19-specific characteristics, as well as mental health. METHODS Between November 2020 and January 2021, 6217 employees in the German healthcare system were questioned about their vaccination willingness, sociodemographic, occupational, COVID-19-specific, and psychosocial characteristics using the online VOICE survey within the framework of the University Medicine Network (NUM). RESULTS The vaccination willingness of the sample group was 65.3%. A higher vaccination willingness was associated with male gender; age > 40 years; having no children or no migration background; not working in direct patient care; belonging to a COVID-19 risk group or professional group of physicians and psychologists in comparison with nursing staff; feeling sufficiently informed about COVID-19 and protected by the measures of the national or local authorities and the employer; fear of infection; and lack of signs of depression. Physicians showed the highest willingness to get vaccinated. CONCLUSIONS During the study period, an overall moderate vaccination willingness against COVID-19 in the health sector was described. Information about the disease and vaccination, especially for younger people, females, and non-physicians, adequate protective measures and prevention of depressive symptoms could increase the vaccination willingness.
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Affiliation(s)
- Caterina Schug
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland.
| | - Yesim Erim
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - Franziska Geiser
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Bonn, Bonn, Deutschland
| | - Nina Hiebel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Bonn, Bonn, Deutschland
| | - Petra Beschoner
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Ulm, Ulm, Deutschland
| | - Lucia Jerg-Bretzke
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Ulm, Ulm, Deutschland
| | - Christian Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinik, Medizinische Fakultät, Universität zu Köln, Köln, Deutschland
| | - Kerstin Weidner
- Klinik und Poliklinik für Psychotherapie und Psychosomatik, Universitätsklinikum C. G. Carus, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - Susann Steudte-Schmiedgen
- Klinik und Poliklinik für Psychotherapie und Psychosomatik, Universitätsklinikum C. G. Carus, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - Andrea Borho
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - Marietta Lieb
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - Eva Morawa
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Deutschland
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Schneider JN, Hiebel N, Kriegsmann-Rabe M, Schmuck J, Erim Y, Morawa E, Jerg-Bretzke L, Beschoner P, Albus C, Hannemann J, Weidner K, Steudte-Schmiedgen S, Radbruch L, Brunsch H, Geiser F. Moral Distress in Hospitals During the First Wave of the COVID-19 Pandemic: A Web-Based Survey Among 3,293 Healthcare Workers Within the German Network University Medicine. Front Psychol 2021; 12:775204. [PMID: 34867685 PMCID: PMC8636670 DOI: 10.3389/fpsyg.2021.775204] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The present study aimed to investigate the correlation between moral distress and mental health symptoms, socio-demographic, occupational, and COVID-19-related variables, and to determine differences in healthcare workers’ (HCW) moral distress during the first wave of the COVID-19 pandemic. Method: Data from 3,293 HCW from a web-based survey conducted between the 20th of April and the 5th of July 2020 were analyzed. We focused on moral distress (Moral Distress Thermometer, MDT), depressive symptoms (Patient Health Questionnaire-2, PHQ-2), anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), and increased general distress of nurses, physicians, medical-technical assistants (MTA), psychologists/psychotherapists, and pastoral counselors working in German hospitals. Results: The strongest correlations for moral distress were found with depressive symptoms, anxiety symptoms, occupancy rate at current work section, and contact with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nurses and MTA experienced significantly higher moral distress than physicians, psychologists/psychotherapists, and pastoral counselors. The average level of moral distress reported by nurses from all work areas was similar to levels which before the pandemic were only experienced by nurses in intensive or critical care units. Conclusion: Results indicate that moral distress is a relevant phenomenon among HCW in hospitals during the COVID-19 pandemic, regardless of whether they work at the frontline or not and requires urgent attention.
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Affiliation(s)
- Juliane Nora Schneider
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Milena Kriegsmann-Rabe
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Jonas Schmuck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Julian Hannemann
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Holger Brunsch
- Department of Palliative Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Medical Faculty, Bonn, Germany
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Deter HC, Orth-Gomér K, Rauch-Kröhnert U, Albus C, Ladwig KH, Söllner W, de Zwaan M, Grün AS, Ronel J, Hellmich M, Herrmann-Lingen C, Weber C. Depression, anxiety, and vital exhaustion are associated with pro-coagulant markers in depressed patients with coronary artery disease - A cross sectional and prospective secondary analysis of the SPIRR-CAD trial. J Psychosom Res 2021; 151:110659. [PMID: 34763203 DOI: 10.1016/j.jpsychores.2021.110659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/18/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION A hyper-coagulant state is a biological mechanism that triggers cardiac events in patients with coronary artery disease (CAD). Depressive symptoms and anxiety predict an unfavourable course of CAD. The SPIRR-CAD-RCT examined the effects of a psychological intervention and provided the opportunity to explore cross-sectional associations between indices of psychological strain and coagulation parameters, as well as prospective changes in depression scores and coagulation parameters. METHODS In this secondary analysis, we investigated 253 CAD patients (194 male; age m 58.9, SD 8.3 yrs.) with mild to moderate depression (≥8 on the HADS-D) at baseline and at follow-up 18 months later: TF, fibrinogen, D-dimer, VWF, FVII and PAI-1 and the course of depression (HAM-D), vital exhaustion (VE) and anxiety scores (HADS-A) were examined by ANOVA in the total and younger age groups (≤ 60). RESULTS HAM-D at baseline was correlated with TF (corr. R2 = 0.27; F = 9.31, p = 0.001). HADS anxiety was associated with fibrinogen (corr. R2.20; F = 7.27, p = 0.001). There was no detectable therapeutic effect on coagulation. Fibrinogen and VWF decreased within 18 months (time effect; p = 0.02; p = 0.04), as did HADS-D in both treatment groups (p < 0.001). Fibrinogen decreased more in patients ≤60 years with high VE compared to low VE (interaction time x group, p = 0.01). CONCLUSIONS This is the first study to show an association between TF and depression. Coagulation parameters as potential mediators of CAD progression correlated cross-sectionally with depression and anxiety and prospectively with VE. Further studies should replicate these correlations in depressed and non-depressed CAD patients. ISRCTN 76240576; clinicaltrials.gov.
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Affiliation(s)
- Hans-Christian Deter
- Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany.
| | | | - Ursula Rauch-Kröhnert
- Medical Clinic, Cardiology and Pulmonology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Germany
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München (TUM), German Center for Cardiovascular Research, Partner Site Munich, Germany
| | - Wolfgang Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Germany
| | - Anna-Sophia Grün
- Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany
| | - Joram Ronel
- Klinik Barmelweid, Switzerland; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Germany
| | - Martin Hellmich
- Clinical Trials Center Cologne, Institute for Medical Statistics, Informatic und Epidemiology (IMSIE), University of Cologne, Germany
| | - Christoph Herrmann-Lingen
- Dept. of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, German Center for Cardiovascular Research, Partner Site Göttingen, Germany
| | - Cora Weber
- Medical Clinic, Psychosomatics, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, German Center for Cardiovascular Research, Partner Site Berlin, Germany
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Hiltrop K, Hiebel N, Geiser F, Kriegsmann-Rabe M, Gambashidze N, Morawa E, Erim Y, Weidner K, Albus C, Ernstmann N. Measuring COVID-19 Related Health Literacy in Healthcare Professionals-Psychometric Evaluation of the HL-COV-HP Instrument. Int J Environ Res Public Health 2021; 18:ijerph182211959. [PMID: 34831720 PMCID: PMC8624823 DOI: 10.3390/ijerph182211959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Thus far, there is no instrument available measuring COVID-19 related health literacy of healthcare professionals. Therefore, the aim of this study was to develop an instrument assessing COVID-19 related health literacy in healthcare professionals (HL-COV-HP) and evaluate its psychometric properties. METHODS An exploratory factor analysis, a confirmatory factor analysis, and descriptive analyses were conducted using data from n = 965 healthcare professionals. Health literacy related to COVID-19 was measured with 12 items, which were adapted from the validated HLS-EU-Q16 instrument measuring general health literacy. RESULTS Exploratory factor analysis demonstrated that 12 items loaded on one component. After removing one item due to its high standardized residual covariance, the confirmatory factor analysis of a one-factor model with 11 items showed satisfactory model fit (χ2 = 199.340, df = 41, χ2/df = 4.862, p < 0.001, RMSEA = 0.063, CFI = 0.963 and TLI = 0.951). The HL-COV-HP instrument showed good internal consistency (Cronbach's alpha 0.87) and acceptable construct reliability. CONCLUSIONS The HL-COV-HP is a reliable, valid, and feasible instrument to assess the COVID-19 related health literacy in healthcare professionals. It can be used in hospitals or other healt hcare settings to assess the motivation and ability of healthcare professionals to find, understand, evaluate, and use COVID-19 information.
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Affiliation(s)
- Kati Hiltrop
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany;
- Correspondence: ; Tel.: +49-228-287-11803
| | - Nina Hiebel
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Franziska Geiser
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Milena Kriegsmann-Rabe
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Nikoloz Gambashidze
- Institute for Patient Safety, University Hospital Bonn, 53127 Bonn, Germany;
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
| | - Kerstin Weidner
- Department for Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany;
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital Cologne, 50931 Cologne, Germany;
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany;
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Kulzer B, Albus C, Herpertz S, Kruse J, Lange K, Lederbogen F, Petrak F. Psychosoziales und Diabetes. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1515-9250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bernhard Kulzer
- Diabetes-Zentrum Bad Mergentheim, Forschungsinstitut der Diabetes Akademie (FIDAM), Mergentheim
| | - Christian Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universität Köln
| | - Stephan Herpertz
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum
| | - Johannes Kruse
- Klinik für Psychosomatik und Psychotherapie der Justus-Liebig-Universität Gießen und Philipps-Universität Marburg
| | - Karin Lange
- Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule, Hannover
| | | | - Frank Petrak
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum
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Steudte-Schmiedgen S, Stieler L, Erim Y, Morawa E, Geiser F, Beschoner P, Jerg-Bretzke L, Albus C, Hiebel N, Weidner K. Correlates and Predictors of PTSD Symptoms Among Healthcare Workers During the COVID-19 Pandemic: Results of the egePan-VOICE Study. Front Psychiatry 2021; 12:686667. [PMID: 34483985 PMCID: PMC8416177 DOI: 10.3389/fpsyt.2021.686667] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 03/27/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The COVID-19 pandemic has led to ongoing challenges for healthcare systems across the world. Previous research has provided evidence for an increased prevalence of depression and anxiety as well as post-traumatic stress disorder (PTSD). In Germany, however, only scarce data on correlates and predictors for PTSD symptomatology in the context of the COVID-19 pandemic among healthcare workers (HCW) are available. Methods: This research is part of a large prospective web-based survey (egePan-VOICE study) among HCW in Germany. The current sample (N = 4,724) consisted of physicians (n = 1,575), nurses (n = 1,277), medical technical assistants (MTA, n = 1,662), and psychologists (n = 210). PTSD symptomatology was measured using the abbreviated version of the Impact of Event Scale (IES-6). In addition, sociodemographic, occupational, COVID-19-related, psychological (e.g., depressive symptoms and generalized anxiety), as well as work-related variables were assessed. Results: Our findings revealed significant higher PTSD symptoms with medium effect sizes among HCW reporting an increased self-report burden during the pandemic, increased fear of becoming infected or infecting relatives with the virus, sleep problems, feeling physically or mentally exhausted, as well as increased levels of depressiveness and generalized anxiety. According to multiple linear regression analysis, the most relevant predictors for higher IES-6 scores were increased level of generalized anxiety and depressiveness, increased fear of infecting relatives, as well as medical profession (MTA compared to physicians). Conclusion: Despite the cross-sectional design of our study, the here identified associations with PTSD symptomatology may provide a basis for future preventive interventions.
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Affiliation(s)
- Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lisa Stieler
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Affiliation(s)
- Bernhard Kulzer
- Diabetes Center Bad Mergentheim, Research Institute of the Diabetes Academy (Forschungsinstitut der Diabetes Akademie - FIDAM), Mergentheim, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital of the Ruhr-University Bochum Germany
| | - Johannes Kruse
- Department of Psychosomatics and Psychotherapy of the Justus-Liebig-University Gießen and Philipps University Marburg, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Germany
| | | | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital of the Ruhr-University Bochum Germany
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Schmuck J, Hiebel N, Rabe M, Schneider J, Erim Y, Morawa E, Jerg-Bretzke L, Beschoner P, Albus C, Hannemann J, Weidner K, Steudte-Schmiedgen S, Radbruch L, Brunsch H, Geiser F. Sense of coherence, social support and religiosity as resources for medical personnel during the COVID-19 pandemic: A web-based survey among 4324 health care workers within the German Network University Medicine. PLoS One 2021; 16:e0255211. [PMID: 34310616 PMCID: PMC8312980 DOI: 10.1371/journal.pone.0255211] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction The COVID-19 pandemic resulted in severe detrimental effects on the mental well-being of health care workers (HCW). Consequently, there has been a need to identify health-promoting resources in order to mitigate the psychological impact of the pandemic on HCW. Objective Our objective was to investigate the association of sense of coherence (SOC), social support and religiosity with self-reported mental symptoms and increase of subjective burden during the COVID-19 pandemic in HCW. Methods Our sample comprised 4324 HCW of four professions (physicians, nurses, medical technical assistants (MTA) and pastoral workers) who completed an online survey from 20 April to 5 July 2020. Health-promoting resources were assessed using the Sense of Coherence Scale Short Form (SOC-3), the ENRICHD Social Support Inventory (ESSI) and one item on religiosity derived from the Scale of Transpersonal Trust (TPV). Anxiety and depression symptoms were measured with the PHQ-2 and GAD-2. The increase of subjective burden due to the pandemic was assessed as the retrospective difference between burden during the pandemic and before the pandemic. Results In multiple regressions, higher SOC was strongly associated with fewer anxiety and depression symptoms. Higher social support was also related to less severe mental symptoms, but with a smaller effect size, while religiosity showed minimal to no correlation with anxiety or depression. In professional group analysis, SOC was negatively associated with mental symptoms in all groups, while social support only correlated significantly with mental health outcomes in physicians and MTA. In the total sample and among subgroups, an increase of subjective burden was meaningfully associated only with a weaker SOC. Conclusion Perceived social support and especially higher SOC appeared to be beneficial for mental health of HCW during the COVID-19 pandemic. However, the different importance of the resources in the respective occupations requires further research to identify possible reasons.
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Affiliation(s)
- Jonas Schmuck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Hospital Bonn, Bonn, Germany
- * E-mail:
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Milena Rabe
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Juliane Schneider
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, University Cologne, Cologne, Germany
| | - Julian Hannemann
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, University Cologne, Cologne, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Holger Brunsch
- Department of Palliative Medicine, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Hospital Bonn, Bonn, Germany
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41
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Schwaab B, Bjarnason-Wehrens B, Meng K, Albus C, Salzwedel A, Schmid JP, Benzer W, Metz M, Jensen K, Rauch B, Bönner G, Brzoska P, Buhr-Schinner H, Charrier A, Cordes C, Dörr G, Eichler S, Exner AK, Fromm B, Gielen S, Glatz J, Gohlke H, Grilli M, Gysan D, Härtel U, Hahmann H, Herrmann-Lingen C, Karger G, Karoff M, Kiwus U, Knoglinger E, Krusch CW, Langheim E, Mann J, Max R, Metzendorf MI, Nebel R, Niebauer J, Predel HG, Preßler A, Razum O, Reiss N, Saure D, von Schacky C, Schütt M, Schultz K, Skoda EM, Steube D, Streibelt M, Stüttgen M, Stüttgen M, Teufel M, Tschanz H, Völler H, Vogel H, Westphal R. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 2. J Clin Med 2021; 10:jcm10143071. [PMID: 34300237 PMCID: PMC8306118 DOI: 10.3390/jcm10143071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients’ groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.
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Affiliation(s)
- Bernhard Schwaab
- Curschmann Klinik, D-23669 Timmendorfer Strand, Germany
- Medizinische Fakultät, Universität zu Lübeck, D-23562 Lübeck, Germany
- Correspondence:
| | - Birna Bjarnason-Wehrens
- Institute for Cardiology and Sports Medicine, Department of Preventive and Rehabilitative Sport- and Exercise Medicine, German Sportuniversity Cologne, D-50933 Köln, Germany; (B.B.-W.); (H.-G.P.)
| | - Karin Meng
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, D-97080 Würzburg, Germany;
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital, D-50937 Köln, Germany;
| | - Annett Salzwedel
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
| | | | | | - Matthes Metz
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | - Bernhard Rauch
- Institut für Herzinfarktforschung Ludwigshafen, IHF, D-67063 Ludwigshafen am Rhein, Germany;
- Zentrum für ambulante Rehabilitation, ZAR Trier GmbH, D-54292 Trier, Germany
| | - Gerd Bönner
- Medizinische Fakultät, Albert-Ludwigs-Universität zu Freiburg, D-79104 Freiburg, Germany;
| | - Patrick Brzoska
- Fakultät für Gesundheit, Universität Witten/Herdecke, Lehrstuhl für Versorgungsforschung, D-58448 Witten, Germany;
| | | | | | - Carsten Cordes
- Gollwitzer-Meier-Klinik, D-32545 Bad Oeynhausen, Germany;
| | - Gesine Dörr
- Alexianer St. Josefs-Krankenhaus Potsdam, D-14472 Potsdam, Germany;
| | - Sarah Eichler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
| | - Anne-Kathrin Exner
- Klinikum Lippe GmbH, Standort Detmold, D-32756 Detmold, Germany; (A.-K.E.); (S.G.)
| | - Bernd Fromm
- REHA-Klinik Sigmund Weil, D-76669 Bad Schönborn, Germany;
| | - Stephan Gielen
- Klinikum Lippe GmbH, Standort Detmold, D-32756 Detmold, Germany; (A.-K.E.); (S.G.)
| | - Johannes Glatz
- Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany; (J.G.); (E.L.)
| | - Helmut Gohlke
- Private Practice, D-79282 Ballrechten-Dottingen, Germany;
| | - Maurizio Grilli
- Library Department, University Medical Centre Mannheim, D-68167 Mannheim, Germany;
| | - Detlef Gysan
- Department für Humanmedizin, Private Universität Witten/Herdecke GmbH, D-58455 Witten, Germany;
| | - Ursula Härtel
- LMU München, Institut für Medizinische Psychologie, D-80336 München, Germany;
| | | | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, D-37075 Göttingen, Germany;
| | | | | | | | | | | | - Eike Langheim
- Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany; (J.G.); (E.L.)
| | | | - Regina Max
- Zentrum für Rheumatologie, Drs. Dornacher/Schmitt/Max/Lutz, D-69115 Heidelberg, Germany;
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine University, D-40225 Düsseldorf, Germany;
| | - Roland Nebel
- Hermann-Albrecht-Klinik METTNAU, Reha-Einrichtungen der Stadt Radolfzell, D-7385 Radolfzell, Germany;
| | - Josef Niebauer
- Universitätsinstitut für Präventive und Rehabilitative Sportmedizin, Uniklinikum Salzburg, Paracelsus Medizinische Privatuniversität, A-5020 Salzburg, Austria;
| | - Hans-Georg Predel
- Institute for Cardiology and Sports Medicine, Department of Preventive and Rehabilitative Sport- and Exercise Medicine, German Sportuniversity Cologne, D-50933 Köln, Germany; (B.B.-W.); (H.-G.P.)
| | - Axel Preßler
- Privatpraxis für Kardiologie, Sportmedizin, Prävention, Rehabilitation, D-81675 München, Germany;
| | - Oliver Razum
- Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, D-33615 Bielefeld, Germany;
| | - Nils Reiss
- Schüchtermann-Schiller’sche Kliniken, D-49214 Bad Rothenfelde, Germany;
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | | | - Morten Schütt
- Diabetologische Schwerpunktpraxis, D-23552 Lübeck, Germany;
| | - Konrad Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, D-83435 Bad Reichenhall, Germany;
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital, University of Duisburg-Essen, D-45147 Essen, Germany; (E.-M.S.); (M.T.)
| | | | - Marco Streibelt
- Department for Rehabilitation Research, German Federal Pension Insurance, D-10704 Berlin, Germany;
| | | | | | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital, University of Duisburg-Essen, D-45147 Essen, Germany; (E.-M.S.); (M.T.)
| | | | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
- Klinik am See, D-15562 Rüdersdorf, Germany
| | - Heiner Vogel
- Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg, D-97070 Würzburg, Germany;
| | - Ronja Westphal
- Herzzentrum Segeberger Kliniken, D-23795 Bad Segeberg, Germany;
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Augustin M, Schommers P, Stecher M, Dewald F, Gieselmann L, Gruell H, Horn C, Vanshylla K, Cristanziano VD, Osebold L, Roventa M, Riaz T, Tschernoster N, Altmueller J, Rose L, Salomon S, Priesner V, Luers JC, Albus C, Rosenkranz S, Gathof B, Fätkenheuer G, Hallek M, Klein F, Suárez I, Lehmann C. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur 2021; 6:100122. [PMID: 34027514 PMCID: PMC8129613 DOI: 10.1016/j.lanepe.2021.100122] [Citation(s) in RCA: 323] [Impact Index Per Article: 107.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND While the leading symptoms during coronavirus disease 2019 (COVID-19) are acute and the majority of patients fully recover, a significant fraction of patients now increasingly experience long-term health consequences. However, most data available focus on health-related events after severe infection and hospitalisation. We present a longitudinal, prospective analysis of health consequences in patients who initially presented with no or minor symptoms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Hence, we focus on mild COVID-19 in non-hospitalised patients. METHODS 958 Patients with confirmed SARS-CoV-2 infection were observed from April 6th to December 2nd 2020 for long-term symptoms and SARS-CoV-2 antibodies. We identified anosmia, ageusia, fatigue or shortness of breath as most common, persisting symptoms at month 4 and 7 and summarised presence of such long-term health consequences as post-COVID syndrome (PCS). Predictors of long-term symptoms were assessed using an uni- and multivariable logistic regression model. FINDINGS We observed 442 and 353 patients over four and seven months after symptom onset, respectively. Four months post SARS-CoV-2 infection, 8•6% (38/442) of patients presented with shortness of breath, 12•4% (55/442) with anosmia, 11•1% (49/442) with ageusia and 9•7% (43/442) with fatigue. At least one of these characteristic symptoms was present in 27•8% (123/442) and 34•8% (123/353) at month 4 and 7 post-infection, respectively. A lower baseline level of SARS-CoV-2 IgG, anosmia and diarrhoea during acute COVID-19 were associated with higher risk to develop long-term symptoms. INTERPRETATION The on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalised patients was observed at four and seven months post-infection and summarised as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19. FUNDING COVIM:"NaFoUniMedCovid19"(FKZ: 01KX2021).
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Affiliation(s)
- Max Augustin
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Philipp Schommers
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Felix Dewald
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Lutz Gieselmann
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Henning Gruell
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Carola Horn
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Kanika Vanshylla
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Luise Osebold
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Maria Roventa
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Toqeer Riaz
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Nikolai Tschernoster
- Cologne Center for Genomics and West German Genome Center, University of Cologne, 50931 Cologne, Germany
| | - Janine Altmueller
- Cologne Center for Genomics and West German Genome Center, University of Cologne, 50931 Cologne, Germany
| | - Leonard Rose
- Institute of Transfusion Medicine, University Hospital Cologne, 50937 Cologne, Germany
| | - Susanne Salomon
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Vanessa Priesner
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Jan Christoffer Luers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, 50937, Cologne, Germany
| | - Stephan Rosenkranz
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- Department III of Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany
- Cologne Cardiovascular Research Center (CCRC) and Heart Center, University Hospital Cologne, 50937 Cologne, Germany
| | - Birgit Gathof
- Institute of Transfusion Medicine, University Hospital Cologne, 50937 Cologne, Germany
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Cologne, Germany
| | - Florian Klein
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Isabelle Suárez
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
| | - Clara Lehmann
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Germany
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Hermann R, Schaller A, Lay D, Bloch W, Albus C, Petrowski K. Effect of acute psychosocial stress on the brain-derived neurotrophic factor in humans - a randomized cross within trial. Stress 2021; 24:442-449. [PMID: 33236949 DOI: 10.1080/10253890.2020.1854218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The brain-derived neurotrophic factor (BDNF) is involved in the plasticity and development of the central nervous system. Thereby the protein synthesis is highly related to neuronal activity, and its signaling pathways are associated with several substances like, e.g. glucocorticoids, which seem to be able to activate BDNF-Tropomyosin receptor kinase B (TrkB). While there is evidence that acute physical stress can result in advantageous physiological outcomes like an enhanced BDNF level, outcome parameters in response to psychosocial stress are primarily focused on psychological parameters. The existing literature pointing on the impact of acute psychosocial stress on physiological parameters is controversial and differs depending on the species, the stressor used, and the study methodology. It was hypothesized that an acute standardized psychosocial stressor would increase the BDNF level and therefore show beneficial physiological outcome parameters through psychosocial stress. The serum BDNF levels of 32 healthy young males (M = 24.31 years of age, SD = 3.35), who performed the Trier Social Stress Test (TSST), were assessed and compared to a control condition. To prove the stress-generating effect of the TSST, additional cortisol levels were measured. Acute psychosocial stress significantly increased the serum BDNF- and the cortisol-level, whereby no alteration was found during the control. This study expands the rare literature focusing on the effect of an acute standardized psychosocial stressor on the BDNF level in healthy humans, including a control condition. Implications for future studies are being discussed.
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Affiliation(s)
- Robin Hermann
- Working group physical activity-related preventive research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Koln, Germany
- Medical Psychology and Medical Sociology, University Medicine Mainz, Mainz, Germany
| | - Andrea Schaller
- Working group physical activity-related preventive research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Koln, Germany
| | - Daniel Lay
- Department Preventative and Rehabilitative Sports and Performance Medicine, German Sport University Cologne, Institute of Cardiology and Sports Medicine, Cologne, Germany
| | - Wilhelm Bloch
- Department Molecular and Cellular Sports Medicine, German Sport University Cologne, Institute of Cardiology and Sports Medicine, Cologne, Germany
| | - Christian Albus
- Clinic and Policlinic for Psychosomatic and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, University Medicine Mainz, Mainz, Germany
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Rauch B, Salzwedel A, Bjarnason-Wehrens B, Albus C, Meng K, Schmid JP, Benzer W, Hackbusch M, Jensen K, Schwaab B, Altenberger J, Benjamin N, Bestehorn K, Bongarth C, Dörr G, Eichler S, Einwang HP, Falk J, Glatz J, Gielen S, Grilli M, Grünig E, Guha M, Hermann M, Hoberg E, Höfer S, Kaemmerer H, Ladwig KH, Mayer-Berger W, Metzendorf MI, Nebel R, Neidenbach RC, Niebauer J, Nixdorff U, Oberhoffer R, Reibis R, Reiss N, Saure D, Schlitt A, Völler H, von Känel R, Weinbrenner S, Westphal R. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1. J Clin Med 2021; 10:2192. [PMID: 34069561 PMCID: PMC8161282 DOI: 10.3390/jcm10102192] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although cardiovascular rehabilitation (CR) is well accepted in general, CR-attendance and delivery still considerably vary between the European countries. Moreover, clinical and prognostic effects of CR are not well established for a variety of cardiovascular diseases. METHODS The guidelines address all aspects of CR including indications, contents and delivery. By processing the guidelines, every step was externally supervised and moderated by independent members of the "Association of the Scientific Medical Societies in Germany" (AWMF). Four meta-analyses were performed to evaluate the prognostic effect of CR after acute coronary syndrome (ACS), after coronary bypass grafting (CABG), in patients with severe chronic systolic heart failure (HFrEF), and to define the effect of psychological interventions during CR. All other indications for CR-delivery were based on a predefined semi-structured literature search and recommendations were established by a formal consenting process including all medical societies involved in guideline generation. RESULTS Multidisciplinary CR is associated with a significant reduction in all-cause mortality in patients after ACS and after CABG, whereas HFrEF-patients (left ventricular ejection fraction <40%) especially benefit in terms of exercise capacity and health-related quality of life. Patients with other cardiovascular diseases also benefit from CR-participation, but the scientific evidence is less clear. There is increasing evidence that the beneficial effect of CR strongly depends on "treatment intensity" including medical supervision, treatment of cardiovascular risk factors, information and education, and a minimum of individually adapted exercise volume. Additional psychologic interventions should be performed on the basis of individual needs. CONCLUSIONS These guidelines reinforce the substantial benefit of CR in specific clinical indications, but also describe remaining deficits in CR-delivery in clinical practice as well as in CR-science with respect to methodology and presentation.
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Affiliation(s)
- Bernhard Rauch
- Institut für Herzinfarktforschung Ludwigshafen, D-67063 Ludwigshafen, Germany
- Zentrum für Ambulante Rehabilitation, ZAR Trier GmbH, D-54292 Trier, Germany
| | - Annett Salzwedel
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); (H.V.)
| | - Birna Bjarnason-Wehrens
- Institut für Kreislaufforschung und Sportmedizin, Abt. Präventive und rehabilitative Sport- und Leistungsmedizin, Deutsche Sporthochschule Köln, D-50937 Köln, Germany;
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital, D-50937 Köln, Germany;
| | - Karin Meng
- Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, D-97078 Würzburg, Germany;
| | | | | | - Matthes Hackbusch
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.H.); (K.J.); (D.S.)
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.H.); (K.J.); (D.S.)
| | - Bernhard Schwaab
- Curschmann Klinik Dr. Guth GmbH & Co KG, D-23669 Timmendorfer Strand, Germany;
| | | | - Nicola Benjamin
- Zentrum für Pulmonale Hypertonie, Thorax-Klinik am Universitätsklinikum Heidelberg, D-69126 Heidelberg, Germany; (N.B.); (E.G.)
| | - Kurt Bestehorn
- Institut für Klinische Pharmakologie, Technische Universität Dresden, Fiedlerstraße 42, D-01307 Dresden, Germany;
| | - Christa Bongarth
- Klinik Höhenried gGmbH, Rehabilitationszentrum am Starnberger See, D-82347 Bernried, Germany; (C.B.); (H.-P.E.)
| | - Gesine Dörr
- Alexianer St. Josefs-Krankenhaus Potsdam-Sanssouci, D-14471 Potsdam, Germany;
| | - Sarah Eichler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); (H.V.)
| | - Hans-Peter Einwang
- Klinik Höhenried gGmbH, Rehabilitationszentrum am Starnberger See, D-82347 Bernried, Germany; (C.B.); (H.-P.E.)
| | - Johannes Falk
- Deutsche Rentenversicherung Bund (DRV-Bund), D-10709 Berlin, Germany; (J.F.); (S.W.)
| | - Johannes Glatz
- Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany;
| | - Stephan Gielen
- Klinikum Lippe, Standort Detmold, D-32756 Detmold, Germany;
| | - Maurizio Grilli
- Universitätsbibliothek, Universitätsmedizin Mannheim, D-68167 Mannheim, Germany;
| | - Ekkehard Grünig
- Zentrum für Pulmonale Hypertonie, Thorax-Klinik am Universitätsklinikum Heidelberg, D-69126 Heidelberg, Germany; (N.B.); (E.G.)
| | - Manju Guha
- Reha-Zentrum am Sendesaal, D-28329 Bremen, Germany;
| | - Matthias Hermann
- Klinik für Kardiologie, Universitätsspital Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland;
| | - Eike Hoberg
- Wismarstraße 13, D-24226 Heikendorf, Germany;
| | - Stefan Höfer
- Universitätsklinik für Medizinische Psychologie und Psychotherapie, Medizinische Universität Innsbruck, A-6020 Innsbruck, Austria;
| | - Harald Kaemmerer
- Klinik für Angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Klinik der Technischen Universität München, D-80636 München, Germany;
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München (TUM) Langerstraße 3, D-81675 Munich, Germany;
| | - Wolfgang Mayer-Berger
- Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, D-42799 Leichlingen, Germany;
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine University, Werdener Straße. 4, D-40227 Düsseldorf, Germany;
| | - Roland Nebel
- Hermann-Albrecht-Klinik METTNAU, Medizinische Reha-Einrichtungen der Stadt Radolfzell, D-73851 Radolfzell, Germany;
| | - Rhoia Clara Neidenbach
- Institut für Sportwissenschaft, Universität Wien, Auf der Schmelz 6 (USZ I), AU-1150 Wien, Austria;
| | - Josef Niebauer
- Universitätsinstitut für Präventive und Rehabilitative Sportmedizin, Uniklinikum Salzburg Paracelsus Medizinische Privatuniversität, A-5020 Salzburg, Austria;
| | - Uwe Nixdorff
- EPC GmbH, European Prevention Center, Medical Center Düsseldorf, D-40235 Düsseldorf, Germany;
| | - Renate Oberhoffer
- Lehrstuhl für Präventive Pädiatrie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, D-80992 München, Germany;
| | - Rona Reibis
- Kardiologische Gemeinschaftspraxis Am Park Sanssouci, D-14471 Potsdam, Germany;
| | - Nils Reiss
- Schüchtermann-Schiller’sche Kliniken, Ulmenallee 5-12, D-49214 Bad Rothenfelde, Germany;
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.H.); (K.J.); (D.S.)
| | - Axel Schlitt
- Paracelsus Harz-Klinik Bad Suderode GmbH, D-06485 Quedlinburg, Germany;
| | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); (H.V.)
- Klinik am See, D-15562 Rüdersdorf, Germany
| | - Roland von Känel
- Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich, CH-8091 Zürich, Switzerland;
| | - Susanne Weinbrenner
- Deutsche Rentenversicherung Bund (DRV-Bund), D-10709 Berlin, Germany; (J.F.); (S.W.)
| | - Ronja Westphal
- Herzzentrum Segeberger Kliniken, D-23795 Bad Segeberg, Germany;
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Morawa E, Schug C, Geiser F, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Hiebel N, Borho A, Erim Y. Psychosocial burden and working conditions during the COVID-19 pandemic in Germany: The VOICE survey among 3678 health care workers in hospitals. J Psychosom Res 2021; 144:110415. [PMID: 33743398 PMCID: PMC7944879 DOI: 10.1016/j.jpsychores.2021.110415] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [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: 11/17/2020] [Revised: 02/25/2021] [Accepted: 03/08/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this cross-sectional web-based study was to examine self-reported mental distress, psychosocial burdens, working conditions and potential risk and protective factors for depressive and anxiety symptoms during the COVID-19 pandemic in health care workers (HCW). METHODS In the largest survey on mental health of HCW conducted during the first wave of COVID-19 in Europe (N = 8071 HCW), we investigated depressive (Patient Health Questionnaire-2, PHQ-2), and anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), working conditions, and psychosocial burden of 3678 HCW of three health care professions in hospitals: physicians (n = 1061), nurses (n = 1275), and medical technical assistants (MTA, n = 1342). RESULTS The prevalence of clinically significant levels of depressive and anxiety symptoms was 17.4% and 17.8% for physicians, 21.6% and 19.0% for nurses, and 23.0% and 20.1% for MTA, respectively. All three professions demonstrated significantly elevated PHQ-2 and GAD-2 scores, when compared with general German population before the pandemic, but lower scores in relation to that during the pandemic. Multiple linear regression analyses revealed that higher levels of depressive symptoms were associated with insufficient recovery during leisure time, increased alcohol consumption, and less trust in colleagues in difficult situations at work. In addition, elevated anxiety scores were related to increased fear of becoming infected with COVID-19. CONCLUSION During the pandemic HCW demonstrated a lower burden of mental distress compared to the general population. Nevertheless, a high percentage of HCW demonstrates psychosocial distress, so that the establishment of regular mental health screening and prevention programmes for HCW is indicated.
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Affiliation(s)
- Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany.
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital of Cologne, Cologne, Germany.
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany.
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Petrowski K, Bührer S, Albus C, Schmalbach B. Increase in cortisol concentration due to standardized bright and blue light exposure on saliva cortisol in the morning following sleep laboratory. Stress 2021; 24:331-337. [PMID: 32723201 DOI: 10.1080/10253890.2020.1803265] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Research studies on LED light exposure and cortisol are inconsistent and not comparable due to different types of light, exposure times, and sample sizes. Therefore, one hour of standardized exposure LED light at different intensities and the spectral composition during the post-awakening phase at 7:30 were compared. A sample of 23 (Study 1) and 26 (Study 2) healthy males were randomly assigned to: 1) bright white light (414 lux) and 2) dim darkened light (<2 lux) as well as 3) red light (235 lux) and 4) blue light (201 lux) exposure conditions. Results from repeated measures ANOVA confirm that light exposure affects the cortisol concentration. Study 1 revealed an increase in the saliva cortisol concentration after bright light exposure compared to dim light. An increase in the cortisol concentration of blue light compared to red light (Study 2) and dim light was found. This study shows that bright light and blue light affect the cortisol response in contrast to dim light and red light conditions. The HPA axis showed a stimulatory effect by bright versus dim light and different wavelengths of light exposure.Lay summaryThe effects of LED light exposure on the stress hormone cortisol were investigated. The light exposure took place during the hours people would start working at the office. The results showed that after one hour of exposure to bright light or blue light the stress hormones increase in contrast to dim light and red light conditions. Thus, stress hormones can be altered by the types of light people are exposed to.
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Affiliation(s)
- Katja Petrowski
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stefan Bührer
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of University Cologne, Cologne, Germany
| | - Bjarne Schmalbach
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Niecke A, Ramesh I, Albus C, Lüngen M, Pfaff H, Samel C, Peters KM. [Chronic Pain in People Impaired by Thalidomide Embryopathy: An Explorative Analysis of Prevalence, Pain Parameters and Biopsychosocial Factors]. Psychother Psychosom Med Psychol 2021; 71:370-380. [PMID: 33915582 DOI: 10.1055/a-1457-2846] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the study was to show the frequency, localisation, intensity, quality and degree of chronic pain in people with thalidomide-induced congenital defects (thalidomide embryopathy) and to investigate the association with biopsychosocial factors more closely. METHODS A group of 202 people from North Rhine-Westphalia with thalidomide embryopathy were studied for the first time both physically for the pattern of the original damage and also psychiatrically in a structured diagnostic interview (SCID I & SCID II). The results were combined with a standardized pain interview (MPSS) and questionnaires on further pain-related (SF-36, painDETECT) and sociodemographic variables and analysed. In the analysis 167 completed datasets were included. RESULTS The prevalence of pain in the sample population was 94%. The majority (107, 54.0%) already showed an advanced stage of chronicity in the MPSS: 63 subjects with Stage II (37.7%) and 44 with Stage III (26.3%). In 74 subjects (44.3%) the PainDetect score showed a possible or neuropathic pain component. The factors that most reliably influenced the chronicity of pain proved to be hip pain (p<0.001) and also mental health disorders (p=0.001), above major depression (p<0.001) and also somatic symptom disorders and substance-related disorders (p=0.001 in each case). Social variables proved non-significant here (p=0.094 for living alone, p=0.122 for unemployment, p=0.167 for lack of college education), as did the care situation (p=0.191 for care dependency) and the underlying pattern of organ damage (p=0.229 for damage to hearing, p=0.764 for dysmelia). CONCLUSIONS People with thalidomide defects frequently suffer from a separate pain disorder which can be seen as secondary thalidomide-induced damage and which requires specialized and personalized multimodal pain management.
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Affiliation(s)
- Alexander Niecke
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Medizinische Fakultät und Uniklinik, Universität zu Köln, Deutschland
| | - Irene Ramesh
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Medizinische Fakultät und Uniklinik, Universität zu Köln, Deutschland
| | - Christian Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Medizinische Fakultät und Uniklinik, Universität zu Köln, Deutschland
| | - Markus Lüngen
- Fakultät Wirtschafts- und Sozialwissenschaften, Hochschule Osnabrück, Deutschland
| | - Holger Pfaff
- IMVR - Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft der Humanwissenschaftlichen Fakultät und der Medizinischen Fakultät, Universität zu Köln, Deutschland
| | - Christina Samel
- Institut für Medizinische Stastistik und Bioinformatik, Mediziische Fakultät, Universität zu Köln, Deutschland
| | - Klaus M Peters
- Abteilung für Orthopädie und Osteologie, Dr Becker Rhein-Sieg-Klinik, Numbrecht, Deutschland
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48
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Schug C, Morawa E, Geiser F, Hiebel N, Beschoner P, Jerg-Bretzke L, Albus C, Weidner K, Steudte-Schmiedgen S, Borho A, Lieb M, Erim Y. Social Support and Optimism as Protective Factors for Mental Health among 7765 Healthcare Workers in Germany during the COVID-19 Pandemic: Results of the VOICE Study. Int J Environ Res Public Health 2021; 18:3827. [PMID: 33917493 PMCID: PMC8038794 DOI: 10.3390/ijerph18073827] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic is impacting mental health worldwide, particularly among healthcare workers (HCWs). Risk and protective factors for depression and generalized anxiety in healthcare workers need to be identified to protect their health and ability to work. Social support and optimism are known protective psychosocial resources, but have not been adequately studied in the context of the COVID-19 pandemic among healthcare workers in Germany. METHODS Within the first wave of the VOICE study (n = 7765), a longitudinal web-based survey study among healthcare workers in Germany, we assessed symptoms of depression (PHQ-2) and generalized anxiety (GAD-2), social support (ENRICHD Social Support Inventory; ESSI), and generalized optimism as well as sociodemographic, occupational, and COVID-19 related variables. Multiple linear regression analyses were conducted to examine associations between the constructs. RESULTS The analyses revealed that higher levels of social support and optimism were associated with lower levels of depression and generalized anxiety. They showed a higher association with depression and generalized anxiety than demographic or occupational risk factors such as female gender and direct contact with infected individuals. CONCLUSION Psychosocial resources such as social support and optimism appear to contribute to successful coping with the COVID-19 pandemic and should be considered in future studies.
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Affiliation(s)
- Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (A.B.); (M.L.); (Y.E.)
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (A.B.); (M.L.); (Y.E.)
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, 53127 Bonn, Germany; (F.G.); (N.H.)
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, 53127 Bonn, Germany; (F.G.); (N.H.)
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (P.B.); (L.J.-B.)
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (P.B.); (L.J.-B.)
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Medical Faculty and University Hospital, 50931 Cologne, Germany;
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (K.W.); (S.S.-S.)
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany; (K.W.); (S.S.-S.)
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (A.B.); (M.L.); (Y.E.)
| | - Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (A.B.); (M.L.); (Y.E.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (A.B.); (M.L.); (Y.E.)
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Jerg-Bretzke L, Kempf M, Jarczok M, Kilian R, Weimer K, Gündel H, Morawa E, Hiebel N, Schmiedgen S, Albus C, Beschoner P. Results of a factor analysis of items regarding COVID-19 pandemic-specific workload among medical staff in Germany. Eur Psychiatry 2021. [PMCID: PMC9471909 DOI: 10.1192/j.eurpsy.2021.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionEpidemics lead to an increase in occupational stress and psychological strain among medical staff (cf. Mulfinger et al. 2020). However, there are no validated questionnaires to measure stress caused by an epidemic such as Covid-19, instead self-constructed questions are used frequently.ObjectivesThe aim was to develop items for the assessment of specific workload in epidemics which can be used to obtain longitudinal data.MethodsA sample of N=8078 persons working in the health care sector in Germany participated in the VOICE, EviPan online survey addressing the burden of Covid-19 pandemic during the 2nd quarter of 2020. We used 15 self-constructed items to examine whether these items can represent Covid-19 specific topics. A total of N=7549 (24% males) had complete data to run a confirmatory factor analysis using SEM procedure in Stata 14.2.ResultsFive factors were identified a priory: Factor (F) 1: Workload due to Covid-19 pandemic (4 items; Cronbachs’ alpha (α))=0.740); F 2: Fear, uncertainty of SarsCoV-2infection (self and others) (3 items; α= 0.741); F 3: Patient safety (3 items; α=0.533; F 4: Perception of protection concepts (2 items; α=0.590); F 5: Dysfunctional coping strategies (3 items; α=0.447). Fit-Indices: χ²(73)= 1373.849, p<.001, CFI=.946, TLI=.923, RMSEA=.0049, SRMR=.037)ConclusionsWe identified 5 factors associated with problems occurring during the Covid-19 pandemic with acceptable to good internal consistency. Most of the constructed items could therefore be used in further surveys to monitor stress, as a basis for recommendations in the area of stress prevention and interventions for medical staff during epidemics.
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Albus C, Petrak F. [Psychodiabetology]. Psychother Psychosom Med Psychol 2021; 71:141-157. [PMID: 33784765 DOI: 10.1055/a-1338-2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People affected by diabetes mellitus often have difficulties coping with their condition. This can be further worsened by psychological co-morbidities (e. g., depression or anxiety disorders). Both factors are associated with diabetes-specific problems (e. g., persistent hyperglycaemia, recurrent hypoglycaemia), but also with diabetes complications or comorbid somatic diseases. When psychotherapeutic or psychopharmacological treatment is indicated, it is essential to take into account the particularities of diabetes and the different types of diabetes. This review focuses on adults only and includes a brief description of the clinical features and therapeutic goals in diabetes mellitus. Critical diabetic symptoms that should result in specific interventions (yellow flags) as much as symptoms that require immediate intervention (red flags) are highlighted. Finally, psychological and behavioural factors as well as mental comorbidities that are relevant to the management of diabetes mellitus are discussed.
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