@article{VoellerSchwaab2020, author = {V{\"o}ller, Heinz and Schwaab, Bernhard}, title = {Kardiologische Rehabilitation}, series = {Der Kardiologe : die Fortbildungszeitschrift der Deutschen Gesellschaft f{\"u}r Kardiologie, Herz- und Kreislaufforschung}, volume = {14}, journal = {Der Kardiologe : die Fortbildungszeitschrift der Deutschen Gesellschaft f{\"u}r Kardiologie, Herz- und Kreislaufforschung}, number = {2}, publisher = {Springer}, address = {Berlin}, issn = {1864-9718}, doi = {10.1007/s12181-020-00384-2}, pages = {106 -- 112}, year = {2020}, abstract = {Hintergrund Eine Verl{\"a}ngerung der Lebens- und Arbeitszeit erfordert einen aktiven Lebensstil, eine Optimierung von kardiovaskul{\"a}ren Risikofaktoren und psychosoziale Unterst{\"u}tzung chronisch Herzkranker. Fragestellung K{\"o}nnen die Prognose und Lebensqualit{\"a}t sowie die soziale oder berufliche Teilhabe kardiovaskul{\"a}r Erkrankter durch kardiologische Rehabilitation (KardReha) verbessert werden? Material und Methode Auf der Grundlage neuer Metaanalysen und aktueller Positionspapiere gibt die S3-Leitlinie zur kardiologischen Rehabilitation evidenzbasierte Empfehlungen. Ergebnisse Eine KardReha reduziert bei Patienten nach akutem Koronarsyndrom, nach PCI („percutaneous coronary interventions") oder nach aortokoronarer Koronarbypassoperation (ACB-Op.) sowie nach Klappenkorrektur die Gesamtsterblichkeit. Bei Patienten mit systolischer Herzinsuffizienz (HFrEF [„heart failure with reduced ejection fraction"]) werden Belastbarkeit und Lebensqualit{\"a}t durch eine KardReha verbessert. Psychosozialer Distress kann verringert und die berufliche Wiedereingliederung besser strukturiert werden. Schlussfolgerung Im Jahr 2019 liegen aktuelle, evidenzbasierte Leitlinien vor, die aufgrund verbesserter Prognose, Belastbarkeit und Lebensqualit{\"a}t eine multimodale kardiologische Rehabilitation bei Patienten nach akutem kardialem Ereignis auch bei technischem Fortschritt (z. B. katheterbasierter Klappenkorrektur) und unter Aspekten der sozialen und beruflichen Teilhabe empfehlen.}, language = {de} } @article{WarschburgerPetersenvonRezorietal.2021, author = {Warschburger, Petra and Petersen, Ann-Christin and von Rezori, Roman Enzio and Buchallik, Friederike and Baumeister, Harald and Holl, Reinhard and Minden, Kirsten and M{\"u}ller-​Stierlin, Annabel Sandra and Reinauer, Christina and Staab, Doris and COACH consortium,}, title = {A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study}, series = {BMC Pediatrics}, volume = {21}, journal = {BMC Pediatrics}, publisher = {BMC pediatrics}, address = {London}, issn = {1471-2431}, doi = {10.1186/s12887-021-02869-9}, pages = {1 -- 13}, year = {2021}, abstract = {Background Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N = 450 adolescents (12-21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups - "inconspicuous" (PHQ-9 and GAD-7 < 7) vs. "conspicuous" (PHQ-9 or GAD-7 ≥ 7) - participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.}, language = {en} } @article{CalvanoWarschburger2018, author = {Calvano, Claudia and Warschburger, Petra}, title = {Quality of life among parents seeking treatment for their child's functional abdominal pain}, series = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation}, volume = {27}, journal = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation}, number = {10}, publisher = {Springer}, address = {Dordrecht}, issn = {0962-9343}, doi = {10.1007/s11136-018-1916-2}, pages = {2557 -- 2570}, year = {2018}, abstract = {Purpose: Dealing with a child who suffers from functional abdominal pain (FAP) is a major challenge for the child's parents. However, little is known about the quality of life (QoL) of this group of parents. Therefore, this cross-sectional study aimed to provide a comprehensive analysis of parental QoL among parents seeking treatment for their child's abdominal pain. Methods: 133 parents of 7-13-year-old children diagnosed with FAP reported on their health-related QoL (HRQoL), as assessed by the SF-12, and on caregiver-related QoL, as assessed by two CHQ-PF50 scales (emotional impact, time impact). T tests were used to compare the parents' scores on these measures with reference scores. Subgroups which were at risk of impairment were defined by cut-off scores. Determinants of parental QoL were identified by hierarchical regression analyses. Results: While the parents showed significantly poorer mental health compared to population-based reference samples (d = 0.33-0.58), their physical health did not differ. However, parents were severely strained with respect to the time impact and emotional impact of their child's health (d = 0.33-1.58). While 12.7-27.9\% of the parents were at risk of poor HRQoL, 60.6-70.1\% were highly strained due to the demands of their role as caregivers. Physical and mental health were best explained by parents' psychiatric symptoms, while parents' perception of their child's impairment additionally determined the high time and emotional impact. Conclusions: Physical HRQoL is not impaired in the majority of parents seeking treatment for their child's functional abdominal pain. However, the time demands and worries due to the child's pain deserve specific attention. Psychosocial interventions for a child's FAP should include information provided to the parents about coping with time constraints and emotional impact. Further prospective studies are warranted.}, language = {en} } @article{SalzwedelWegscheiderSchulzBehrendtetal.2019, author = {Salzwedel, Annett and Wegscheider, Karl and Schulz-Behrendt, Claudia and D{\"o}rr, Gesine and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {No impact of an extensive social intervention program on return to work and quality of life after acute cardiac event: a cluster-randomized trial in patients with negative occupational prognosis}, series = {International archives of occupational and environmental health}, volume = {92}, journal = {International archives of occupational and environmental health}, number = {8}, publisher = {Springer}, address = {New York}, issn = {0340-0131}, doi = {10.1007/s00420-019-01450-3}, pages = {1109 -- 1120}, year = {2019}, abstract = {Objectives To examine the effectiveness of extensive social therapy intervention during inpatient multi-component cardiac rehabilitation (CR) on return to work and quality of life in patients with low probability of work resumption after an acute cardiac event. Methods Patients after acute cardiac event with negative subjective expectations about return to work or unemployment (n = 354) were included and randomized in clusters of 3-6 study participants. Clusters were randomized for social counseling and therapy led by a social worker, six sessions of 60 min each in 3 weeks, or control group (usual care: individual counseling meeting by request). The return to work (RTW) status and change in quality of life (QoL, short form 12: Physical and Mental Component Summary PCS and MCS) 12 months after discharge from inpatient CR were outcome measures. Results The regression model for RTW showed no impact of the intervention (OR 1.1, 95\% CI 0.6-2.1, P = 0.79; n = 263). Predictors were unemployment prior to CR as well as higher anxiety values at discharge from CR. Likewise, QoL was not improved by social therapy (linear mixed model: Delta PCS 0.3, 95\% CI - 1.9 to 2.5; P = 0.77; n = 177; Delta MCS 0.7, 95\% CI - 1.9 to 3.3; P = 0.58; n = 215). Conclusions In comparison to usual care, an intensive program of social support for patients during inpatient cardiac rehabilitation after an acute cardiac event had no additional impact on either the rate of resuming work or quality of life.}, language = {en} } @article{WarschburgerKroellerHaertingetal.2016, author = {Warschburger, Petra and Kr{\"o}ller, Katja and Haerting, Johannes and Unverzagt, Susanne and van Egmond-Fr{\"o}hlich, Andreas}, title = {Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training}, series = {Appetite : multidisciplinary research on eating and drinking}, volume = {103}, journal = {Appetite : multidisciplinary research on eating and drinking}, publisher = {Elsevier}, address = {London}, issn = {0195-6663}, doi = {10.1016/j.appet.2016.04.007}, pages = {148 -- 156}, year = {2016}, abstract = {Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances 'obesity-specific' parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7-13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95\% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95\% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects.}, language = {en} } @article{KonradJacobRappetal.2016, author = {Konrad, Marcel and Jacob, Louis and Rapp, Michael Armin and Kostev, Karel}, title = {Depression risk in patients with coronary heart disease in Germany}, series = {World Journal of Cardiology}, volume = {8}, journal = {World Journal of Cardiology}, publisher = {Baishideng Publishing Group}, address = {Pleasanton}, issn = {1949-8462}, doi = {10.4330/wjc.v8.i9.547}, pages = {547 -- 552}, year = {2016}, abstract = {AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices. METHODS Longitudinal data from nationwide general practices in Germany (n = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1: 1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders. RESULTS Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9\% of patients were men. After a five-year follow-up, 21.8\% of the CHD group and 14.2\% of the control group were diagnosed with depression (P < 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95\% CI: 1.49-1.59, P < 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively. CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.}, language = {en} } @article{SanchezThomasDeekenetal.2019, author = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael Armin}, title = {Patient safety, cost-effectiveness, and quality of life}, series = {Trials}, volume = {20}, journal = {Trials}, number = {71}, publisher = {BioMed Central}, address = {London}, issn = {1468-6694}, doi = {10.1186/s13063-018-3148-8}, pages = {15}, year = {2019}, abstract = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.}, language = {en} } @article{HoffmannWarschburger2015, author = {Hoffmann, Svenja and Warschburger, Petra}, title = {Body image in obese children and adolescents. Body dissatisfaction and body size perception in relation to quality of life and weight loss}, series = {Psychotherapeut}, volume = {60}, journal = {Psychotherapeut}, number = {6}, publisher = {Springer}, address = {New York}, issn = {0935-6185}, doi = {10.1007/s00278-015-0060-5}, pages = {498 -- 504}, year = {2015}, abstract = {Body dissatisfaction and an unrealistic perception of own body size are particularly common in obese children and adolescents; however, little is known about the association with weight-related quality of life and the impact on successful long-term weight loss. At the beginning of an inpatient child obesity rehabilitation program, 408 children and adolescents aged 9-12 years completed a questionnaire on body image (body silhouettes) and a body weight-specific questionnaire for overweight and obese children and adolescents (GW-LQ-KJ) on quality of life. Height and weight were measured by a physician at the beginning and 1 year after inpatient hospitalization. Of the participants 91.9 \% reported body dissatisfaction and 75.7 \% underestimated their own body size. There were no gender-specific differences in body dissatisfaction but boys perceived their body size more realistically than girls. Participants with body dissatisfaction and realistic body size perception showed a reduced weight-related quality of life. Those participants who realistically perceived their body size also lost less weight in the long term. The subjective underestimation of body size proved to be important for reduced weight-related quality of life and more pronounced long-term weight loss; therefore, body image should be taken into account in multimodal treatment programs.}, language = {de} }