@article{WeckJungaKliegletal.2021, author = {Weck, Florian and Junga, Yvonne Marie and Kliegl, Reinhold and Hahn, Daniela and Brucker, Katharina and Witth{\"o}ft, Michael}, title = {Effects of competence feedback on therapist competence and patient outcome}, series = {Journal of consulting and clinical psychology}, volume = {89}, journal = {Journal of consulting and clinical psychology}, number = {11}, publisher = {American Psychological Association}, address = {Washington}, issn = {0022-006X}, doi = {10.1037/ccp0000686}, pages = {885 -- 897}, year = {2021}, abstract = {Objective: Therapist competence is considered essential for the success of psychotherapy. Feedback is an intervention which has the potential to improve therapist competence. The present study investigated whether competence feedback leads to an improvement of therapist competence and patient outcome. Method: Sixty-seven master-level clinical trainees were randomly assigned to either a competence feedback group (CFG) or a control group (CG). Patients with a diagnosis of major depression (N = 114) were randomly assigned to CFG or CG. Treatment included 20 individual sessions of cognitive behavioral therapy (CBT). In CFG, therapists received, parallel to the treatment, five competence feedbacks, based on videotaped therapy sessions. Independent raters assessed therapist competence with the Cognitive Therapy Scale (CTS) and provided the competence feedback. Patient outcome was evaluated with the Beck Depression Inventory-II (BDI-II) and therapeutic alliance (Helping Alliance Questionnaire [HAQ]) from both therapist's (HAQ-T) and patient's (HAQ-P) perspective were evaluated after each of the 20 sessions. Results: (a) Therapist competence (CTS) increased significantly more for CFG than CG. (b) Depression (BDI-II) decreased significantly across sessions for both groups, but without evidence for a group-differential benefit for the CFG. (c) Therapeutic alliance (HAQ-T/P) increased significantly across sessions for both groups from both perspectives, but without group differences. (d) There is a positive effect of BDI-II on CTS at the beginning and a negative effect of CTS on BDI-II at the end of therapy. Conclusion: Competence feedback improves therapists' independently rated competence, but there is no evidence that competence feedback in CBT leads to better outcome. What is the public health significance of this article? This study suggests the substantial value of systematic competence feedback for improving therapist competence in the psychotherapy of depression. No significant effect of competence feedback on the reduction of reported depressive symptoms was found.}, language = {en} } @article{SalzwedelHauboldBarnacketal.2018, author = {Salzwedel, Annett and Haubold, Kathrin and Barnack, Beate and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {Indikatoren der Ergebnisqualit{\"a}t kardiologischer Rehabilitation Ergebnisse einer Delphi-Befragung von Mitgliedern der Deutschen Gesellschaft f{\"u}r Pr{\"a}vention und Rehabilitation von Herz- und Kreislauferkrankungen e. V. (DGPR)}, series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, volume = {58}, journal = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {0034-3536}, doi = {10.1055/s-0044-101048}, pages = {31 -- 38}, year = {2018}, abstract = {Ziel der Studie Die vorliegende Untersuchung beinhaltete die explorative Erfassung potenzieller Indikatoren der Ergebnisqualit{\"a}t der kardiologischen Rehabilitation (CR) f{\"u}r Patienten unter 65 Jahren. Methoden In einer 4-stufigen webbasierten Delphi-Befragung (04-07/2016) von in der CR t{\"a}tigen {\"A}rzten[2] , Psychologen und Sport-/Physiotherapeuten wurden Parameter der k{\"o}rperlichen Leistungsf{\"a}higkeit, der Sozialmedizin, der subjektiven Gesundheit und kardiovaskul{\"a}re Risikofaktoren hinsichtlich ihrer Eignung als Qualit{\"a}tsindikator bewertet. Ergebnisse Von 44 vorgegebenen wie auch von den Teilnehmern vorgeschlagenen Parametern wurden 21 Parameter (48\%), die H{\"a}lfte davon psychosoziale Faktoren, als potenzielle Qualit{\"a}tsindikatoren ausgew{\"a}hlt, wobei lediglich f{\"u}r das Rauchverhalten, den Blutdruck, das LDL-Cholesterin und die max. Belastbarkeit im Belastungs-EKG ein Konsens (Zustimmung>75\% der Befragten) erzielt wurde. Schlussfolgerung Die Wahl der Qualit{\"a}tsindikatoren durch die Experten erfolgte mehrheitlich mit nur geringer Einigkeit. Eine klinische und wissenschaftliche Evaluierung der gew{\"a}hlten Parameter ist daher zwingend erforderlich.}, language = {de} } @article{LiangHuangLietal.2014, author = {Liang, Xu-Jing and Huang, Si-Min and Li, Jian-Ping and Zhu, Xian-Nv and Lu, Yong-Ping and Hocher, Berthold and Chen, You-Peng}, title = {Hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction}, series = {Clinical laboratory : the peer reviewed journal for clinical laboratories and laboratories related to blood transfusion}, volume = {60}, journal = {Clinical laboratory : the peer reviewed journal for clinical laboratories and laboratories related to blood transfusion}, number = {1}, publisher = {Clin Lab Publ., Verl. Klinisches Labor}, address = {Heidelberg}, issn = {1433-6510}, doi = {10.7754/Clin.Lab.2013.121203}, pages = {63 -- 68}, year = {2014}, abstract = {Background: Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. There is little attention given to hepatic impairment in the adults with scrub typhus. This study investigated the incidence and the prognostic implications of hepatic impairment in patients with scrub typhus. Methods: We retrospectively reviewed a total of 143 adult patients with scrub typhus who were admitted between January 1999 and December 2010 in Guangdong province, China. The patients were divided into three groups, e.g., normal, mild, and moderate to severe groups based on the elevated serum ALT and/or total bilirubin levels. Furthermore, clinical characteristics and prognosis of the patient groups were compared. Results: 109 patients (76.2\%) had abnormal liver function. Among the patients with hepatic impairment 45 cases (31.4\%), 54 cases (37.8\%), and 10 cases (7.0\%) had mild, moderate, and severe hepatic damage, respectively. The moderate to severe hepatic impairment group had higher levels of serum creatinine compared with that of normal hepatic function. The incidence of new onset of renal dysfunction - defined as peak serum creatinine >= 176 mu mol/L during hospital stay with no evidence of renal disease prior hospitalization - was 0\% in the mild hepatic impairment group, 8.9\% in the moderate hepatic impairment group, and 21.9\% in the severe hepatic impairment group, (p = 0.005 for trend). Additionally, the patients with hepatic impairment (n = 109) had higher incidences of episodes of thrombocytopenia (45.9\% vs. 8.82\%, p < 0.001), hypoalbuminemia (50.5\% vs. 11.8\%, p < 0.001), new onset of renal dysfunction (16.5\% vs. 0.0\%, p = 0.011), and electrocardiogram abnormality (28.4\% vs. 8.82\%, p = 0.019) than the patients without hepatic impairment. Conclusions: The degree of hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction.}, language = {en} } @article{RoehrigNosperLinckEleftheriadisetal.2014, author = {Roehrig, B. and Nosper, M. and Linck-Eleftheriadis, S. and Strandt, G. and Salzwedel, Annett and V{\"o}ller, Heinz}, title = {Method of the assessment of patients Outcome in cardiac rehabilitation by means of quality indicators - a description of the method}, series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, volume = {53}, journal = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {0034-3536}, doi = {10.1055/s-0033-1341457}, pages = {31 -- 37}, year = {2014}, abstract = {Introduction: Cardiac rehabilitation is designed for patients suffering from cardiovascular diseases or functional disabilities. The aim of a cardiac rehabilitation is to improve overall physical health, psychological well-being, physical function, the ability to participate in social life and help patients to change their habits. Regarding the heterogeneity of these aims measuring of the effect of cardiac rehabilitation is still a challenge. This study recommends a concept to assess the effects of cardiac rehabilitation regarding the individual change of relevant quality indicators. Methods: With EVA-Reha; cardiac rehabilitation the Medical Advisory Service of Statutory Health Insurance Funds in Rhineland-Palatinate, Alzey (MDK Rheinland-Pfalz) developed a software to collect data set including sociodemographic and diagnostic data and also the results of specific assessments. The project was funded by the Techniker Krankenkasse, Hamburg, and supported by participating rehabilitation centers. From 01. July 2010 to 30. June 2011 1309 patients (age 71.5 years, 76.1\% men) from 13 rehabilitation centers were consecutively enrolled. 13 quality indicators in 3 scales were developed for evaluation of cardiac rehabilitation: 1) cardiovascular risk factors (blood pressure, LDL cholesterol, triglycerides), 2) exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure [NYHA classification], and angina pectoris [CCS classification]) and 3) subjective health (IRES-24: pain, somatic health, psychological wellbeing and depression as well as anxiety on the HADS). The study was prospective; data of patients were assessed at entry and discharge of rehabilitation. To measure the success of rehabilitation each parameter was graded in severity classes at entry and discharge. For each of the 13 quality indicators changes of severity class were rated in a rating matrix. For indicators without a requirement for medical care neither at entry nor at discharge no rating was performed. Results: The grading into severity classes as well as the minimal important differences were given for the 13 quality indicators. The result of rehabilitation can be demonstrated in suitable form by means of rating of the 13 quality indicators according to a clinical population. The rating model differs well between clinically changed and unchanged patients for the quality indicators. Conclusion: The result of cardiac rehabilitation can be assessed with 13 quality indicators measured at entry and discharge of the rehabilitation program. If a change into a more favorable category at the end of rehabilitation could be achieved it was counted as a success. The 13 quality indicators can be used to assess the individual result as well as the result of a population - e.g. all patients of a clinic in a specific time period. In addition, the assessment and rating of relevant quality indicators can be used for comparisons of rehabilitation centers.}, language = {de} } @article{ChaudharyWalchHeroldetal.2013, author = {Chaudhary, Tanja and Walch, Elisabeth and Herold, Birgit and Metze, B. and Lejeune, A. and Burkhardt, F. and Buehrer, C.}, title = {Predictive and concurrent validity of standardized neurodevelopmental examinations by the griffiths scales and bayley scales of infant development II}, series = {Klinische P{\"a}diatrie : clinical research and practice in pediatrics}, volume = {225}, journal = {Klinische P{\"a}diatrie : clinical research and practice in pediatrics}, number = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {0300-8630}, doi = {10.1055/s-0032-1331169}, pages = {8 -- 12}, year = {2013}, abstract = {Background: Standardized examinations of preterm infants are used to identify candidates for early intervention. We aimed to assess the predictive power and concurrent validity of the mental development index of the Bayley scales of infant development II (Bayley MDI) and the Griffiths scales developmental quotient (Griffiths DQ) in healthy term and preterm infants < 1 500 g birth weight without major perinatal complications. Methods: 137 Infants (89 term, 48 preterm) were examined by both tests at a corrected age of 6, 12, and 22 months, and 114 went on to undergo Bayley assessments at 39 months. Results: There were significant correlations between Bayley and Griffiths results at 6, 12, and 22 months (r = 0.530, 0.714, and 0.833, respectively, p < 0.001) but Bland Altman plots revealed major systematic bias at 6 months (Griffiths > Bayley, mean differences 14.3 +/- 9.8) and 22 months (Bayley > Griffiths, mean difference 5.2 +/- 13.9) and wide 95\% limits of agreement at 6, 12 and 22 months (35.9\%, 40.0\%, and 52.4\%, respectively). The agreement for a presumptive diagnosis of developmental impairment in the group of preterm infants between Bayley examinations obtained at 39 months corrected age (reference) and previous examinations was poor at 6, 12, and 22 months for both Bayley and Griffiths (Cohen's kappa for Griffiths: 0.225, 0.192, 0.369; for Bayley: 0.121, 0.316, 0.369, respectively). Conclusion: Caution should be exercised when interpreting results from standardized neurodevelopmental examinations obtained during the first 2 years of life in comparatively well preterm infants.}, language = {en} }