TY - BOOK A1 - Drathschmidt, Nicolas T1 - Umgang von Verwaltungsmitarbeitenden mit Red Tape T3 - BestMasters (BEST) N2 - Wesenskern der Verwaltungswissenschaft ist nach wie vor die Frage nach Dysfunktionalitäten bürokratischer Organisationen. Schwerfälligkeit durch überbordende Bürokratie wird in der Forschung hierbei als Red Tape bezeichnet. Aufgrund der relationalen Beschaffenheit ist die Frage weniger, was alles Red Tape ist, sondern vielmehr wie Verwaltungsmitarbeitende mit Red Tape umgehen. Diese Arbeit soll dazu beitragen, Bewältigungsstrategien, auch Coping genannt, bezogen auf Red Tape zu verstehen. Mittels Survey-Experiment wird untersucht, inwieweit die individuelle Bewältigungsstrategie durch die Form (analog/digital), über die Red Tape transportiert wird, und den Ursprung (intern/extern), von dem Red Tape ausgeht, beeinflusst wird. Die Ergebnisse zeigen unter Berücksichtigung des transaktionalen Stressmodells von Lazarus und Folkman, dass Mitarbeitende der Verwaltung insbesondere dann aktive Bewältigungsstrategien auswählen, wenn diese durch externe Quellen hervorgerufen wird und zudem analog vorliegt. KW - Coping KW - survey experiment KW - Bürokratie KW - Digitalisierung KW - Red Tape KW - Verwaltung KW - Stress Y1 - 2022 SN - 978-3-658-39764-7 SN - 978-3-658-39765-4 U6 - https://doi.org/10.1007/978-3-658-39765-4 PB - Springer VS CY - Wiesbaden ER - TY - JOUR A1 - Ewert, Christina A1 - Hoffmann, Cosma Frauke Antonia A1 - Schröder-Abé, Michela T1 - Stress processing mediates the link between momentary self-compassion and affective well-being JF - Mindfulness N2 - Objectives While the positive effects of trait self-compassion on affective well-being are widely known, within-person effects of state self-compassion and underlying mechanisms between state self-compassion and affective well-being have rarely been investigated. The current study aimed at examining whether perceived stress and healthier coping responses are mediators in the relation between momentary self-compassion and affective well-being. Methods A total of 213 participants completed measures of momentary self-compassion, momentary perceived stress, and engagement and disengagement coping responses, as well as affective well-being (i.e., presence of positive and absence of negative affect) via their smartphones. The ambulatory assessment design included three measurements per day (morning, afternoon, evening) for 7 days. Results Multilevel modeling revealed that within-persons, momentary levels of self-compassion were related to momentary levels of stress, coping responses, and affective well-being components. 1-1-1 multilevel mediation analyses were conducted and demonstrated that, at the within-person level, momentary self-compassion was related to more positive and less negative affect via perceived stress and facilitating healthy coping responses. The within-person relations of the original 1-1-1 multilevel mediation could partially be replicated in an alternative model with momentary self-compassion one occasion prior and positive affect. However, the link between self-compassion one occasion prior and negative affect was only mediated by perceived stress. Conclusions This work helps to understand the processes underlying the adaptive effects of momentary self-compassion on momentary affective well-being on a given occasion. Theoretical and practical implications of these findings are discussed. KW - Self-compassion KW - Stress processing KW - Coping KW - Affective well-being Y1 - 2022 U6 - https://doi.org/10.1007/s12671-022-01954-z SN - 1868-8527 SN - 1868-8535 VL - 13 IS - 9 SP - 2269 EP - 2281 PB - Springer CY - Dordrecht ER - TY - THES A1 - Ewert, Christina T1 - The role of self-compassion in effective stress processing T1 - Die Rolle von Selbstmitgefühl bei einer effektiven Stressverarbeitung BT - a multimethod approach BT - eine multimethodische Analyse N2 - Background: The concept self-compassion (SC), a special way of being compassionate with oneself while dealing with stressful life circumstances, has attracted increasing attention in research over the past two decades. Research has already shown that SC has beneficial effects on affective well-being and other mental health outcomes. However, little is known in which ways SC might facilitate our affective well-being in stressful situations. Hence, a central concern of this dissertation was to focus on the question which underlying processes might influence the link between SC and affective well-being. Two established components in stress processing, which might also play an important role in this context, could be the amount of experienced stress and the way of coping with a stressor. Thus, using a multi-method approach, this dissertation aimed at finding to which extent SC might help to alleviate the experienced stress and promotes the use of more salutary coping, while dealing with stressful circumstances. These processes might ultimately help improve one’s affective well-being. Derived from that, it was hypothesized that more SC is linked to less perceived stress and intensified use of salutary coping responses. Additionally, it was suggested that perceived stress and coping mediate the relation between SC and affective well-being. Method: The research questions were targeted in three single studies and one meta-study. To test my assumptions about the relations of SC and coping in particular, a systematic literature search was conducted resulting in k = 136 samples with an overall sample size of N = 38,913. To integrate the z-transformed Pearson correlation coefficients, random-effects models were calculated. All hypotheses were tested with a three-wave cross-lagged design in two short-term longitudinal online studies assessing SC, perceived stress and coping responses in all waves. The first study explored the assumptions in a student sample (N = 684) with a mean age of 27.91 years over a six-week period, whereas the measurements were implemented in the GESIS Panel (N = 2934) with a mean age of 52.76 years analyzing the hypotheses in a populationbased sample across eight weeks. Finally, an ambulatory assessment study was designed to expand the findings of the longitudinal studies to the intraindividual level. Thus, a sample of 213 participants completed questionnaires of momentary SC, perceived stress, engagement and disengagement coping, and affective well-being on their smartphones three times per day over seven consecutive days. The data was processed using 1-1-1 multilevel mediation analyses. Results: Results of the meta-analysis indicated that higher SC is significantly associated with more use of engagement coping and less use of disengagement coping. Considering the relations between SC and stress processing variables in all three single studies, cross-lagged paths from the longitudinal data, as well as multilevel modeling paths from the ambulatory assessment data indicated a notable relation between all relevant stress variables. As expected, results showed a significant negative relation between SC and perceived stress and disengagement coping, as well as a positive connection with engagement coping responses at the dispositional and intra-individual level. However, considering the mediational hypothesis, the most promising pathway in the link between SC and affective well-being turned out to be perceived stress in all three studies, while effects of the mediational pathways through coping responses were less robust. Conclusion: Thus, a more self-compassionate attitude and higher momentary SC, when needed in specific situations, can help to engage in effective stress processing. Considering the underlying mechanisms in the link between SC and affective well-being, stress perception in particular seemed to be the most promising candidate for enhancing affective well-being at the dispositional and at the intraindividual level. Future research should explore the pathways between SC and affective well-being in specific contexts and samples, and also take into account additional influential factors. N2 - Hintergrund: In den letzten zwei Jahrzehnten erregte das Konzept Selbstmitgefühl (SMG), eine besondere Art des Mitgefühls um sich im Umgang mit stressigen Lebensumständen zurechtzufinden, zunehmend Aufmerksamkeit in der Forschung. Zahlreiche Untersuchungen haben bereits gezeigt, dass SMG positive Auswirkungen auf das affektive Wohlbefinden sowie auf die psychische Gesundheit im Allgemeinen hat. Allerdings ist wenig darüber bekannt wie SMG unser affektives Wohlbefinden in Stresssituationen verbessern kann. Daher war es ein zentrales Anliegen dieser Dissertation, die Frage zu beantworten, welche zugrundeliegenden Prozesse den Zusammenhang zwischen SMG und affektivem Wohlbefinden beeinflussen können. Zwei etablierte Komponenten im Stressverarbeitungsprozess, die in diesem Zusammenhang ebenfalls eine wichtige Rolle spielen könnten, sind die Menge an erlebtem Stress sowie die Art und Weise, wie mit einem Stressor umgegangen wird (Coping). Unter Verwendung eines Multimethodenansatzes, war es demnach Ziel dieser Dissertation herauszufinden, inwieweit SMG dazu beitragen kann, den erlebten Stress abzumildern und eine heilsamere Bewältigung im Umgang mit stressigen Situationen zu fördern. Diese Prozesse könnten letztendlich dazu beitragen, das affektive Wohlbefinden zu verbessern. Daraus abgeleitet, wurde die Hypothese aufgestellt, dass mehr SMG mit weniger wahrgenommenem Stress und einem intensiveren Gebrauch von protektiven Bewältigungsreaktionen verbunden ist. Darüber hinaus wurde vermutet, dass wahrgenommener Stress und Coping den Zusammenhang zwischen SMG und affektivem Wohlbefinden vermitteln. Methode: Zur Beantwortung der Forschungsfragen wurden drei Einzelstudien und eine Metastudie konzipiert. Um die Annahmen über die Zusammenhänge von SMG und Bewältigungsstrategien zu überprüfen, wurde eine systematische Literaturrecherche durchgeführt. Die durchgeführte Suche ergab k = 136 Stichproben mit einer Gesamtstichprobengröße von N = 38.913. Zur Integration der z-transformierten Pearson-Korrelationskoeffizienten wurden Random-Effects-Modelle berechnet. In zwei Längsschnittstudien wurden alle Hypothesen mit einem Drei-Wellen-Cross-Lagged-Design überprüft, um die Zusammenhänge von SMG, wahrgenommenem Stress und Bewältigungsreaktionen zu bewerten. Die erste Studie untersuchte über einen Zeitraum von 12 Wochen die Annahmen anhand einer Stichprobe von Studenten (N = 684) mit einem Durchschnittsalter von 27,91 Jahren. Die zweite Studie fand im Rahmen einer bevölkerungsbasierten Paneluntersuchung (GESIS) in einem Zeitraum von 4 Monaten statt. An der Befragung nahmen N = 2934 mit einem Durchschnittsalter von 52,76 Jahren teil. Abschließend wurde eine Ambulante Assessmentstudie konzipiert, mit Hilfe dieser sollten die Hypothesen auf der intraindividuellen Ebene überprüft werden. 213 TeilnehmerInnen füllten Fragebögen zu momentanem SC, wahrgenommenem Stress, verwendeten Copingstrategien und affektivem Wohlbefinden dreimal täglich auf ihren Smartphones an sieben aufeinanderfolgenden Tagen aus. Die Daten wurden mithilfe von 1-1-1-Multilevel-Mediationsanalysen analysiert. Ergebnisse: Die Ergebnisse der Metaanalyse zeigten, dass eine Ausprägung in SMG signifikant mit mehr Einsatz von Annäherungscoping und weniger Einsatz von Vermeidungscoping verbunden ist. Sowohl die cross-lagged Pfade der Längstschnittstudien als auch die Pfade der Mehrebenenanalysen des Ambulanten Assessments zeigten erwartete Zusammenhänge zwischen SMG und allen relevanten Stressvariablen. Wie erwartet, zeigte sich ein signifikant negativer Zusammenhang zwischen SMG und wahrgenommenem Stress sowie Vermeidungscoping sowohl auf dispositioneller als auch intraindividueller Ebene. Des Weiteren wurde ein positiver Zusammenhang mit Annäherungscoping auf beiden Ebenen gefunden. Die Mediationshypothese konnte nur teilweise bestätigt werden. So erwies sich der Mediator wahrgenommener Stress als konsistent im Zusammenhang zwischen SMG und affektivem Wohlbefinden in allen drei Studien, während die Mediationspfade für Coping weniger robust waren. Fazit: Eine selbstmitfühlendere Haltung sowie höheres momentanes SMG kann in bestimmten Situationen dabei helfen, Stress effektiver zu bewältigen. Insbesondere weniger Stresswahrnehmung scheint ein vielversprechender Kandidat in der Vermittlung des Zusammenhangs zwischen SMG und affektivem Wohlbefinden auf dispositionell und auf intraindividueller Ebene zu sein. Personen mit mehr SMG erleben in anspruchsvollen Situationen weniger Stress, was schon von Beginn des stressigen Erlebnisses für das AWB förderlich sein kann, ohne dass weitere Bewältigungsreaktionen erforderlich werden. Zukünftige Forschung sollte zugrundeliegende Mechanismen zwischen SMG und affektivem Wohlbefinden in spezifischen Kontexten und Stichproben untersuchen, und auch weitere Einflussfaktoren berücksichtigen. KW - self-compassion KW - Selbstmitgefühl KW - stress processing KW - Stressverarbeitung KW - coping KW - Coping KW - well-being KW - Wohlbefinden Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-607486 ER - TY - JOUR A1 - Ewert, Christina A1 - Vater, Annika A1 - Schröder-Abé, Michela T1 - Self-compassion and coping BT - a meta-analysis JF - Mindfulness N2 - Objectives: Self-compassion, a positive and caring attitude toward oneself, has been identified as an important correlate of coping in stressful situations. High self-compassion is related to higher use of adaptive and less maladaptive coping in demanding or painful situations. However, estimates of these relations in terms of specific adaptive and maladaptive coping strategies have remained inconclusive. Therefore, the present meta-analysis investigates the relation between self-compassion and different forms of adaptive and maladaptive coping. It also takes into account potential moderators such as age, gender, and regional background. Methods: A systematic literature search resulted in k = 136 samples with an overall sample size of N = 38,913. Random-effects models were used to integrate the z-transformed Pearson correlation coefficients. Results: Analyses yielded a positive correlation between self-compassion and adaptive coping (r = .306) and a negative correlation between self-compassion and maladaptive coping (r = - .500). The association of self-compassion with emotional approach coping was positive (r = .340), as was the association with problem-focused coping (r = .205). Participants' age appeared to be a significant moderator of the relation between self-compassion and coping. Conclusions: Self-compassion is important for understanding the mechanisms involved in coping with stress and demanding life events. The size and direction of correlations depend on the coping strategies considered, with protective effects of self-compassion with respect to maladaptive coping being the most pronounced. Further research should examine the relation between self-compassion and coping in more detail and focus on additional moderators. KW - Meta-analysis KW - Self-compassion KW - Coping KW - Stress regulation Y1 - 2021 U6 - https://doi.org/10.1007/s12671-020-01563-8 SN - 1868-8527 SN - 1868-8535 VL - 12 IS - 5 SP - 1063 EP - 1077 PB - Springer CY - Dordrecht ER - TY - GEN A1 - Warschburger, Petra A1 - Petersen, Ann-Christin A1 - von Rezori, Roman Enzio A1 - Buchallik, Friederike A1 - Baumeister, Harald A1 - Holl, Reinhard A1 - Minden, Kirsten A1 - Müller-​Stierlin, Annabel Sandra A1 - Reinauer, Christina A1 - Staab, Doris A1 - COACH consortium, T1 - A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 762 KW - Chronic conditions KW - Adolescents KW - Prospective KW - Quality of life KW - Resiliency KW - Coping KW - Protective factors KW - Type 1 diabetes KW - Juvenile idiopathic arthritis KW - Cystic fibrosis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-549951 SN - 1866-8364 VL - 21 SP - 1 EP - 13 PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Warschburger, Petra A1 - Petersen, Ann-Christin A1 - von Rezori, Roman Enzio A1 - Buchallik, Friederike A1 - Baumeister, Harald A1 - Holl, Reinhard A1 - Minden, Kirsten A1 - Müller-​Stierlin, Annabel Sandra A1 - Reinauer, Christina A1 - Staab, Doris A1 - COACH consortium, T1 - A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study JF - BMC Pediatrics N2 - 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. KW - Chronic conditions KW - Adolescents KW - Prospective KW - Quality of life KW - Resiliency KW - Coping KW - Protective factors KW - Type 1 diabetes KW - Juvenile idiopathic arthritis KW - Cystic fibrosis Y1 - 2021 U6 - https://doi.org/10.1186/s12887-021-02869-9 SN - 1471-2431 VL - 21 SP - 1 EP - 13 PB - BMC pediatrics CY - London ER - TY - JOUR A1 - Ewert, Christina A1 - Gaube, Benjamin A1 - Geisler, Fay Caroline Mary T1 - Dispositional self-compassion impacts immediate and delayed reactions to social evaluation JF - Personality and individual differences : an international journal of research into the structure and development of personality, and the causation of individual differences N2 - In the present study, we investigated the beneficial effects of trait self-compassion (SC) on perceived stress, shame, and the use of coping strategies in reaction to a socio-evaluative stressor while controlling for the effects of neuroticism (N) and conscientiousness (C). Participants (N = 105) performed a mental-arithmetic task with immediate in-person feedback. SC predicted less perceived stress and shame immediately after the stressor. Additionally, SC predicted less shame after a short recovery phase. This effect was fully mediated by less use of denial. Furthermore, SC buffered the effect of N on the use of denial, and C on shame after recovery. SC also predicted more use of positive reframing. Thus, SC may make a socio-evaluative stressor less threatening and may thwart a shame-inducing conception of the stressor by promoting clearer processing. Furthermore, SC may be especially beneficial for those vulnerable to dysfunctional coping and negative self-conscious emotions. This study contributes to the understanding of how trait self-compassion beneficially influences the processing of stressful situations. KW - Self-compassion KW - Stress KW - Coping KW - Shame KW - Social evaluation KW - Denial KW - Acceptance KW - Positive refraining Y1 - 2018 U6 - https://doi.org/10.1016/j.paid.2017.12.037 SN - 0191-8869 VL - 125 SP - 91 EP - 96 PB - Elsevier CY - Oxford ER - TY - THES A1 - Berding, Anja T1 - Kurz-, mittel- und langfristige Effekte einer Schulung für Patienten mit chronisch entzündlichen Darmerkrankungen auf krankheitsbezogene Ängste und Gesundheitskompetenzen T1 - Beneficial short-, medium-, and long-term effects of education on disease-related worries and concerns and health competencies in patients with inflammatory bowel diseases N2 - Menschen mit chronisch entzündlichen Darmerkrankungen (CED) leiden unter vielfältigen körperlichen und psychosozialen Einschränkungen. Wie auch bei anderen chronischen Erkrankungen könnten Patientenschulungen ihr psychisches Befinden verbessern (z.B. De Ridder & Schreurs, 2001; Faller, Reusch & Meng, 2011a; Küver, Becker & Ludt, 2008; Schüssler, 1998; Warsi, Wang, LaValley, Avorn & Solomon, 2004). Für CED liegen jedoch nur wenige Schulungsevaluationen vor (z.B. Bregenzer et al., 2005; Mussell, Böcker, Nagel, Olbrich & Singer, 2003; Oxelmark, Magnusson, Löfberg & Hillerås, 2007), deren Aussagekraft i.d.R. durch methodische Mängel eingeschränkt ist. Daher ist die Bedeutung von Schulungsprogrammen für CED-Betroffene weiterhin offen. Überdies gibt es für den deutschen Sprachraum noch keine Schulung, die zu psychischen Verbesserungen führt. Aus diesem Grunde wurde ein 1,5-tägiges Wochenend-Seminar mit medizinischen und psychologischen Inhalten konzeptionalisiert, manualisiert und in der vorliegenden Studie evaluiert. Zur summativen Evaluation nahmen 181 ambulante CED-Patienten an einer prospektiven, multizentrischen, randomisierten, kontrollierten Studie mit vier Messzeitpunkten teil: vor (T1), zwei Wochen (T2) und drei Monate (T3) nach dem Seminar. Zur 12-Monatskatamnese (T4EG) wurde die Stabilität der Effekte in der Experimentalgruppe (EG; n = 86) überprüft. Die Wartekontrollgruppe (n = 95) erhielt zunächst die Standardbehandlung, also keine Patientenschulung, und konnte an dieser nach der dritten Datenerhebung ebenfalls teilnehmen. Kovarianzanalysen (ANCOVAs) mit Kontrolle für die jeweilige Ausgangslage wurden durchgeführt. Weitere Analysen legten eine Adjustierung für die Krankheitsaktivität zu T1 nahe, weshalb diese als zusätzliche Kovariate in die ANCOVAs aufgenommen wurde. Krankheitsbezogene Ängste und Sorgen (PS-CEDE Gesamtwert zu T3; Krebs, Kachel & Faller, 1998) fungierten als primärer Zielparameter. Zu den sekundären Zielkriterien gehörten Progredienzangst und Angstbewältigung (PA-F-KF und PA-F; Mehnert, Herschbach, Berg, Henrich & Koch, 2006 bzw. Dankert et al., 2003; Herschbach et al., 2005) sowie die Gesundheitskompetenzen Positive Grundhaltung, Aktive Lebensgestaltung und Erwerb von Fertigkeiten und Handlungsstrategien (heiQ; Osborne, Elsworth & Whitfield, 2007; Schuler et al., 2013). Weitere sekundäre Zielparameter waren gesundheitsbezogene Lebensqualität (SF-12; Bullinger & Kirchberger, 1998), Symptome einer Angststörung oder Depression (PHQ-4; Kroenke, Spitzer, Williams & Löwe, 2009; Löwe et al., 2010), Wissen, der Umgang mit der CED bzw. von ihr ausgelösten negativen Gefühlen sowie die Zufriedenheit der Teilnehmenden mit dem Seminar. Von Interesse war außerdem, ob Geschlecht, Alter, Art, Dauer oder Aktivität der Erkrankung vor der Schulung einen Einfluss auf die genannten Variablen hatten und ob für sie differentielle Wirksamkeitseffekte bestanden. Darüber hinaus wurden krankheitsbezogene Ängste und Sorgen von ungeschulten Studienteilnehmern untersucht. Zwei Wochen und drei Monate nach der Schulung ließen sich im Vergleich von Experimental- und Kontrollgruppe signifikante, mittlere bis große Effekte auf krankheitsbezogene Ängste und Sorgen, Progredienzangst und deren Bewältigung sowie eine Positive Grundhaltung der CED gegenüber erzielen (stets p ≤ .001). Außerdem kam es zu beiden Messzeitpunkten zu signifikanten, großen Interventionseffekten auf den Erwerb von Fertigkeiten und Handlungsstrategien im Umgang mit der Erkrankung, das Wissen um sie und den Umgang mit ihr (stets p < .001) sowie zu moderaten Effekten auf den Umgang mit CED-bedingten negativen Gefühlen (T2: p = .001; T3: p = .008). Alle beschriebenen Effekte waren auch nach zwölf Monaten noch stabil. Für Aktive Lebensgestaltung, gesundheitsbezogene Lebensqualität sowie Angst- und Depressionssymptomatik konnten keine Schulungseffekte nachgewiesen werden. Die zusätzliche Kontrolle für die Krankheitsaktivität zu T1 führte zu keinen wesentlichen Änderungen in den Ergebnissen. Auch bei den Subgruppenanalysen hatte die Krankheitsaktivität keinen relevanten Einfluss auf die Wirksamkeit der Schulung. Gleiches gilt für Geschlecht, Alter, Art und Dauer der CED. Mit Ausnahme der Krankheitsaktivität deuteten dies bereits die zur Baseline durchgeführten t-Tests an, bei denen insgesamt nur sehr wenige signifikante, höchstens moderate Unterschiede zwischen den einzelnen Subgruppen auftraten. Sowohl bei der formativen als auch der summativen Evaluation zeigte sich überdies die hohe Zufriedenheit der Teilnehmenden mit der Schulung. Neben der Akzeptanz konnte außerdem die Durchführbarkeit bestätigt werden. Die Auswertung der Ängste und Sorgen der Studienteilnehmenden lieferte zudem Hinweise für die Entwicklung und Modifikation von Interventionen für CED-Betroffene. Es lässt sich festhalten, dass für die hier evaluierte Schulung für CED-Patienten ein Wirksamkeitsnachweis erbracht werden konnte und sie sehr positiv von den Teilnehmenden bewertet wurde. Sie führte sowohl kurz-, mittel- als auch langfristig zu substantiellen Verbesserungen in psychischer Belastung, Selbstmanagement-Fähigkeiten, der Bewältigung der Erkrankung sowie im Wissen und war gleichermaßen wirksam bei Betroffenen, die sich in Geschlecht, Alter, Art, Dauer oder Aktivität ihrer CED unterschieden. N2 - People with inflammatory bowel diseases (IBD) are affected by a wide range of somatic and psychosocial impairments. As in other chronic conditions, patient education might improve their well-being (e.g., De Ridder & Schreurs, 2001; Faller et al., 2011a; Küver et al., 2008; Schüssler, 1998; Warsi et al., 2004). In IBD only a few evaluations of education programs are available (e.g., Bregenzer et al., 2005; Mussell et al., 2003; Oxelmark et al., 2007) whose significance is limited due to several methodological flaws. The impact of education in IBD remains therefore unclear. Furthermore, there is no program contributing to psychological improvements for the German-speaking area so far. Thus, a manualized 1.5-day weekend-seminar for IBD patients, addressing medical and psychological issues, was designed. The main aim of this study was to evaluate it in a large controlled trial. For summative evaluation, 181 outpatients participated in a prospective, multicenter, randomized, waitlist-controlled trial with assessments before (t1) as well as two weeks (t2) and three months (t3) after the seminar. Patients serving as waitlist controls (n = 95) received treatment as usual (no patient education) and were also offered to participate in the intervention after the third data collection. The intervention group (IG, n = 86) was reassessed for stability of effects at the 12-months follow-up (t4IG). Analysis of covariance (ANCOVA) with adjustment for the respective baseline score was used. Due to further analyses, which suggested a control for baseline perceived disease activity, the ANCOVAs were repeated with that additional covariate. Disease-related worries and concerns (IBDPC total score at t3, German validation by Krebs et al., 1998; original: RFIPC by Drossman et al., 1991) were the primary outcome. Secondary outcomes included fear of progression and coping with anxiety (FoP-Q-SF; Mehnert et al., 2006; FoP-Q; Dankert et al., 2003; Herschbach et al., 2005), and the following three health competencies: constructive attitudes and approaches, skill and technique acquisition as well as positive and active engagement in life (heiQ; Osborne et al., 2007; Schuler et al., 2013). Further sec¬ondary outcomes were health-related quality of life (HRQoL; SF-12; Bullinger & Kirchberger, 1998), symptoms of depression and anxiety (PHQ-4; Kroenke et al., 2009; Löwe et al., 2010), disease-related knowledge, coping, and participants’ satisfaction with the seminar. It was also of interest, if patient characteristics like sex, age, type, duration or activity of IBD influenced those variables at baseline and if differential effects of the intervention existed. Moreover, baseline disease-related worries and concerns were analyzed. At two weeks and three months post-intervention, significant medium to large effects on disease-related worries and concerns, fear of progression, and coping with anxiety as well as constructive attitudes and approaches could be achieved (each p ≤ .001). In addition, large significant effects on skill and technique acquisition, knowledge, and coping with IBD (each p < .001) and medium effects on coping with disease-related negative emotions (t2: p = .001; t3: p = .008) were found. All aforementioned effects persisted even after one year. Effects on positive and active engagement in life, HRQoL as well as symptoms of anxiety and depression could not be observed. Additional adjustment for perceived disease activity basically yielded similar results. Moreover, subgroup analyses did not show any relevant influence of disease activity on the effectiveness of the intervention. The same applies to participants’ sex and age as well as their type of IBD and its duration. With the exception of disease activity, this was already suggested by t-tests performed at baseline, which showed only very few significant differences of moderate size between subgroups. Furthermore, for formative and summative evaluation the education program was rated very favorably by the attendees. In addition to its acceptance, its feasibility was confirmed. The results of the analyses of study participants’ disease-related worries and concerns can be used for the develop¬ment and modification of interventions for patients with IBD. In conclusion, the patient education program tested in this study proved to be effective and was appreciated by the attendees. It contributed to substantial short-, medium-, and even long-term improvements in psychological distress, self-management skills, coping with IBD, and knowledge, which were independent of sex, age, type, duration, or activity of IBD. KW - Patientenschulung KW - chronisch entzündliche Darmerkrankungen KW - Krankheitsbewältigung KW - Lebensqualität KW - Selbstmanagement KW - Ängste und Sorgen KW - Progredienzangst KW - Depression KW - Wissen KW - Coping KW - patient education KW - Morbus Crohn KW - Colitis ulcerosa KW - inflammatory bowel disease KW - Crohn's disease KW - ulcerative colitis KW - coping KW - disease management KW - self-management KW - quality of life KW - worries and concerns KW - fear of progression KW - anxiety KW - depression KW - knowledge Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401063 ER - TY - JOUR A1 - Gross, Martina A1 - Warschburger, Petra T1 - Chronic abdominal pain psychosocial strain and treatment-associated changes in coping JF - Verhaltenstherapie N2 - Background: Chronic abdominal pain (CAP) in childhood is a commonly occurring condition and shows a high stability. Psychosocial dysfunctioning of children, such as increased stress experience, is a burden for children and parents and complicates clinical management. Additional comorbid disorders may develop. To minimize the onset of such disorders, treatment at an early stage and taking psychosocial aspects into consideration is strongly recommended. Through this approach, the cognitive-behavioral, child-centered group program 'Stop the pain with Happy-Pingu' was developed, applied, and subsequently evaluated. What is the psychosocial situation of the affected children? Can the cognitive-behavioral group program be applied to improve psychosocial limitations? Method: The cognitive-behavioral group program comprises 6 weekly sessions for children and 1 single meeting for parents. In a randomized controlled study, the program was evaluated with 29 children aged between 6 and 12 years. The evaluation was based on a comparison between the intervention group (IG) and the waiting list control group (WLC), measured at 3 measurement points: T1 (pre), T2 (post), and T3 (3-month follow-up). Results: Emotional problems in particular can emerge in children with CAP. The program was well received, with a high level of participation through to completion. The results demonstrate that children participating in the IG experience significant stress reduction and improved psychosocial functioning compared to children participating in the WLC. The effect sizes range from medium to high. Conclusions: Drawing upon the above findings, multimodal cognitive-behavioral techniques appear to be suitable to successfully treat children with CAP. However, further controlled studies are required to identify the specific elements of the training that are most effective in reducing pain. KW - Cognitive-behavioral therapy KW - Children KW - Abdominal pain KW - Psychosocial functioning KW - Coping Y1 - 2013 U6 - https://doi.org/10.1159/000351215 SN - 1016-6262 VL - 23 IS - 2 SP - 80 EP - 89 PB - Karger CY - Basel ER -