TY - JOUR A1 - Zech, Philipp A1 - Schuch, Felipe A1 - Pérez Chaparro, Camilo Germán Alberto A1 - Kangas, Maria A1 - Rapp, Michael Armin A1 - Heissel, Andreas T1 - Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV BT - The HIBES Cohort Study JF - International Journal of Environmental Research and Public Health N2 - (1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors. KW - HIV KW - exercise intensity KW - quality of life KW - comorbidity Y1 - 2020 U6 - https://doi.org/10.3390/ijerph17145138 SN - 1660-4601 SN - 1661-7827 VL - 17 IS - 14 PB - MDPI AG CY - Basel ER - TY - GEN A1 - Zech, Philipp A1 - Schuch, Felipe A1 - Pérez Chaparro, Camilo Germán Alberto A1 - Kangas, Maria A1 - Rapp, Michael Armin A1 - Heissel, Andreas T1 - Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV BT - The HIBES Cohort Study T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - (1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 661 KW - HIV KW - exercise intensity KW - quality of life KW - comorbidity Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-480289 SN - 1866-8364 IS - 661 ER - TY - THES A1 - Zech, Philipp T1 - Effects of exercise on different parameters in people living with HIV N2 - Hintergrund. Personen, die mit der chronischen Erkrankung HIV leben (PWH), müssen ihr Leben lang die sog. antiretrovirale Therapie (ART) einnehmen, um einen Ausbruch der Erkrankung in das Vollbild AIDS (Akquiriertes Immun-Defizienz-Syndrom) zu vermeiden. Gleichzeitig ist die ART und HIV selbst assoziiert mit dem Auftreten zusätzlicher Erkrankungen (Komorbiditäten) kardiovaskulärer oder psychologischer Natur. Die Prävalenz von Komorbiditäten und schlechter Lebensqualität ist im Vergleich zu HIV-negativen Personen deutlich höher. Methoden. Es wurden zwei Metaanalysen zu sportlicher Betätigung, PWH und (1) kardiovaskulären und (2) psychologischen Parametern sowie eine Querschnittsstudie (HIBES-Studie, HIV-Begleiterkrankungen und Sport) durchgeführt. Für die Auswertung der metaanalytischen Daten wurde der Review Manager 5.3, für die Auswertung der Daten der HIBES-Studie das Analyseprogramm „R“ verwendet. In den Metaanalysen wurden, neben den Hauptanalysen verschiedener Parameter, erstmals spezifische Subgruppenanalysen durchgeführt. Die HIBES-Studie untersuchte Unterschiede zwischen kumulativen (2-3 verschiedenen Sportarten pro Woche) und einfachen (eine Sportart pro Woche) Freizeitsport und analysiert die Zusammenhänge von Parametern des Freizeitsports (Trainingshäufigkeit, -Minuten und –Intensität), Komorbiditäten und der Lebensqualität. Ergebnisse. Ausdauer- und Krafttraining haben einen mittel-starken bis starken positiven Effekt auf die maximale Sauerstoffaufnahme (SMD= 0.66, p< .00001), den 6-Minuten-Walk-Test (6MWT) (SMD= 0.59, p= .02), die maximale Watt Zahl (SMD= 0.80, p= .009). Kein Effekt wurde bei der maximalen Herzfrequenz und dem systolischen sowie diastolischen Blutdruck gefunden. Subgruppenanalysen zu ≥3 Einheiten/Woche, ≥150 Min./Woche ergaben hohe Effektstärken in der maximalen Watt Zahl und 6MWT. Ausdauer- und Krafttraining zusammen mit Yoga haben einen starken Effekt auf Symptome der Depression (SMD= -0.84, p= .02) und Angststörungen (SMD= -1.23, p= .04). Die Subanalyse der Depression zu professioneller Supervision und sportlicher Betätigung wiesen einen sehr starken Effekt (SMD= -1.40, p= .03). Die HIBES-Studie wies ein sehr differenziertes Bild im Sportverhalten von PWH in Deutschland auf. 49% der Teilnehmer übten mehr als eine Sportart pro Woche aus. Es wurden keine Unterschiede zwischen kumuliertem (CTE) und einfachem Sport (STE) in der Lebensqualität gefunden. Die Freizeitsportparameter (Häufigkeiten/Woche, Minuten/Woche, Intensität/Woche) waren in der CTE-Gruppe deutlich höher als in der STE-Gruppe. Trainingsminuten und die -Intensität zeigten beim Vorhandensein einer Komorbidität einen großen Zusammenhang mit der Lebensqualität. Die Minuten und die Intensität des durchgeführten Sportes zeigten einen prädiktiven Zusammenhang mit der Lebensqualität. Konklusion: Sportliche Betätigung verbessert die maximale Sauerstoffaufnahme und Symptome der Depression und Angststörungen. Die Aussagekraft der Subanalysen ist aufgrund der geringen Studienzahl, vorsichtig zu interpretieren. Erhöhte Trainingsparameter finden sich eher bei PWH, die mehr als eine Sportart pro Woche treiben. Daher kann kumulierter Sport als mediierender Faktor zur Steigerung der Lebensqualität interpretiert werden; zumindest bei PWH mit einer psychologischen Komorbidität. KW - HIV KW - exercise KW - Komorbiditäten KW - Lebensqualität KW - HIV KW - exercise KW - comorbidities KW - quality of life Y1 - 2021 ER - TY - GEN A1 - Wollny, Anna A1 - Jacobs, Ingo A1 - Pabel, Luise T1 - Trait emotional intelligence and relationship satisfaction BT - the mediating role of dyadic coping T2 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Trait emotional intelligence (TEI) is an important individual difference variable that is related to the quality of romantic relationships. The present study investigated the associations between TEI, dyadic coping, and relationship satisfaction. A convenience sample of N = 136 heterosexual couples was recruited online. When the actor-partner interdependence model was applied to the data, TEI showed a positive actor effect and a positive partner effect on relationship satisfaction. The actor effect and partner effect of TEI on relationship satisfaction were partially mediated through positive dyadic coping and common dyadic coping, respectively. A small total indirect actor effect was also found for negative dyadic coping. Controlling for potential content overlap between TEI and relationship satisfaction did not alter the results. However, removing variance from the TEI score that was shared with the Big Five trait factors attenuated TEI's actor and partner effects on relationship satisfaction and rendered all but one actor effect for TEI on dyadic coping and all but one indirect effect nonsignificant. The results underline the importance of TEI for the quality of romantic relationships and they shed light on underlying mechanisms. Implications for theory, research, and applications in counseling contexts will be discussed. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 1175 KW - actor-partner mediator model KW - Big Five KW - dyadic coping KW - trait emotional intelligence KW - interpersonal relations KW - relationship satisfaction KW - personality KW - quality of life Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-517629 SN - 1866-8372 IS - 1175 SP - 75 EP - 93 ER - TY - JOUR A1 - Wollny, Anna Irena A1 - Jacobs, Ingo A1 - Pabel, Luise T1 - Trait emotional intelligence and relationship satisfaction BT - The mediating role of Dyadic Coping JF - The journal of psychology : interdisciplinary and applied N2 - Trait emotional intelligence (TEI) is an important individual difference variable that is related to the quality of romantic relationships. The present study investigated the associations between TEI, dyadic coping, and relationship satisfaction. A convenience sample of N = 136 heterosexual couples was recruited online. When the actor-partner interdependence model was applied to the data, TEI showed a positive actor effect and a positive partner effect on relationship satisfaction. The actor effect and partner effect of TEI on relationship satisfaction were partially mediated through positive dyadic coping and common dyadic coping, respectively. A small total indirect actor effect was also found for negative dyadic coping. Controlling for potential content overlap between TEI and relationship satisfaction did not alter the results. However, removing variance from the TEI score that was shared with the Big Five trait factors attenuated TEI’s actor and partner effects on relationship satisfaction and rendered all but one actor effect for TEI on dyadic coping and all but one indirect effect nonsignificant. The results underline the importance of TEI for the quality of romantic relationships and they shed light on underlying mechanisms. Implications for theory, research, and applications in counseling contexts will be discussed. KW - Actor-partner mediator model KW - Big Five KW - dyadic coping KW - trait emotional intelligence KW - relationship satisfaction KW - interpersonal relations KW - personality KW - quality of life Y1 - 2019 U6 - https://doi.org/10.1080/00223980.2019.1661343 SN - 0022-3980 SN - 1940-1019 VL - 154 IS - 1 SP - 75 EP - 93 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - GEN A1 - Warschburger, Petra A1 - Zitzmann, Jana T1 - Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? Results from a Controlled Study BT - Results from a Controlled Study T2 - Postprints der Universität Potsdam Humanwissenschaftliche Reihe N2 - Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 584 KW - adolescents KW - emerging adults KW - behavioral weight loss KW - obesity KW - controlled trial KW - quality of life Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-439424 SN - 1866-8364 IS - 584 ER - TY - JOUR A1 - Warschburger, Petra A1 - Zitzmann, Jana T1 - Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? BT - Results from a Controlled Study JF - Nutrients N2 - Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach. KW - adolescents KW - emerging adults KW - behavioral weight loss KW - obesity KW - controlled trial KW - quality of life Y1 - 2019 U6 - https://doi.org/10.3390/nu11092053 SN - 2072-6643 VL - 2019 IS - 11 PB - MDPI CY - Basel ER - TY - JOUR A1 - Warschburger, Petra A1 - Haenig, Johanna A1 - Friedt, Michael A1 - Posovszky, Carsten A1 - Schier, Maike A1 - Calvano, Claudia T1 - Health-Related quality of life in children with abdominal pain due to functional or organic gastrointestinal disorders JF - Journal of pediatric psychology KW - abdominal pain KW - catastrophizing KW - chronic illness KW - coping KW - quality of life Y1 - 2014 U6 - https://doi.org/10.1093/jpepsy/jst070 SN - 0146-8693 SN - 1465-735X VL - 39 IS - 1 SP - 45 EP - 54 PB - Oxford Univ. Press CY - Cary ER - TY - JOUR A1 - Niemann-Mirmehdi, Mechthild A1 - Häusler, Andreas A1 - Gellert, Paul A1 - Nordheim, Johanna T1 - Perceived Overprotection and Its Association With Quality of Life in Dementia JF - Geropsych - The Journal of gerontopsychology and geriatric psychiatry N2 - To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy. KW - dementia KW - perceived overprotection KW - perceived stress KW - depression KW - quality of life Y1 - 2019 U6 - https://doi.org/10.1024/1662-9647/a000207 SN - 1662-9647 SN - 1662-971X VL - 32 IS - 3 SP - 125 EP - 134 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Häusler, Andreas A1 - Sánchez, Alba A1 - Gellert, Paul A1 - Deeken, Friederike A1 - Rapp, Michael Armin A1 - Nordheim, Johanna T1 - Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter? JF - International psychogeriatrics N2 - Background: Given the well-established association between perceived stress and quality of life (QoL) in dementia patients and their partners, our goal was to identify whether relationship quality and dyadic coping would operate as mediators between perceived stress and QoL. Results: We found negative correlations between stress and QoL in both partners (QoL-AD: r = -0.62; p < 0.001; WHO-QOL Overall: r = -0.27; p = 0.02). Spousal caregivers had a significantly lower DCI total score than dementia patients (p < 0.001). Dyadic coping was a significant mediator of the relationship between stress and QoL in spousal caregivers (z = 0.28; p = 0.02), but not in dementia patients. Likewise, relationship quality significantly mediated the relationship between stress and QoL in caregivers only (z = -2.41; p = 0.02). Conclusions: This study identified dyadic coping as a mediator on the relationship between stress and QoL in (caregiving) partners of dementia patients. In patients, however, we found a direct negative effect of stress on QoL. The findings suggest the importance of stress reducing and dyadic interventions for dementia patients and their partners, respectively. KW - dementia KW - dyadic coping KW - perceived stress KW - quality of life Y1 - 2016 U6 - https://doi.org/10.1017/S1041610216001046 SN - 1041-6102 SN - 1741-203X VL - 28 SP - 1857 EP - 1866 PB - Cambridge Univ. Press CY - New York ER - TY - GEN A1 - Häusler, Andreas A1 - Sánchez, Alba A1 - Gellert, Paul A1 - Deeken, Friederike A1 - Nordheim, Johanna A1 - Rapp, Michael Armin T1 - Perceived stress and quality of life in dementia patients and their caregiving spouses BT - does dyadic coping matter? T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background: Given the well-established association between perceived stress and quality of life (QoL) in dementia patients and their partners, our goal was to identify whether relationship quality and dyadic coping would operate as mediators between perceived stress and QoL. Methods: 82 dyads of dementia patients and their spousal caregivers were included in a cross-sectional assessment from a prospective study. QoL was assessed with the Quality of Life in Alzheimer's Disease scale (QoL-AD) for dementia patients and the WHO Quality of Life-BREF for spousal caregivers. Perceived stress was measured with the Perceived Stress Scale (PSS-14). Both partners were assessed with the Dyadic Coping Inventory (DCI). Analyses of correlation as well as regression models including mediator analyses were performed. Results: We found negative correlations between stress and QoL in both partners (QoL-AD: r = -0.62; p < 0.001; WHO-QOL Overall: r = -0.27; p = 0.02). Spousal caregivers had a significantly lower DCI total score than dementia patients (p < 0.001). Dyadic coping was a significant mediator of the relationship between stress and QoL in spousal caregivers (z = 0.28; p = 0.02), but not in dementia patients. Likewise, relationship quality significantly mediated the relationship between stress and QoL in caregivers only (z = -2.41; p = 0.02). Conclusions: This study identified dyadic coping as a mediator on the relationship between stress and QoL in (caregiving) partners of dementia patients. In patients, however, we found a direct negative effect of stress on QoL. The findings suggest the importance of stress reducing and dyadic interventions for dementia patients and their partners, respectively. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 448 KW - dementia KW - dyadic coping KW - perceived stress KW - quality of life Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-413464 IS - 448 ER - TY - JOUR A1 - Hawro, Tomasz A1 - Przybylowicz, Katarzyna A1 - Spindler, Max A1 - Hawro, Marlena A1 - Steć, Michał A1 - Altrichter, Sabine A1 - Weller, Karsten A1 - Magerl, Markus A1 - Reidel, Ulrich A1 - Alarbeed, Ezzat A1 - Alraboni, Ola A1 - Maurer, Marcus A1 - Metz, Martin T1 - The characteristics and impact of pruritus in adult dermatology patients BT - a prospective, cross-sectional study JF - Journal of the American Academy of Dermatology N2 - Background: Pruritus often accompanies chronic skin diseases, exerting considerable burden on many areas of patient functioning; this burden and the features of pruritus remain insufficiently characterized. Objective: To investigate characteristics, including localization patterns, and burden of pruritus in patients with chronic dermatoses. Methods: We recruited 800 patients with active chronic skin diseases. We assessed pruritus intensity, localization, and further characteristics. We used validated questionnaires to assess quality of life, work productivity and activity impairment, anxiety, depression, and sleep quality. Results: Nine out of every 10 patients had experienced pruritus throughout their disease and 73% in the last 7 days. Pruritus often affected the entire body and was not restricted to skin lesions. Patients with moderate to severe pruritus reported significantly more impairment to their sleep quality and work productivity, and they were more depressed and anxious than control individuals and patients with mild or no pruritus. Suicidal ideations were highly prevalent in patients with chronic pruritus (18.5%) and atopic dermatitis (11.8%). Conclusions: Pruritus prevalence and intensity are very high across all dermatoses studied; intensity is linked to impairment in many areas of daily functioning. Effective treatment strategies are urgently required to treat pruritus and the underlying skin disease. ( J Am Acad Dermatol 2021;84:691-700.) KW - activity KW - anxiety KW - depression KW - pruritus KW - quality of life KW - sleep quality KW - suicidal ideations KW - work productivity Y1 - 2021 U6 - https://doi.org/10.1016/J.JAAD.2020.08.035 SN - 0190-9622 SN - 1097-6787 VL - 84 IS - 3 SP - 691 EP - 700 PB - Elsevier CY - Amsterdam [u.a.] ER - TY - JOUR A1 - Gellert, Paul A1 - Häusler, Andreas A1 - Gholami, Maryam A1 - Rapp, Michael Armin A1 - Kuhlmey, Adelheid A1 - Nordheim, Johanna T1 - Own and partners’ dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners JF - Aging & Mental Health N2 - Objectives: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between ‘own DC’ and ‘perceived partner DC’ with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels. Method: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor–partner interdependence models were applied to the resulting four independent evaluations. Results: Results differed substantially between patients and caregivers. DC was significantly related to patients’ but not to caregivers’ depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals. Conclusion: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole. KW - Dyadic coping KW - dementia KW - actor-partner interdependence model KW - caregiver KW - quality of life KW - depression Y1 - 2017 U6 - https://doi.org/10.1080/13607863.2017.1334759 SN - 1360-7863 SN - 1364-6915 VL - 22 IS - 8 SP - 1008 EP - 1016 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Reibis, Rona A1 - Nothroff, Jörg A1 - Harnath, Axel A1 - Schikora, Martin A1 - Butter, Christian A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation BT - predictors of functional and psychocognitive recovery JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background: In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods: From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results: One hundred and thirty-six patients (80.6 +/- 5.0 years, 47.8% male) were enrolled. 6MWD and maximum work load increased by 56.3 +/- 65.3 m (p < 0.001) and 8.0 +/- 14.9 watts (p < 0.001), respectively. An improvement in SF-12 (physical 2.5 +/- 8.7, p = 0.001, mental 3.4 +/- 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions: Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life. KW - Cardiac rehabilitation KW - TAVI KW - frailty KW - quality of life KW - exercise capacity Y1 - 2017 U6 - https://doi.org/10.1177/2047487316679527 SN - 2047-4873 SN - 2047-4881 VL - 24 IS - 3 SP - 257 EP - 264 PB - Sage Publ. CY - London ER - TY - THES A1 - Eichler, Sarah T1 - Multidisziplinäre kardiologische Rehabilitation bei Patienten nach kathetergestützter Aortenklappenkorrektur T1 - Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation BT - Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und Lebensqualität BT - predictors of functional and psychocognitive recovery N2 - Hintergrund Für Patienten mit hochgradiger Aortenklappenstenose, die aufgrund ihres Alters oder ihrer Multimorbidität ein hohes Operationsrisiko tragen, konnte mit der kathetergestützten Aortenklappenkorrektur (transcatheter aortic valve implantation, TAVI) eine vielversprechende Alternative zum herzchirurgischen Eingriff etabliert werden. Explizite Daten zur multidisziplinären kardiologischen Rehabilitation nach TAVI liegen bislang nicht vor. Ziel vorliegender Arbeit war, den Effekt der kardiologischen Rehabilitation auf die körperliche Leistungsfähigkeit, den emotionalen Status, die Lebensqualität und die Gebrechlichkeit bei Patienten nach TAVI zu untersuchen sowie Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und der Lebensqualität zu identifizieren. Methodik Zwischen 10/2013 und 07/2015 wurden 136 Patienten (80,6 ± 5,0 Jahre, 47,8 % Männer) in Anschlussheilbehandlung nach TAVI in drei kardiologischen Rehabilitationskliniken eingeschlossen. Zur Beurteilung des Effekts der kardiologischen Rehabilitation wurden jeweils zu Beginn und Ende der Rehabilitation der Frailty (Gebrechlichkeits)-Index (Score bestehend aus Barthel-Index, Instrumental Activities of Daily Living, Mini Mental State Exam, Mini Nutritional Assessment, Timed Up and Go und subjektiver Mobilitätsverschlechterung), die Lebensqualität im Short-Form 12 (SF-12) sowie die funktionale körperliche Leistungsfähigkeit im 6-Minuten Gehtest (6-minute walk test, 6MWT) und die maximale körperliche Leistungsfähigkeit in der Belastungs-Ergometrie erhoben. Zusätzlich wurden soziodemographische Daten (z. B. Alter und Geschlecht), Komorbiditäten (z. B. chronisch obstruktive Lungenerkrankung, koronare Herzkrankheit und Karzinom), kardiovaskuläre Risikofaktoren und die NYHA-Klasse dokumentiert. Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und Lebensqualität wurden mit Kovarianzanalysen angepasst. Ergebnisse Die maximale Gehstrecke im 6MWT konnte um 56,3 ± 65,3 m (p < 0,001) und die maximale körperliche Leistungsfähigkeit in der Belastungs-Ergometrie um 8,0 ± 14,9 Watt (p < 0001) gesteigert werden. Weiterhin konnte eine Verbesserung im SF-12 sowohl in der körperlichen Summenskala um 2,5 ± 8,7 Punkte (p = 0,001) als auch in der psychischen Summenskala um 3,4 ± 10,2 Punkte (p = 0,003) erreicht werden. In der multivariaten Analyse waren ein höheres Alter und eine höhere Bildung signifikant mit einer geringeren Zunahme im 6MWT assoziiert, währenddessen eine bessere kognitive Leistungsfähigkeit und Adipositas einen positiven prädiktiven Wert aufwiesen. Eine höhere Selbstständigkeit und ein besserer Ernährungsstatus beeinflussten die Veränderung in der körperlichen Summenskala des SF-12 positiv, währenddessen eine bessere kognitive Leistungsfähigkeit einen Prädiktor für eine geringere Veränderung darstellte. Des Weiteren hatten die jeweiligen Ausgangswerte der körperlichen und psychischen Summenskala im SF-12 einen inversen Einfluss auf die Veränderungen in der gleichen Skala. Schlussfolgerung Eine multidisziplinäre kardiologische Rehabilitation kann sowohl die körperliche Leistungs-fähigkeit und Lebensqualität verbessern als auch die Gebrechlichkeit von Patienten nach kathetergestützter Aortenklappenkorrektur verringern. Daraus resultierend gilt es, spezifische Assessments für die kardiologische Rehabilitation zu entwickeln. Weiterhin ist es notwendig, individualisierte Therapieprogramme mit besonderem Augenmerk auf kognitive Funktionen und Ernährung zu initiieren, um die Selbstständigkeit hochbetagter Patienten zu erhalten bzw. wiederherzustellen und um die Pflegebedürftigkeit der Patienten hinauszuzögern. N2 - Background In the last decade, transcatheter aortic valve implantation (TAVI) has reached widespread clinical acceptance as treatment for elderly and high-risk patients with aortic stenosis. Little is known about influencing factors of function and quality of life during multicomponent cardi-ac rehabilitation. The aim of the underlying study was to investigate the impact of a multidis-ciplinary inpatient cardiac rehabilitation on function and frailty as well as to find predictors for changes in quality of life and physical capacity. Methods From 10/2013 to 07/2015, patients with an elective TAVI and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. A Frailty-Index (a score including Activities of Daily Living, Instrumental Activities of Daily Living, Mini Men-tal State Exam, Mini Nutritional Assessment, Timed Up and Go und subjective mobility disa-bility), quality of life by Short Form-12 (SF-12), function by 6-minute walk distance (6MWD) and by maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. Additionally, sociodemographic parameters (e. g. age, sex), comorbidities (e. g. chronic obstructive pulmonary disease, coronary artery disease), cardiovascular risk factors and NYHA-class were documented. Predictors for changes in 6MWD and SF-12 were studied using analysis of covariance. Results 136 patients (80.6 ± 5.0 years, 47.8 % male) were enrolled. 6MWD and maximum work load increased by 56.3 ± 65.3 m (p < 0.001) and 8.0 ± 14.9 Watts (p < 0.001), respectively. An improvement in SF-12 (physical component scale 2.5 ± 8.7, p = 0.001, mental component scale 3.4 ± 10.2, p = 0.003) could be observed. In the multivariate analysis, age and a higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Nutrition and autonomy positively influenced the physical scale of SF-12, whereas a better cognitive performance negatively influenced it. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after TAVI. This results in a reevaluation of diagnostic modalities, prognostic parameters and an individualised definition of achievable goals in the contemporary TAVI population during the recovery phase at cardiac rehabilitation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life. KW - TAVI KW - Gebrechlichkeit KW - kardiologische Rehabilitation KW - Lebensqualität KW - körperliche Leistungsfähigkeit KW - TAVI KW - frailty KW - cardiac rehabilitation KW - quality of life KW - exercise capacity Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-406618 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 -