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  • 1
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    Efficacy of a novel patient-focused intervention aimed at increasing adherence to guideline-based preventive measures in asplenic patients: the PrePSS trial
    Springer Science and Business Media LLC ; 2023
    In:  Infection
    Details
    In: Infection, Springer Science and Business Media LLC
    Abstract: To determine whether a novel intervention improves the adherence to guideline-based preventive measures in asplenic patients at risk of post-splenectomy sepsis (PSS). Methods We used a prospective controlled, two-armed historical control group design to compare a novel, health action process approach (HAPA)-based telephonic intervention involving both patients and their general practitioners to usual care. Eligible patients were identified in cooperation with the insurance provider AOK Baden-Wuerttemberg, Germany. Patients with anatomic asplenia ( n  = 106) were prospectively enrolled and compared to a historical control group ( n  = 113). Comparisons were done using a propensity-score-based overlap-weighting model. Adherence to preventive measures was quantified by the study-specific ‘Preventing PSS score’ (PrePSS score) which includes pneumococcal and meningococcal vaccination status, the availability of a stand-by antibiotic and a medical alert card. Results At six months after the intervention, we estimated an effect of 3.96 (95% CI 3.68–4.24) points on the PrePSS score scale (range 0–10) with mean PrePSS scores of 3.73 and 7.70 in control and intervention group, respectively. Substantial improvement was seen in all subcategories of the PrePSS score with the highest absolute gains in the availability of stand-by antibiotics. We graded the degree of participation by the general practitioner (no contact, short contact, full intervention) and noted that the observed effect was only marginally influenced by the degree of physician participation. Conclusions Patients who had received the intervention exhibited a significantly higher adherence to guideline-based preventive measures compared to the control group. These data suggest that widespread adoption of this pragmatic intervention may improve management of asplenic patients. Health insurance provider-initiated identification of at-risk patients combined with a patient-focused intervention may serve as a blueprint for a wide range of other preventive efforts leading to patient empowerment and ultimately to better adherence to standards of care.
    Type of Medium: Online Resource
    ISSN: 0300-8126 , 1439-0973
    URL: Article
    DOI: 10.1007/s15010-023-02088-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2006315-5
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  • 2
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    Patients’ with asplenia and doctors’ experiences in implementing preventative measures following a novel educational intervention: a qualitative analysis
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 11 ( 2022-11), p. e060492-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 11 ( 2022-11), p. e060492-
    Abstract: To explore patients’ with asplenia and general practitioners’ (GPs) (1) perceptions of a novel, Health Action Process Approach (HAPA)-based, educational intervention which targets to increase adherence to post-splenectomy sepsis (PSS) prevention measures and (2) their experience in implementing prevention measures following this intervention. Design A process evaluation conducted on average 3.5 (for patients) and 3.8 (for GPs) months after the intervention between January 2020 and April 2021 individually by means of semi-structured guideline-based telephone interviews. Data was analysed using qualitative content analysis. Participants Volunteer subsample of N=25 patients with asplenia and N=8 GPs who received the intervention. Inclusion criteria were met by prior participation in the intervention (German-speaking, of full age and insured by the cooperating health insurance). Patient selection was done by purposeful selection aiming at maximum variability in terms of adherence to preventative measures prior to intervention participation. Participating GPs are a non-purposeful selected convenience sample. For reasons of data protection, no personal data was collected. Results The intervention was positively evaluated and its personal relevancy for patients and for the GPs’ professional work became apparent. The intervention promoted risk awareness, intention to action, action planning and subsequently, improved adherence to preventative measures. Helpful factors for implementation among the patients were social support by relatives and GPs. Barriers to adherence identified in both groups can be divided into patient-attributed (eg, comorbidities), doctor-related (eg, lack of knowledge or support) as well as contextual factors (eg, vaccine supply constraints). Conclusions Our findings indicate a patient and GP perceived benefit of the intervention, but still identify prevailing barriers to implementation. In a further step, a quantitative evaluation of the intervention will be conducted and recommendations for integrating the intervention in usual care will be made. Trial registration number DRKS00015238.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2021-060492
    DOI: 10.1136/bmjopen-2021-060492.supp1
    DOI: 10.1136/bmjopen-2021-060492.supp2
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 3
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    Effects of a health psychology-based intervention for patients with asplenia on psychological determinants of preventive behaviour: A propensity score analysis
    Elsevier BV ; 2023
    In:  Patient Education and Counseling Vol. 114 ( 2023-09), p. 107851-
    Details
    In: Patient Education and Counseling, Elsevier BV, Vol. 114 ( 2023-09), p. 107851-
    Type of Medium: Online Resource
    ISSN: 0738-3991
    URL: Article
    DOI: 10.1016/j.pec.2023.107851
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2019572-2
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  • 4
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    Availability and quality of assessment instruments on patient-centredness in older adults with multimorbidity: a systematic review
    Oxford University Press (OUP) ; 2023
    In:  Age and Ageing Vol. 52, No. 3 ( 2023-03-01)
    Details
    In: Age and Ageing, Oxford University Press (OUP), Vol. 52, No. 3 ( 2023-03-01)
    Abstract: Patient-centredness (PC) is central to the health care of older adults with multimorbidity, but knowledge about the psychometric quality of instruments measuring it in this group is scarce. Based on an integrative model of PC, we aimed to identify assessment instruments of PC for this particular group and evaluate their psychometric properties. Methods We systematically searched six electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO, Web of Science and PSYNDEX), initially covering research published up to 2018 and updated later to include work up to July 2022. In evaluating the psychometric properties of identified instruments, we followed the COSMIN methodology. Results We identified 12 studies reporting on 10 instruments measuring PC in the health care of older adults with multimorbidity. For these instruments, structural validity and internal consistency were the psychometric properties reported most often. Based on the COSMIN criteria, eight instruments received favourable ratings for internal consistency with respect to methodological quality (‘very good’), measurement property (‘sufficient’) and overall quality of evidence (‘moderate’). Ratings of structural validity varied more largely, with three to seven instruments showing at least adequate methodological quality, sufficient structural validity or moderate quality of evidence. Conclusions Similar to comparable previous reviews, evidence on the psychometric properties of instruments assessing PC in the health care of older adults with multimorbidity was rather limited. Informed by comprehensive models of PC, further research should aim at developing measures of PC that stand out on a broader range of psychometric properties.
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    URL: Article
    DOI: 10.1093/ageing/afac314
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2065766-3
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  • 5
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    Availability and Quality of Assessment Instruments on Patient-Centredness in the Multimorbid Elderly (AQuA-PCE): a study protocol of a systematic review
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 2 ( 2020-02), p. e033273-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 2 ( 2020-02), p. e033273-
    Abstract: Elderly, multimorbid patients are a primary target group for patient-centred care, and fostering patient-centredness (PC) in this group has been associated with different healthcare aims such as safety and quality of healthcare. However, evidence on effects of patient-centred interventions is still limited and mixed. In part, the lack of consistent evidence has its roots in a conceptual uncertainty of the term ‘PC’, which also hampers the development of assessment tools for PC. Consequently, reviews on assessment instruments of PC reveal problems regarding the quality of identified assessment instruments and regarding their comparability. Some of these reviews focus on the elderly. However, while the concept of multimorbidity is partly inherent, this focus is not explicit in any of the reviews. The aim of this systematic review is to identify assessment instruments of PC in the multimorbid elderly, using a subgroup-specific definition of PC (‘subgroup-specific integrative model of PC’) as the conceptual underpinning, and to provide a critical quality appraisal of their psychometric properties. Methods and analysis A comprehensive systematic literature search for assessment tools on PC will be conducted in the MEDLINE, CINAHL, EMBASE, PsycINFO, Web of Science and PSYNDEX electronic databases. The search strategy will be informed by the subgroup-specific integrative model of PC. The electronic literature search will be complemented by a hand-search combining citation tracking, search in project databases, and contacting authors from relevant studies/reviews. The literature search (systematic and hand-search) will cover the period from November, 2018 to December 2019. The retrieval of relevant studies will be conducted via title screening, abstract screening, and full-text eligibility assessment applying defined inclusion criteria. Full texts will be independently assessed by two team members. Data from the included articles will be extracted using a standardised extraction form and evaluated based on the COSMIN methodology for systematic reviews of patient-reported outcome measures, which focuses on the methodological quality of included studies as well as on the measurement properties of the assessment instruments. Data extraction and quality assessment will be conducted by two independent reviewers. Ethics and dissemination The study has received approval from the Ethics Committee of the University of Freiburg (reference number 587/17). The results of the project will be disseminated via scientific oral presentations at national and international conferences and will be published in scientific journals. Trial registration numbers CRD42018084057; DRKS00013309.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-033273
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Patient-centeredness in the multimorbid elderly: a focus group study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Geriatrics Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract:  Patient-centeredness (PC) aims to adapt health care to the individual needs and preferences of patients. An existing integrative model of PC comprises several dimensions of PC which have not yet been investigated from the patients’ perspective. Older patients with multimorbidity represent a target group for patient-centered care, as their care needs are particularly complex and should be addressed individually. We aimed to assess the perspective that older patients with multimorbidity have of patient-centered care and to examine the transferability of the integrative model of PC to this specific population. Method We performed 4 guided focus group interviews with a total of 20 older individuals with multimorbidity. The focus group interviews were audio-recorded and transcribed verbatim. Patients’ statements were content-analyzed applying an a priori designed system of categories that included the dimensions of PC from the integrative model and the additional category ‘prognosis and life expectancy’, which had emerged from an initial literature search on aspects of PC specific to the multimorbid elderly. Results The new category ‘prognosis and life expectancy’ was confirmed and expanded to ‘individual care needs related to aging and chronic disesase’. All dimensions of our integrative PC model were confirmed for older patients with multimorbidity. Among these, we found that eight dimensions (individual care needs related to aging and chronic disease, biopsychosocial perspective, clinician-patient communication, essential characteristics of the clinician, clinician-patient-relationship, involvement of family and friends, coordination and continuity of care, access to care) were complemented by aspects specific to this target population. Conclusions The integrative PC model is applicable to the population of older patients with multimorbidity. For a population-specific adaptation, it might be complemented by the dimension ‘individual care needs in aging and chronic disease’, in conjunction with age-specific aspects within existing dimensions. Together with corresponding results from a Delphi survey, our adapted PC model will serve as the basis for a subsequent systematic review of instruments measuring PC in older patients with multimorbidity. Trial registration PROSPERO ( https://www.crd.york.ac.uk/prospero; CRD42018084057; 2018/02/01), German Clinical Trials Register ( www.drks.de ; DRKS00013309; 2018/01/23).
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-021-02448-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059865-8
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  • 7
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    Patient-Centeredness in Older Adults With Multimorbidity: Results of an Online Expert Delphi Study
    Oxford University Press (OUP) ; 2021
    In:  The Gerontologist Vol. 61, No. 7 ( 2021-09-13), p. 1008-1018
    Details
    In: The Gerontologist, Oxford University Press (OUP), Vol. 61, No. 7 ( 2021-09-13), p. 1008-1018
    Abstract: Older adults suffering from multimorbidity represent a priority target group for patient-centeredness (PC). We aimed to investigate the transferability of an existing integrated model of PC comprising 15 dimensions on the care of older adults with multimorbidity from an expert perspective. Research Design and Methods A total of 242 experts were invited to participate in a 2-round online Delphi study. In round 1, they were asked to (a) individually rate relevance and clarity of the dimensions, (b) add missing dimensions, and (c) prioritize the dimensions. In round 2, experts received results of round 1 and were asked to rerate their ratings. Results Forty-eight experts participated in round 1 and 39 in round 2. Ten dimensions were rated as sufficiently relevant and clear, including one new dimension (“prognosis and life expectancy, burden of treatment”). Four dimensions were rated as relevant but insufficiently clear. One dimension failed to reach our validation threshold on both criteria. The 5 dimensions rated as most important were: “patient as a unique person,” “clinician–patient communication,” “patient involvement in care,” “physical, cognitive, and emotional support,” and “involvement of family and friends.” Discussion and Implications The experts’ ratings were higher regarding relevance than regarding clarity, which emphasizes the still existing conceptual uncertainty of PC. Our results give further directions regarding the operationalization of PC in older adults with multimorbidity, which is essential for its implementation in routine care. Further refined using focus groups with geriatric patients, our adapted model serves as a basis for a systematic review of assessment instruments.
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    URL: Article
    DOI: 10.1093/geront/gnaa223
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2043844-8
    SSG: 12
    SSG: 5,2
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  • 8
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    Illness beliefs and treatment beliefs as predictors of short and middle term outcome in depression
    SAGE Publications ; 2013
    In:  Journal of Health Psychology Vol. 18, No. 1 ( 2013-01), p. 139-152
    Details
    In: Journal of Health Psychology, SAGE Publications, Vol. 18, No. 1 ( 2013-01), p. 139-152
    Abstract: The article investigates whether illness beliefs and beliefs about rehabilitation are predictors of short and middle term outcome in depression even when adjustments are made for variables, which are known to be predictors of the course of depression. Within the context of a non-controlled prospective study design, data were analyzed using forced entry hierarchical multiple regression analyses. The sample comprised N = 98 patients. Adjusting for a range of sociodemographic and medical predictors, illness beliefs and beliefs about rehabilitation predict outcome in depression. Illness beliefs and beliefs about rehabilitation are relevant starting points for designing patient-oriented interventions.
    Type of Medium: Online Resource
    ISSN: 1359-1053 , 1461-7277
    URL: Article
    DOI: 10.1177/1359105311433907
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2021897-7
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  • 9
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    Treatment Beliefs of Children and Adolescents With Chronic Diseases: Development of the Rehabilitation Treatment Beliefs Questionnaire for Children and Adolescents
    Oxford University Press (OUP) ; 2023
    In:  Journal of Pediatric Psychology Vol. 48, No. 1 ( 2023-01-12), p. 5-13
    Details
    In: Journal of Pediatric Psychology, Oxford University Press (OUP), Vol. 48, No. 1 ( 2023-01-12), p. 5-13
    Abstract: Rehabilitation is an important component in the health care of children and adolescents with chronic diseases and aims at supporting patients’ self-regulation for dealing with the disease. Patients’ beliefs about illness and treatment are core elements in the self-regulation process. While questionnaires measuring illness beliefs for children and adolescents exist, questionnaires about their rehabilitation-related treatment beliefs are lacking. We therefore developed a questionnaire to assess the rehabilitation-related treatment beliefs of children and adolescents with chronic diseases (Rehabilitation Treatment Beliefs Questionnaire, RTBQ) and tested its psychometric properties. Methods Ahead of their rehabilitation, children and adolescents, aged 12–17 years, answered 129 items, which were developed based on previous qualitative findings exploring children and adolescents’ rehabilitation-related treatment beliefs. Psychometric testing included item analyses, exploratory factor analysis, internal consistency and bivariate correlations of the extracted scales, and the discriminatory power and difficulty of the final items. Results The sample consisted of 170 participants with a mean age of 14.3 years (SD = 1.6); 53.5% were female. After item analyses, 47 items remained for the exploratory factor analysis which revealed 22 items allocated to 4 scales: “expectations of communication and interaction,” “expectations of the treatment process,” “expectations of treatment success and sustainability,” and “expectations of one’s own role in the rehabilitation process.” The psychometric properties were acceptable to good. Conclusions The RTBQ assesses various dimensions of rehabilitation-related treatment beliefs of children and adolescents with chronic diseases. While first psychometric results are promising, further psychometric testing is needed.
    Type of Medium: Online Resource
    ISSN: 0146-8693 , 1465-735X
    URL: Article
    DOI: 10.1093/jpepsy/jsac033
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1470323-3
    SSG: 5,2
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  • 10
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    Development and Psychometric Evaluation of a German Version of the PROMIS ® Item Banks for Satisfaction With Participation
    SAGE Publications ; 2015
    In:  Evaluation & the Health Professions Vol. 38, No. 2 ( 2015-06), p. 160-180
    Details
    In: Evaluation & the Health Professions, SAGE Publications, Vol. 38, No. 2 ( 2015-06), p. 160-180
    Abstract: The Patient Reported Outcomes Measurement Information System (PROMIS) initiative aims to provide reliable and precise item banks measuring patient-reported outcomes in different health domains. The aim of the present work was to provide a German translation of the PROMIS item banks for satisfaction with participation and to psychometrically test these German versions. Cognitive interviews followed a forward–backward translation. Distribution characteristics, unidimensionality, Rasch model fit, reliability, construct validity, and internal responsiveness were tested in 262 patients with chronic low back pain undergoing rehabilitation. Results for the final 13- and 10-item German static scales (Satisfaction with Participation in Social Roles–German version [PSR-G] and Satisfaction for Participation in Discretionary Social Activities–German version [PSA-G] ) regarding unidimensionality were satisfactory. The scales are reliable and show good Rasch model fit and distribution characteristics. Both scales are sensitive to small to moderate clinical changes, and we observed initial proof of construct validity. These German versions of the Satisfaction with Participation scales can be recommended to assess participation in a clinical context. The scales’ applicability in other contexts should be examined.
    Type of Medium: Online Resource
    ISSN: 0163-2787 , 1552-3918
    URL: Article
    DOI: 10.1177/0163278713503468
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2067657-8
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