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  • 1
    Online Resource
    Online Resource
    Siponimod versus placebo in secondary progressive multiple sclerosis (EXPAND): a double-blind, randomised, phase 3 study
    Elsevier BV ; 2018
    In:  The Lancet Vol. 391, No. 10127 ( 2018-03), p. 1263-1273
    Details
    In: The Lancet, Elsevier BV, Vol. 391, No. 10127 ( 2018-03), p. 1263-1273
    Type of Medium: Online Resource
    ISSN: 0140-6736
    URL: Article
    DOI: 10.1016/S0140-6736(18)30475-6
    RVK:
    XA 10000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2067452-1
    detail.hit.zdb_id: 3306-6
    detail.hit.zdb_id: 1476593-7
    SSG: 5,21
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  • 2
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    Psychometric properties of the German revised version of the eHealth literacy scale in individuals with cardiac diseases: Validation and test of measurement invariance
    SAGE Publications ; 2023
    In:  DIGITAL HEALTH Vol. 9 ( 2023-01)
    Details
    In: DIGITAL HEALTH, SAGE Publications, Vol. 9 ( 2023-01)
    Abstract: The internet is most people's primary source of (health) information. However, no validated instrument exists to assess eHealth literacy in the group of patient with cardiac diseases. Objective The objective of this study was the evaluation of the psychometric properties of the German revised version of the eHealth literacy scale (GR-eHEALS) in individuals with coronary artery disease (CAD) and congestive heart failure (CHF). Methods A cross-sectional study was conducted. N = 455 were included in the statistical analyses. The assessment compromised the GR-eHEALS, medical history, sociodemographic data, and technology-related data. Confirmatory factor analyses, correlational analyses, and tests of measurement invariance were performed. Results The two-factorial model reached a good model fit. The sub-scales information seeking and information appraisal, as well as the eHealth literacy total score, reached high reliability coefficients. Construct and criterion validity was fully confirmed For the two-factorial model, measurement invariance up to the scalar level could be confirmed regarding the sociodemographic characteristics sex, age, and educational level. Conclusions This study confirmed the two-factor structure, construct, and criterion validity as well as measurement invariance at the scalar level for sex, age, and educational level of the GR-eHEALS scale in a sample of individuals with CAD and CHF.
    Type of Medium: Online Resource
    ISSN: 2055-2076 , 2055-2076
    URL: Article
    DOI: 10.1177/20552076231194915
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2819396-9
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  • 3
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    Acceptance, drivers, and barriers to use eHealth interventions in patients with post-COVID-19 syndrome for management of post-COVID-19 symptoms: a cross-sectional study
    SAGE Publications ; 2023
    In:  Therapeutic Advances in Neurological Disorders Vol. 16 ( 2023-01), p. 175628642311757-
    Details
    In: Therapeutic Advances in Neurological Disorders, SAGE Publications, Vol. 16 ( 2023-01), p. 175628642311757-
    Abstract: Post-COVID-19 syndrome is a new and debilitating disease without adequate treatment options. eHealth could be a reasonable approach for symptom management. Objectives: This study aims to evaluate the acceptance for eHealth interventions for symptom management in individuals with post-COVID-19 syndrome, as well as drivers and barriers influencing acceptance. Design: Cross-sectional study. Methods: This study was conducted from January 19 until 24 May 2022. Recruitment took place with a web-based survey. Acceptance and predictors of eHealth interventions were measured by the extended UTAUT model. Included in the model were the core predictor performance expectancy, social influence, and effort expectancy. Previously diagnosed mental illness was estimated and mental health by using the well-established Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire Depression Scale. The effect of sociodemographic and medical data was assessed. Multiple hierarchical regression analyses as well as group comparisons were performed. Results: 342 individuals with post-COVID-19 syndrome were examined. The acceptance of eHealth interventions for symptom management was moderate to high (M = 3.60, SD = 0.89). Acceptance was significantly higher in individuals with lower/other education, patients with moderate to severe symptoms during initial COVID-19 infection, still significantly impaired patients, and individuals with a mental illness. Identified predictors of acceptance were age (β = .24, p  〈  .001), current condition including moderate (β = .49, p = .002) and still significantly impaired (β = .67, p  〈  .001), digital confidence (β = .19, p  〈  .001), effort expectancy (β = .26, p  〈  .001), performance expectancy (β = .33, p  〈  .001), and social influence (β = .26, p  〈  .001). Conclusion: Patients with post-COVID-19 syndrome reported a satisfying level of acceptance and drivers and barriers could be identified. These factors need to be considered for the implementation and future use of eHealth interventions.
    Type of Medium: Online Resource
    ISSN: 1756-2864 , 1756-2864
    URL: Article
    DOI: 10.1177/17562864231175730
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2442245-9
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  • 4
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    Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 2
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 14 ( 2021-07-12), p. 3071-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 14 ( 2021-07-12), p. 3071-
    Abstract: Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients’ groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10143071
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 5
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    Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach
    Oxford University Press (OUP) ; 2023
    In:  European Heart Journal - Digital Health Vol. 4, No. 5 ( 2023-10-03), p. 393-401
    Details
    In: European Heart Journal - Digital Health, Oxford University Press (OUP), Vol. 4, No. 5 ( 2023-10-03), p. 393-401
    Abstract: Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention. Methods and results A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters. Conclusion The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.
    Type of Medium: Online Resource
    ISSN: 2634-3916
    URL: Article
    DOI: 10.1093/ehjdh/ztad038
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 3076078-1
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  • 6
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    Mental health burden of patients with diabetes before and after the initial outbreak of COVID-19: predictors of mental health impairment
    Springer Science and Business Media LLC ; 2021
    In:  BMC Public Health Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: The COVID-19 pandemic is affecting people’s mental health worldwide. Patients with diabetes are at risk for a severe course of illness when infected with SARS-CoV-2. The present study aims to retrospectively examine mental health changes in patients with diabetes in Germany before and after the initial COVID-19 outbreak, and to furthermore explore potential predictors of such changes. Methods Over the course of eight weeks from April to June 2020, 253 individuals diagnosed with diabetes participated in an online cross-sectional study. Participants completed an anonymous survey including demographics, depression (PHQ-2) and generalized anxiety symptoms (GAD-2), distress (DT), and health status (EQ-5D-3L). In addition, all instruments used were modified to retrospectively ask participants to recall their mental health and health status before the outbreak had started. Additionally examined factors were COVID-19-related fear, trust in governmental actions to face the pandemic, and the subjective level of information about COVID-19. Results This study shows a significant increase in prevalence of depression symptoms, generalized anxiety symptoms and distress, as well as significantly decreased health statuses in diabetes patients after the initial COVID-19 outbreak. Increased depression symptoms, generalized anxiety symptoms and distress were predicted by COVID-19-related fear, whereas trust in governmental actions to face COVID-19 predicted higher depression symptoms. Conclusions The results indicate a negative impact of the initial COVID-19 outbreak on mental health and health status in patients with diabetes. In order to improve the efficacy of psychological support strategies for diabetes patients during the pandemic, possible predictors of mental health impairment such as the aforementioned should be examined more thoroughly and addressed more openly.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-021-12101-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041338-5
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  • 7
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    Increased COVID-19-related fear and subjective risk perception regarding COVID-19 affects behavior in individuals with internal high-risk diseases
    SAGE Publications ; 2021
    In:  Journal of Primary Care & Community Health Vol. 12 ( 2021-01), p. 215013272199689-
    Details
    In: Journal of Primary Care & Community Health, SAGE Publications, Vol. 12 ( 2021-01), p. 215013272199689-
    Abstract: Since December 2019, the coronavirus disease-2019 (COVID-19) has been keeping the world in suspense. Proven risk factors for a severe course of COVID-19 are common diseases like diabetes, hypertension, cardiovascular or respiratory disorders. Until today, little is known about the psychological burden of individuals suffering from these high-risk diseases regard to COVID-19. The aim of the study was to define the impact of the coronavirus pandemic on behavior and mental health in individuals at high risk for developing a severe COVID-19 course. Items assessed generalized anxiety (GAD-7), COVID-19-related fear, adherent/dysfunctional safety behavior, and the subjective risk perception of regarding symptoms, having a severe course and dying because of COVID-19. Data were compared between participants with the high risk diseases and individuals without any of those diseases. 16,983 respondents completed the study. Generalized anxiety, COVID-19-related fear, adherent/dysfunctional safety behavior and subjective risk perception were elevated in participants with high-risk diseases. The increased COVID-19-related fear as a functional concern is a conclusion on the increased risk of a severe course. The functionality of the fear is reflected in people’s increased need for security and includes an increase in both adherent and dysfunctional safety behavior that underlines the need for psychological support strategies.
    Type of Medium: Online Resource
    ISSN: 2150-1327 , 2150-1327
    URL: Article
    DOI: 10.1177/2150132721996898
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2550221-9
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  • 8
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    Techniques, Methods, and Dissemination of Community-Based Psychological Support Strategies in Times of the COVID-19 Pandemic
    SAGE Publications ; 2020
    In:  Journal of Primary Care & Community Health Vol. 11 ( 2020-01), p. 215013272094332-
    Details
    In: Journal of Primary Care & Community Health, SAGE Publications, Vol. 11 ( 2020-01), p. 215013272094332-
    Abstract: In times of the coronavirus pandemic caused by SARS-CoV-2 psychological support needs to meet certain requirements. Due to the lockdown in many countries of the world, the every-day activities of millions of people are reduced to a minimum. This may cause increased psychosomatic symptoms in persons with pre-existing mental illnesses, and additionally raises new challenges for the general population. As a result of the current contact restrictions, access to psychotherapy is further complicated. To guarantee the best possible care under the given conditions, we developed the CoPE (Coping with Corona: Extended Psychosomatic care in Essen) concept. CoPE is delivered by telephone or video calls as well as online contents. The materials presented at our webpage www.cope-corona.de aim to easily reach citizens affected by symptoms such as worries, depression or anger and let them receive readily understandable expert knowledge and training in basic self-help methods.
    Type of Medium: Online Resource
    ISSN: 2150-1327 , 2150-1327
    URL: Article
    DOI: 10.1177/2150132720943328
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 9
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    COVID-19 Vaccine for Children: Vaccination Willingness of Parents and Its Associated Factors—A Network Analysis
    MDPI AG ; 2022
    In:  Vaccines Vol. 10, No. 7 ( 2022-07-20), p. 1155-
    Details
    In: Vaccines, MDPI AG, Vol. 10, No. 7 ( 2022-07-20), p. 1155-
    Abstract: Different COVID-19 vaccines have been approved for underage children, so parents and caregivers currently face the decision of whether to vaccinate their children against COVID-19 or not. Due to the rather moderate vaccine acceptance among parents across different countries, the objective of the present study was to investigate the relationship between different psychological, demographic, and behavioral factors related to the acceptance of the COVID-19 vaccine for underage children among parents. In particular, vaccination attitudes, whether parents have been vaccinated against COVID-19 themselves, COVID-19 fear, attitude towards COVID-19 policy measures, governmental trust, subjective level of information, perceived risk of disease progression, and perceived risk of vaccine side effects were the variables of interest. The study adopted a cross-sectional study design, and the sample consisted of 2405 participants. A network analysis was conducted to investigate the associations and interconnection among these variables. The results showed that, in particular, compliance, confidence in the safety of vaccines, whether parents have been vaccinated against COVID-19 themselves, trust in the governmental system, fear of COVID-19, and the parents’ age were directly related to the acceptance of the COVID-19 vaccine for children. To increase compliance and confidence in the vaccines’ safety among parents, promotion campaigns should provide more information concerning the vaccines’ safety, particularly for younger parents who are not vaccinated against COVID-19 themselves.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines10071155
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2703319-3
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  • 10
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    Long-Term SARS-CoV-2 Specific Immunity Is Affected by the Severity of Initial COVID-19 and Patient Age
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 19 ( 2021-10-08), p. 4606-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 19 ( 2021-10-08), p. 4606-
    Abstract: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently the greatest medical challenge. Although crucial to the future management of the pandemic, the factors affecting the persistence of long-term SARS-CoV-2 immunity are not well understood. Therefore, we determined the extent of important correlates of SARS-CoV-2 specific protection in 200 unvaccinated convalescents after COVID-19. To investigate the effective memory response against the virus, SARS-CoV-2 specific T cell and humoral immunity (including virus-neutralizing antibodies) was determined over a period of one to eleven months. SARS-CoV-2 specific immune responses were present in 90% of individual patients. Notably, immunosuppressed patients did not have long-term SARS-CoV-2 specific T cell immunity. In our cohort, the severity of the initial illness influenced SARS-CoV-2 specific T cell immune responses and patients’ humoral immune responses to Spike (S) protein over the long-term, whereas the patients’ age influenced Membrane (M) protein-specific T cell responses. Thus, our study not only demonstrated the long-term persistence of SARS-CoV-2 specific immunity, it also determined COVID-19 severity and patient age as significant factors affecting long-term immunity.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10194606
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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