TY - JOUR A1 - Musekamp, Gunda A1 - Schuler, Michael A1 - Seekatz, Bettina A1 - Bengel, Jürgen A1 - Faller, Hermann A1 - Meng, Karin T1 - Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education JF - BMC Cardiovascular Disorders N2 - Background: Heart failure (HF) patient education aims to foster patients’ self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter. Methods: The sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms. Results: Short-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes. KW - patient education KW - chronic heart failure KW - self-management KW - quality of life KW - latent change KW - cardiac rehabilitation Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-157501 VL - 17 IS - 51 ER - TY - JOUR A1 - Musekamp, Gunda A1 - Gerlich, Christian A1 - Ehlebracht-König, Inge A1 - Faller, Hermann A1 - Reusch, Andrea T1 - Evaluation of a self-management patient education program for patients with fibromyalgia syndrome: study protocol of a cluster randomized controlled trial JF - BMC Musculoskeletal Disorders N2 - Background Fibromyalgia syndrome (FMS) is a complex chronic condition that makes high demands on patients’ self-management skills. Thus, patient education is considered an important component of multimodal therapy, although evidence regarding its effectiveness is scarce. The main objective of this study is to assess the effectiveness of an advanced self-management patient education program for patients with FMS as compared to usual care in the context of inpatient rehabilitation. Methods/Design We conducted a multicenter cluster randomized controlled trial in 3 rehabilitation clinics. Clusters are groups of patients with FMS consecutively recruited within one week after admission. Patients of the intervention group receive the advanced multidisciplinary self-management patient education program (considering new knowledge on FMS, with a focus on transfer into everyday life), whereas patients in the control group receive standard patient education programs including information on FMS and coping with pain. A total of 566 patients are assessed at admission, at discharge and after 6 and 12 months, using patient reported questionnaires. Primary outcomes are patients’ disease- and treatment-specific knowledge at discharge and self-management skills after 6 months. Secondary outcomes include satisfaction, attitudes and coping competences, health-promoting behavior, psychological distress, health impairment and participation. Treatment effects between groups are evaluated using multilevel regression analysis adjusting for baseline values. Discussion The study evaluates the effectiveness of a self-management patient education program for patients with FMS in the context of inpatient rehabilitation in a cluster randomized trial. Study results will show whether self-management patient education is beneficial for this group of patients. KW - rheumatology KW - evaluation KW - self-management KW - patient education KW - fibromyalgia syndrome KW - cluster-RCT KW - rehabilitation Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-146075 VL - 17 IS - 55 ER - TY - THES A1 - Wilkening, Sandra Anahid Mariam T1 - Krankheitsbezogenes Interesse und Schulungsbedürfnis bei Patienten mit chronischer Herzinsuffizienz T1 - disease-related interest and educational needs of chronic heart failure patients N2 - Thematik: Patientenschulungen haben sich für diverse Erkrankungen als effektiv und effizient erwiesen. Die individuellen Schulungsbedürfnisse von Patienten mit chronischer Herzinsuffizienz wurden bisher kaum untersucht. Methode: In Kooperation des Instituts für Psychotherapie und Medizinische Psychologie mit der Medizinischen Poliklinik und der Medizinischen Klinik der Universität Würzburg wurden 60 Patienten sowie 23 Angehörige anhand eines standardisierten Interviews bezüglich Ihrer Schulungsbedürfnisse befragt. Das Bedürfnis nach mehr Mitsprache bei der Behandlung wurde über Fallvignetten erfasst. Ergebnisse: Es besteht bei 51 % der Patienten ein klares Interesse, an einer Patientenschulung teilzunehmen, wobei das Interesse negativ mit dem Alter korreliert (p=0,00). Bei vorgegebenen Schulungsinhalten zeigt mehr als die Hälfte der Patienten Interesse für medizinische Themen wie Risikofaktoren, Funktion des Herzens sowie Symptomatik. Informationen zu gesunder Ernährung oder Bewegungsprogrammen werden von den Patienten weniger gewünscht, psychosoziale Inhalte wie Krankheits-und Stressbewältigung werden nur von einem Drittel der Patienten gewünscht. Seelisch belastete Patienten interessieren sich mehr für psychosoziale Inhalte. Die Hälfte der befragten Patienten wünscht sich ein partnerschaftliches Arzt-Patient-Verhältnis. Diese Patienten sind tendenziell jünger (p=0,01) und zeigen größeres Schulungsinteresse (p=0,00). Die Angehörigen der Patienten zeigen mit 61 % großes Schulungsinteresse. Das Interessensprofil ist jedoch anders als bei den Patienten. Schlussfolgerung: Im Rahmen einer Patientenschulung sollten in Bezug auf Alter, Inhalte und Didaktik verschiedene Gruppen gebildet werden. Die Zielvorstellungen Empowerment und Shared-Decision-Making werden nicht von allen Patienten getragen. Ein Curriculum auch für Angehörige wird gewünscht. N2 - Objectives: Patient education programs have turned out to be quite effective with regard to the treatment of various diseases. The individual needs of heart failure patients to obtain information about their disease have hardly been investigated till now. Methods: In cooperation of the Institute for Psychotherapy and Medical Psychology with the Outpatients` Departement and the Clinic for Internal Diseases of the University of Würzburg, 60 patients and 23 family members were questioned about their interest in patient education. A standardized interview was used. Their needs for empowerment to act as a partner in shared-decision-making in questions relating to the treatment of their disease were recorded by means of a case vignette. Results: 51 % of the patients are definitely interested in participating in patient education programs, but the degree of their interest was negatively correlated with their age (p = 0,00). Given the choice of possible educational topics, the majority of the patients voted for topics as e.g. risk factors, function of the heart as well as information on symptoms of the disease. Information on form of nutrition, fitness programs or psychosocial topics, as e.g. how to cope with illness and stress proved to be on minor interest. Psychologically distressed patients are more likely to respond to psychosocial issues. About 50 % of the patients interviewed prefer a cooperative physician-patient-relationship. These patients tend to be younger (0,01) and show a stronger inclination to participate in patient education (p = 0,00). The patients family members´(61 %) interest in education is considerable, too, although their fields of interest differ from those of the patients. Conclusion: Patients should be trained in various groups; in setting up those groups, the patients`age, the educational topics they are interested in as well as the adequate teaching methods should be taken into consideration. Empowerment and shared-decision making are not among the patients`general interests. A curriculum for family members of patients suffering from heart failure would be desirable, too. KW - Bedürfnisse KW - Patientenschulung KW - Herzinsuffizienz KW - Empowerment KW - Shared-Decision-Making KW - Needs KW - patient education KW - heart failure KW - empowerment KW - shared-decision-making Y1 - 2006 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-20111 ER -