TY - JOUR A1 - Müller, Martin A1 - Grill, E. A1 - Strobl, R. ED - Medical Journals Limited, T1 - Goals of patients with rehabilitation needs in acute hospitals: goal achivement is an indicator for improved functioning JF - Journal of Rehabilitation Medicine N2 - Objective: To identify goals of patients with rehabilitation needs in the acute hospital setting using the International Classification of Functioning, Disability and Health (ICF), to examine association of goal achievement with improvement in overall functioning, and to examine whether ICF Core Sets for the acute hospital cover patients goals. Design: Multi-centre cohort study. Patients: A total of 397 patients (50% female, mean age 63 years) from 5 hospitals in Austria, Switzerland and Germany. Methods: A semi-structured questionnaire was used to assess patient goals and goal achievement. Overall functioning from the patients' and health professionals' perspective was assessed on a numerical rating scale. Improvement in functioning was calculated using a residualized gain score. Association between goal achievement and improvement in overall functioning was assessed with logistic regression. Results: A total of 397 patients reported achievement of at least 1 goal. Eighty-eight percent of the goals were translated into categories of the ICF. Logistic regression analyses revealed significant association between goal achievement and overall functioning. Conclusion: The ICF might be useful to identify and structure patient's goals in acute hospital care. The association between goal achievement and improved functioning underlines that it is essential to involve the patient in the process of planning rehabilitation interventions in acute hospitals. KW - Advance care planning KW - Classification KW - Cohort study KW - ICF KW - Intensive Care KW - Outcome assessment Y1 - 2018 ER - TY - JOUR A1 - Peters, A. A1 - Doring, A. A1 - Ladwig, K.-H. A1 - Meisinger, C. A1 - Linkohr, B. A1 - Autenrieth, C. A1 - Baumeister, S.E. A1 - Behr, J. A1 - Bergner, A. A1 - Bickel, H. A1 - Bidlingmaier, M. A1 - Dias, A. A1 - Emeny, R.T. A1 - Fischer, B. A1 - Grill, E. A1 - Gorzelniak, L. A1 - Hansch, H. A1 - Heidbreder, S. A1 - Heier, M. A1 - Horsch, A. A1 - Huber, D. A1 - R. M., Huber A1 - Jorres, R.A. A1 - Kaab, S. A1 - Karrasch, S. A1 - Kirchberger, I. A1 - Klug, G. A1 - Kranz, B. A1 - Kuch, B. A1 - Lacruz, M.E. A1 - Lang, O. A1 - Mielck, A. A1 - Nowak, D. A1 - Perz, S. A1 - Schneider, A. A1 - Schulz, H. A1 - Müller, Martin A1 - Seidl, H. A1 - Strobl, R. A1 - Thorand, B. A1 - Wende, R. A1 - Weidenhammer, W. A1 - Zimmermann, A.-K. A1 - Wichmann, H.-E. A1 - Holle, R. ED - BioMed Central, T1 - Multimorbidity and successful aging: the population-based KORA-Age study JF - Health and quality of life outcomes N2 - Background Multimorbidity in the older population is well acknowledged to negatively affect health-related quality of life (HRQL). Several studies have examined the independent effects of single diseases; however, little research has focused on interaction between diseases. The purpose of this study was to assess the impact of six self-reported major conditions and their combinations on HRQL measured by the EQ-5D. Methods The EQ-5D was administered in the population-based KORA-Age study of 4,565 Germans aged 65 years or older. A generalised additive regression model was used to assess the effects of chronic conditions on HRQL and to account for the nonlinear associations with age and body mass index (BMI). Disease interactions were identified by a forward variable selection method. Results The conditions with the greatest negative impact on the EQ-5D index were the history of a stroke (regression coefficient -11.3, p < 0.0001) and chronic bronchitis (regression coefficient -8.1, p < 0.0001). Patients with both diabetes and coronary disorders showed more impaired HRQL than could be expected from their separate effects (coefficient of interaction term -8.1, p < 0.0001). A synergistic effect on HRQL was also found for the combination of coronary disorders and stroke. The effect of BMI on the mean EQ-5D index was inverse U-shaped with a maximum at around 24.8 kg/m2. Conclusions There are important interactions between coronary problems, diabetes mellitus, and the history of a stroke that negatively affect HRQL in the older German population. Not only high but also low BMI is associated with impairments in health status. KW - Aging KW - Multimorbidity KW - KORA Study Y1 - 2011 ER - TY - JOUR A1 - Klingshirn, H. A1 - Mittrach, R. A1 - Braitmayer, K. A1 - Strobl, R. A1 - Bender, A. A1 - Grill, E. A1 - Müller, Martin T1 - RECAPDOC - a questionnaire for the documentation of rehabilitation care utilization in individuals with disorders of consciousness in long-term care in Germany: development and pretesting JF - BMC Health Services Research N2 - Background A multitude of different rehabilitation interventions and other specific health care services are offered for individuals with disorders of consciousness in long-term care settings. To investigate the association of those services and patient-relevant outcomes, a specific instrument to document the utilization of those services is needed. The purpose of this study was to develop such a questionnaire administered to caregivers in epidemiological studies or patient registries in Germany. Methods The development process of the RECAPDOC questionnaire was carried out in three steps. Step 1 consisted of a systematic literature review and an online-based expert survey to define the general content. Step 2 was an expert interview to evaluate the preliminary content of the questionnaire. Step 3 was a pretest including cognitive interviews with caregivers. After each step, the results were combined into a new version of the questionnaire. Results The first version of the questionnaire included items on utilization of medical care, medical aids, nursing and therapeutic care. The results of the expert interview led to the integration of five new items and the modification of six other items. The pretest led to some minor modifications of the questionnaire since it was rated as feasible and acceptable. The final questionnaire consisted of 29 items covering the domains “living situation”, “social insurance status”, “utilisation of home health care”, “domestic services”, “outpatient health care”, “specific diagnostic measures”, “adaptive technologies”, “medical aids” and “utilization of therapies”. Also the experience of family support and multidisciplinary collaboration of health professionals is covered. Conclusions The developed questionnaire is a first step to make the situation of patients with disorders of consciousness in the long-term care setting accessible for evaluation in epidemiological studies and in the context of patient registries. However, further reliability and validity studies are needed. KW - Questionnaire development KW - Cognitive Interview KW - Pretest KW - Rehabilitation KW - Long-term care KW - Disorder of consciousness KW - Vegetative state KW - Minimaly conscious state Y1 - 2018 UR - https://doi.org/10.1186/s12913-018-3153-3 VL - 18 SP - 329 ER - TY - JOUR A1 - Kovacs, E. A1 - Strobl, R. A1 - Phillips, A. A1 - Stephan, A.-J. A1 - Müller, Martin A1 - Gensichen, J. A1 - Grill, E. T1 - Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care JF - Journal of General Internal Medicine N2 - Background As clinical practice guidelines represent the most important evidence-based decision support tool, several strategies have been applied to improve their implementation into the primary health care system. This study aimed to evaluate the effect of intervention methods on the guideline adherence of primary care providers (PCPs). Methods The studies selected through a systematic search in Medline and Embase were categorised according to intervention schemes and outcome indicator categories. Harvest plots and forest plots were applied to integrate results. Results The 36 studies covered six intervention schemes, with single interventions being the most effective and distribution of materials the least. The harvest plot displayed 27 groups having no effect, 14 a moderate and 21 a strong effect on the outcome indicators in the categories of knowledge transfer, diagnostic behaviour, prescription, counselling and patient-level results. The forest plot revealed a moderate overall effect size of 0.22 [0.15, 0.29] where single interventions were more effective (0.27 [0.17, 0.38]) than multifaceted interventions (0.13 [0.06, 0.19]). Discussion Guideline implementation strategies are heterogeneous. Reducing the complexity of strategies and tailoring to the local conditions and PCPs’ needs may improve implementation and clinical practice. KW - Evidence- based medicine KW - Implementation KW - General practitioner KW - Intervention KW - Harvest plot Y1 - 2018 UR - https://doi.org/10.1007/s11606-018-4435-5 VL - 33 SP - 1142 EP - 1154 ER - TY - CHAP A1 - Krause, Harald A1 - Strobl, Thomas A1 - Wirnsberger, Markus T1 - Einfache Lüftungssysteme für Wohngebäude – Untersuchungen in einer Forschungswohnung T2 - Konferenzband Int. Passivhaustagung 2018 N2 - Besonders einfache Lüftungssysteme sind heute vor allem in der Sanierung wichtig. In einer Vielzahl von Messreihen hat sich gezeigt, dass das System der zentralen Zulufteinbringung mit Verteilung über aktive Überströmer im Hinblick auf den Schadstoffaufbau und der sich einstellenden Luftqualität ausreichend funktioniert. KW - Passivhaus KW - Wohnungslüftung Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:861-opus4-9492 ER - TY - RPRT A1 - Barth, Simon A1 - Benecken, Gerd A1 - Betz, Andreas A1 - Binninger, Karsten A1 - Graule, Verena A1 - Hack, Andreas A1 - Haegele, Rainer A1 - Hartmann, Markus A1 - Hauck-Bauer, Eva A1 - Haut, Sandra A1 - Jäger, Johannes A1 - Kagerl, Andreas A1 - Karlinger, Peter A1 - Konle, Elke A1 - Köster, Heinrich A1 - Krause, Harald A1 - Krommes, Sandra A1 - Meissner, Thomas A1 - Michanickl, Andreas A1 - Sandor, Viktor A1 - Schanda, Ulrich A1 - Schemme, Michael A1 - Sebald, Daniela A1 - Spindler, Uli A1 - Stauss, Kilian A1 - Strobl, Thomas A1 - Sussmann, Monika A1 - Versen, Martin A1 - Voit, Johann A1 - Wambsganß, Mathias A1 - Wellisch, Ulrich A1 - Zauner, Johannes T1 - Forschungsbericht 2015 N2 - Mit dem jährlich erscheinenden Forschungsbericht möchte die Hochschule Rosenheim einen Einblick in ihre vielfältigen Projekte und Aktivitäten der angewandten Forschung und Entwicklung geben. Im Forschungsbericht 2015 wird über Vorhaben im Jahr 2015 berichtet. T3 - Schriftenreihen - Forschungsbericht - 4 KW - Forschung Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:861-opus4-12304 ER - TY - CHAP A1 - Krause, Harald A1 - Wirnsberger, Markus A1 - Strobl, Thomas T1 - Einfache Lüftungssysteme für den Wohnungsbau – Untersuchungen in der roteg Forschungswohnung T2 - Konferenzband 10. HolzBauSpezial Bauphysik & Gebäudetechnik 2019 N2 - Effiziente Lüftungssysteme zur Sicherstellung guter Luftqualität sind für energieeffiziente Gebäude essentiell. Ein Hemmnis für den Einsatz stellen insbesondere in der Sanierung die nach wie vor hohen Kosten dar. In mehreren Projekten [Schiantarelli 2015] [Sibille et al. 2013] wurde bisher versucht, vereinfachte Systeme zu entwickeln [Sibille, Pfluger 2016] [Huber 2013]. In diesem Forschungsprojekt wurde die Idee einer technisch einfachen und möglichst kanalfreien Belüftungsmöglichkeit mithilfe von aktiven Überströmern untersucht. Dabei wird die Zuluft nur zentral in der Mischzone der Wohnung (Flur, offenes Wohnzimmer) eingebracht. Die Abluft wird konventionell erfasst. Dadurch kann auf ein Zuluftkanalnetz verzichtet werden. Der aktive Überströmer ist dabei in die Zwischenwand bzw. im Türsturz des Anforderungsraumes (z.B. Schlafzimmer) eingebaut. Er besteht aus einem Axiallüfter mit einem Durchmesser von 120 mm, der (bei geschlossener Tür) die Luft aus der Mischzone in das angrenzende Schlafzimmer fördert. KW - Wohnungslüftung Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:861-opus4-13128 SP - 1 EP - 8 ER - TY - JOUR A1 - Saal, Susanne A1 - Klingshirn, Hanna A1 - Beutner, Katrin A1 - Strobl, Ralf A1 - Grill, Eva A1 - Müller, Martin A1 - Meyer, Gabriele T1 - Improved participation of older people with joint contractures living in nursing homes: feasibility of study procedures in a cluster-randomised pilot trial JF - Trials N2 - Background: Acquired joint contractures have a significant impact on functioning and quality of life in nursing home residents. There is very limited evidence on measures for prevention and treatment of disability due to joint contractures. We have developed the PECAN intervention (Participation Enabling CAre in Nursing) to improve social participation in nursing home residents. A cluster-randomised pilot trial was conducted to assess the feasibility of study procedures in preparation for a main trial according to the UK Medical Research Council (MRC) framework. Methods: Nursing homes in two regions of Germany were randomly allocated either to the intervention or optimised standard care (control group). All residents with joint contractures aged > 65 years were eligible for the study. The residents’ data were collected through structured face-to-face interviews by blinded assessors at baseline, after 3 and 6 months. The primary outcome was social participation, measured by a subscale of the PaArticular Scales. Secondary outcomes included activities and instrumental activities of daily living, health-related quality of life, falls and fall-related consequences. Data on the trial feasibility were collected via documentation forms. Results: Seven out of 12 nursing homes agreed to participate and remained in the trial. Of 265 residents who fulfilled the inclusion criteria, 129 were randomised either to the intervention (n = 64) or control group (n = 65) and analysed. A total of 109 (85%) completed the trial after 6 months. The mean age was 85.7 years (SD 7.0), 80% were women. The severity of the residents’ disability differed across the clusters. The completion rate was high (> 95%), apart from the Instrumental Activities of Daily Living Scale. Some items of the PaArticular Scales were not easily understood by residents. The frequency of falls did not differ between study groups. Conclusion: Our data confirmed the feasibility of the overall study design. We also revealed the need to improve the procedures for the recruitment of residents and for data collection before implementation into a main trial. The next step will be an adequately powered main trial to assess the effectiveness and cost-effectiveness of the intervention. KW - Joint contractures KW - Nursing homes KW - Participation KW - Complex intervention KW - Cluster-randomised pilot trial KW - Feasibility trial Y1 - 2019 UR - https://doi.org/10.1186/s13063-019-3522-1 VL - 20 SP - 411 ER -