Jürgen kasper | University of Tromsø (original) (raw)
Papers by Jürgen kasper
Background: Evidence-based practice, decision aids, patient preferences and autonomy preferences ... more Background: Evidence-based practice, decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM). They are crucial in the process of decision making and can be incorporated into quality criteria which assess decision making in health care. However, there are few studies on SDM and AP in the field of dentistry. This study explored patients’ autonomy preferences in dentistry in comparison to other medical domains, comparing them with patient preferences in two other cohorts of patients with different conditions and in different health care settings.Methods: A sample of 100 dental patients attending 16 dentists was consecutively recruited in a university-based prosthodontic clinic. Patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions were compared using the Control Preference Scale (CPS). This was followed by cross sectional surveys to stu...
Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy prefe... more Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM) and are useful tools in the process of medical and dental decisions as well as in developing of quality criteria for decision making in many fields of health care. However, there aren’t many studies on SDM and AP in the field of dentistry. This study aimed at exploring patients’ autonomy preferences in dentistry in comparison to other medical domains. Methods: As a first step, a consecutive sample of 100 dental patients and 16 dentists was recruited at a university-based prosthodontic clinic to assess and compare patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions using the Control Preference Scale (CPS). This was followed by a cross sectional survey to study autonomy preferences in three cohorts of 100 patients each recruited from g...
Deutsches Arzteblatt international, Jun 6, 2016
Patients can only make well-informed decisions if the information they are given by health profes... more Patients can only make well-informed decisions if the information they are given by health professionals is based on scientific evidence. In this study, we assessed the foundation in evidence of free, publicly available telephone consultations in Germany. From March 2013 to January 2014, four hidden clients seeking information asked standardized questions about three medical topics (screening for colorectal cancer, for glaucoma, and for trisomy 21) and three dental ones (the sealing of dental fissures, professional dental cleaning, and mercury detoxification). Depending on the topic, the questions addressed such issues as the risk of disease and the purpose, content, validity, benefits, and risks of potential diagnostic and therapeutic measures. All identifiable telephone consultation services that provided counselling on the above topics were included in the study (23 government-sponsored institutions, 31 institutions independently run by physicians, 521 institutions under religiou...
PLOS ONE, 2015
Background Adequate risk knowledge of patients is a prerequisite for shared decision making but f... more Background Adequate risk knowledge of patients is a prerequisite for shared decision making but few attempts have been made to develop assessment tools. Multiple Sclerosis (MS) is a chronic inflammatory disease of young adults with an increasing number of partially effective immunotherapies and therefore a paradigmatic disease to study patient involvement. Objective/methods Based on an item bank of MS risk knowledge items and patient feedback including perceived relevance we developed a risk knowledge questionnaire for relapsing remitting (RR) MS (RIKNO 1.0) which was a primary outcome measure in a patient education trial (192 early RRMS patients). Results Fourteen of the RIKNO 1.0 multiple-choice items were selected based on patient perceived relevance and item difficulty indices, and five on expert opinion. Mean item difficulty was 0.58, ranging from 0.14 to 0.79. Mean RIKNO 1.0 score increased after the educational intervention from 10.6 to 12.4 (p = 0.0003). Selected items were particularly difficult (e.g.
![Research paper thumbnail of [Evidence-based patient information: the example of immunotherapy for patients with multiple sclerosis]](https://attachments.academia-assets.com/91577824/thumbnails/1.jpg)
](Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 2009
The article elucidates consideration of scientific criteria for the development and design of evi... more The article elucidates consideration of scientific criteria for the development and design of evidence-based patient information (EBPI). Immunotherapy of multiple sclerosis serves as an example. Since in EBPI lack of evidence or ambiguities in available evidence are explicitly communicated, processing of EBPI does not necessarily lead to certainty about benefit and harms of medical interventions. However, only if the information is comprehensive in this respect can the EBPI be regarded as a robust basis for an informed choice. EBPI requires substantial developmental efforts. Regarding the growing number of medical interventions and the half-life of information, the question of responsibility for provision of EBPI is crucial. A vision is drafted in which EBPI is driven by demand of the patients and the public and is provided according to a costs-by-cause principle by those who distribute usual information hitherto. Trained patient advocates can appraise quality of information by use ...
Diabetologia, 2006
Aims/hypothesis: Diabetes prevention studies have reported reductions of diabetes risk by up to 6... more Aims/hypothesis: Diabetes prevention studies have reported reductions of diabetes risk by up to 60%. Since the underlying metabolic changes are small, the clinical significance of this effect may be overestimated. The present survey explores the extent to which different formats of presenting study results may influence diabetes healthcare professionals' perceptions of the importance of intervention effects on diabetes risk. Subjects, materials and methods: Participants of three European diabetes conferences (160 nurse educators, 112 physicians, 27 other professionals) were presented with a questionnaire that included nine items, in which results from three diabetes prevention studies were presented in different ways. Results: Participation rate was 96%. Effects were interpreted as important or very important by 92% (255/276) when results were presented as proportions of subjects with diabetes (14% intervention group, 29% control group), by 87% (248/285) when results were communicated as a risk reduction of 57%, by 39% (110/284) when the corresponding fasting plasma glucose values were presented (mean difference 0.3 mmol/l), and by 18% (52/283) when glycosylated haemoglobin values were used (6.0 vs 6.1%). Corresponding results of the three diabetes prevention studies were rated as being of identical importance by only 23, 13 and 16% of participants, respectively. Conclusions and interpretation: Healthcare professionals rate the benefit of preventive interventions substantially higher when changes in diabetes risk are communicated rather than related glycaemic parameters. Transformation of continuous metabolic data into diagnostic categories may impair understanding of study effects.
Additional file 2. TIDieR checklist.
Zielsetzung/Hintergrund: Der Workshop führt die Thematik des Vorgänger-Workshops (Schneider Kaspe... more Zielsetzung/Hintergrund: Der Workshop führt die Thematik des Vorgänger-Workshops (Schneider Kasper) weiter, indem spezifische Barrieren der Kommunikation von Ungewissheit im Arzt Patient Gespräch fokussiert werden. Ergebnisse aus Studien zeigen ein Dilemma: Ein großer Teil der[for full text, please go to the a.m. URL]
Hintergrund: Menschen mit Multipler Sklerose (MS) werden mit vielen Ungewissheiten z.B. zu Diagno... more Hintergrund: Menschen mit Multipler Sklerose (MS) werden mit vielen Ungewissheiten z.B. zu Diagnose, Prognose sowie zu Nutzen und Schaden von Immuntherapien konfrontiert. Evidenz-basierte Patienteninformation ist eine Grundvoraussetzung zur Ermöglichung von informierten Entscheidungen. Aus diesem[for full text, please go to the a.m. URL]
Hintergrund: Zur Herzinfarktvorbeugung bei Typ 2 Diabetes gibt es eine Vielzahl Empfehlungen. Pat... more Hintergrund: Zur Herzinfarktvorbeugung bei Typ 2 Diabetes gibt es eine Vielzahl Empfehlungen. Patienten haben ein Recht auf evidenzbasierte Informationen und wollen verstärkt in Entscheidungen einbezogen werden. In Kooperation mit der Uniklinik Jena wird ein Programm zur informierten Entscheidungsfindung[for full text, please go to the a.m. URL]
Introduction: In Germany the implementation of HPV vaccination for women 12-17 years of age was a... more Introduction: In Germany the implementation of HPV vaccination for women 12-17 years of age was accompanied by various campaigns. Evidence based information including numerical data was not provided. However, standard information leads to overestimation of cancer risk and effects of HPV vaccination. Confidence in children’s ability to deal with numerical data is low, especially in disadvantaged pupils. The aim of the present study was to compare the effects of a standard leaflet with an information leaflet supplemented with numerical data on ‘risk knowledge’ regarding HPV vaccination among schoolgirls. Methods: Randomised-controlled short-term trial. All 108 schoolgirls of seven school classes were asked to participate and 105 agreed. Participants were vocational schoolgirls who were preparing for grade 10 graduation and who were members of the target group for HPV vaccination. The control group was asked to read a standard leaflet on HPV vaccination of the German Women's Health Network. The intervention group received the same leaflet, but it was supplemented with numerical information on cancer risk and assumed effects of the HPV vaccination on cancer prevention. As baseline characteristics we surveyed: age, vaccination status, attitude towards HPV vaccination and aspects regarding migration background. The primary end point was ‘risk knowledge’. Questionnaire surveys were performed under experimental conditions. Individual randomisation, participants, and intention-to-treat data analyses were blinded. The study was approved by the Ministry of Education and Culture of Schleswig-Holstein and the ethics committee of the Hamburg Chamber of Physicians. Results: We analysed ‘risk knowledge’ for all 105 randomised participants. Baseline characteristics of the two groups were comparable. Numerical risk information recipients were more likely to give correct answers compared to standard information recipients: Mean value of risk knowledge score (0-5 points): 4.6 ± 1.0 vs. 2.6 ± 1.2 (mean difference 2.0 (95% CI 1.6-2.4)); (P<0.001). Post hoc distractor analysis of single items was performed. Incorrect answers of control participants indicated that cervical cancer risk was highly overestimated whereas total cancer risk was mostly underestimated, and possible impact of HPV vaccination on cancer prevention was overestimated. Conclusion: Supplementing health information on HPV vaccination with numerical data improves ‘risk knowledge’ among schoolgirls
Applying the theory of planned behaviour to multiple sclerosis patients ’ decisions on disease
Patient Education and Counseling, 2018
To identify determinants of older patients' perceptions of involvement in decision-making on colo... more To identify determinants of older patients' perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions. Methods: Patients' perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers' perceptions were constructed by the OPTION5, OPTION12, and MAPPIN'SDM. Convergent validities were calculated between the patientsided and observer instruments using Spearman's correlation coefficient. Linear regression was used to identify determinants per criterion. Results: 58 CRC and 22 PC patients were included (mean age: 71.8 AE 5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients' impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers' perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills. Conclusion: Due to evident differences in determinants, older CRC/PC patients' and observers' perceptions of involvement should both be collected in evaluating the quality of medical decision-making. Practice Implications: General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction.
Clinical Rehabilitation, 2016
Objective: To investigate the effectiveness of a multi-component evidence-based education program... more Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was “informed choice”, comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue. Results...
Pflege, 2009
Stroke Units haben sich in der Versorgung von Schlaganfallpatienten deutschlandweit etabliert. Zu... more Stroke Units haben sich in der Versorgung von Schlaganfallpatienten deutschlandweit etabliert. Zum spezifischen Beitrag Pflegender am Erfolg des Konzepts der Stroke Units liegen international bisher wenige Daten vor. Die vorliegenden Studien beschreiben u.a. eine Schnittstellenfunktion der Pflegenden im multiprofessionellen Team der Stroke Units. Für Deutschland fehlen solche Daten. In einer Fragebogenstudie mit 55 Mitarbeitern der Teams dreier überregionaler Stroke Units wurden die am Versorgungsprozess einer Stroke Unit beteiligten Berufsgruppen zu verschiedenen Aspekten der Zusammenarbeit (u.a. Kommunikationsverhalten, Anerkennung im Team) befragt und um Einschätzung des spezifischen Anteils der Pflegenden an der Organisation der Stroke Unit und der Genesung der Patienten gebeten. Die Vertreter der verschiedenen Berufsgruppen kommen zu ähnlichen Einschätzungen bezüglich der interdisziplinären Zusammenarbeit. Pflegende und therapeutische Mitarbeitende schätzen den Anteil der Pfleg...
Patient Education and Counseling, 2006
Objective: This study analysis the comprehension and emotional responses of people suffering from... more Objective: This study analysis the comprehension and emotional responses of people suffering from multiple sclerosis when provided with an evidence-based information module. It is a core module of a comprehensive decision aid about immunotherapy. The core module is designed to enable patients to process scientific uncertainty without adverse effects. It considers existing standards for risk communication and presentation of data. Methods: Using a mailing approach we investigated 169 patients with differing courses of disease in a before-after design. Items addressed the competence in processing relative and absolute risk information and patients' emotional response to the tool, comprising grade of familiarity with the information, understanding, relevance, emotional arousal, and certainty. Results: Overall, numeracy improved (p < 0.001), although 99 of 169 patients did not complete the numeracy task correctly. Understanding depended on the relevance related to the course of disease. A moderate level of uncertainty was induced. No adverse emotional responses could be shown, neither in those who did comprehend the information, nor in those who did not develop numeracy skills. Conclusion: In conclusion, the tool supports people suffering from multiple sclerosis to process evidence-based medical information and scientific uncertainty without burdening them emotionally. Practice implications: This study is an example for the documentation of an important step in the development process of a complex intervention.
Hintergrund und Fragestellung: Um informierte Entscheidungen über Behandlungen treffen zu können,... more Hintergrund und Fragestellung: Um informierte Entscheidungen über Behandlungen treffen zu können, benötigen Patienten evidenzbasierte Informationen. Allerdings ist die Evidenz hinsichtlich der graphischen Präsentation von Wahrscheinlichkeiten für therapiebedingten Nutzen und[for full text, please go to the a.m. URL]
Ziel: Jeden Tag sprechen Sie mit Ihren Patienten darüber, was deren Diagnosen bedeuten und versuc... more Ziel: Jeden Tag sprechen Sie mit Ihren Patienten darüber, was deren Diagnosen bedeuten und versuchen zusammen, die richtigen Entscheidungen über medizinische Maßnahmen zu treffen. Wir nennen das Risiko-Kommunikation, weil immer Möglichkeiten abgeschätzt oder gegeneinander abgewogen[for full text, please go to the a.m. URL]
Hintergrund und Fragestellung: Es gibt wenige nachweislich wirksame Ärztetrainings zur Verbesseru... more Hintergrund und Fragestellung: Es gibt wenige nachweislich wirksame Ärztetrainings zur Verbesserung von Shared Decision Making-Kompetenzen (SDM). Eine gründliche Evaluation muss den komplexen Charakter der Intervention berücksichtigen. Das Poster zeigt, dass die bisherigen Studien zur[zum vollständigen Text gelangen Sie über die oben angegebene URL]
Background: Evidence-based practice, decision aids, patient preferences and autonomy preferences ... more Background: Evidence-based practice, decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM). They are crucial in the process of decision making and can be incorporated into quality criteria which assess decision making in health care. However, there are few studies on SDM and AP in the field of dentistry. This study explored patients’ autonomy preferences in dentistry in comparison to other medical domains, comparing them with patient preferences in two other cohorts of patients with different conditions and in different health care settings.Methods: A sample of 100 dental patients attending 16 dentists was consecutively recruited in a university-based prosthodontic clinic. Patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions were compared using the Control Preference Scale (CPS). This was followed by cross sectional surveys to stu...
Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy prefe... more Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM) and are useful tools in the process of medical and dental decisions as well as in developing of quality criteria for decision making in many fields of health care. However, there aren’t many studies on SDM and AP in the field of dentistry. This study aimed at exploring patients’ autonomy preferences in dentistry in comparison to other medical domains. Methods: As a first step, a consecutive sample of 100 dental patients and 16 dentists was recruited at a university-based prosthodontic clinic to assess and compare patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions using the Control Preference Scale (CPS). This was followed by a cross sectional survey to study autonomy preferences in three cohorts of 100 patients each recruited from g...
Deutsches Arzteblatt international, Jun 6, 2016
Patients can only make well-informed decisions if the information they are given by health profes... more Patients can only make well-informed decisions if the information they are given by health professionals is based on scientific evidence. In this study, we assessed the foundation in evidence of free, publicly available telephone consultations in Germany. From March 2013 to January 2014, four hidden clients seeking information asked standardized questions about three medical topics (screening for colorectal cancer, for glaucoma, and for trisomy 21) and three dental ones (the sealing of dental fissures, professional dental cleaning, and mercury detoxification). Depending on the topic, the questions addressed such issues as the risk of disease and the purpose, content, validity, benefits, and risks of potential diagnostic and therapeutic measures. All identifiable telephone consultation services that provided counselling on the above topics were included in the study (23 government-sponsored institutions, 31 institutions independently run by physicians, 521 institutions under religiou...
PLOS ONE, 2015
Background Adequate risk knowledge of patients is a prerequisite for shared decision making but f... more Background Adequate risk knowledge of patients is a prerequisite for shared decision making but few attempts have been made to develop assessment tools. Multiple Sclerosis (MS) is a chronic inflammatory disease of young adults with an increasing number of partially effective immunotherapies and therefore a paradigmatic disease to study patient involvement. Objective/methods Based on an item bank of MS risk knowledge items and patient feedback including perceived relevance we developed a risk knowledge questionnaire for relapsing remitting (RR) MS (RIKNO 1.0) which was a primary outcome measure in a patient education trial (192 early RRMS patients). Results Fourteen of the RIKNO 1.0 multiple-choice items were selected based on patient perceived relevance and item difficulty indices, and five on expert opinion. Mean item difficulty was 0.58, ranging from 0.14 to 0.79. Mean RIKNO 1.0 score increased after the educational intervention from 10.6 to 12.4 (p = 0.0003). Selected items were particularly difficult (e.g.
Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 2009
The article elucidates consideration of scientific criteria for the development and design of evi... more The article elucidates consideration of scientific criteria for the development and design of evidence-based patient information (EBPI). Immunotherapy of multiple sclerosis serves as an example. Since in EBPI lack of evidence or ambiguities in available evidence are explicitly communicated, processing of EBPI does not necessarily lead to certainty about benefit and harms of medical interventions. However, only if the information is comprehensive in this respect can the EBPI be regarded as a robust basis for an informed choice. EBPI requires substantial developmental efforts. Regarding the growing number of medical interventions and the half-life of information, the question of responsibility for provision of EBPI is crucial. A vision is drafted in which EBPI is driven by demand of the patients and the public and is provided according to a costs-by-cause principle by those who distribute usual information hitherto. Trained patient advocates can appraise quality of information by use ...
Diabetologia, 2006
Aims/hypothesis: Diabetes prevention studies have reported reductions of diabetes risk by up to 6... more Aims/hypothesis: Diabetes prevention studies have reported reductions of diabetes risk by up to 60%. Since the underlying metabolic changes are small, the clinical significance of this effect may be overestimated. The present survey explores the extent to which different formats of presenting study results may influence diabetes healthcare professionals' perceptions of the importance of intervention effects on diabetes risk. Subjects, materials and methods: Participants of three European diabetes conferences (160 nurse educators, 112 physicians, 27 other professionals) were presented with a questionnaire that included nine items, in which results from three diabetes prevention studies were presented in different ways. Results: Participation rate was 96%. Effects were interpreted as important or very important by 92% (255/276) when results were presented as proportions of subjects with diabetes (14% intervention group, 29% control group), by 87% (248/285) when results were communicated as a risk reduction of 57%, by 39% (110/284) when the corresponding fasting plasma glucose values were presented (mean difference 0.3 mmol/l), and by 18% (52/283) when glycosylated haemoglobin values were used (6.0 vs 6.1%). Corresponding results of the three diabetes prevention studies were rated as being of identical importance by only 23, 13 and 16% of participants, respectively. Conclusions and interpretation: Healthcare professionals rate the benefit of preventive interventions substantially higher when changes in diabetes risk are communicated rather than related glycaemic parameters. Transformation of continuous metabolic data into diagnostic categories may impair understanding of study effects.
Additional file 2. TIDieR checklist.
Zielsetzung/Hintergrund: Der Workshop führt die Thematik des Vorgänger-Workshops (Schneider Kaspe... more Zielsetzung/Hintergrund: Der Workshop führt die Thematik des Vorgänger-Workshops (Schneider Kasper) weiter, indem spezifische Barrieren der Kommunikation von Ungewissheit im Arzt Patient Gespräch fokussiert werden. Ergebnisse aus Studien zeigen ein Dilemma: Ein großer Teil der[for full text, please go to the a.m. URL]
Hintergrund: Menschen mit Multipler Sklerose (MS) werden mit vielen Ungewissheiten z.B. zu Diagno... more Hintergrund: Menschen mit Multipler Sklerose (MS) werden mit vielen Ungewissheiten z.B. zu Diagnose, Prognose sowie zu Nutzen und Schaden von Immuntherapien konfrontiert. Evidenz-basierte Patienteninformation ist eine Grundvoraussetzung zur Ermöglichung von informierten Entscheidungen. Aus diesem[for full text, please go to the a.m. URL]
Hintergrund: Zur Herzinfarktvorbeugung bei Typ 2 Diabetes gibt es eine Vielzahl Empfehlungen. Pat... more Hintergrund: Zur Herzinfarktvorbeugung bei Typ 2 Diabetes gibt es eine Vielzahl Empfehlungen. Patienten haben ein Recht auf evidenzbasierte Informationen und wollen verstärkt in Entscheidungen einbezogen werden. In Kooperation mit der Uniklinik Jena wird ein Programm zur informierten Entscheidungsfindung[for full text, please go to the a.m. URL]
Introduction: In Germany the implementation of HPV vaccination for women 12-17 years of age was a... more Introduction: In Germany the implementation of HPV vaccination for women 12-17 years of age was accompanied by various campaigns. Evidence based information including numerical data was not provided. However, standard information leads to overestimation of cancer risk and effects of HPV vaccination. Confidence in children’s ability to deal with numerical data is low, especially in disadvantaged pupils. The aim of the present study was to compare the effects of a standard leaflet with an information leaflet supplemented with numerical data on ‘risk knowledge’ regarding HPV vaccination among schoolgirls. Methods: Randomised-controlled short-term trial. All 108 schoolgirls of seven school classes were asked to participate and 105 agreed. Participants were vocational schoolgirls who were preparing for grade 10 graduation and who were members of the target group for HPV vaccination. The control group was asked to read a standard leaflet on HPV vaccination of the German Women's Health Network. The intervention group received the same leaflet, but it was supplemented with numerical information on cancer risk and assumed effects of the HPV vaccination on cancer prevention. As baseline characteristics we surveyed: age, vaccination status, attitude towards HPV vaccination and aspects regarding migration background. The primary end point was ‘risk knowledge’. Questionnaire surveys were performed under experimental conditions. Individual randomisation, participants, and intention-to-treat data analyses were blinded. The study was approved by the Ministry of Education and Culture of Schleswig-Holstein and the ethics committee of the Hamburg Chamber of Physicians. Results: We analysed ‘risk knowledge’ for all 105 randomised participants. Baseline characteristics of the two groups were comparable. Numerical risk information recipients were more likely to give correct answers compared to standard information recipients: Mean value of risk knowledge score (0-5 points): 4.6 ± 1.0 vs. 2.6 ± 1.2 (mean difference 2.0 (95% CI 1.6-2.4)); (P<0.001). Post hoc distractor analysis of single items was performed. Incorrect answers of control participants indicated that cervical cancer risk was highly overestimated whereas total cancer risk was mostly underestimated, and possible impact of HPV vaccination on cancer prevention was overestimated. Conclusion: Supplementing health information on HPV vaccination with numerical data improves ‘risk knowledge’ among schoolgirls
Applying the theory of planned behaviour to multiple sclerosis patients ’ decisions on disease
Patient Education and Counseling, 2018
To identify determinants of older patients' perceptions of involvement in decision-making on colo... more To identify determinants of older patients' perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions. Methods: Patients' perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers' perceptions were constructed by the OPTION5, OPTION12, and MAPPIN'SDM. Convergent validities were calculated between the patientsided and observer instruments using Spearman's correlation coefficient. Linear regression was used to identify determinants per criterion. Results: 58 CRC and 22 PC patients were included (mean age: 71.8 AE 5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients' impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers' perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills. Conclusion: Due to evident differences in determinants, older CRC/PC patients' and observers' perceptions of involvement should both be collected in evaluating the quality of medical decision-making. Practice Implications: General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction.
Clinical Rehabilitation, 2016
Objective: To investigate the effectiveness of a multi-component evidence-based education program... more Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was “informed choice”, comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue. Results...
Pflege, 2009
Stroke Units haben sich in der Versorgung von Schlaganfallpatienten deutschlandweit etabliert. Zu... more Stroke Units haben sich in der Versorgung von Schlaganfallpatienten deutschlandweit etabliert. Zum spezifischen Beitrag Pflegender am Erfolg des Konzepts der Stroke Units liegen international bisher wenige Daten vor. Die vorliegenden Studien beschreiben u.a. eine Schnittstellenfunktion der Pflegenden im multiprofessionellen Team der Stroke Units. Für Deutschland fehlen solche Daten. In einer Fragebogenstudie mit 55 Mitarbeitern der Teams dreier überregionaler Stroke Units wurden die am Versorgungsprozess einer Stroke Unit beteiligten Berufsgruppen zu verschiedenen Aspekten der Zusammenarbeit (u.a. Kommunikationsverhalten, Anerkennung im Team) befragt und um Einschätzung des spezifischen Anteils der Pflegenden an der Organisation der Stroke Unit und der Genesung der Patienten gebeten. Die Vertreter der verschiedenen Berufsgruppen kommen zu ähnlichen Einschätzungen bezüglich der interdisziplinären Zusammenarbeit. Pflegende und therapeutische Mitarbeitende schätzen den Anteil der Pfleg...
Patient Education and Counseling, 2006
Objective: This study analysis the comprehension and emotional responses of people suffering from... more Objective: This study analysis the comprehension and emotional responses of people suffering from multiple sclerosis when provided with an evidence-based information module. It is a core module of a comprehensive decision aid about immunotherapy. The core module is designed to enable patients to process scientific uncertainty without adverse effects. It considers existing standards for risk communication and presentation of data. Methods: Using a mailing approach we investigated 169 patients with differing courses of disease in a before-after design. Items addressed the competence in processing relative and absolute risk information and patients' emotional response to the tool, comprising grade of familiarity with the information, understanding, relevance, emotional arousal, and certainty. Results: Overall, numeracy improved (p < 0.001), although 99 of 169 patients did not complete the numeracy task correctly. Understanding depended on the relevance related to the course of disease. A moderate level of uncertainty was induced. No adverse emotional responses could be shown, neither in those who did comprehend the information, nor in those who did not develop numeracy skills. Conclusion: In conclusion, the tool supports people suffering from multiple sclerosis to process evidence-based medical information and scientific uncertainty without burdening them emotionally. Practice implications: This study is an example for the documentation of an important step in the development process of a complex intervention.
Hintergrund und Fragestellung: Um informierte Entscheidungen über Behandlungen treffen zu können,... more Hintergrund und Fragestellung: Um informierte Entscheidungen über Behandlungen treffen zu können, benötigen Patienten evidenzbasierte Informationen. Allerdings ist die Evidenz hinsichtlich der graphischen Präsentation von Wahrscheinlichkeiten für therapiebedingten Nutzen und[for full text, please go to the a.m. URL]
Ziel: Jeden Tag sprechen Sie mit Ihren Patienten darüber, was deren Diagnosen bedeuten und versuc... more Ziel: Jeden Tag sprechen Sie mit Ihren Patienten darüber, was deren Diagnosen bedeuten und versuchen zusammen, die richtigen Entscheidungen über medizinische Maßnahmen zu treffen. Wir nennen das Risiko-Kommunikation, weil immer Möglichkeiten abgeschätzt oder gegeneinander abgewogen[for full text, please go to the a.m. URL]
Hintergrund und Fragestellung: Es gibt wenige nachweislich wirksame Ärztetrainings zur Verbesseru... more Hintergrund und Fragestellung: Es gibt wenige nachweislich wirksame Ärztetrainings zur Verbesserung von Shared Decision Making-Kompetenzen (SDM). Eine gründliche Evaluation muss den komplexen Charakter der Intervention berücksichtigen. Das Poster zeigt, dass die bisherigen Studien zur[zum vollständigen Text gelangen Sie über die oben angegebene URL]