Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie, Feb 1, 2009
The HEALTH questionnaire, which originally consisted of 79 items, aims to assess generic aspects ... more The HEALTH questionnaire, which originally consisted of 79 items, aims to assess generic aspects of psychosocial health. Based on large clinical and healthy samples (n = 1548 psychotherapy inpatients, n = 5630 primary-care patients), the questionnaire was shortened and psychometrically analyzed. The resulting 49-item questionnaire ("HEALTH-49") comprises six discrete modules with nine scales (somatoform complaints, depressiveness, phobic anxiety, psychological wellbeing, interactional problems, self-efficacy, activity and participation, social support, and social stress). It proves to be well accepted and feasible under routine conditions. Factor analyses confirm the intended dimensional configuration and the relative independence of modules. The scales reveal high reliability. Evidence of their validity and sensitivity to change are demonstrated. The HEALTH-49 is a self-rating instrument that allows for the comprehensive and economic assessment of generic aspects of psychosocial health. It is highly suitable for use in clinical practice. The questionnaire is available as a free download from http://www.hamburger-module.de/
The recommendations for aftercare listed in discharge reports represent a core component of commu... more The recommendations for aftercare listed in discharge reports represent a core component of communication between inpatient psychosomatic rehabilitation and ambulatory follow-up care. The standardized discharge report used by the pension insurance institutes makes use of a generic category system for systematization and simplification of recommendations for aftercare. Neither the practice of making recommendations for aftercare as observed by therapists and physicians responsible for treatment in the inpatient setting nor the appropriateness and differentiation of the category system has previously been systematically examined. A randomized sample of discharge reports was analyzed for this purpose. A sample of 500 discharge reports from an inpatient-oriented psychosomatic rehabilitation setting were analyzed regarding the categories of recommended aftercare measures and their relationship with socio-demographic variables, clinical diagnosis and sociomedical variables. Outpatient psy...
... Martin Härter1,2, Christian Klesse2, Mathias Berger2, Isaac Bermejo2, Tom Bschor3, Jochen Gen... more ... Martin Härter1,2, Christian Klesse2, Mathias Berger2, Isaac Bermejo2, Tom Bschor3, Jochen Gensichen4, Timo Harfst5, Martin Hautzinger6, Christine ... Stirman, SW, Derubeis, RJ, Crits-Christoph, P., Rothman, A. (2005): Can the randomized controlled trial literature generalize ...
Zeitschrift fü Arztliche Fortbildung und Qualitatssicherung
It is becoming increasingly more relevant for health care providers to also participate in extern... more It is becoming increasingly more relevant for health care providers to also participate in external quality assurance measures. A few systematic approaches that also integrate outcome quality and include a comparison of different clinics have only recently been developed for the area of the treatment of patients with mental disorders. In this context, a key issue is the appropriate consideration of confounders, i.e., of unevenly distributed patient characteristics that are causally related to the treatment results. Using a sample of consecutive patients from four psychotherapeutic clinics, we exemplarily examined the significance of the confounders for the comparison of the clinics with regard to short-term outcome. The results show that an adjustment is principally advisable and is generally associated with a reduction of the differences in treatment results. The discussion asserts that the use of regression weights, which were ascertained using an independent, representative sample, allows for a more valid risk adjustment. Finally, reference will be made to the relevance of giving consideration to varying resource usage in the assessment of the risk-adjusted clinic comparisons.
The following article presents aspects of the field of psychosocial medicine in Germany from the ... more The following article presents aspects of the field of psychosocial medicine in Germany from the perspective of health services research. First, the tasks and topics of health services research are listed. The identification and appropriate treatment of people with mental disorders is one of the core themes of psychosocial health care; therefore, a brief overview of research results on the epidemiology of mental disorders is first presented. The primary focus of this article is then to provide a description and analysis of the structures of psychosocial care in inpatient and outpatient settings. Research findings concerning treatment processes and the result of these processes are additionally presented. The findings show that there is still a considerable lack of research results regarding the treatment of patients with mental disorders, as is also the case in other health care areas. An important empirical basis for rationally founded treatment planning in this area is thus lacking.
Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic a... more Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic aims to support human health and well-being. Up to now, standardized instruments to evaluate these treatment goals are still missing. We present results of analyses of the psychometric properties of the Hamburg Self-Care Questionnaire (HamSCQ). Besides reliability we are focusing on different aspects of validity: factor structure, concurrent validity, and sensitivity to change. A total sample of 7 478 inpatients with mental disorders from four different psychotherapeutic clinics participated in the study. Patients completed self-rating questionnaires at admission and discharge: Besides the HamSCQ we used the Symptom Checklist SCL-14, the Short Form SF-8, the CES-D depression scale, the Inventory of Interpersonal Problems IIP-25 and the AVEM. The two-dimensional structure of the HamSCQ with the two subscales PACING and POSITIVE EXPERIENCE could be replicated by means of both principal comp...
Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie, Feb 1, 2009
The HEALTH questionnaire, which originally consisted of 79 items, aims to assess generic aspects ... more The HEALTH questionnaire, which originally consisted of 79 items, aims to assess generic aspects of psychosocial health. Based on large clinical and healthy samples (n = 1548 psychotherapy inpatients, n = 5630 primary-care patients), the questionnaire was shortened and psychometrically analyzed. The resulting 49-item questionnaire ("HEALTH-49") comprises six discrete modules with nine scales (somatoform complaints, depressiveness, phobic anxiety, psychological wellbeing, interactional problems, self-efficacy, activity and participation, social support, and social stress). It proves to be well accepted and feasible under routine conditions. Factor analyses confirm the intended dimensional configuration and the relative independence of modules. The scales reveal high reliability. Evidence of their validity and sensitivity to change are demonstrated. The HEALTH-49 is a self-rating instrument that allows for the comprehensive and economic assessment of generic aspects of psychosocial health. It is highly suitable for use in clinical practice. The questionnaire is available as a free download from http://www.hamburger-module.de/
The recommendations for aftercare listed in discharge reports represent a core component of commu... more The recommendations for aftercare listed in discharge reports represent a core component of communication between inpatient psychosomatic rehabilitation and ambulatory follow-up care. The standardized discharge report used by the pension insurance institutes makes use of a generic category system for systematization and simplification of recommendations for aftercare. Neither the practice of making recommendations for aftercare as observed by therapists and physicians responsible for treatment in the inpatient setting nor the appropriateness and differentiation of the category system has previously been systematically examined. A randomized sample of discharge reports was analyzed for this purpose. A sample of 500 discharge reports from an inpatient-oriented psychosomatic rehabilitation setting were analyzed regarding the categories of recommended aftercare measures and their relationship with socio-demographic variables, clinical diagnosis and sociomedical variables. Outpatient psy...
... Martin Härter1,2, Christian Klesse2, Mathias Berger2, Isaac Bermejo2, Tom Bschor3, Jochen Gen... more ... Martin Härter1,2, Christian Klesse2, Mathias Berger2, Isaac Bermejo2, Tom Bschor3, Jochen Gensichen4, Timo Harfst5, Martin Hautzinger6, Christine ... Stirman, SW, Derubeis, RJ, Crits-Christoph, P., Rothman, A. (2005): Can the randomized controlled trial literature generalize ...
Zeitschrift fü Arztliche Fortbildung und Qualitatssicherung
It is becoming increasingly more relevant for health care providers to also participate in extern... more It is becoming increasingly more relevant for health care providers to also participate in external quality assurance measures. A few systematic approaches that also integrate outcome quality and include a comparison of different clinics have only recently been developed for the area of the treatment of patients with mental disorders. In this context, a key issue is the appropriate consideration of confounders, i.e., of unevenly distributed patient characteristics that are causally related to the treatment results. Using a sample of consecutive patients from four psychotherapeutic clinics, we exemplarily examined the significance of the confounders for the comparison of the clinics with regard to short-term outcome. The results show that an adjustment is principally advisable and is generally associated with a reduction of the differences in treatment results. The discussion asserts that the use of regression weights, which were ascertained using an independent, representative sample, allows for a more valid risk adjustment. Finally, reference will be made to the relevance of giving consideration to varying resource usage in the assessment of the risk-adjusted clinic comparisons.
The following article presents aspects of the field of psychosocial medicine in Germany from the ... more The following article presents aspects of the field of psychosocial medicine in Germany from the perspective of health services research. First, the tasks and topics of health services research are listed. The identification and appropriate treatment of people with mental disorders is one of the core themes of psychosocial health care; therefore, a brief overview of research results on the epidemiology of mental disorders is first presented. The primary focus of this article is then to provide a description and analysis of the structures of psychosocial care in inpatient and outpatient settings. Research findings concerning treatment processes and the result of these processes are additionally presented. The findings show that there is still a considerable lack of research results regarding the treatment of patients with mental disorders, as is also the case in other health care areas. An important empirical basis for rationally founded treatment planning in this area is thus lacking.
Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic a... more Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic aims to support human health and well-being. Up to now, standardized instruments to evaluate these treatment goals are still missing. We present results of analyses of the psychometric properties of the Hamburg Self-Care Questionnaire (HamSCQ). Besides reliability we are focusing on different aspects of validity: factor structure, concurrent validity, and sensitivity to change. A total sample of 7 478 inpatients with mental disorders from four different psychotherapeutic clinics participated in the study. Patients completed self-rating questionnaires at admission and discharge: Besides the HamSCQ we used the Symptom Checklist SCL-14, the Short Form SF-8, the CES-D depression scale, the Inventory of Interpersonal Problems IIP-25 and the AVEM. The two-dimensional structure of the HamSCQ with the two subscales PACING and POSITIVE EXPERIENCE could be replicated by means of both principal comp...
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