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Biomedical subjects

F Petermann

Publications and source records attributed to F Petermann.

At least 19 recordsLinked to original sources
PubMed2006

[Multimodal therapy of children with attention deficit/hyperactivity disorder and their parents in in-patient rehabilitation].

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent psychic disorders of childhood, characterized by high persistence and an increased risk for the development of externalising disorders of behavior. Due to ADHD increased problems can be frequently observed at school as well as in the social and emotional context of the child. Concepts for in-patient rehabilitation have not been developed, although effective modifications of the behavior of ADHD patients appeared to be achievable under the conditions found in in-patient rehabilitation. OBJECTIVE: The present pilot study aimed to evaluate whether this newly developed concept has any benefit on psychological problems, coping and quality of life. METHOD: In total, n = 28 boys with ADHD 7 to 12 years old were included into a quasi-experimental pre-post design and completed self-report questionnaires on psychological problems, coping and quality of life. In addition, 26 mothers evaluated the behavior problems, psychological problems and quality of life of their sons at the beginning and the end of in-patient rehabilitation. During a 4-week in-patient rehabilitation all children and their mothers took part in a multimodal training containing components of behavior therapy and cognitive-behavioral therapy (self-instruction, self-management, and stress management), applied in child-, parent-child- and parent-centered interventions. RESULTS: Parents estimated the behavior problems of their children as significantly reduced after in-patient rehabilitation as compared to before. In addition, psychological problems and quality of life improved significantly in self- and parent-proxy reports during the in-patient rehabilitation. CONCLUSION: Our results support the hypothesis that this multimodal therapy concept is an effective tool for the treatment of ADHD patients. However, a replication of our results in a control-group study on a larger population is required.

Adolescent↗
PubMed2006

[Education of children with epilepsy and their parents by the modular education program epilepsy for families (FAMOSES)--results of an evaluation study].

PURPOSE: The aim of the study was to evaluate the efficacy of the modular educational program for children with epilepsy and their parents (FAMOSES). This program was developed by an interdisciplinary project group to improve knowledge, coping, treatment outcome, emotional and practical adaptation to the condition. METHODS: A prospective, controlled, multi-center, pre-post study design was used to examine the efficacy of the program in the treatment group compared to the waiting group (control group). Questionnaires included epilepsy specific scales regarding knowledge, attitudes, restrictions in daily living, epilepsy related fears, coping with the chronic disease and generic instruments (quality of life, KINDL). 55 parents of the treatment group completed the questionnaires three months before the course and three months later; the corresponding waiting group included 48 parents. Respectively, 31 children, who participated in the program, completed the questionnaires immediately before the course and three months later; the corresponding waiting group included 19 children. RESULTS: Children, who attended the program, showed improvements in the domains perceived restrictions (significant, medium effect size), absence from school and seizure frequency. Not significantly greater compared to the control group were the improvements of knowledge, attitudes and fears regarding to the epilepsy. Parents of the treatment group showed significant enhancements in epilepsy specific knowledge (large effect size), attitudes toward the epilepsy, management of epileptic seizures and significant reductions of fears and restrictions of their child with epilepsy (small to medium effect sizes).

Adolescent↗
PubMed2006

[Rehabilitation of children and adolescents].

In recent years a significant increase in most chronic mental and physical illnesses among children and adolescents was reported. Thus, medical child and adolescent rehabilitation plays a major role. Therefore, early diagnosis and multimodal intervention in childhood and adolescence is necessary, to prevent a chronic course of disease. Patient education programs have been shown to be effective in the treatment of chronic illnesses. Those programs are mostly aimed to improve the compliant behavior and disease management. Consecutively, the health status and quality of life should be improved. Due to the implementation of guidelines and evaluation studies the quality of rehabilitation programs was ameliorated during the past 15 years. However, future research should develop flexible rehabilitation programs in particular (rehabilitation duration, rehabilitation near or far from place of residence, rehabilitation chain with in-patient, partially out-patient, and out-patient programs), whose effectiveness has to be proven.

Adolescent↗
PubMed2006

[Medication behavior of children and adolescents with asthma before and after in-patient rehabilitation--results of a multicenter study].

The article presented is based on data of a multicenter study examining the effectiveness of an inpatient rehabilitation program for children and adolescents with asthma. The study took place from August 1996 to November 2001. It shows more noticeable long-term improvement of disease management and lung function parameters after in-patient rehabilitation (n = 226) than after out-patient rehabilitation programs (n = 92). The re-analysis of the data examines the influence of medication on these results. A decisive effect on treatment results for both in- and outpatients can be achieved by complying with the guidelines recommended by the medical societies. However, at the same time the results demonstrate that prescribing a correct treatment plan is not always sufficient. The significant improvement of outcome parameters (functional restriction, lung function, days absent from school, visits to a physician) of the rehabilitation group shows the importance of rehabilitation for teaching strategies for disease management and increase in compliance.

Adolescent↗
PubMed2005

[Patient education].

Patient education is considered to be a major feature of medical rehabilitation in chronic disorders. The rehabilitation sciences research programme funded by the German Pension Insurance scheme and the Federal Ministry of Education and Research comprises a considerable number of evaluation studies carried out with methodological rigor. Over two funding periods, patient education programmes were developed and evaluated with respect to their medical, psychosocial, occupational and economic effects. In this article, a conceptual definition of patient education is presented. Then, the aims and results of ten patient education studies of the funding programme as well as of several implementation projects are described. When integrating these results into previous research taking both a national and international perspective, it can be concluded that patient education programmes are effective regarding medical psychosocial and socio-economic outcomes, although effects sizes may vary. However, in some disorders the state of the research is still unsatisfactory and results are either scarce or heterogeneous. In particular, it is unclear whether such programmes are widely used in medical rehabilitation on a routine basis. Several education programmes provide train-the-trainer opportunities, others are still in the process of development or evaluation. Implementation projects such as those described in the article are aimed at closing these gaps and disseminating research results into the practice of rehabilitation.

Biomedical Research↗
PubMed2004

Health-related quality of life in children and adolescents with asthma: results from the ESTAR Study.

Our aim was to assess the psychosocial well-being of asthmatic children and adolescents, the influencing factors, and to determine the effect of inpatient rehabilitation on their quality of life; 226 asthmatic children and adolescents participated in the inpatient rehabilitation (IG). The comparison group (CG) included 92 asthmatic children and adolescents receiving standard medical treatments. Patients were aged between 8 and 16 years and were predominantly male. The health-related quality of life was measured with the German version of the "Paediatric Asthma Quality of Life Questionnaire." Interviews were carried out for IG 2 weeks before the commencement of their inpatient stay and 1 year after their stay ended. The same time schedule was carried out for CG. All patients reported a mild to moderate impairment of their quality of life. Girls described a slightly lower quality of life than boys. With increasing asthma severity, quality of life decreased. Inpatients described a lower quality of life than CG at enrollment. Inpatient rehabilitation resulted in a greater improvement of quality of life over time for IG than for CG. Gender and severity status had no effect on this time course. The only modestly affected quality of life may reflect the good adaptation to the disease and medical treatment. Children and adolescents in the IG recorded improvements in their quality of life. Differences in quality of life based on gender and disease severity were not shown to influence the improvements. In summary, inpatient rehabilitation results in an improvement of health-related quality of life. Further research concerning the psychosocial situation of children and adolescents in this setting is needed.

Adolescent↗
PubMed2004

Psychological adjustment in parents of young children with atopic dermatitis: which factors predict parental quality of life?

BACKGROUND: Bringing up children with atopic dermatitis (AD) is widely perceived as being stressful because parenting demands considerable time and energy. There have been only a few studies to assess the extent of problems experienced by the parents. OBJECTIVE: To assess the psychosocial well-being of parents caring for a young child with AD and to examine the relationship between parental quality of life and disease-related and sociodemographic variables. METHODS: One hundred and eighty-seven parents of young children with AD attending an inpatient rehabilitation clinic participated in the study. At admission, parents completed a set of questionnaires (assessing health-related quality of life, coping with the disease, family functioning). Dermatologists assessed disease severity using the severity scoring of AD index (SCORAD). RESULTS: In general, parents cope well with their situation. Compared with normal values, high rates of psychological distress were observed in a subsample of parents of children with AD. Parents of children with a higher severity of disease reported a significantly higher impact on family functioning, a greater financial burden and a higher level of disease management. Parental disease management could be predicted by the familial situation, their personal well-being and the severity of disease of their child. Differences attributed to their child's gender or age were not observed. CONCLUSIONS: Childhood AD has a profound impact on the emotional and social well-being of many of the parents. The results underline the importance of psychological treatment approaches designed to increase parental well-being and ability to cope with stress and social strain.

Adaptation, Psychological↗
PubMed2003

[Stroke in children and adolescents. Epidemiology--etiology--neurological deficits--neuropsychological manifestations].

Significant epidemiological facts for stroke are different in children and adolescents than in adults. A wide range of causes and risk factors are available for assessment, which is not the case for older patients. Long-term outcome must be regarded by different aspects such as spontaneous remission or the neural plasticity of child brain. Stroke in childhood results in neurological and specific neuropsychological impairments which depend on phases of brain maturity. Special attention should be paid to psychosocial effects of the disease and the impairments that result.

Adolescent↗
PubMed2002

[In-patient asthma education and self-management training in clinical practice--a national survey in Germany].

BACKGROUND: According to international guidelines patient education is a key component of modern asthma-management. Especially in rehabilitation, patient training is considered essential for long-term treatment success. Based on growing empirical evidence for clinical efficacy of asthma self-management training, standardized education programs as well as guidelines and recommendations for quality management in health care practice have been developed. AIM: Due to the lack of evidence [empirical data] on compliance to these recommendations we conducted a nation-wide survey including in-patient pneumological clinics in Germany. METHODS: Exploiting address registers of national asthma organizations (i. e. Deutsche Atemwegsliga) we identified 75 clinics that offer education programs on a regular basis, 65 of which participated in this study (drop-out-rate: 12 %). These institutions were asked to complete a questionnaire in order to assess various aspects of their education practice. RESULTS: Although 91 % of clinics reported to adhere to guidelines and recommendations for patient education, merely 50 % supplied standardized and evaluated education and self-management training programs. A rather small proportion (19 %) was found to fully adhere to protocol (maximum treatment integrity, no mixing of different education schemes). Furthermore, substantial variance between clinics was observed in actual performance of asthma education, the major indicators being: indication criteria and eligibility of patients; education contents; group size, duration and frequency of sessions; extent and intensity; didactical methods; number and qualification of trainers; measures of quality management, and settings. Accordingly, a consistent standard of patient education in rehabilitation practice has not yet been achieved. CONCLUSION: While substantial advances in the proposition of patient education and self-management trainings in in-patient health care remain unquestioned, there are some deficits in actually performing such programs in clinical practice. Results also show that another question needs to be addressed: qualifying trainers. Less than half of trainers participating in this study reported to have absolved a train-the-trainer-course.

Asthma↗
PubMed2002

[Long-term effect of indoor rehabilitation on children and young people with moderate and severe asthma].

In a multi-centre trial the effect of indoor rehabilitation in case of bronchial asthma in childhood and adolescence was evaluated on a prospective basis in comparison to an ambulant group of patients. 195 children and adolescents aged between 8 and 16 suffering from bronchial asthma (grading of severity 3 and 4) were included in the trial. The rehabilitation group (RG) included 149 patients, whereas the out-patient reference group consisted of 46 patients. At the beginning of the trial (in the rehabilitation group about 14 days before rehabilitation started) and 12 months afterwards, the pulmonary function (FEV 1, peak flow and MEF50), asthma-related school day off, participation in school sport, asthma management and quality of life were recorded. 12 months after the indoor rehabilitation, the rehabilitation group had significantly better MEF50-values (P = 0.007) than the ambulant group. The rehabilitation group also had significantly better values (P < 0.01) with regard to the asthma management. Already at the beginning of the study both groups indicated a satisfactory participation in school sport with 3.5 hours a week which could not be increased further. The baseline values for asthma-related school day off and quality of life of the rehabilitation group were worse than those of the ambulant group. 12 months after rehabilitation, however, the values were significantly better (P < 0.01) compared to baseline and almost similar to the levels of the ambulant group. Significantly improvements with regard to MEF50, asthma management, school day off and quality of life could thus be achieved by indoor rehabilitation.

Adolescent↗
PubMed2002

[Health-related auality of life (HRQL) in patients receiving home mechanical ventilation].

Evaluation of health-related quality of life (HRQL) has become steadily more essential during the last two decades in research and health care practice in order to evaluate the human and financial costs and benefits of modern medical techniques. HRQL in its definition is based on different components of health including physical state, psychological well-being, social relations and functional capacities that are influenced by a persons experience, beliefs, expectations, and perceptions. For the purpose of assessment of HRQL several instruments have been developed. Generic instruments are not specific to any particular disease and are therefore most commonly used for general survey research on health allowing comparisons between disease states. In contrast, disease-specific questionnaires which are necessary in order to focus on domains most relevant to a particular disease are thought to be more sensitive than generic instruments following therapeutic interventions. Home mechanical ventilation (HMV) delivered noninvasively by a facial mask is a well established treatment for chronic hypercapnic respiratory failure. It is widely accepted that survival improves following institution of HMV in most patients with chest wall deformities or neuromuscular diseases while this is still controversially discussed in patients with COPD. However, patients receiving HMV usually have severe respiratory insufficiency with a past medical history of several years or decades, and suffer from end stage disease with objectively severe limitations of daily living. In addition, HMV is a time consuming and cost intensive therapy. Therefore, several studies have been conducted in the last decade to evaluate HRQL in patients receiving HMV. Recent studies using generic questionnaires have shown impairments in HRQL in patients receiving HMV compared to normals. This was primarily attributed to severe limitations in physical health, but not in mental health indicating that if severe physical limitation occurs in advanced respiratory disease this will not necessarily lead to mental limitation. In addition, limitations in HRQL in patients with HMV were not substantially higher than in patients with different chronic disease being not dependent on HMV. Improvements in HRQL following the institution of HMV were only mild or even insignificant in patients with COPD, but patients with restrictive ventilatory disorders are suspected to have more benefits. However, well validated disease-specific questionnaires which are designed to be more sensitive in the assessment of changes in HRQL than generic instruments have been introduced recently for patients with severe respiratory failure, but the influence of HMV to HRQL remains still unclear, since prospective studies using these questionnaires have yet not been finished.

Attitude to Health↗
PubMed2001

Conceptualisation and evaluation of a cognitive-behavioural training programme for children and adolescents with obesity.

OBJECTIVE: Obesity is common in children and adolescents with incidence rates increasing both nationally and internationally. Its causes are complex and multifaceted, and obesity is associated with high morbidity and mortality as well as psychological distress. Multidimensional programmes are necessary in the treatment of this chronic disease in order to change eating and physical activity habits. A cognitive-behavioural training programme was developed and evaluated. In combination with diet and exercise, this special group programme that includes well established behavioural methods, was expected to result in long-term weight reduction and decrease of psychological distress in connection with obesity. DESIGN: As part of the six week in-patient rehabilitation for children and adolescents at Viktoriastift in Bad Kreuznach, the three-part programme (experimental group, EG) was compared with a programme that differed only in the psychological intervention component (instead of the specific training programme they undertook muscle relaxation training, comparison group, CG). SUBJECTS: In total, 197 children and adolescents between 9 and 19 y-of-age were recruited into the study. MEASUREMENTS: Somatic (eg weight status), behavioural (eg eating behaviour) and psychological (eg quality of life) outcomes were assessed at five points in time: two weeks before the intervention, at the beginning and end of the programme, as well as six months and one year post-intervention. The study started in spring 1997. Main outcomes will be presented. RESULTS: Pre- vs post-intervention-tests showed significant improvements in self-reported eating behaviours for the EG compared with the CG (F=6.38, P<0.05); these changes were independent of age and sex. The weight status measured as the percentage of overweight dependent on height was reduced in both groups immediately after the intervention and at follow-up (F=16.51, P<0.01). Reduction in the prevalence of obesity tended to be higher in the EG than in the CG (15% vs 10%). Self-reported quality of life increased from before the intervention to follow-up more in the EG than in the CG (F=3.27, P=0.08). In all, the acceptance of the behavioural patient education programme was good. CONCLUSION: In summary, evaluation results indicate that the cognitive-behavioural training programme is a promising approach to alter obesity-related habits and to reduce somatic and psychosocial consequences. Long-term effects after two years are expected to underscore these results.

Adolescent↗
PubMed2001

[The impact of developmental psychological and developmental psychopathological aspects on psychotherapy research with children].

The development of efficacious psychosocial interventions for children and psychotherapy for children and adults differ significantly from each other. Nevertheless, interventions have often been developed for adults and--assuming efficacy--generalized for children; as a rule, efficacy studies of interventions with children are implemented like studies with adults. Several studies put evidence on the efficacy of interventions from different therapeutic traditions, but effectiveness studies of psychotherapy--carried out under authentic conditions--revealed less beneficial effects. Important differences between psychotherapy with children and adults are discussed and several aspects are named, which could be responsible for the differing results of efficacy and effectiveness studies. Hence, several implications for psychotherapy studies with children can be derived (particularly concerning developmental psychological and developmental psychopathological aspects). Following issues are discussed: a) influence of maturation and development; b) influencing factors, e.g. characteristics of the clients; c) developmental appropriate methods; d) multimodal and multimethodological interventions; e) utilization of manuals; f) follow-up-studies; g) outcome criteria; h) sources of information.

Child↗