[Stress Management Interventions at the Workplace Improve Perceived Stress Reactivity of Men at Higher Risk]. / Prävention stressbedingter Gesundheitsschäden in einem Industriebetrieb bei Männern mit erhöhtem Risiko.

A randomised controlled trial was conducted in a metal working plant. The primary endpoint was perceived stress reactivity (Stress Reactivity Scale, SRS). 174 participants were randomly assigned to a stress-management intervention (SMI) (IG) or a waiting control group (CG). N=174 participants (171 male) were recruited at t0, 154 (89%) were still taking part after one year (t1), 131 (76%) after 2 years. The SRS score decreased in both groups. The conducted SMI proved to be effective over both a 1- and a 2-year period.

[Health Promotion for Long-Term Unemployed Persons]. / Gesundheitsförderung für Menschen in Langzeitarbeitslosigkeit.

A controlled trial to improve perceived health in a sample of long-term unemployed persons was conducted. As primary endpoint the SF12-questionnaire was used. The intervention was tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and group sessions designed with the participation of the participants. 365 participants were enrolled in the study. 287 or, respectively, 148 unemployed persons participated at the 3-months/12-months follow-up assessments. A positive effect of the intervention in the setting of long-term unemployed persons has been shown for perceived health, mental health and changes towards more physical activity and healthier nutrition.

[Health coaching as a part of integration into the job market--evaluation of a qualification concept]. / Gesundheits-Coaching in der Arbeitsmarktintegration--Evaluation eines Qualifizierungskonzepts.

OBJECTIVES: The aim of this study is to develop, implement and evaluate an education programme enabling the pedagogic staff of employment promotion agencies to integrate health promotion approaches und activities in vocational training programmes. METHODS: The evaluation of the education programme is based on Kirkpatrick's 4 levels training evaluation model. Besides the participants' verbal end of session feedback, a standardised questionnaire was used at the end of the education programme and after 3 months practical experience. Process evaluation included the implementation level of the methods learned. RESULTS: From a total of 71 participants, 56 completed the first and 31 the second questionnaire (return rate 79% and 44%, respectively). The participants' mean age was 42 years, 80% were female. Only 22% of them integrated health topics systematically into their daily work. A 3-day basic training followed by case conferences during practical work was developed to transfer knowledge and practical competence in person-to-person talks and group activities (so called FIT-counselling and FIT-group). For 96% of participants, their expectations regarding the education programme were met completely or predominantly. 91% indicated a rise in motivation to work as health coach. When rating the training material, 96% judged it helpful for implementation/transfer. Many participants marked the education programme as being too short and wished more time for the topic of "mental health" and exchange of experiences. The follow-up after 3 months on-the-job training revealed that 84 and 97%, respectively, found FIT-counselling and FIT-groups helpful for their daily work. In all employment promotion agencies FIT-counselling and FIT-groups were implemented. CONCLUSION: Our results affirm the need for and prove the acceptance of education programmes enabling the pedagogic staff of job-training programmes to deliver health coaching. Periodic case conferences take into account the participants' request for more exchange of experiences, facilitate implementation and contribute to quality and sustainability. Further development of the education programme is ongoing.

[Health promotion for long-term unemployed. Effects on motivation for a healthy lifestyle]. / Gesundheitskompetenztraining für Menschen in Langzeitarbeitslosigkeit. Auswirkungen auf die Motivation zu einem gesünderen Lebensstil.

Among the long-term unemployed ill health is often a hindrance to successful reintegration in the job market. In a quasi-experimental controlled study we examined the effects of a health promotion intervention program tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and participatory group sessions including physical activity. Over a period of 3 months the participants of the intervention group (n = 179) showed more improvement compared to the control group (n = 108) in terms of motivation for lifestyle changes towards more physical activity and healthier nutrition. Participants of the intervention group developed an intention to act significantly more often (active lifestyle: odds ratio 4.44; 95% CI: 2.00-9.83; healthy nutrition: odds ratio 3.94; 95% CI: 1.55-10.00) and actually implemented a behavior change significantly more often (active lifestyle: odds ratio 2.77; 95% CI: 1.35-5.71; healthy nutrition: odds ratio 4.34; 95% CI: 1.92-9.78). In terms of smoking and alcohol consumption no significant intervention effects were detected. The results of the study show the effectiveness of the described health promotion program regarding a lifestyle change towards more healthy nutrition and more physical activity.

Practicability of segmental stabilizing exercises in the context of a group program for the secondary prevention of low back pain. An explorative pilot study.

AIM: Segmental stabilizing exercises (SSE) for specific dysfunction of local muscles (m. transversus abdominis, m. multifidus, pelvic floor muscles and diaphragm pelvis) have been advocated in patients with low back pain (LBP). The specific aims of this study were to examine: 1) whether participants of a group program learn SSE; 2) whether they respond to SSE with a reduction in present LBP and 3) to what extent people report using SSE in daily living. METHODS: One-hundred nurses participated in this explorative pilot study. Data from a 12-week multimodal program including SSE as intervention for the prevention of LBP were analysed. The prone test was taken as an indicator for the participants' ability to perform SSE correctly. Present back pain was assessed on a numerical rating scale (0-10). A compliance questionnaire and a transfer questionnaire assessed compliance and transfer of SSE into daily living. RESULTS: After the intervention, 72% of participants were able to perform SSE correctly as measured by the prone test. Between 48% and 78% of the participants with present LBP experienced a minimal, clinically important change (minimal clinical changes, [MCC]) while performing SSE. No strong interrelations between the ability to correctly perform SSE and the MCC of LBP could be identified. Participants reported exercising SSE for 12 min on average 4-5 days a week. At 3 months after the intervention, 76% of participants reported using SSE ''always'' in their work with patients. CONCLUSION: First findings are that SSE can be learned by the majority of the participants of a group program for the prevention of LBP. Additionally, SSE reduces present LBP and so can help people with LBP learn to help themselves. We are unable to explain how participants benefited from SSE even when they were unable to perform SSE correctly, as measured by the prone test.

Assessment of health-related quality-of-life in patients after heart transplantation under therapy with tacrolimus or cyclosporine.

Reduction of allograft rejections remains a primary goal for patients after orthotopic heart transplantation. In an open, multicentre, prospectively randomised, parallel group study, patients with primary orthotopic heart transplantation under oral immunosuppressive treatments with tacrolimus (FK506) or cyclosporine (sandimmun) were compared with respect to medical outcome data. As health-related quality-of-life (HRQOL) is also supposed to be an important outcome parameter, it was assessed as a secondary variable in these two patient groups. Patients' self-rated generic HRQOL was assessed 6 weeks, 3 months, 6 months and 12 months after surgery with the SF-36 questionnaire, a generic HRQOL instrument. For 70 patients (46 under tacrolimus, 24 under cyclosporine), intent-to-treat analyses were carried out. The tacrolimus group showed improvements in the different HRQOL subscales of the SF-36 compared to the cyclosporine group. Especially the SF-36 subscales 'vitality' and 'mental health' showed statistically higher scores for the tacrolimus group. Aggregating psychological and cognitive subscales in the 'mental component score', patients treated with tacrolimus showed a statistically significant improvement compared to the cyclosporine group. The assessment of HRQOL variables in the evaluation of treatment effects proved to be an outcome parameter in this study. The results demonstrate the benefit of tacrolimus with respect to the HRQOL of patients, especially in the psychological dimension.

[Perception of stress by mothers of children with language development disorders]. / Belastungserleben von Müttern sprachentwicklungsgestörter Kinder.

Subject of this study is the maternal stress as a result of the disabilities of language impaired children. The report concentrates on the influence of the children disabilities and the maternal coping strategies on the stress in the families. The study is based on an inquiry of 98 mothers with speech and language impaired children. Nearly 50% of the mothers suffer from stress because of their children' disabilities. Special caregiving demands, family conflicts, anxiety about the child future, depressive mood, aggressive feeling or deception were often experienced by the mothers as a direct consequence of their child's problems. The correlation of this specific maternal stress with general stress factors was insignificant. The maternal stress was more due to the attention deficits and the behavioural problems of the children than to the language delay. An increased level of stress was hardly related to the severity of the impairment, but to the maternal coping strategies. Mothers applying emotion focused coping strategies experienced more stress than those who predominantly used problem focused strategies. The results prove that mothers of children with even minor disabilities feel overstrained by their children' disorders. During counseling experts should attach more importance to deal with the needs and wishes of mothers and families of language impaired children. Reduction of family stress can be achieved by intervention programs helping the mothers to improve their psychological resources.