Norbert Schäffeler

Stigmatization of obese individuals by human resource professionals: an experimental study.

BackgroundWeight-related stigmatization is a public health problem. It impairs the psychological well-being of obese individuals and hinders them from adopting weight-loss behaviors. We conducted an experimental study to investigate weight stigmatization in work settings using a sample of experienced human resource (HR) professionals from a real-life employment setting.MethodsIn a cross-sectional, computer-based experimental study, a volunteer sample of 127 HR professionals (age: 41.1 ± 10.9 yrs., 56% female), who regularly make career decisions about other people, evaluated individuals shown in standardized photographs regarding work-related prestige and achievements. The photographed individuals differed with respect to gender, ethnicity, and Body Mass Index (BMI).ResultsParticipants underestimated the occupational prestige of obese individuals and overestimated it for normal-weight individuals. Obese people were more often disqualified from being hired and less often nominated for a supervisory position, while non-ethnic normal-weight individuals were favored. Stigmatization was most pronounced in obese females.ConclusionsThe data suggest that HR professionals are prone to pronounced weight stigmatization, especially in women. This highlights the need for interventions targeting this stigmatization as well as stigma-management strategies for obese individuals. Weight stigmatization and its consequences needs to be a topic that is more strongly addressed in clinical obesity care.

Psychological Distress, Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.

Akzeptanz und Reliabilität eines elektronischen psychoonkologischen Screenings bei Patientinnen mit Brustkrebs: eine randomisiert-kontrollierte Studie

Many oncology centres have implemented a screening to identify distress in cancer patients. Assessments using paper-pencil questionnaires are time-consuming to score and may cause delays in providing psychooncological care. This challenges care-givers because it reduces the time available for inpatient treatment. In a randomized-controlled study, we examined an electronic screening tool which would enhance psychooncological clinical care by improving information flow, and by meeting demands of an electronic patient chart. In total 206 patients with breast cancer randomly received either a paper-pencil or electronic questionnaire to measure distress, as well as, the acceptance of the current screening procedure. The acceptance of the electronic screening was greater compared to that of the paper-pencil screening. The results of the two assessment approaches did not -differ. An electronic screening may provide a time -saving alternative with excellent data quality.

Internet use among patients with psychosomatic disorders: What are the health-related demands and needs?

While Internet-based health-related offers for various disorders are increasing, little is known about the way patients with psychosomatic disorders use the Internet. We conducted a questionnaire survey in outpatient clinics at two university hospitals’ Departments of Psychosomatic Medicine. Seventy-four percent of N = 274 patients had Internet home access and 60 percent of those patients reported health-related Internet use. Patients expressed the wish for more professional, evidence-based online information and expert-guided treatment. The survey results support the Internet’s high potential in future treatment strategies for patients with psychosomatic disorders.

Communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks – a randomized controlled trial

BackgroundInformed consent talks are mandatory before invasive interventions. However, the patients’ information recall has been shown to be rather poor. We investigated, whether medical laypersons recalled more information items from a simulated informed consent talk after advanced medical students participated in a communication training aiming to reduce a layperson’s cognitive load.MethodsUsing a randomized, controlled, prospective cross-over-design, 30 5th and 6th year medical students were randomized into two groups. One group received communication training, followed by a comparison intervention (early intervention group, EI); the other group first received the comparison intervention and then communication training (late intervention group, LI). Before and after the interventions, the 30 medical students performed simulated informed consent talks with 30 blinded medical laypersons using a standardized set of information. We then recorded the number of information items the medical laypersons recalled.ResultsAfter the communication training both groups of medical laypersons recalled significantly more information items (EI: 41 ± 9% vs. 23 ± 9%, p < .0001, LI 49 ± 10% vs. 35 ± 6%, p < .0001). After the comparison intervention the improvement was modest and significant only in the LI (EI: 42 ± 9% vs. 40 ± 9%, p = .41, LI 35 ± 6% vs. 29 ± 9%, p = .016).ConclusionShort communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks.

Managing Obesity Prevention Using Digital Media: A Double-Sided Approach

In this chapter we report results from a study on a digital health communication campaign initiated by Children’s Healthcare of Atlanta. This campaign has triggered a highly controversial discussion in the USA, because it used obese children and showed them in online media talking about being stigmatized. Our research is based on the assumption that controversial campaigns disseminated via online media run the risk of being re-contextualized, with the possible negative result of jeopardizing the original communicator’s intentions. Results showed that contextual reinforcement of the campaign message (in three contexts: Facebook, online-news, and a health-related blog) improved the self-relevance-perceptions of adolescent recipients. Also, the participants’ affective self-perceptions concerning their own weight were significantly influenced by the argumentative reframing of the original message on a Facebook site, a Blog, and an online news site. In addition, we report about the development and evaluation of a motion-controlled serious game used to address barriers of obesity prevention in school aged children. In the media, communication about health-related risks mainly uses fear as a motivation for lifestyle-changes, as the time window to communicate the message is usually very short. In contrast, to support motivation in an informal unguided learning context which has to be viable for a longer time, the gamification of learning content is an important strategy. The focus of the serious game is on (1) self-reflective diagnostic tools to analyse the daily food intake and free-time activities, (2) gamified information and knowledge-tests about food groups, drinks, and energy density, as well as (3) relaxation exercises to aid addressing psychosocial aspects.

Religiöse/spirituelle Bedürfnisse und psychosoziale Belastung von Patienten mit malignem Melanom

Questions of meaning and purpose in life are becoming relevant during cancer. Studies have shown that most patients have spiritual needs and that religion/spirituality can be an important ressource in coping with illness. So far, only few studies examine the psychosocial burden and the role of spiritual needs during the treatment process of patients with malignant melanoma. 22 patients were included in this study and assessed for psychosocial distress and spiritual needs while being screened for cancer metastases (t1) and 8 weeks later (t2). Distress, anxiety and depression, furthermore spiritual needs and religiousness were examined with standardized assessments (HSI, DT, HADS, PHQ-2, SpNQ, SpREUK). All patients express spiritual needs independent of the time of measurement and overall burden. Important needs are the need to be complete and safe, the need for social support, for actively giving and for inner peace and the possibility to talk about anxiety and sorrow. Analyses have shown that religious patients are less distressed 8 weeks later, while there was no difference in the first time of measurement. The results show the importance to include spiritual needs in the process of treatment of cancer in a clinical and ambulatory context. Results indicate that religion/spirituality could be an important resource to cope with cancer. During the process of treatment, spiritual needs could be addressed by psychooncology and pastoral care with respect for their different approach and address this topic to support cancer patients.

Treatment management during the adolescent transition period of girls and young women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS): a systematic literature review

IntroductionIn health services research, there is a special emphasis on the transition from adolescence into adulthood. During this transition period, adolescents change from pediatric to adult medical care. This process must be carefully structured, particularly when special medical care is required. Challenges and difficulties become apparent particularly in the case of rare diseases. This is increasingly so when the rare disease affects the adolescence-specific development of patients, such as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), also known as Müllerian agenesis.MethodsA systematic literature review identified the care requirements of girls and young women with MRKHS, as well as studies of medical care during the adolescent transition period for various other diseases. This investigation was carried out in the years 2012 and 2013, and was updated in 2014/2015. In addition, the reference lists of the identified studies were reviewed.ResultsNine publications on MRKHS and ten publications on the transition from adolescence to adulthood were included. Medical care requirements and measures were identified for the following areas: diagnosis during adolescence and organization of medical care, reactions to the diagnosis, functional infertility, psychological stress and threat to self-image, contact with others, and dealing with MRKHS coping strategies.DiscussionThere is still a great demand for research in the area of care during the transition period from adolescence into adulthood, particularly for rare diseases. The recommendations for treating MRKHS patients derived from the literature should be implemented and evaluated with regard to their effectiveness.