Papers by Pia-Maria Wippert
Gesundheitswesen, Sep 16, 2013
ABSTRACT Einführung: Eine große Anzahl empirischer Befunde verweist darauf, dass in Gruppen mit n... more ABSTRACT Einführung: Eine große Anzahl empirischer Befunde verweist darauf, dass in Gruppen mit niedrigem sozioökonomischen Status (SES) das Risiko für bestimmte Krankheiten oder eines früheren Versterbens höher eingeschätzt werden muss. Hinsichtlich der Forschungsarbeiten lässt sich jedoch eine erhebliche Heterogenität der Messung des SES resümieren. Das erschwert zum einen eine systematische Bewertung des Forschungsstandes und zum anderen bleibt offen, inwieweit die unterschiedliche Operationalisierung des SES dessen berechneten Einfluss auf Gesundheitsvariablen systematisch verändert. Fragestellung: In der vorliegenden Studie soll untersucht werden, inwieweit die berechnete Stärke des Zusammenhangs zwischen SES und Chronifizierungsgrad von Rückenschmerzen variiert, wenn der SES auf unterschiedliche Weise operationalisiert wird. Methode: Die querschnittliche Stichprobe umfasst 130 Probanden, die nach einem Bandscheibenvorfall (Krankheitsdauer ≥3 Monate ≤1 Jahr) in zwei Brandenburger Rehabilitationskliniken behandelt wurden. Diese wurden zu Beginn des Klinikaufenthalts anhand des Korff-Fragebogens über das Ausmaß der Chronifizierung befragt. Zudem werden demographische Variablen nach den Empfehlungen der Arbeitsgruppe „Epidemiologische Methoden“ erhoben. In der Auswertung werden zunächst unterschiedliche Varianten des SES mithilfe unterschiedlicher Einzelindikatoren (Bildung nach CASMIN, Berufsstatus nach ISCO-88, Netto-Haushaltsäquivalenzeinkommen in 5 Stufen) und mithilfe eines mehrdimensionalen Schichtindex (entwickelt im Rahmen der Deutschen Herz-Kreislauf-Präventionsstudie und später von Joachim Winkler für das RKI modifiziert) gebildet. Anschließend erfolgt die Berechnung der Korrelationen zwischen diesen Operationalisierungen und dem Chronifizierungsgrad mithilfe der Spearman Rangkorrelation. Ergebnisse: Ergebnisse liegen aktuell noch nicht vor. Es wird vermutet, dass sich die Art der Operationalisierung auf die festgestellte Stärke des Zusammenhanges von SES und dem Chronifizierungsgrad auswirkt. Diskussion: Sollten sich Unterschiede zeigen, ist zu diskutieren, inwiefern Forschungsergebnisse, welche mit verschiedenen Operationalisierungen arbeiten, miteinander vergleichbar sind. Zudem wäre dies ein Argument dafür, eine größere Homogenität der Berechnung des SES in Bezug auf die Erforschung gesundheitlicher Ungleichheit innerhalb der Forschercommunity anzustreben.
Prävention und Rehabilitation, 2011
BMC musculoskeletal disorders, Mar 8, 2024
Background Chronic low back pain (CLBP) is a prevalent and debilitating condition, leading to sig... more Background Chronic low back pain (CLBP) is a prevalent and debilitating condition, leading to significant challenges to both patients and the governmental healthcare system. Non-pharmacologic interventions have received increasing attention as potential strategies to alleviate chronic low back pain and improve patient outcomes. The aim of this systematic review was to comprehensively assess the changes in blood inflammatory biomarkers after nonpharmacologic interventions for CLBP patients, thus trying to understand the complex interactions between nonpharmacologic interventions and inflammatory biomarker changes in CLBP. Methods A thorough search (from January 1st, 2002 to October 5th, 2022) of PubMed, Medline (platform Web of Science), and the Cochrane Library (platform Wiley Online Library) were conducted, and inclusion criteria as well as exclusion criteria were refined to selection of the studies. Rigorous assessments of study quality were performed using RoB 2 from Cochrane or an adaptation of the Downs and Black checklist. Data synthesis includes alterations in inflammatory biomarkers after various non-pharmacologic interventions, including exercise, acupressure, neuroemotional technique, and other modalities. Results Thirteen primary studies were included in this systematic review, eight randomized controlled trials, one quasi-randomized trial, and four before-after studies. The interventions studied consisted of osteopathic manual treatment (one study), spinal manipulative therapy (SMT) (three studies), exercise (two studies), yoga (two studies) and acupressure (two studies), neuro-emotional technique (one study), mindfulness-based (one study) and balneotherapy study (one study). Four studies reported some changes in the inflammatory biomarkers compared to the control group. Decreased tumor necrosis factor-alpha (TNF-α) after osteopathic manual treatment (OMT), neuro-emotional technique (NET), and yoga. Decreased interleukin (IL)-1, IL-6, IL-10, and c-reactive protein (CRP) after NET, and increased IL-4 after acupressure. Another five studies found changes in inflammatory biomarkers through pre-and post-intervention comparisons, indicating improvement outcomes after intervention. Increased IL-10 after balneotherapy; decreased TNF-α, IL-1β, IL-8, Interferon-gamma, interferon-γ-induced protein 10-γ-induced protein 10 after exercise; decreased IL-6 after exercise and SMT; decreased CRP and chemokine ligand 3 after SMT.
Psychoneuroendocrinology, Sep 1, 2021
Frontiers in Cardiovascular Medicine, Jul 1, 2022
Background: As the number of cardiac diseases continuously increases within the last years in mod... more Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization. Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines.
Psychoneuroendocrinology, Sep 1, 2021
Ein Karriereabbruch führt neben persönlich schmerzvollen Statusverlusten auch zu Verlusten des bi... more Ein Karriereabbruch führt neben persönlich schmerzvollen Statusverlusten auch zu Verlusten des bisherigen Netzwerkes sowie der bisher gültigen Norm-und Wertvorstellungen. Er ist ein Ereignis, das den Betroffenen zwingt, neue Lebensbereiche zu eröffnen und in eine unsichere Lebensphase überzutreten. Ein "Abbrucherlebnis", das eine solche Veränderung in den üblichen Aktivitäten einer Person hervorruft, wird in den Forschungsbereich kritischer Lebensereignisse eingeordnet. Es zieht, einem Dominospiel gleich, eine ganze Kette von Ereignissen im individuellen und sozialen Lebensraum nach sich und stellt einen hohen Belastungsgrad für den Betroffenen dar.
Schmerz, Aug 5, 2016
Chronische Schmerzen und Skelettbeschwerden sind häufig Ursache langfristiger Morbidität und somi... more Chronische Schmerzen und Skelettbeschwerden sind häufig Ursache langfristiger Morbidität und somit von klinischer und wirtschaftlicher Bedeutung [1]. Allein im Jahr 2008 wurden für die Behandlung von Erkrankungen des Muskel-, Skelett-und Bindegewebes in Vorsorge-und Rehabilitationseinrichtungen insgesamt 2,2 Mrd. Euro ausgegeben [2]. Entsprechende therapeutische Maßnahmen sollen die Prävalenzzahlen reduzieren oder eine Chronifizierung nach erstmaligem Krankheitseintritt verhindern.
Schmerz, Dec 1, 2015
ABSTRACT
BMC Health Services Research, Dec 1, 2017
Background: In health research, indicators of socioeconomic status (SES) are often used interchan... more Background: In health research, indicators of socioeconomic status (SES) are often used interchangeably and often lack theoretical foundation. This makes it difficult to compare results from different studies and to explore the relationship between SES and health outcomes. To aid researchers in choosing appropriate indicators of SES, this article proposes and tests a theory-based selection of SES indicators using chronic back pain as a health outcome. Methods: Strength of relationship predictions were made using Brunner & Marmot's model of 'social determinants of health'. Subsequently, a longitudinal study was conducted with 66 patients receiving in-patient treatment for chronic back pain. Sociodemographic variables, four SES indicators (education, job position, income, multidimensional index) and back pain intensity and disability were obtained at baseline. Both pain dimensions were assessed again 6 months later. Using linear regression, the predictive strength of each SES indicator on pain intensity and disability was estimated and compared to the theory based prediction. Results: Chronic back pain intensity was best predicted by the multidimensional index (beta = 0.31, p < 0.05), followed by job position (beta = 0.29, p < 0.05) and education (beta = −0.29, p < 0.05); whereas, income exerted no significant influence. Back pain disability was predicted strongest by education (beta = −0.30, p < 0.05) and job position (beta = 0. 29, p < 0.05). Here, multidimensional index and income had no significant influence. Conclusions: The choice of SES indicators influences predictive power on both back pain dimensions, suggesting SES predictors cannot be used interchangeably. Therefore, researchers should carefully consider prior to each study which SES indicator to use. The introduced framework can be valuable in supporting this decision because it allows for a stable prediction of SES indicator influence and their hierarchy on a specific health outcomes.
Frontiers in Neurology, Aug 5, 2022
Sportwissenschaft, Jun 1, 2008
Disability and Rehabilitation, Jun 15, 2020
Purpose: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chine... more Purpose: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chinese version (CAIT-TW), and to evaluate the validity, reliability and cutoff score of CAIT-TW for Taiwan-Chinese athletic population. Materials and methods: The English version of CAIT was translated to CAIT-TW based on a guideline of cross-cultural adaptation. 77 and 58 Taiwanese collegial athletes with and without chronic ankle instability filled out CAIT-TW, Taiwan-Chinese version of Lower Extremity Functional Score (LEFS-TW) and Numeric Rating Scale (NRS). The construct validity, test-retest reliability, internal consistency and cutoff score of CAIT-TW were evaluated. Results: In construct validity, the Spearman's correlation coefficients were moderate (CAIT-TW vs LEFS-TW: Rho ¼ 0.39, p < 0.001) and strong (CAIT-TW vs NRS: Rho¼ 0.76, p < 0.001). The test retest reliability was excellent (ICC 2.1 ¼ 0.91, 95% confidential interval ¼ 0.87-0.94, p < 0.001) with a good internal consistency (Cronbach's a: 0.87). Receiver operating characteristic curve showed a cutoff score of 21.5 (Youden index: 0.73, sensitivity: 0.87, specificity 0.85). Conclusions: The CAIT-TW is a valid and reliable tool to differentiate between stable and instable ankles in athletes and may further apply for research or daily practice in Taiwan. ä IMPLICATIONS FOR REHABILITATION For athletes, chronic ankle instability is prevalent and causes negative sequela, such as lowered quality of daily life, affected functional performance, and may cause post traumatic osteoarthritis. The psychometric properties of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool showed moderate to strong construct validity, excellent test retest reliability, a good internal consistency and a cutoff score of 21.5. The validity and reliability of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool are to enable clinicians to evaluate and manage ankle instability in Taiwanese who speaks Mandarin Chinese.
Pilot and Feasibility Studies, Aug 30, 2021
Background: The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. T... more Background: The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS.
International Journal of Molecular Sciences, May 29, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of Pain Research, Mar 1, 2020
Purpose: Psychosocial variables are known risk factors for the development and chronification of ... more Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (±13.4) years; baseline pain intensity: 27.8 (±18.4); disability: 14.3 (±17.9)). In the 1-year follow-up, the stress types "tendency to worry", "social isolation", "work discontent" as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types "tendency to worry", "social isolation", "social conflicts", and "perceived long-term stress" as potential risk factors for both pain intensity and disability. Furthermore, "self-efficacy" ("internality", "self-concept") and "social externality" play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.
European journal of public health, Oct 1, 2015
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Papers by Pia-Maria Wippert