Journal• ISSN: 1860-5214
GMS Psycho-Social-Medicine
About: GMS Psycho-Social-Medicine is an academic journal. The journal publishes majorly in the area(s): Medicine & Anxiety. It has an ISSN identifier of 1860-5214. Over the lifetime, 99 publications have been published receiving 3045 citations.
Topics: Medicine, Anxiety, Population, Poison control, Psychosocial
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TL;DR: Although associations were found between the main factors examined in the studies and the utilization of health care, there was a lack of consistency in these findings and there were huge variations in the way these variables were categorized.
Abstract: Objective: This systematic review aims to assess the use and implementation of the Behavioral Model of Health Services Use developed by Ronald M. Andersen in recent studies explicity using this model.
Methods: A systematic search was conducted using PubMed in April 2011. The search strategy aimed to identify all articles in which the Andersen model had been applied and which had been published between 1998 and March 2011 in English or German. The search yielded a total of 328 articles. Two researchers independently reviewed the retrieved articles for possible inclusion using a three-step selection process (1. title/author, 2. abstract, 3. full text) with pre-defined inclusion and exclusion criteria for each step. 16 studies met all of the inclusion criteria and were used for analysis. A data extraction form was developed to collect information from articles on 17 categories including author, title, population description, aim of the study, methodological approach, use of the Andersen model, applied model version, and main results. The data collected were collated into six main categories and are presented accordingly.
Results: Andersen’s Behavioral Model (BM) has been used extensively in studies investigating the use of health services. The studies identified for this review showed that the model has been used in several areas of the health care system and in relation to very different diseases. The 1995 version of the BM was the version most frequently applied in the studies. However, the studies showed substantial differences in the variables used. The majority of the reviewed studies included age (N=15), marital status (N=13), gender/sex (N=12), education (N=11), and ethnicity (N=10) as predisposing factors and income/financial situation (N=10), health insurance (N=9), and having a usual source of care/family doctor (N=9) as enabling factors. As need factors, most of the studies included evaluated health status (N=13) and self-reported/perceived health (N=9) as well as a very wide variety of diseases. Although associations were found between the main factors examined in the studies and the utilization of health care, there was a lack of consistency in these findings. The context of the studies reviewed and the characteristics of the study populations seemed to have a strong impact on the existence, strength and direction of these associations.
Conclusions: Although the frequently used BM was explicitly employed as the theoretical background for the reviewed studies, their operationalizations of the model revealed that only a small common set of variables was used and that there were huge variations in the way these variables were categorized, especially as it concerns predisposing and enabling factors. This may stem from the secondary data sets used in the majority of the studies, which limited the variables available for study. Primary studies are urgently needed to enrich our understanding of health care utilization and the complexity of the processes shown in the BM.
1,126 citations
Journal Article•
TL;DR: The COPSOQ (Copenhagen Psychosocial Questionnaire), a comprehensive instrument for the assessment of psychosocial factors at work, was tested in a partly modified version in a large German sample and an abbreviated version of the instrument was created.
Abstract: The undisputed increase of the relevance of mental work load is confronted with a lack of qualified or at least well documented measuring instruments covering all important aspects.The COPSOQ (Copenhagen Psychosocial Questionnaire), a comprehensive instrument for the assessment of psychosocial factors at work, was tested in a partly modified version in a large German sample (N = 2561 employees). The aims of the study were the detailed investigation of the psychometric measurement properties, and based on these results, the development of an abbreviated version of the instrument.The analysis of objectivity, acceptance, practicability, sensitivity and content validity of the questionnaire as a whole did not show any problematic results - with some limitations regarding the length of the questionnaire.The assessment of the reliability, generalisability, construct validity, criterion validity and diagnostic power of the single scales showed medium to good measuring qualities for the majority of the scales (i.e. Cronbach's alpha mostly >0.7). In addition, the psychometric properties were very similar to those in the Danish COPSOQ-study.Considering all aspects of the measurement quality, a shortened version of the instrument was created. It attempts to combine measuring qualities as high as possible with a number of questions as low as possible.The German COPSOQ questionnaire is a free screening-instrument for the recording of psychosocial work load and strain for all enterprises and organisations interested. The next step is the construction of a "job exposure matrix" for psychosocial factors at work, that means a central database with work load profiles and reference values for as many occupational groups as possible.
206 citations
Journal Article•
TL;DR: The reported findings suggest, that the German version of the CPG is a reliable, valid and useful instrument if a brief, simple method of grading the severity of chronic pain is needed.
Abstract: In 1992 Von Korff and his co-workers developed a simple, brief questionnaire to assess the severity of chronic pain problems, the Chronic Pain Grade (CPG). The present study was conducted to analyse the psychometric properties of the translated German version of the CPG within a population of primary care back pain patients (n=130). Factor analysis yielded two factors which accounted for 72% of the variance of the questionnaire. The first factor 'Disability Score' (53.56% of the variance) revealed a good internal consistency (alpha=.88), the internal consistency of the second factor 'Characteristic Pain Intensity' was moderate (alpha=.68). The reliability of the whole instrument was good (alpha=.82). The CPG and its subscales show moderate to high relations with other instruments assessing the patient's disability (FFbH-R, Pain Disability Index PDI). Additionally weak to moderate but significant correlations were found between the CPG and other measures of grading and staging chronic pain (MPSS, RGS). Further, positive correlations between the CPG and both, the frequency of doctor visits and the frequent use of pain medication have been seen. The reported findings suggest, that the German version of the CPG is a reliable, valid and useful instrument if a brief, simple method of grading the severity of chronic pain is needed. The German version leads to a better comparability between German and English language studies and facilitates an international collaboration in this field of research.
189 citations
TL;DR: The six item short form of the GSE scale is a reliable and valid instrument that is useful for the economical assessment of general self-efficacy in large multivariate studies and for screening purposes.
Abstract: Objective: General self-efficacy has been found to be an influential variable related to the adaptation to stress and chronic illness, with the General Self-Efficacy (GSE) Scale by Jerusalem and Schwarzer being a reliable and valid instrument to assess this disposition. The aim of this study was to construct and test a short form of this scale to allow for a more economical assessment of the construct.
Methods: The item characteristics of the original scale were assessed using an intercultural non-clinical sample (n=19,719). Six items with the highest coefficient of variation and good discrimination along the range of the trait were selected to build a short form of the instrument (GSE-6). Subsequently, the psychometric properties and the concurrent and predictive validity of the GSE-6 were tested in a longitudinal design with three measurements using a sample of patients with risk factors for heart failure (n=1,460).
Results: Cronbach’s alpha for the GSE-6 was between .79 and .88. We found negative associations with symptoms of depression (–.35 and –.45), anxiety (–.35), and vital exhaustion (–.38) and positive associations with social support (.30), and mental health (.36). In addition, the GSE-6 score was positively associated with active problem-focused coping (.26) and distraction/self-encouragement (.25) and negatively associated with depressive coping (–.34). The baseline GSE-6 score predicted mental health and physical health after 28 months, even after controlling for the respective baseline score. The relative stability over twelve and 28 months was r=.50 and r=.60, respectively, while the mean self-efficacy score did not change over time.
Conclusions: The six item short form of the GSE scale is a reliable and valid instrument that is useful for the economical assessment of general self-efficacy in large multivariate studies and for screening purposes.
186 citations
TL;DR: Overall self-reported HRQOL in patients with high functioning ASD seems to be lower than in healthy individuals, but better than in patientsWith schizophrenia spectrum disorder (SSD), the sample of individuals with ASD was significantly better in all domains except for the “social relations” domain.
Abstract: Aim: Over the last years, health-related quality of life (HRQOL) has emerged as an important measure not only in somatic medicine but also in psychiatry. To date, there are only few reports on HRQOL in patients with autism-spectrum disorder (ASD). This study aimed at studying HRQOL in ASD patients with an IQ >70, using a self-report HRQOL questionnaire with cross-cultural validity.
Methods: In this cross-sectional study, twenty-six male adolescents and young adults with the diagnosis of Asperger Syndrome, high functioning autism and atypical autism were evaluated, using the German version of the WHOQOL-BREF HRQOL questionnaire.
Results: Mean WHOQOL-BREF global scores were 60.6 (SD ±26.1), mean WHOQOL-BREF subscale scores were 70.1 (SD ±19.1) for the domain “physical health”, 61.5 (SD ±21.9) for the domain “psychological health”, 53.8 (SD ±23.5) for the domain “social relationships” and 67.9 (SD ±17.4) for the domain “environment”. Compared to a reference population of healthy controls, our sample scored significantly lower in three of four WHOQOL-BREF domains. In comparison to a reference sample of individuals with schizophrenia spectrum disorder (SSD), HRQOL of our sample was significantly better in all domains except for the “social relations” domain. There was a significant association between HRQOL and the Vineland Adaptive Behavior Scales domain “daily living skills”, but not with age, IQ, or ADOS-G summary scores.
Conclusion: Overall self-reported HRQOL in patients with high functioning ASD seems to be lower than in healthy individuals, but better than in patients with SSD. Also, higher HRQOL was associated with better daily living skills. This interrelationship should especially be accounted for in the design and application of treatment programmes for individuals with ASD, as it is of importance for the level of self-perceived HRQOL.
141 citations
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Performance Metrics
| Year | Papers |
|---|---|
| 2013 | 9 |
| 2012 | 12 |
| 2011 | 9 |
| 2010 | 7 |
| 2009 | 6 |
| 2008 | 12 |