[Tobacco cessation - the underused potential in clinical routine]. / Tabakentwöhnung ­ die bisher wenig genutzte Chance im ärztlichen Alltag.

Tobacco control, psychosocial and medical assistance regarding tobacco cessation is still a hidden potential within the German health care system. So far doctors rarely talk to their patients about their smoking status and physical and psychological benefits of quitting.This paper focusses on recommended current diagnostic and treatment standards, as well as evidence-based methods to address the topic on how to stop smoking and its association with certain diseases such as COPD, lung cancer and COVID-19 infection. The role of e-cigarettes as a cessation tool and its health related risks are critically examined. Consequences and advice how to implement smoking cessation procedures into daily practice are presented.

[Smoke-free in Psychiatry - A Qualitative Analysis of Staff Perspectives]. / Rauchfrei in der Psychiatrie ­ Eine qualitative Analyse der Ansichten von Mitarbeiter:innen.

BACKGROUND: People with mental illness are more likely to be nicotine-dependent and they have a shorter life expectancy as a result of smoking. Although guidelines recommend smoking cessation support, this is rarely provided by psychiatric staff who often view the implementation of smoke-free policies critically. METHOD: We undertook inductive thematic analysis of the free-text fields of a staff survey on smoking. RESULTS: Feedback on the topic was often emotional and related to the areas patient care, staff and the protection of non-smokers. Participants were often concerned that smoking cessation could worsen the patient's psychiatric condition or lead to aggressive behavior. CONCLUSIONS: There is no scientific evidence for these concerns. It is important to counteract false assumptions by providing the appropriate training on smoking cessation.

A Qualitative Investigation of Staff Feedback on an Online Learning Module on Smoking Cessation in a German Healthcare Company.

Quitting smoking is a powerful way for patients to improve their own wellbeing and to significantly reduce the risk of health problems. Evidence shows that health professionals can effectively intervene in order to prevent and stop tobacco smoking in their patients. Online learning modules have proved to be effective in terms of transferring knowledge and skills. In an urban community hospital setting in Germany, a novel e-learning course for staff on the treatment of tobacco dependence was implemented in 2021. In this study, we analyzed free-text feedback of participants completing this online module in order to examine the feasibility and acceptance of this new format. We were able to reach a reasonable proportion of staff. Our qualitative analysis showed that most feedback was positive and described the module as well-designed and helpful. Some staff, however, expressed extremely negative views and did not see smoking cessation support as essential to their role in healthcare. We argue that in order to achieve a shift in attitude in healthcare staff, a change in German policy is required which includes the creation of smoke-free environments and the adherence to smoke-free policies on hospital sites. Furthermore, the provision of smoking cessation support in line with the WHO Framework Convention on Tobacco Control and a true understanding of the role of all healthcare professionals in promoting health of patients and staff will be essential.

[Tobacco Cessation - The Underused Potential in Clinical Routine]. / Tabakentwöhnung ­ die bisher wenig genutzte Chance im ärztlichen Alltag.

Tobacco control, psychosocial and medical assistance regarding tobacco cessation is still a hidden potential within the German health care system. So far doctors rarely talk to their patients about their smoking status and physical and psychological benefits of quitting.This paper focusses on recommended current diagnostic and treatment standards, as well as evidence-based methods to address the topic on how to stop smoking and its association with certain diseases such as COPD, lung cancer and COVID-19 infection. The role of e-cigarettes as a cessation tool and its health related risks are critically examined. Consequences and advice how to implement smoking cessation procedures into daily practice are presented.

Evaluation of long-term quitters: who stays smoke free forever?

BACKGROUND: Smoking cessation is one of the most powerful health promotion tools in the Western world. Behavioral group therapies are regarded as very promising interventions in this field. Quitting rates are usually evaluated after 6-12 months and lie between 30 and 45%. So far, there are no scientific data on potential protective indicators to remain successfully smoke free after this period. Therefore, the aim of this study was to detect the current smoking status of former participants of a cessation service in an urban German surrounding. We investigated reasons for relapses, quitting strategies, and psychosocial parameters. METHODS: In 2019, 130 former patients (2011-2017; mean age 54 years; 37 pack/years; Fagerstroem = 5.75; 58.5% male, 41.5% female; 66% physical comorbidities; 35% psychiatric diagnoses) were invited to participate in a mailed survey (including WHO 5, SF 12, self-efficacy scale) and were asked about their current smoking status, personal history of smoking, and individual experiences with stopping after the 1­year abstinence date. RESULTS: A total of 53 persons replied (RR 41%), 29 (54%) of whom are currently smoke free; 24 relapsed intermittently or permanently, 9 experimented with e­cigarettes, and 2 became dual users. Daily hassles as well as physical and mental challenges were the main reasons for relapsing. CONCLUSION: Due to the low response rate, conclusions are limited; however, the 1­year abstinence rate might not be as reliable as thought so far; long-term "sober" nicotine addicts remain at risk of relapse.

Effects of a multi-behavioral health promotion program at worksite on smoking patterns and quit behavior.

BACKGROUND: Tobacco use is associated with various severe health risks. Therefore, the need to decrease smoking rates is a great public health concern. The workplace has capability as a setting through which large groups of smokers can be reached to encourage smoking cessation. OBJECTIVE: The aim of the present study was to evaluate effects of a multi behavioral worksite health promotion intervention. The primary outcome was the change of smoking rate. Secondary outcomes were changes in smoking attitudes and readiness to stop smoking among employees over an intervention period of 12 months. METHOD: 112 and 110 employees were enrolled in the intervention and control arm respectively. The intervention group received a 12-month multicomponent health promotion intervention. One of the main elements of the multicomponent intervention was a smoking cessation and counseling program. During the pilot year, participants completed a self-evaluation questionnaire at baseline and again after 12 months to related outcomes and changes. RESULTS: Results showed that participants' quit behavior and smoking behavior changed over time in the intervention group (IG). Readiness to quit smoking also increased in the IG compared to the comparison group (CG). Some positive intervention effects were observed for cognitive factors (e.g., changes attitudes towards smoking). Baseline willingness to change smoking behavior was significantly improved over time. CONCLUSIONS: This study showed initial results of a long-term multicomponent worksite health promotion program with regard to changes in smoking behavior, attitudes towards smoking and readiness to quit smoking. The evaluation suggests that a worksite health promotion program may lead to improvements in smoking behavior for a number of workers.

A pilot study evaluation of psychosocial competency training for junior physicians working in oncology and hematology.

BACKGROUND: This pilot and feasibility study evaluated a work-related self-care competency training in oncology and hematology medicine for junior physicians working in oncology and hematology medicine. METHODS: A pilot study was conducted with 80 physicians working in oncology and hematology hospital departments in Germany. Physicians were distributed to either the intervention group receiving competency training or a comparison group. The intervention took place in groups over a period of 12 weeks. Training content included work-related self-care strategies, problem-solving techniques solution-focused counselling. The outcomes studied were changes in work-related stress, emotional exhaustion, emotion regulation, and job satisfaction. Follow-up assessments were arranged after 12 weeks (T1), after 24 weeks (T2), and after 36 weeks (T3). RESULTS: Intervention group reached a decrease in perceived job stress and emotional exhaustion. Self-perceived improvements were also obvious regarding enhanced emotion regulation skills. Future oncologists valued the intervention with high scores for training design, content, received outcome, and overall training satisfaction. CONCLUSIONS: This study provided first indications that an innovative self-care competency training might be a supportive approach for junior physicians starting work in oncology and hematology. However, replication studies are needed to verify the results in the medical working context.

Being prepared to work in Gynecology Medicine: evaluation of an intervention to promote junior gynecologists professionalism, mental health and job satisfaction.

BACKGROUND: Dealing with work-related stress is highly prevalent for employees in Gynecology Medicine. Junior physicians, in particular, have to face high working demands and challenges while starting their medical career after graduation. Job resources (i.e., social support) and personal resources (coping skills) might reduce job strain. The evidence for supportive and effective mental health interventions for clinicians is limited. Offering psychosocial skill training for entrants in Gynecology Medicine is expected to be highly beneficial. Following this, the present pilot study focused on strengthening physicians' psychosocial skills and analyzed the effects of innovative training for junior gynecologists working in German hospitals. METHODS: Coping skills training for junior gynecologists was offered as group training for 12 weekly sessions over a time period of 3 months. Physicians were randomized to either an intervention group (IG) receiving the training (n = 38) or a control group (CG; n = 40). Training content involved developing and learning coping skills as well as solution-focused and cognitive behavioral counselling for junior gynecologists. Study outcomes were (1) perceived occupational stress, (2) emotional exhaustion, (3) resilience coping behavior, (4) emotion regulation skills and (5) job satisfaction. Surveys were distributed at baseline (T0), after the training (T1), after 3 (T2) and 6 months (T3). RESULTS: Junior gynecologists (IG) reported a significant decrease in perceived job stress and emotional exhaustion from baseline to all follow-ups, whereas the control group did not show any comparable results. A clear positive value of the mental health promotion program was also noticeable with regard to job satisfaction and increased coping skills (i.e., emotion regulation). Overall satisfaction with the skill training was high: gynecologists reported high scores for training design, content, received outcome and overall satisfaction with the training. CONCLUSIONS: In this pilot study, participating in a psychosocial skills training course adapted for gynecology clinicians was associated with reductions in perceived job stress, exhaustion and improvements in coping skills and satisfaction. Modified psychosocial skills training may be a time-efficient tool to support gynecologists in their performance and well-being, which may have positive implications for patient care.

Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals.

OBJECTIVES: This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties. METHODS: 435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability. RESULTS: Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated. CONCLUSIONS: Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management.

Evaluation of a Multicomponent Psychosocial Skill Training Program for Junior Physicians in Their First Year at Work: A Pilot Study.

BACKGROUND: The present study was designed to gather preliminary information regarding the feasibility of implementing a psychosocial resilience program and to assess if the program would potentially promote protective factors (such as resiliency, self-efficacy) and job satisfaction as well as decreasing perceived stress among a sample of German junior physicians. METHODS: Eighty-two junior physicians in their first year after graduation took part in the project and were randomized in a controlled trial to either an intervention or a control group for 3 months. The intervention group was offered resilience training combined with cognitive behavioral and solution-focused counseling. Primary outcome measures included scales of the PSQ, BRCS, SWOPE, and COPSOQ. Two post-intervention follow-up measurements proved the effectiveness of the intervention. RESULTS: There was a significant improvement between baseline and follow-up intervention scores on measures of resilience, self-efficacy, optimism, and perceived stress observed in the intervention group compared to the control group. Job satisfaction did not significantly differ between baseline and follow-ups. CONCLUSIONS: These results indicate that the program to enhance resilience and decrease stress among physicians is feasible to implement as a group training program in a workplace setting. Further, the intervention provides statistically significant improvement in perceptions of distress and strengthens protective factors (such as resiliency).

Managing work-family conflict in the medical profession: working conditions and individual resources as related factors.

OBJECTIVES: This study developed and tested a research model that examined the effects of working conditions and individual resources on work-family conflict (WFC) using data collected from physicians working at German clinics. MATERIAL AND METHODS: This is a cross-sectional study of 727 physicians working in German hospitals. The work environment, WFC and individual resources were measured by the Copenhagen Psychosocial Questionnaire, the WFC Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism. Descriptive, correlation and linear regression analyses were applied. RESULTS: Clinical doctors working in German hospitals perceived high levels of WFC (mean=76). Sociodemographic differences were found for age, marital status and presence of children with regard to WFC. No significant gender differences were found. WFCs were positively related to high workloads and quantitative job demands. Job resources (eg, influence at work, social support) and personal resources (eg, resilient coping behaviour and self-efficacy) were negatively associated with physicians' WFCs. Interaction terms suggest that job and personal resources buffer the effects of job demands on WFC. CONCLUSIONS: In this study, WFC was prevalent among German clinicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WFC. Our results give a strong indication that both individual and organisational factors are related to WFC. Results may play an important role in optimising clinical care. Practical implications for physicians' career planning and recommendations for future research are discussed.

Prevention of study-related stress symptoms: health-promoting behavior among dental students.

BACKGROUND: Training to become a dentist is one of the most demanding professional education experiences. There are very few studies on strategies and activities to cope with study-related stress during dental training. We therefore evaluated the prevalence of burnout symptoms and coping activities among dental students. METHODS: A cross-sectional survey was performed analyzing a sample of 239 dental students from Germany. Students were asked to complete a survey containing questions about burnout symptoms and coping behavior. RESULTS: A total of 38% of the dental students perceived symptoms of emotional exhaustion; 17% reported symptoms of personal accomplishment and 11% perceived scores of depersonalization. Students reported on coping activities, ranging from health-promoting techniques, such as exercising, to less recommendable health harming relaxation strategies, such as taking drugs. CONCLUSION: Our results indicate the need for relevant health promotion and may aid decision makers in developing health promotion programs.

Exploring the impact of resilience, self-efficacy, optimism and organizational resources on work engagement.

BACKGROUND: The German health care system has undergone radical changes in the last decades. These days health care professionals have to face economic demands, high performance pressure as well as high expectations from patients. To ensure high quality medicine and care, highly intrinsic motivated and work engaged health care professionals are strongly needed. OBJECTIVE: The aim of this study was to examine relations between personal and organizational resources as essential predictors for work engagement of German health care professionals. METHODS: This investigation has a cross-sectional questionnaire study design. Participants were a sample of hospital doctors. Personal strengths, working conditions and work engagement were measured by using the SWOPE-K9, COPE Brief Questionnaire, Perceived Stress Questionnaire, COPSOQ and Utrecht Work Engagement Scale. RESULTS: Significant relations between physicians' personal strengths (e.g. resilience, optimism) and work engagement were evaluated. Work related factors showed to have a significant influence on work engagement. Differences in work engagement were also found with regard to socio-demographic variables. CONCLUSION: Results demonstrated important relationships between personal and organizational resources and work engagement. Health care management needs to use this information to maintain or develop work engaging job conditions in hospitals as one key factor to ensure quality health care service.

Surgeons' work engagement: influencing factors and relations to job and life satisfaction.

BACKGROUND: Work engagement has become a topic of great interest in recent years. However, clinicians' work engagement has rarely been studied and relatively little is known about its predictors and consequences. Therefore the objective of this cross-sectional questionnaire study was to test a model of possible institutional and personal predictors and significant relations to job and life satisfaction. METHODS: 123 clinicians specializing in Surgery Medicine participated in the study. Self-administered questionnaires, including the Copenhagen Psychosocial Questionnaire, the Utrecht Work Engagement Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism, were administered. Bivariate analyses and a stepwise regression analysis were performed. RESULTS: The whole sample of surgeons rated work engagement with a high mean of M = 4.38; SD = .91. Job satisfaction and perceived quality of life have been rated with moderate scores. The results show that job resources have a greater impact on surgeons' work engagement than their job demands. Significant correlations between surgeons' work engagement, their job satisfaction and quality of life were found. Moreover, work engagement mediated the relation between institutional factors and surgeons' job satisfaction. CONCLUSION: Our research suggests that strengthening surgeons' work engagement will contribute to a more sustainable workplace, in terms of both individual and hospital performance. Therefore, increasing work engagement among surgeons should be of concern for supervisors and hospital managers. Future research should focus on further predictors that may have an influence on health professionals' work engagement. Another field for future research is to study potential effects of interventions on work engagement.

Eating behavior and nutrition knowledge among musical theatre students.

Eating is a central part in human (social) life. Athletic performance and physical attractiveness are linked to appropriate nutritional behavior, especially for performing artists. Eating behavior and nutrition knowledge have not been examined in musical theatre students so far, which this study aims to analyze. We administered a cross-sectional questionnaire study to 37 musical theatre students. Results for the Eating Disorder Examination-Questionnaire (EDE-Q) showed non-pathological values for 92% of all participants, but 81% of participants answered correctly on only 30-59% of questions on the General Nutrition Knowledge Questionnaire (GNKQ). Our study results reveal the need for specific nutritional knowledge transfer programs for this target group.

Smoking behaviour and attitudes among German nursing students.

Tobacco consumption is a major public health threat. Healthcare workers can contribute to the reduction of tobacco use. The principles of intervention need to be provided already during vocational school. This research examines the smoking habits, the personal attitudes towards smoking and the professional beliefs of healthcare trainees. The aim of this study is to ascertain the necessity and the general conditions for multilevel interventions of prevention and health promotion. In 2010, a questionnaire survey was conducted in a Berlin vocational school for healthcare workers. Of 148 students (RR = 49.3%) 41.9% of the students are daily or occasional smokers. The nicotine dependency and the number of cigarettes per day are comparatively low. The majority of smoking students is willing to quit and has already undertaken several attempts. Non-smoking protection is evaluated to be very important and intervention rates in patient care range between 49% and 72%. In both questions, non-smokers and smokers differ significantly. The self-reported smoking prevalence in our population is considerably lower than in previous studies. However, the smoking rate among healthcare trainees is still higher than in the general population. The students' own smoking behaviours and its influences on the treatment of patients should be reflected during school. It is necessary to develop adequate recruitment strategies and attractive interventions for this target group.

Survey of health problems in musical theater students: a pilot study.

UNLABELLED: Musical theater performers are the "triathletes" in the performing arts. The field requires versatility in a combination of skills including dancing, singing, and drama in a high frequency of performances. The aim of this study was to analyze and evaluate the health situation of musical theater students using a complete musical educational institute as an example (n = 37). METHODS: The basis for the evaluation was a questionnaire survey (standardized F 1000). All students of the school participated (20 males, 17 females). RESULTS: Of the students, 62% have a part-time job for financial reasons, and 67.7% state only a "partial satisfaction" with their body. Regarding injury, 45.9% claim to sustain an orthopaedic injury up to twice a year, and 29.7% up to three or four times. A total of 49 acute injuries (1.3/student) and 42 chronic complaints (1.1/student) were stated. The lower extremity was the most common acutely injured region (65.3%), followed by the spine (16.3%) and upper extremity (14.3%). Of chronic complaints, the lumbar spine was the most commonly affected area, followed by the hip joint and pelvic area. Thirty-three and 24% of acute injuries occurred during "spins" and/or "stretching," respectively. There were various causes for physical and mental problems. DISCUSSION: The results show both parallels and differences to the relevant literature. It is shown that health hazards already arise in the education of musical performers. This provides particulars for the implementation of injury prevention measures during the theoretical and practical education of musical students.

Stress, health and satisfaction of Australian and German doctors--a comparative study.

BACKGROUND: Currently no study exists focusing on international differences in perception of stress, working conditions and satisfaction of hospital staff. Therefore the present study aimed to examine and compare the work and privacy situation of Australian and German physicians. METHODS: The present study was designed as a cross-sectional comparison using questionnaire data. The population consisted of representative samples of 310 German and 256 Australian hospital doctors who received mailed questionnaires. The questionnaires contained items on demography, perception of stress, working conditions, job satisfaction and Life satisfaction. RESULTS: According to the comparison, German physicians perceived higher values of work stress. They work significantly longer hours than Australian doctors. In general, work intensity and demands are highly rated in both countries. In terms of job and life satisfaction, Australian doctors responded more positively than German doctors. CONCLUSION: This is the first comparative study illustrating a subjective evaluation of physicians' perception of stress, their work and privacy situation in two different countries. Based on these results health policy decisions can be developed.