Applicability and Validity of Second Victim Assessment Instruments among General Practitioners and Healthcare Assistants (SEVID-IX Study).

BACKGROUND: The second victim phenomenon and moral injury are acknowledged entities of psychological harm for healthcare providers. Both pose risks to patients, healthcare workers, and medical institutions, leading to further adverse events, economic burden, and dysfunctionality. Preceding studies in Germany and Austria showed a prevalence of second victim phenomena exceeding 53 percent among physicians, nurses, emergency physicians, and pediatricians. Using two German instruments for assessing moral injury and second victim phenomena, this study aimed to evaluate their feasibility for general practitioners and healthcare assistants. METHODS: We conducted a nationwide anonymous online survey in Germany among general practitioners and healthcare assistants utilizing the SeViD (Second Victims in Deutschland) questionnaire, the German version of the Second Victim Experience and Support Tool Revised Version (G-SVESTR), and the German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP). RESULTS: Out of 108 participants, 67 completed the survey. In G-SVESTR, the collegial support items exhibited lower internal consistency than in prior studies, while all other scales showed good-quality properties. Personality traits, especially neuroticism, negatively correlated to age, seem to play a significant role in symptom count and warrant further evaluation. Multiple linear regression indicated that neuroticism, agreeableness, G-SVESTR, and G-MISS-HP were significant predictors of symptom count. Furthermore, moral injury partially mediated the relationship between second victim experience and symptom count. DISCUSSION: The results demonstrate the feasible use of the questionnaires, except for collegial support. With respect to selection bias and the cross-sectional design of the study, moral injury may be subsequent to the second victim phenomenon, strongly influencing symptom count in retrospect. This aspect should be thoroughly evaluated in future studies.

Scoping review of climate change and mental health in Germany - Direct and indirect impacts, vulnerable groups, resilience factors.

Background: Climate change is a major threat to human health and has direct and indirect impacts on the human psyche. Methods: To assess the state of knowledge on the impact of climate change on mental health in Germany, a scoping review was conducted for the focus topics extreme weather events, temperature increase, intra-psychological processing, sociological aspects, and resilience factors. Ten studies met the inclusion criteria of the searches in the databases Academic Search Complete, CINAHL, PubPsych, PubMed, and PsychInfo. The majority of the studies looked at correlative relationships in a cross-sectional design. Results: There are indications of an accumulation of psychiatric disorders after extreme weather events; in addition, the risk of suicide increases with higher temperatures and it appears there is an increase in aggressive behaviour. The majority of people surveyed in Germany report concerns about the consequences of climate change, although these currently rarely lead to clinically significant impairments in mental health. Conclusions: Overall, the evidence for Germany must be classified as insufficient. In addition to the absolute priority of climate protection (mitigation) by reducing emissions, there is a particular need for additional research with a focus on vulnerable groups and possibilities for prevention and adaptation.

Residential green space and air pollution are associated with brain activation in a social-stress paradigm.

We examined the influence of three major environmental variables at the place of residence as potential moderating variables for neurofunctional activation during a social-stress paradigm. Data from functional magnetic resonance imaging of 42 male participants were linked to publicly accessible governmental databases providing information on amount of green space, air pollution, and noise pollution. We hypothesized that stress-related brain activation in regions important for emotion regulation were associated positively with green space and associated negatively with air pollution and noise pollution. A higher percentage of green space was associated with stronger parietal and insular activation during stress compared with that in the control condition. More air pollution was associated with weaker activation in the same (but also extended) brain regions. These findings may serve as an important reference for future studies in the emerging field of "neuro-urbanism" and emphasize the importance of environmental factors in urban planning.

Measuring Anxiety in Older Adults: Development, Diagnostic Accuracy, and Preliminary Validation of a Short-Form of the German Geriatric Anxiety Scale (GAS-G-SF).

Anxiety symptoms and anxiety disorders are highly prevalent among older adults, and are associated with considerable distress, functional impairment, and burden. Also, there is growing need for brief instruments to measure anxiety symptoms in primary care and geriatric medical settings. Therefore, the current study focuses on the development and psychometric evaluation of a short-form of the Geriatric Anxiety Scale (GAS-G), a well-established anxiety instrument for use with older adults. Study 1 draws on the original data from the GAS-G validation study (N = 242) to develop the short-form (GAS-G-SF) and determines whether the results replicate with the short-form. Study 2 extends the validation of the GAS-G-SF to a clinical sample (N = 156; 62 patients with heart disease, 94 patients with Parkinson's disease). Overall, the GAS-G-SF showed promising psychometric properties in terms of internal consistency and validity. Also, the GAS-G-SF showed good discriminatory power based on receiver operating characteristic curve analysis in both studies. These results support the utility of the GAS-G-SF as a brief assessment measure for anxiety.

[Contribution of natural spaces to human health and wellbeing]. / Einfluss von Naturräumen auf die Gesundheit ­ Evidenzlage und Konsequenzen für Wissenschaft und Praxis.

Natural spaces and especially urban green and blue spaces have been recognised for a long time as spaces with great potential for protecting and promoting human health and well-being. They may affect human physical, mental and social health and well-being in various ways. On one hand, this comes to pass through reduction and moderation of potential environmental health risks (e. g. noise, particulate matter, heat), psycho-physiological effects of nature experience, as well as physical effects of exposure to natural compounds and elements. On the other hand, natural spaces can affect health and well-being indirectly e. g. through motivation of health promoting behaviour (e. g. more physical activity) and through use as outdoor meeting spaces, by decreasing aggression, and through the resulting positive effects on social well-being. Yet, some potential adverse health effects of nature and landscapes have been reported, too (e. g. insecurity or fear in confusing or unmaintained natural spaces, potential rivalry in usage, allergies or skin irritations due to natural elements, risk of communicable diseases from vectors). Against the background of positive effects of natural spaces, creating, restoring and enhancing urban green and blue spaces are often claimed in terms of sustainable and integrated urban development. But which associations and impacts exist between natural spaces and health? What are the resulting demands when integrating natural spaces for a health-promoting implementation practice? This overview article provides some answers to these questions.

[Climate change - physical and mental consequences]. / Klimawandel ­ physische und psychische Folgen.

Climate change has already had a large influence on the human environmental system and directly or indirectly affects physical and mental health. Triggered by extreme meteorological conditions, for example, storms, floods, earth slides and heat periods, the direct consequences range from illnesses to serious accidents with injuries, or in extreme cases fatalities. Indirectly, a changed environment due to climate change affects, amongst other things, the cardiovascular system and respiratory tract, and can also cause allergies and infectious diseases. In addition, increasing confrontation with environmental impacts may cause negative psychological effects such as posttraumatic stress disorders and anxiety, but also aggression, distress and depressive symptoms. The extent and severity of the health consequences depend on individual pre-disposition, resilience, behaviour and adaptation.

Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study.

AIMS: We analysed heart-focused anxiety (HFA) and its predictors in patients with heart failure before implantation of an implantable cardioverter defibrillator (ICD). Herein, we report the baseline data of the Anxiety-CHF Study which investigates HFA before and after ICD implantation. METHODS AND RESULTS: HFA, general anxiety and depression, perceived quality of life (QoL) and type D personality were measured with validated psychological instruments. Clinical parameters such as severity of heart failure measured by NYHA class and left ventricular ejection fraction (EF) were determined. One hundred and ten patients were interrogated before ICD implantation (70 % male, mean age = 60.5 ± 14.9 years, mean EF = 31 % ± 9 %, 91 % NYHA II-III, 92 % primary prevention). HFA was present in 53 patients (48.6 %); 37 participants (33.9 %) showed increased levels of general anxiety and 33 patients (30.3 %) showed increased levels of depression with clinical significant levels in 16 subjects (14.7 %) for general anxiety and 13 subjects (11.9 %) for depression. Poor QoL was reported in 30 patients (27.5 %). HFA was correlated with QoL, general anxiety, depression, type D personality, myocardial infarction (MI), and systolic blood pressure. QoL, general anxiety and former MI were significant predictors of HFA (R (2) = 0.453). CONCLUSION: Heart-focused anxiety is highly prevalent in heart failure patients prior to ICD implantation. Measures of disease severity such as EF or NYHA class do not predict HFA, neither does Type D personality. HFA is predicted by a history of MI and psychological parameters such as general anxiety and impaired QoL. CLINICALTRIALS. GOV IDENTIFIER: NCT02226770.

[Psychocardiology: how heart and mind interact]. / Psychokardiologie: Wie Herz und Psyche zusammenhängen.

Patients with heart disease often suffer from psychological comorbidities in addition to various physical impairments. These mental disorders reduce the quality of life and have a negative effect on the development and course of heart diseases. Particularly the occurrence of depression, anxiety and post-traumatic stress disorder (PTSD) may lead to an increase in hospitalization-, morbidity-, and mortality rates. Early diagnosis of psychological disorders in patients with cardiovascular disease and consecutive treatment is therefore desirable. In this context, psychocardiology addresses the interaction of cardiac disease and psychological alterations as well as the influencing psychosocial factors.

Anxiety, depression, quality of life and stress in patients with resistant hypertension before and after catheter-based renal sympathetic denervation.

AIMS: This study analysed quality of life (QoL), anxiety and depression, headache and stress tolerance in patients with resistant hypertension before and after renal denervation (RDN). METHODS AND RESULTS: RDN was performed in 119 patients (age 62 ± 11 years, 55% male) with resistant hypertension (office blood pressure [BP] 165/91 ± 22/15 mmHg), treated with 5.7 ± 0.2 antihypertensive drugs. At baseline, at three and at six months after RDN, psychological status, intensity of headache and stress tolerance were documented. Stress was induced by a multitasking situation (Wiener Determination Task [DT]). Depression and anxiety (hospital anxiety and depression scale) and QoL (short form-12 health survey) were investigated. Intensity of headache was measured by visual analogous scale. Systolic and diastolic BP decreased by -20 ± 2.4 and -10 ± 1.4 mmHg, respectively, six months after RDN (p<0.0001). Patients showed more correct reactions (p<0.0001), fewer errors (p<0.05) and reacted faster (p<0.001) in the DT. Patients reported an improvement in QoL (p<0.05). Furthermore, anxiety (p<0.0001) and depression (p<0.0001) scores decreased. Intensity of headache decreased after RDN (p<0.01). CONCLUSIONS: RDN is associated with reduced anxiety and depression, intensity of headache and with improved QoL and stress tolerance in patients with resistant hypertension.