[How the implementation of a school for people with Parkinson's disease can succeed-Results of a consensus study and a formative evaluation]. / Wie die Umsetzung einer Schule für Menschen mit Parkinson-Krankheit gelingen kann ­ Ergebnisse eines Konsensusverfahrens und einer formativen Evaluation.

BACKGROUND: As the most rapidly increasing neurodegenerative disease worldwide, Parkinson's disease is highly relevant to society. Successful treatment requires active patient participation. Patient education has been successfully implemented for many chronic diseases, such as diabetes and could also provide people with Parkinson's disease with skills to manage the disease better and to participate in shared decision making. MATERIAL AND METHODS: To prepare the implementation of a concept for patient education for people with Parkinson's disease, a structured consensus study was conducted and a pilot project formatively evaluated. The structured consensus study included experts from all over Germany. It consisted of two online surveys and an online consensus conference. The formative evaluation was conducted as three focus groups. Transcripts were evaluated using content-structuring qualitative content analysis. RESULTS: From the consensus procedure 59 consented statements emerged, mainly regarding the contents of a patient school and a group size of 6-8 persons. Only two statements could not be consented. The formative evaluation detected a tendency towards a positive attitude for a digital training format and a very positive evaluation of the contents. DISCUSSION: Overall, important recommendations for a patient school can be drawn from this study. The following subjects require further investigation: format, inclusion criteria, group composition and inclusion of caregivers.

A randomized controlled trial of problem-solving training (PST) for hematopoietic stem cell transplant (HSCT) patients: Effects on anxiety, depression, distress, coping and pain.

The effect of problem-solving training (PST) on psychological distress, coping, pain, overall distress, and problem-solving behavior in hematopoietic stem cell transplant (HSCT) patients was investigated in a randomized controlled trial. The intervention was performed during aplasia and included five 1-hour individual sessions; it was started 2 days before HSCT. Forty-five patients were included in the intervention group (IG) and 46 in the control group (CG). The effects were measured at 11 (t2) and 21 days (t3) after HSCT. At t2, 31 patients remained in the IG and 36 patients in the CG. Patients > 18 years, with adequate cognitive performance, and with adequate command of the German language, were included. They were assessed with regard to anxiety and depression (Hospital Anxiety and Depression Scale), psychological distress (Symptom Checklist short version-9), coping (Brief Cope), problem-solving (Social Problem Solving Inventory-Revised), pain (Questions of Pain), and distress (National Comprehensive Cancer Network Distress Thermometer). The data were analyzed using analyses of covariance (general linear model) to examine the differences between the two conditions. Anxiety, psychological distress, pain, and general stress were reduced after PST in the IG compared with those in the CG. Active coping was reinforced in the IG. The IG patients were also better able to reduce negative problem orientation and improve problem implementation. The effect of the PST on these features was between Eta 2 =.13 and .45 and can thus be described as medium to strong. There were no changes in depression and social support. After careful interpretation of the results, it can be said that PST affects patients' mental health, problem-solving, and coping. Because these psychological changes occur shortly after the transplantation in the phase of aplasia, HSCT patients are likely to be given a more favorable starting position for the course of recovery.