The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older

Background: The WHOQOL-OLD is an instrument for the assessment of subjective quality of life in elderly people. It is based on the WHO definition of quality of life and is available in more than 20 languages. However, in most countries, the psychometric properties of the WHOQOL-OLD have been assessed only on the basis of small local samples and not in representative studies. In this study, the psychometric properties of the WHOQOL-OLD are evaluated based on a representative sample of Germany\''s elderly population. Methods: Face-to-face interviews with 1133 respondents from the German population aged 60 years and older were conducted. Quality of life was assessed by means of the WHOQOL-BREF, the WHOQOL-OLD and the SF12. Moreover, the GDS, the DemTect and the IADL were applied for the assessment of depressive symptoms, cognitive capacities and capacity for carrying out daily activities. Psychometric properties of the WHOQOL-OLD were evaluated by means of classical and probabilistic test theory, confirmatory factor analysis and multivariate regression model.Results: Cronbach\''s alpha was found to be above 0.85 for four and above .75 for two of the six facets of the WHOQOL-OLD. IRT analyses indicated that all items of the WHOQOL-OLD contribute considerably to the measurement of the associated facets. While the six-facet structure of the WHOQOL-OLD was well supported by the results of the confirmatory factor analysis, a common latent factor for the WHOQOL-OLD total scale could not be identified. Correlations with other quality of life measures and multivariate regression models with GDS, IADL and the DemTect indicate a good criterion validity of all six WHOQOL-OLD facets.Conclusions: Study results confirm that the good psychometric properties of the WHOQOL-OLD that have been found in international studies could be replicated in a representative study of the German population. These results suggest that the WHOQOL-OLD is an instrument that is well suited to identify the needs and the wishes of an aging population

Rationale, component description and pilot evaluation of a physical health promotion measure for people with mental disorders across Europe

Introduction: The HELPS project aimed at developing a toolkit for the promotion of physical health in people with mental disorders to reduce the substantial excess morbidity and mortality in the target group. Methods: The HELPS toolkit was developed by means of national and international literature reviews, Delphi rounds with mental health experts and focus groups with mental health experts and patients/ residents in 14 European countries. The toolkit was translated into the languages of all participating countries, and usability of toolkit modules was tested. Results: The toolkit consists of several modules addressing diverse somatic health problems, lifestyle, environment issues, patient goals and motivation for health-promotion measures. It aims at empowering people with mental illness and staff to identify physical health risks in their specific contexts and to select the most appropriate modules from a range of health promotion tools. Discussion: The HELPS project used an integrative approach to the development of simple tools for the target population and is available online in 14 European languages. Preliminary evidence suggests that the toolkit can be used in routine care settings and should be put to test in controlled trials to reveal its potential impact

Psychische Erkrankungen im ländlichen Raum - Gemeindestrukturen und Aufnahmeraten im ländlichen Einzugsgebiet der psychiatrischen Klinik des Bezirkskrankenhauses Günzburg

Background: Researching environmental risk factors for mental illnesses in urban areas has a history since the 1930s, but research in rural areas on this topic is lacking. Methods: For the years 2006 to 2009, hospital admission rates for depression and schizophrenia were identified for 174 rural municipalities in the catchment area of the state psychiatric hospital in Günzburg. Relationships of overall and diagnosis-specific admission rates with municipality characteristics were analysed by means of negative binomial regression models. Results: Admission rates for both diagnoses combined decrease with population growth, population density, average income and green areas, while they are positively correlated with commuter balance, income inequality, unemployment rates and traffic areas. Admission rates for schizophrenia alone are negatively correlated with population growth, average income and agricultural areas, but positively correlated with mobility index, income inequality and unemployment rate. Admission rates for affective disorders are negatively correlated with population growth, population density, average income and green areas, while higher admission rates are correlated with commuter balance, high income inequality, unemployment rate and traffic-related areas. Discussion: As expected from former urban studies, the study shows that economic factors are related to admission rates on the municipality level in rural areas. Population density shows a different effect: low population density was associated with higher admission rates. While stress could be the key to the findings in urban areas, the lack of social networks and fixed social norms could be behind the findings here. Land use types are rarely researched in rural areas, which is why the findings are really astonishing and need further investigation, especially since evidence for underlying mechanisms is missing

The analysis of factors affecting municipal employees’ willingness to report to work during an influenza pandemic by means of the extended parallel process model (EPPM)

Abstract Background The management of pandemics with highly infectious diseases in modern urban habitats depends largely on the maintenance of public services. Understanding the factors that influence municipal employees’ willingness to come to work during a pandemic is therefore a basic requirement for adequate public health preparedness. In this study the extended parallel process model (EPPM) is applied to investigate how the readiness of municipal employees to report to work during an influenza pandemic (IP) is affected by individual attitudes and environmental conditions. Methods 1.566 employees of a major German city participated in a cross-sectional online survey. The questions of the survey covered the dimensions of risk perception, role competence, self-efficacy, role importance, sense of duty, and willingness to report to work in the case of an IP. Data were analysed by means of path analyses. Results Data suggest that up to 20 % of the public service workers were not willing to come to work during an IP. Willingness to report to work was increased by the perception of a high working role competence, a high assessment of role importance, high self-efficacy expectations, and a high sense of duty. Negative effects on willingness to report to work were identified as the perception of a high risk to become infected at work and the perceived risk to infect family members. The decomposition of direct and indirect effects provided important insights into the interrelationships between model variables. Conclusions Measures to increase municipal workers’ willingness to report to work in case of an infectious pandemic should include communication strategies to inform employees clearly about their particular tasks during such critical events and training exercises to increase their confidence in their competences and skills to fulfil these tasks

Criminal victimization, cognitive social capital and mental health in an urban region in Germany: a path analysis

There is ample evidence that experiencing a criminal victimization is associated with lasting emotional problems among victims. To date, the mechanisms behind this association are not well understood. Based on the theoretical assumptions derived from a transactional stress-appraisal and coping model this study analyses the role of cognitive social capital (SC) in the association between criminal victimization (CV) and victims' mental health. A cross-sectional, computer-aided telephone survey including a representative sample of 3005 persons from three German cities was conducted. Respondents were asked about CV during their lifetime, cognitive SC, perceived victimization risk, perceived safety and perceived ability to prevent victimization. The PHQ-4 was used as a measure of anxiety and depression. The data were analyzed by means of logistic regression models and a path model controlled for sociodemographic characteristics. Lifetime CV with any type of crime was associated with a clinically relevant increased risk of mental disorder (PHQ-4 >= 9; OR 1.8, p <= 0.05). Path analyses revealed that the direct association between CV and PHQ-4 (beta = 0.454; p <= 0.01) was significantly diminished by cognitive SC (beta = - 0.373; p <= 0.05). Our results suggest that cognitive SC is an individual resilience factor against negative experiences related to CV and that it holds the potential to diminish negative mental health consequences of CV. Further research should explore to what extent an enhancement of cognitive SC can help to prevent anxiety and depression among crime victims