Holger Pfaff

University of Cologne | UOC · Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR)

The major impact on healthcare through the ongoing digital transformation and new technologies results in opportunities for improving quality of care. Electronic patient records (EPR) are a substantial part in this transformation, even though their influence on documentation remains often unclear. This review aims to answer the question of which ef...

Purpose The extent of variation in urinary and sexual functional outcomes after radical prostatectomy (RPE) between prostate cancer (PC) operating sites remains unknown. Therefore, this analysis aims to compare casemix-adjusted functional outcomes (EPIC-26 scores incontinence, irritative/obstructive function and sexual function) between operating s...

Background: As individuals with thalidomide embryopathy now reaching their 60's they undergo long-term sequelae of their prenatal damage and experience a wide range of secondary health problems, in particular chronic musculoskeletal pain, movement restrictions, and mental disorders. These health problems are having a negative impact on their life...

Up to 50% of unsuccessful implementations of organizational change are due to a lack of organizational readiness for change (ORC). This qualitative study aims to investigate the experiences of occupational physicians (OPs) and staff of test and training centers (ETTCs) with team effectiveness in the context of ORC. The change setting is the impleme...

Background Hospitals are globally an important place of care for dying people and the most frequent place of death in Germany (47%), but at the same time, the least preferred one – for both patients and their relatives. Important indicators and outcome variables indexing quality of care in the dying phase are available, and various proposals to ach...

Objectives: To validate the patient-reported measure of Social Support Perceived by Patients Scale-Nurses (SuPP-N). Design/setting: A secondary data analysis based on a cross-sectional breast cancer patient survey in 83 German hospitals. Patients were asked to give written informed consent before they were discharged. If they agreed to participa...

Background: Musculoskeletal and mental disorders are often comorbid, with complex correlations of pain, impairment due to pain, disability, and psychological wellbeing. This study investigates the role of psychological wellbeing in a worksite healthcare program for employees within a German randomized controlled trial. Methods: For our analyses...

Background Evaluating the development phase of a complex intervention programme can be challenging. A prospective evaluation approach is presented based on the example of the new complex psycho-oncological care programme isPO (integrated, cross-sectoral Psycho-Oncology). Prior to programme implementation, we examined (1) if isPO was developed as in...

Background The annual incidence of new cancer cases has been increasing worldwide for many years, and is likely to continue to rise. In Germany, the number of new cancer cases is expected to increase by 20% until 2030. Half of all cancer patients experience significant emotional and psychosocial distress along the continuum of their disease, treatm...

The COVID-19 pandemic has strained long-term care organization staff and placed new demands on them. This study examines the role of the general ability and power of a long-term care organization to act and react collectively as a social system, which is called systemic agency capacity, in safeguarding the provision of person-centered care during a...

Purpose Considering that breast cancer survivors (BCSs) have been dealing with unwanted job changes after diagnosis, this study aimed to investigate involuntary job changes (unwanted modifications in employment since diagnosis) and explore the association between job changes, involuntariness, and occupational development satisfaction in BCSs 5–6 ye...

Boredom has been identified as one of the greatest psychological challenges when staying at home during quarantine and isolation. However, this does not mean that the situation necessarily causes boredom. On the basis of 13 explorative interviews with bored and non-bored persons who have been under quarantine or in isolation, we explain why boredom...

Background There is a significant number of long-term breast cancer survivors in Germany. However, research on the psychological challenges of cancer survivors is limited. This analysis describes prevalence, development and determinants of depression and anxiety 5 to 6 years after diagnosis and identifies predictors for an increase of anxiety and d...

Background: The implementation of complex healthcare programmes can be challenging for respective service providers (SPs) in implementation settings. A strong work-related sense of coherence (Work-SoC) promotes creation of job resources and potentially facilitates coping with demands that may arise during implementation. In this study, we analyse...

High-quality patient information material (PIM) is essential for patients´ informed decision-making, and its quality may influence a care program’s acceptance. In the new psycho-oncological care program, isPO, the initial PIM was developed top-down and required optimization. In this paper, we report on the process and experiences of optimizing PIM’...

The aim of this chapter is to analyze the social preconditions and dynamics of organizational resilience and the role of leadership in managing these conditions and dynamics. The chapter begins with an examination of the concept of organizational resilience, presents an individualistic and systemic perspective on this construct, proposes a social i...

This study analyzes the longitudinal association between precarious employment and physical and mental health in a dualized labor market by disaggregating between-employee and within-employee effects and considering mobility in precariousness of employment. Analyses were based on the German Socio-Economic Panel from 2002 to 2018 considering all emp...

Objective This study investigated the prevalence, individual courses, and determinants of fear of cancer recurrence (FoR) in long-term breast cancer survivors (BCSs) with and without recurrence. Methods A total of 184 breast cancer survivors were surveyed at four measurement time points: during hospitalization (T1), 10 weeks (T2), 40 weeks (T3), a...

Die Coronavirus-Pandemie verändert die Welt. Auch in Deutschland stehen in deren Folge Beschäftigte, Unternehmen sowie die gesamte Gesellschaft enormen Herausforderungen gegenüber. In vielen Bereichen wirkt die Pandemie als Beschleuniger eines bereits stattfindenden Wandels – etwa in puncto digitaler Transformation – der dauerhaft unser Leben und A...

The COVID-19 pandemic has posed an extraordinary challenge for public health and health policy. Questions have arisen concerning the main strategies to cope with this situation and the lessons to be learned from the pandemic. This conceptual paper aims to clarify these questions via sociological concepts. Regarding coping strategies used during the...

Musculoskeletal disorders (MSDs) are among the most common cause for reduced work capacity and sick leave. Workplace health promotion programs are often neither tailored to the workplace nor the individual needs of the employees. To counteract lacking intersectional care, this four-year randomized controlled trial (RCT) aimed to investigate the eff...

The relationship between nurse staffing, physical outcomes of residents, as well as quality of care receives major attention. The impact of staffing levels on residents’ ability to organize their everyday life and maintain social contacts, however, has not been analyzed to date. This study examines whether a relationship between the staff-to-reside...

Purpose The context in which an innovation is implemented is an important and often neglected mediator of change. A prospective payment system (PPS) for psychiatric and psychosomatic facilities with major implications for inpatient psychiatric care in Germany was implemented from 2013 to 2017. This study aims to examine the determinants of implemen...

The Innovationsfonds was launched by the German Federal Government in 2016 and funds both experimental new care models and health services research projects. The applicants respond to annual funding announcements with a broad range of topics. Insights from more than five years of experience encompass prioritisation of topics, types of projects fund...

Background The health care innovation “MamBo – people with multimorbidity in outpatient care: patient-focused and needs-oriented healthcare management” aims to improve the efficiency and quality of care for multimorbid patients by delegating tasks (e.g. taking over house calls or coordinating specialist appointments) to a monitoring and coordinatio...

Background The commitment of hospital managers plays a key role in decisions regarding investments in quality improvement (QI) and the implementation of quality improvement systems (QIS). With regard to the concept of social capital, successful cooperation and coordination among hospital management board members is strongly influenced by commonly s...

Hintergrund Eine chronische Niereninsuffizienz und deren symptomatische Behandlung, die Dialyse, gehen mit verschiedenen Einschränkungen einher. Diese können die körperliche Leistungsfähigkeit und Ernährung betreffen, aber auch die Autonomie in Alltag und Freizeitgestaltung. Dadurch können psychosoziale Belastungen bei Betroffenen entstehen, welche...

https://www.mdpi.com/1660-4601/18/18/9708 Managers often face stress and high work demands. Yet they have received limited attention as targets of workplace health promotion measures (HPMs). This study’s primary objective (1) is to examine managers’ self-reported participation in HPMs and factors associated with HPM participation. The secondary o...

Zusammenfassung Die COVID-19-Pandemie verdeutlicht, dass es nicht eingeplante Gesundheitsrisiken gibt, die erhebliche Auswirkungen auf Gesellschaft, Unternehmen und Menschen haben können. Unabhängig von der COVID-19-Pandemie sind daher Unternehmen und ihr Gesundheitsmanagement gut beraten, sich auf mögliche zukünftige Gesundheitsrisiken vorzubereit...

Im Gesundheitswesen besteht ein hoher Innovationsdruck. Indes erweist sich das deutsche Gesundheitswesen mit seinen vielen Akteuren, Institutionen und Steuerungsorganen als komplex. Die Versorgungsforschung nimmt Bezug auf die Komplexität und untersucht, wie Neuerungen in ein komplexes System mit divergierenden Interessen implementiert werden, um a...

Objectives: The healthcare system is characterised by a high degree of complexity and involves various actors at different institutional levels and in different care contexts. To implement patient-centred care (PCC) successfully, a multidimensional consideration of influencing factors is required. Our qualitative study aims to identify system-level...

Purpose: In order to design a patient-centered discharge process, the entire process is visualized in Value Stream Mapping. The duration of the process steps and waiting times are measured and presented. As a team, health professionals discuss problems and agree on suitable solutions. Methods: After applying Value Stream Mapping, we conducted ei...

Introduction Clinically complex patients often require multiple medications. Polypharmacy is associated with inappropriate prescriptions, which may lead to negative outcomes. Few effective tools are available to help physicians optimise patient medication. This study assesses whether an electronic medication management support system (eMMa) reduces...

Dieser Artikel widmet sich dem Phänomen mütterlicher Langeweile in der Elternzeit. Entlang einer qualitativen Analyse eines Online-Elternforums wird gezeigt, wie gesellschaftliche Diskurse und normative Vorstellungen in Form latenter Sinnstrukturen mütterliche Langeweile in der Elternzeit beeinflussen. Das Ergebnis der Analyse ist, dass sich das Ph...

Background To investigate patients’ perspectives on polypharmacy and the use of a digital decision support system to assist general practitioners (GPs) in performing medication reviews. Methods Qualitative interviews with patients or informal caregivers recruited from participants in a cluster-randomized controlled clinical trial (cRCT). The inter...

The aims of this study were (1) to design a user-friendly instrument to assess and optimize patient information material (PIM), (2) to develop an English version, and (3) to test its psychometric properties. The instrument was needed to optimize the top-down developed PIM of the psycho-oncological care programme isPO. First, a literature-based PIM...

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are medically equivalent alternatives for symptomatic therapy of end-stage renal disease (ESRD). An early referral (ER) of patients with chronic kidney disease (CKD) to a nephrological specialist is associated with a higher proportion of patients choosing PD. Germany historically shows a l...

Patient-reported outcomes (PROs) are increasingly being used to compare the quality of outcomes between different healthcare providers (medical practices, hospitals, rehabilitation facilities). However, such comparisons can only be fair if differences in the case-mix between different types of provider are taken into account. This can be achieved w...

(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization...

Aim To analyse the associations between a nurse's psychological safety and her/his additional training. Design A cross-sectional survey conducted between September 2015 and August 2016. Methods A multi-level modelling approach was used considering unit membership. We used data from 1,239 questionnaires completed by nurses on 75 different German n...

Follow-Up Befragung 2021 zur Veränderung der Präsenz- und Homeofficekultur im öffentlichen Dienst während der Covid-19-Pandemie.

Follow-Up Befragung 2021 zur Veränderung der Präsenz- und Homeofficekultur im Bereich IT und technische Dienstleistungen während der Covid-19-Pandemie.

Purpose Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine...

Neue Versorgungsformen bedürfen vor Einführung in die Regelversorgung einer vorhergehenden Wirksamkeitsprüfung. Die häufig praktizierten Evaluationsansätze werden dem komplexen Kontext der neuen Versorgungsformen jedoch selten gerecht und entsprechend ist die Übertragbarkeit der Ergebnisse der Wirksamkeitsprüfung limitiert. Wir zeigen exemplarisch...

Introduction: The Last Year of Life Study-Cologne Part I (LYOL-C I) has identified general hospital units as the most important checkpoints for transitions in the last year of life of patients. Yet, satisfaction with hospitals, as reported by bereaved relatives, is the lowest of all health service providers. Thus, the LYOL-C Part II (LYOL-C II) fo...

Introduction: Managers often face stress and high work demands, yet they have received limited attention as participants in workplace health promotion measures (HPMs).How are individual and organizational factors connected to managers’ previous participation in health promotion measures? How do managers perceive their subjective work situation and...

In the course of the coronavirus disease 2019 pandemic, long-term nursing care facilities are faced with general and pandemic-specific demands. In our study, we examined their burden from the perspective of managers in long-term nursing care facilities and how it differed in outpatient and inpatient settings. A cross-sectional online survey of long...

Objective: The aim of the study was to show the frequency, localisation, intensity, quality and degree of chronic pain in people with thalidomide-induced congenital defects (thalidomide embryopathy) and to investigate the association with biopsychosocial factors more closely. Methods: A group of 202 people from North Rhine-Westphalia with thalid...

Background The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals m...

Introduction Patient-reported outcomes (PROs) can be used in cancer care to monitor patients’ disease-related symptoms and functional status. However, successful implementation of such instruments is only possible if clinical staff are convinced of the clinical benefits. It is therefore crucial to investigate the attitudes of clinical staff to PROs...

Hintergrund und Zielstellung: Muskel-Skelett-Erkrankungen (MSE) sind die häufigste Ursache für Arbeitsunfähigkeit (AU) in Deutschland und damit eine zentrale Herausforderung der betrieblichen Gesundheitsförderung. Bei Versicherten der Betriebskrankenkassen waren 2018 ca. 24% aller AU-Tage auf MSE zurückzuführen (Knieps et al., 2019). Meta-Analysen...

The Corona pandemic poses major demands for long-term care, which might have impacted the intention to quit the profession among managers of long-term care facilities. We used cross-sectional data of an online survey of long-term care managers from outpatient and inpatient nursing and palliative care facilities surveyed in April 2020 (survey cycle...

Objective: People with cancer are often confronted not only with the burdens of medical treatment but also with psychological strain, which can lead to mental disorders (MD). To date, the prevalence of MD in newly diagnosed cancer patients and their utilization of mental health services (MHS) are mainly estimated through data of primary studies tha...

The purpose of this paper is to investigate the role of positive affect in the association between multimorbidity and depressive symptoms. We used four consecutive waves (2008-2017) from the of the nationally representative German Ageing Survey (DEAS). We applied the mediational g-formula with inverse-probability weighting techniques and we also...

This study provides insights into the longitudinal relation between multimorbidity, mental wellbeing, and social support. The analysis used the German Sociomedical Panel of Employees, a study of the German working population aged 40 to 54. In the context of multimorbidity, this population has been little studied. Multimorbidity is significantly ass...

Interview mit dem Kölner Stadt-Anzeiger zum Thema "Demokratie auf dem Prüfstand". Inhalt: die Corona-Pandemie und ihre Auswirkungen auf Politik und Gesellschaft

Background The consolidated framework for implementation research states that personal leadership matters in quality management implementation. However, it remains to be answered which characteristics of plural leadership in hospital management boards make them impactful. The present study focuses on social determinants of implementation power of h...

Objective The development and validation of a health behaviour scale for cancer patients (HBSCP). Methods An 11‐item scale was developed based on existing literature on health behaviour and cancer prevention and care. Identified dimensions include the following: nutrition and weight, physical activity, nicotine and alcohol use, stress, and adheren...

COVID-19, Impfung und Impfkampagne Drei Botschaften: 1. Sorgfältige Integration der Impfung in eine umfassende Präventionsstrategie 2. Impfkampagne resilient gestalten und wissenschaftlich begleiten 3. Aufklärung und Selbstbestimmung beachten

In der Coronapandemie bilden sich gesellschaftliche Lager heraus, die auf Konfrontation statt Verständigung setzen. Beobachtungen eines Medizinsoziologen

Ein Autorenteam um Dr. h. c. Helmut Hildebrandt hatte in den Ausgaben 7 /B und 9 von WELT DER KRANKENVERSICHERUNG eine Status-Quo-Bestimmung und Vorschläge für eine regelhafte Integrierte Versorgung vorgelegt. Dies ist inzwischen breit diskutiert und kommentiert worden. Einige der Kommentare und Stellungnahmen sind in den Heften 'l 0 und 1 1, eine...