Klaus Pfeiffer

• Dr. rer. nat.
• Robert-Bosch-Krankenhaus, Stuttgart, Germany

Interventions for preventing falls in older people often involve several components, multidisciplinary teams, and implementation in a variety of settings. We have developed a classification system (taxonomy) to describe interventions used to prevent falls in older people, with the aim of improving the design and reporting of clinical trials of fall...

Objective: Intervention trials for stroke caregivers after the early poststroke period are lacking. To address this gap, we examined the effectiveness of a problem-solving intervention (PSI) for stroke caregivers who provided care for at least 6 months and who experienced significant strain in their role. Method: One hundred twenty-two family ca...

Background: Recent Cochrane reviews on falls and fall prevention have shown that it is possible to prevent falls in older adults living in the community and in care facilities. Technologies aimed at fall detection, assessment, prediction and prevention are emerging, yet there has been no consistency in describing or reporting on interventions usin...

Fall related hip and pelvic fractures are among the injuries with the most serious consequences for the elderly population. The prognosis for functional recovery markedly worsens in the large subgroup of patients with cognitive impairment. So far, only a small number of clinical trials could show that cognitive impaired hip fracture patients can be...

Despite the evaluation of more than 200 dementia caregiver interventions over the past three decades, only very few programs have been translated to delivery in service contexts. In this study (05/2013–10/2016) we evaluated if structured problem-solving is feasible to implement in a routine setting and effective compared to statutory care counselli...

Background People post-hip fracture have reported experiences of fragmented care and poor discharge planning, therefore improvements in patient flow are required. This study reports the challenges people face during the discharge process and offers potential solutions for improving the transition from hospital to home from the perspectives of patie...

Introduction Sex differences are commonly reported for hip fracture incidence rates and recovery. Current knowledge about mobility recovery after hip fracture involves clinical assessments of physical capacity or patient-reported outcomes. Information on mobility performance during daily life is missing but relevant to evaluate patients’ recovery....

Psychosocial resources can enhance positive experiences and reduce negative experiences in family caregivers. This study aimed to develop scales for measuring the utilization of resources related to well-being and coping with daily hassles adapted for family caregivers. It aimed to examine their psychometric properties with a German sample of 445 i...

In Germany, different models of orthogeriatric co-management have been implemented in certified geriatric trauma centers. So far, it is not clear how the different models are implemented and what influence the certification has on the structures and processes within the centers. The present study examined the extent of cooperation between surgery a...

Objectives To assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery. Design Two-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitati...

Objectives This study aims to illuminate the perspectives of informal caregivers who support people following hip fracture surgery. Design A qualitative study embedded within a now completed multicentre, feasibility randomised controlled trial (HIP HELPER). Setting Five English National Health Service hospitals. Participants We interviewed 20 pa...

This study examines gender differences in offspring primary caregivers. We compared baseline data from 26 caregiving sons and 244 caregiving daughters. Caregiving sons had higher incomes, were less likely to be married, and provided care to parents less limited in their cognitive functions and instrumental activities of daily living. Daughters matc...

Background Physiotherapy and occupational therapy are currently described using the duration of treatment (days or weeks), the frequency of therapy sessions (on a daily or 3–5 days per week basis) and considering the duration of a session (e.g., 30 or 45 min). The content is often poorly defined and the intensity is rarely reported. Using digital t...

Physiotherapy and occupational therapy are currently described using the duration of treatment (days or weeks) and the frequency of the therapy sessions on a given day (on a daily or 3-to-5 days per week basis) multiplied by the minutes of a session (e.g. 30 or 45 minutes).The content is often ill-defined. The intensity is rarely reported. The find...

Dass es in der häuslichen Pflege aus unterschiedlichsten Gründen zu gegenseitiger Gewalt kommen kann und kommt, findet mittlerweile zunehmend Beachtung. Für eine adäquate Adressierung dieser Problematik jenseits von Pathologisierung und Skandalisierung bedarf es vielfältiger Ansatzpunkte der Prävention, Unterstützung, Intervention und Zusammenarbei...

Background Family caregivers are faced with a variety of challenges and burdens. Recent online studies showed that these burdens have increased even more during the corona pandemic. Here we conducted a low-threshold written survey to assess psychological distress in highly burdened family caregivers during the corona pandemic in Germany.Method Both...

Background A growing number of older adults suffer hip and pelvic fractures leading to hospital admission. They often result in reduced physical activity (PA) and impaired mobility. PA can be objectively measured with body-worn sensors. Usually, global cumulative PA parameters are analysed, such as walking duration, upright-time and number of steps...

Aims This study aims to assess the feasibility of conducting a pragmatic, multicentre randomized controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery. Methods This will be a mixed-methods feasibility RCT, recruiting 60 patient...

Die BerTA-Studie (englisches Akronym: ReDiCare) verfolgt das Ziel, ein versorgungsnahes Unterstützungsangebot für hoch belastete pflegende Angehörige in einer randomisierten Studie auf seine Wirksamkeit zu überprüfen. Mithilfe eines gestuften Ansatzes sollen unterschiedliche Beratungsbedarfe in dieser Zielgruppe abgedeckt werden. In einem ersten ni...

Background Identifying patients with maladaptive fear of falling (FOF) is important in the rehabilitation phase after serious fall. The 6-item Fear of Falling Questionnaire-revised (FFQ-R) was seen as promising measurement instrument as it evaluates FOF in a broader way than the one-item-question and independent of physical activities.AimThe purpos...

Background Providing care for someone with a disease or chronic condition can have a negative psychological, physical, social, and economic impact upon informal caregivers. Despite the socio-economic relevance and more than three decades of caregiver intervention research only very few translational efforts of successful interventions are reported....

Objective: To investigate short-term changes in clinical characteristics in the transition period between geriatric inpatient rehabilitation and independent living at home in older patients with hip/pelvic fracture and cognitive impairment. Design: Longitudinal observational study. Subjects: A total of 127 multi-morbid, older patients with hip/pelv...

Background: fear of falling and reduced fall-related self-efficacy are frequent consequences of falls and associated with poorer rehabilitation outcomes. To address these psychological consequences, geriatric inpatient rehabilitation was augmented with a cognitive behavioural intervention ("Step by Step") and evaluated in a RCT. Methods: one hun...

Objective Physical exercise is associated with many health benefits. Especially for older adults it is challenging to achieve an appropriate adherence to exercise programs. The outcome expectations for exercise scale 2 (OEE-2) is a 13-item self-report questionnaire to assess negative and positive exercise outcome expectations in older adults. The a...

This study investigated the effectivity and sustainability of a physical activity (PA) promotion- and motor training program and analyzed predictors for PA changes in persons with dementia (PwD). A total of 122 participants with mild-to-moderate dementia were randomized to the intervention program designed for PwD (intervention group [IG]) or a mot...

Objective To gain a better understanding about the nature of fear of falling, this study analyzed associations between psychological and physical aspects related to fear of falling and falls efficacy in hip/pelvic fracture patients. Design Baseline data of a randomized controlled trial. Setting Geriatric inpatient rehabilitation hospital. Subjec...

Zusammenfassung Die Depression geht mit einem erhöhten Frakturrisiko einher. Da Fragilitätsfrakturen meist Folge eines Sturzes und/oder einer erhöhten Knochenbrüchigkeit sind, beschreibt die Übersichtsarbeit, über welche Wege die Depression Sturzrisiko und Knochendichte beeinflussen kann. Patienten mit Depression haben ein um 50 % erhöhtes Sturzris...

Hintergrund/Ziel der Studie: Multimorbide, ältere Personen mit Hüft-/Beckenfraktur (HBF) und kognitiver Einschränkung (KE) sind nach einer stationären Rehabilitation von einem erneuten Rückgang ihrer motorischen Leistungsfähigkeit und damit vom Verlust ihrer Autonomie bedroht. Ziel der Studie war es, die Effekte eines von freiwilligen Laienhelfer_i...

Objectives: To review the evidence evaluating the effectiveness of informal caregiver interventions to facilitate the recovery of older people discharged from the hospital. Design: Systematic review and meta-analysis. Setting: Hospital and community. Methods: Published and unpublished randomized and nonrandomized controlled trials assessing...

Background A hip or pelvic fracture is a major fall-related injury which often causes a decline in mobility performance and physical activity. Over 40% of patients with hip fracture have cognitive impairment or dementia and poorer rehabilitation outcomes than those without cognitive impairment. In this subgroup, there is a lack of evidence on the b...

Zusammenfassung Hintergrund Stürze und sturzbedingte Verletzungen gehören zu den großen Herausforderungen heutiger industrieller Gesellschaften. Die bekanntermaßen effektiven gruppenbasierten Trainingsprogramme sind jedoch gerade in ländlichen Gebieten unzureichend verfügbar. Ziel Nach erfolgreicher Implementation der Trittsicher-Bewegungskurse in...

Background: Geriatric patients after hip/pelvic fracture (HPF) have reduced motor performance and are at risk of losing their autonomy during the transition from inpatient rehabilitation to their home environment. This risk increases with cognitive impairment (CI). Aim of this study: The investigation of the change of motor performance in geriatric...

Hintergrund: Geriatrische Patienten mit Hüft - oder Beckenfraktur (HBF) weisen eine reduzierte motorische Leistungsfähigkeit auf und sind in der vulnerablen Phase des Übergangs von der stationären Rehabilitation ins häusliche Umfeld stark vom Verlust ihrer Autonomie bedroht. Dieses Risiko nimmt bei gleichzeitig vorliegender kognitiver Einschränkung...

Die Pflege und Betreuung eines Angehörigen kann als bedeutsame Entwicklungsaufgabe betrachtet werden, mit der vor allem ältere Menschen, die ihre hochbetagten Eltern oder aber ihre (Ehe‑)Partner pflegen, konfrontiert sind. Die Übernahme von Pflegeaufgaben kann mit starken Belastungen verbunden sein und als sehr krisenhaft erlebt werden. Mögliche ps...

Most health systems are based on the premise that families will assume responsibilities for day-to-day care to persons with chronic or disabling conditions. The past three decades of research in this field have been focused on understanding caregivers’ adjustment, consequences of providing protracted care as well as on developing and testing interv...

The question of how to assess fear of falling (FoF) and falls efficacy in hip fracture patients is still not clearly resolved. While the Fall Efficacy Scale International (FES-I) shows good reliability and structural validity in this population, it appears more related to functional performance than to more general anxiety symptoms (Visschedijk et...

Ein Schlaganfall stellt ein schwerwiegendes Krankheitsereignis dar und kann mit zahlreichen neurologischen Symptomen wie zum Beispiel Lähmungen oder Sprachstörungen einhergehen. Nachfolgend entwickeln bis zu 50 % der Betroffenen mindestens einmalig eine signifikante depressive Symptomatik. Hierbei wird von komplexen Wechselwirkungen zwischen läsion...

Den von pflegenden Angehörigen vielfach geäußerten positiven Aspekte der Pflege stehen häufig zahlreiche pflegebedingte Stressoren gegenüber, die ein hohes Maß an Ressourcen und Anpassungsfähigkeit verlangen. In der Summe können diese Anforderungen leicht zu Überlastungssituationen und nachfolgend zu einer Verschlechterung der körperlichen und psyc...

Background Despite the positive evaluation of various caregiver interventions over the past 3 decades, only very few intervention protocols have been translated to delivery in service contexts. The purpose of this study is to train care counsellors of statutory long term care insurances in problem-solving and to evaluate this approach as an additio...

Objective Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. Rationale Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretic...

Objective: Depressive symptoms are a common problem among family caregivers of stroke survivors. The purpose of this study was to examine the association between care recipient's impairment and caregiver depression, and determine the possible mediating effects of caregiver negative problem-orientation, mastery, and leisure time satisfaction. The e...

Zielsetzung: Hüft-/Beckenfrakturen sind folgenreiche sturzbedingte Verletzungen und stellen die Hauptursache für Krankenhauseinweisungen bei über 65-Jährigen dar. Bei gleichzeitig vorliegender kognitiver Einschränkung steigt das Risiko der Pflegebedürftigkeit und Mortalität. Bislang untersuchte keine Studie die Effekte eines Interventionsprogramms...

BACKGROUND Even though the intervention effects on cognitively impaired care recipients are of interest, the evaluation in dementia caregiver studies on caregiver outcomes is often limited. Furthermore, the comparison of studies and interventions is difficult because of the large variance of endpoints and assessments used in this field. OBJECTIVE...

Stroke is a leading cause of long-term disability. A large proportion of geriatric stroke survivors receive informal care. The assessment and monetary valuation of informal care should therefore constitute an essential part of any health economic analysis, but it is hardly measured in stroke caregiver studies. The aim of the current research was to...

Stroke is one of the leading causes of disability in the United States (Rosamond et al., 2007). Many stroke survivors subsequently experience persistent impairments that can include cognitive and neuromuscular dysfunction (ranging from memory problems to paralysis, hemiplegia, and weakness), vision problems, communication deficits (e.g., aphasia),...

Caregiver burden is a main outcome domain in caregiver intervention research. A recommended instrument for measuring burden is the Sense of Competence Questionnaire (SCQ). In this study, we evaluated the psychometric properties of the German version of the SCQ with informal caregivers of stroke patients. Baseline data of a randomized controlled tri...

Within the last years various interventions for cognitively impaired persons and their informal caregivers have been developed and evaluated. As different these interventions are, as different are the outcome dimensions and instruments used. There might be the potential to affect outcomes on both sides. Therefore, the aim of this review is to analy...

Over recent years a number of Information and Communication Technologies (ICTs) have emerged aiming at falls prevention, falls detection and alarms for use in case of fall. There are also a range of ICT interventions, which have been created or adapted to be pro-active in preventing falls, such as those which provide strength and balance training t...

Problem-solving therapies for family caregivers have been described for different dyads and care recipients with various chronic conditions. Only little attention is directed to the specific topics worked on with informal caregivers. This study focuses on the intensive intervention period of 3 months of an individualized mainly telephone-based prob...

Depression and fear of falling are common problems following proximal femoral fracture. The role of fear of falling in depressive symptoms after such a fracture has not yet been investigated. The aim of this study was to establish possible changes during recovery in fear of falling and depressive symptoms following rehabilitation in this population...

Taxonomy to describe and conceptualise fall prevention interventions

Manual for the fall prevention classification system

Monitoring the performance of daily life mobility related activities, such as rising from a chair, standing and walking may be used to support healthcare services. This chapter identifies available wearable motion-sensing technology; its (potential) clinical application for mobility assessment and monitoring; and it addresses the need to assess use...

Monitoring the performance of daily life mobility related activities, such as rising from a chair, standing and walking may be used to support healthcare services. This chapter identifies available wearable motion-sensing technology; its (potential) clinical application for mobility assessment and monitoring; and it addresses the need to assess use...

Despite a wide distribution, little is known about the relationship between subscriber satisfaction and the extent of use or non-use of personal emergency response systems (PERS). To examine the degree of satisfaction with PERS, the wearing time and its use in case of a fall. Telephone and face-to-face interviews were conducted with 52 elderly comm...

Identification of the risk of falls in a cohort of interest is a prerequisite for a targeted fall prevention study. Motor tasks are widely used as baseline assessment in such studies, but there are only a few well-evaluated tests of motor performance to predict falls prospectively. This study was conducted to find out if the potential of the maximu...