Maria Heckel

Maria Heckel
Universitätsklinikum Erlangen · Department of Palliative Medicine

Doctor of Philosophy

About

89
Publications
5,462
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325
Citations
Introduction
Maria Heckel currently works at the Department of Palliative Medicine, Universitätsklinikum Erlangen. She holds the EAPC Early Research Award 2019. Research interests: Quality of Care, Quality of Dying and Death, Dealing with Multidrug-resistant Organisms (MDRO) in Palliative Care, Health Services Research, Older People in Palliative Care, Patient and Public Involvement in Palliative Care Research

Publications

Publications (89)
Article
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Background: During the SARS-CoV-2 pandemic's initial waves, bans on visiting and isolation measures placed limits on providing services for seriously ill and dying people and their relatives. Pandemic response teams at governmental level (macro), at federal state and municipal level (meso) and in healthcare facilities (micro) played their role in...
Article
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Background/Aims: Dementia is incurable and classified as a life-limiting disease. The need for palliative care for people with dementia at the end of life is undisputed. Nevertheless, there is a lack of empirical data on their situation in a specialist palliative care context. How frequent is the documentation of a dementia diagnosis (main or side)...
Article
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Zusammenfassung Hintergrund und Ziel Im föderalen Deutschland sind Krisenstäbe zentrale Instrumente der Pandemiebewältigung. Das Ziel dieses Artikels ist es, Strukturen und Befugnisse von COVID-19-Pandemiekrisenstäben zu beschreiben, die während einer Studie zur Versorgung Schwerkranker und Sterbender in Pandemiezeiten (PallPan) exploriert wurden....
Article
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Objectives: To explore intercountry and intracountry differences in physician opinions about continuous use of sedatives (CUS), and factors associated with their approval of CUS. Settings: Secondary analysis of a questionnaire study. Participants: Palliative care physicians in Germany (N=273), Italy (N=198), Japan (N=334) and the UK (N=111)....
Article
Background Today, guideline-based care for patients with advanced cancer includes regular assessment of needs, not only for patients, but also for their family caregivers.Objectives Identification, evaluation and short description of German validated self-assessment instruments for needs assessment of family caregivers that can be used in daily pra...
Article
Background: The National Hospice and Palliative Registry is a database for palliative care facilities documenting a core data set for quality assurance and scientific evaluations. Objectives: The study aims identifying differences between patients in palliative care units treated in Comprehensive Cancer Centers (CCC) or other hospitals (OH) focu...
Article
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Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impac...
Article
Zusammenfassung Hintergrund Internetseiten stellen eine wichtige Säule in der Darstellungs- und Informationspolitik palliativmedizinischer Angebote dar. Sie fungieren als Anlaufstelle für Patienten und Angehörige, aber auch für medizinisch interessierte Laien. Methoden Es wurden 488 auf dem Wegweiser Palliativmedizin (Stand 31.7.2019) verlinkte Web...
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The world of healthcare constantly aims to improve the lives of people while nurturing their health and comfort. Digital health and wearable technologies are aimed at making this possible. However, there are numerous factors that need to be addressed such as aging, disabilities, and health hazards. These factors are intensified in palliative care (...
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Zusammenfassung Einleitung Eine leitliniengerechte onkologische Versorgung umfasst nicht nur die frühzeitige palliativmedizinische Mitbetreuung unheilbar erkrankter Patienten, sondern auch die Mitbetreuung ihrer Angehörigen. Untersuchungen zur Umsetzung im klinischen Alltag in Deutschland fehlen. Methoden Die AG Palliativmedizin im Netzwerk der von...
Article
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Context: There are few international studies about the continuous use of sedatives (CUS) in the last days of life. Objectives: We aim to describe the experiences and opinions regarding CUS of physicians caring for terminally ill patients in seven countries. Methods: Questionnaire study about practices and experiences with CUS in the last days...
Article
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Zusammenfassung Sterben und Tod können als Abjekte wirksam werden und negative Auswirkungen wie Ablehnung und Ausgrenzung auf personaler und sozialer Ebene sowohl für schwerkranke und sterbende Menschen als auch ihre Zugehörigen haben. Doch sind auch Personen, die in der Hospiz- und Palliativversorgung tätig sind, von diesen Mechanismen betroffen....
Article
PURPOSE Guidelines recommend several screening tools to identify patients with complex palliative needs. This diversity and lack of structural recommendations offer a wide scope for implementing screening. Against this background, the current status of implementation at German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid has...
Article
Background Palliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ persp...
Article
Introduction In 2017, a national recommendation on multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care was published. In order to monitor the implementation in a hospital-based palliative care unit, a dedicated multidisciplinary working group on MDRO was established. It developed a standard operating procedure and a documentatio...
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Zusammenfassung Hintergrund Die Beteiligung von Bürger*innen in Forschungsprojekten gewinnt gesellschaftlich an Bedeutung. Bürger*innen (Patient*innen, deren Vertreter*innen oder Interessierte) an Forschung im Gesundheitswesen zu beteiligen ist bisher in Deutschland noch nicht strukturell verankert. Ziel des vorliegenden Artikels ist es, erste Erf...
Article
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Background: International studies indicate deficits in end-of-life care that can lead to distress for patients and their next-of-kin. The aim of the study was to translate and validate the "Care of the Dying Evaluation" (CODE) into German (CODE-GER). Methods: Translation according to EORTC (European Organisation for Research and Treatment of Can...
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PurposeProviding high-quality care for the dying is essential in palliative care. Quality of care can be checked, compared, and improved by assessing responses from bereaved next-of-kin. The objectives of this study are to examine quality of care in the last 2 days of life of hospitalized patients considering specific aspects of their place of care...
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The surname and name of Christoph (name) Ostgathe (surname) are reversed.
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Background: The working group for palliative medicine within the Comprehensive Cancer Center (CCC) network funded by the German Cancer Aid in Germany has developed and published 14 Standard Operating Procedures (SOPs) for palliative care in CCCs. This study analyzed to what extent these SOPs have been implemented in the clinical routine in the CCC...
Article
The study investigates the usage of metaphorical structures in the German press discourse on multi-resistant pathogens in the clinical context by applying methods of qualitative discourse analysis to a corpus of 900 newspaper and magazine articles published between 1995–2015. The study shows that metaphors are of key importance for the processes of...
Article
Background In end-of-life care hygiene, measures concerning multidrug-resistant bacterial microorganisms may contradict the palliative care approach of social inclusion and be burdensome for patients. Objectives To integrate patients’ perspectives on handling multidrug-resistant bacterial microorganisms at their end of life, their quality of life,...
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Background: One challenge in caring for cancer patients with incurable disease is the adequate identification of those in need for specialized palliative care (SPC). The study's aim was to validate an easy to use phenomenological screening tool. Methods: The German tool is based on the National Comprehensive Cancer Network (NCCN) Palliative Care...
Article
Background: This study examines communication profiles and associated attitudes toward health care professionals in interviews with family caregivers of hospitalized patients with confirmed multidrug-resistant organisms (e.g., methicillin-resistant Staphylococcus aureus or multiresistant gram-negative bacteria) diagnosis at the end of life. Object...
Article
Zusammenfassung Hintergrund Die moderne Palliativmedizin stellt eine junge Disziplin dar, die in den letzten Jahrzehnten ein eigenständiges fachliches Profil mit spezifischen Leitkonzepten, Zielen und Werthaltungen entwickelt hat. An Fachpublikationen lässt sich die Professionalisierung der Disziplin und die Herausbildung eines eigenen Palliativvok...
Article
Background: Internationally, efforts are underway to develop coordinated and standardized approaches for palliative care service delivery by improving service quality in hospice and palliative care networks. German legal regulations explicitly demand networking between hospice and palliative care providers. However, there is little research on mode...
Article
Background Institutions of inpatient geriatric care are dependent on specific and practicable concepts for the terminal care of old people, because residential and nursing homes are places for the last phase of life. Objective The objective of this study was to identify the wishes of residents for their dying who live in a residential or nursing h...
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Purpose: Palliative care professionals are frequently confronted with patients colonized or infected with MDRO. One major challenge is how to balance necessary isolation measures and social inclusion as one of the main principles of palliative and end-of-life care. To date, MDRO-specific policies and protocols vary widely between institutions. Ai...
Poster
Fokus der Palliativmedizin (PM) ist die persönliche Begegnung. Häufig wird bei schwerer Krankheit auf apparative Therapie und Diagnostik verzichtet. Dennoch könnten Biomarker (BM, z.B. Herz- und Atemfrequenz) wichtige ergänzende Hinweise auf Symptomlast und zur individuellen Anpassung der medikamentösen Behandlung geben. Wir erforschen den innovati...
Article
Zusammenfassung Die Studie beschäftigt sich mit den finanziellen Auswirkungen des Auftretens von multiresistenten Erregern auf einer palliativmedizinischen Station eines deutschen Universitätskrankenhauses. Ziele der Studie sind eine Analyse der Kostentreiber sowie ein Kostenvergleich zwischen MRE-positiven und -negativen Patienten. Zur Analyse der...
Article
Aims and objectives To explore healthcare professionals’ personal experiences, feelings, and attitudes about caring for hospitalized patients with multidrug‐resistant bacteria in palliative and geriatric care. Background Working in end‐of‐life care involves at times burdening demands that affect not only healthcare professionals personally but als...
Article
Background There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life ca...
Article
Background: Patient-reported outcomes are usually considered to be the gold standard assessment. However, for the assessment of quality of dying and death, ratings of informal caregivers (ICGs) or health-care professionals (HCPs) must be considered for ethical and methodological reasons. This article aims to present results of ICGs' and HCPs' esti...
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Background: The emergence of multidrug-resistant bacterial microorganisms is a particular challenge for the health care systems. Little is known about the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacteria (MDRGNB) in patients of palliative care units (PCU). Aim: The primary aim of thi...
Data
Antibiotic susceptibility profiles of the obtained MDRGNB isolates. (DOCX)
Article
Hintergrund Das Bayerische Staatsministerium für Gesundheit und Pflege unterstützt den Auf- und Ausbau von Versorgungsnetzwerken der Hospiz- und Palliativversorgung in Bayern. Ziel der vorliegenden Studie ist, die ambulant-stationären Partnerkonstellationen der Netzwerke systematisch zu beschreiben und zu analysieren. Methodik In einem mehrstufigen...
Article
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Background Information lacks about institutional stakeholders’ perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term “institutional stakeholder” includes persons in leading positions with responsibility in hospitals’ multidrug-resistant bacterial organism management. They have great infl...
Article
Background/Objective: Informal caregivers of patients with advanced cancer experience a challenging time, especially while caring for the patient at home. Aim of this study is to compare experiences, perceived burdens, and needs during home care of informal caregivers of brain tumor patients and informal caregivers of non-brain tumor patients. Meth...
Article
Background: In studies enrolling informal caregivers of patients in palliative care, it is necessary to ensure that findings are not influenced by factors such as mental disorders. Aim: This study aims to describe the influence of anxiety and depression on bereaved informal caregivers' retrospective ratings of the quality of dying and death (QoD...
Article
Background: The Bavarian State Ministry of Health and Care fosters the establishment of regional hospice and palliative care networks in Bavaria, Germany. Little is known about well-tried structures and beneficial strategies of collaboration within such networks. Objectives: The present study aims to investigate general conditions under which ho...
Article
Background: Little is known about the experiences of family caregivers of hospitalized patients with confirmed methicillin-resistant Staphylococcus aureus/multiresistant gram-negative bacteria (MRSA/MRGN) diagnosis at the end of life. The study at hand is a subproject of an interdisciplinary cooperation project that aims at developing a patient-,...
Article
Hintergrund: Die Auswirkungen von Kolonisation oder Infektion mit multiresistenten Erregern (MRE) und der Isolationsmaßnahmen auf Patienten am Lebensende, deren Angehörige sowie andere Beteiligte innerhalb des Gesundheitswesens sind unbekannt. Ziel der Studie: Die vorliegende Studie beschäftigt sich mit der Frage, inwieweit die speziellen Anforderu...
Article
Purpose: To validate the Quality of Dying and Death (QoDD) instrument for health professionals (QoDD-D-MA) and to test its feasibility in 2 German palliative care units (PCUs). Methods: The QoDD was translated from English to German and then retranslated following European Organisation for Research and Treatment of Cancer (EORTC) guidelines. Dat...
Article
Numerous (inter-)national guidelines and frameworks have been developed to provide recommendations for the application of palliative sedation (PS). However, they are still not widely known, and large variations in PS clinical practice can be found. This study aims to collect and describe contents from documents used in clinical practice and to comp...
Article
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Background: Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SP...
Article
The quality of dying and death (QOD) influences end-of-life care for patients and their relatives. To the best of our knowledge, there are currently no validated standard instruments for evaluating the QOD of patients in palliative care units (PCUs) in Germany. This study aimed to validate the German version of the multidimensional Quality of Dying...
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One essential element of research is the successful recruitment of participants. However, concerns are obvious regarding the ethical implications of involving terminally ill and even dying patients and their informal caregivers as research participants. This study aims to illustrate central issues encountered when recruiting bereaved informal careg...
Article
Background: Specialised outpatient palliative care teams (in Germany called SAPV) aim to ensure best possible end-of-life care for outpatients with complex needs. Information on the influence of living areas (rural vs. urban) on patient and care related aspects is rare. This study aims to explore differences between palliative care patients in urba...