Stephanie Stiel

Stephanie Stiel
Hannover Medical School | MHH · Institute for General Practice

PD Dr. rer. medic.

About

206
Publications
15,904
Reads
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1,442
Citations
Additional affiliations
February 2011 - present
Friedrich-Alexander-University of Erlangen-Nürnberg
Position
  • Senior Researcher
February 2011 - present
Friedrich-Alexander-University of Erlangen-Nürnberg
Position
  • Senior Researcher
February 2011 - present
Universitätsklinikum Erlangen
Position
  • Senior Researcher

Publications

Publications (206)
Preprint
Background General practitioners (GPs) play a key role in the provision of primary palliative care (PC). The identification of patients who might benefit from PC and the timely initiation of patient-centred measures at the end of life are essential, yet challenging. Although different tools exist to support these key tasks, a structured approach is...
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Introduction Progressive chronic, non-malignant diseases (CNMD) like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia are of growing relevance in primary care. Most of these patients suffer from severe symptoms, reduced quality of life and increased numbers of hospitalisations. Outpatient palliative care can...
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Background: Demographic trends show an increasing number of elderly people and thus a growing need for palliative care (PC). Such care is increasingly being provided by long-term care (LTC) facilities. The present study aimed at exploring PC indicators of residents at LTC facilities belonging to a non-profit provider in Lower Saxony, Germany, in o...
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Introduction: In the course of the implementation of the German Hospice and Palliative Care Act of 2015, an agreement was reached to establish an intermediate level of outpatient palliative care (BQKPMV) in Germany. By its degree of specialization, this form of care is located between generalist and specialist outpatient palliative care (AAPV/SAPV...
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A major proportion of people with Parkinson’s disease (PwP) in Germany has written an advance directive (AD). Unfortunately, these ADs are unclear for PD-specific endpoints. We previously established consensus-based recommendations for disease-specific content of an AD in PwP. However, the implementation of those recommendations and the consulting...
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Background Of the approximately 4.7 million people in Germany caring for a relative, many live at a geographical distance from their loved one. The provision of remote care to a terminally ill patient is associated with specific challenges and burdens. In the German context, research is lacking on the specific experiences and needs of caregivers in...
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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)....
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Background General practitioners (GPs) play a crucial role in the provision of end-of-life care (EoLC). The present study aimed at comparing the quality of GPs’ EoLC before and after an intervention involving a clinical decision aid and a public campaign. Methods The study was part of the larger interventional study ‘Optimal care at the end of lif...
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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...
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Zusammenfassung Hintergrund Mit der ‚besonders qualifizierten und koordinierten palliativmedizinischen Versorgung‘ (BQKPMV) führte der Gesetzgeber eine Versorgungsform zwischen allgemeiner und spezialisierter ambulanter Palliativversorgung ein. Ziel der Studie Analyse der Wahrnehmung und Einschätzung der BQKPMV von Akteur*innen anhand aktueller Ste...
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Background Distress and burnout are common in physicians. Both may already arise during medical training and persist throughout residency. An analysis of needs is necessary in order to develop target group specific curricular concepts at medical faculties. Aim of this study was to assess the perceived stress of medical students, to explore study-re...
Preprint
Background: General practitioners (GPs) play a crucial role in the provision of end-of-life care (EoLC). The present study aimed at comparing the quality of GPs’ EoLC before and after an intervention involving a clinical decision aid and a public campaign. Methods: The study was part of the larger interventional study ‘Optimal care at the end of li...
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Background The majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging...
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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...
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Parkinson’s disease (PD) is a progressive neurodegenerative disorder resulting in reduced health-related quality of life (HR-QoL) of people with PD (PwP) and their caregivers. Furthermore, there is an accumulating burden on caregivers of patients in advanced stages of the disease. In previous studies, motor- and non-motor-symptoms of PwP have been...
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Zusammenfassung Hintergrund Bis zu 90% der Menschen am Lebensende benötigen eine Palliativversorgung. Die Mehrheit davon kann im Rahmen der allgemeinen ambulanten Palliativversorgung (AAPV) durch Hausärzt*innen betreut werden. Frühere Studien haben gezeigt, dass ambulante Palliativleistungen hinter dem geschätzten Bedarf zurückbleiben und insgesam...
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Purpose The availability of psychosocial support measures has a significant impact on the quality of life of terminally ill and dying patients and the burden experienced by their relatives. To date, no intervention has specifically focused on promoting interaction within the dyads of the following: (1) terminally ill adult children and their parent...
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Aim This study aimed to analyse the number of deceased people who received different types of outpatient palliative care, the length of time prior to death that care was initiated, and their palliative care trajectory including the rate of hospital death. Subject and methods Data on 35,514 adults insured by the statutory health insurance who died...
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Zusammenfassung Zielsetzung Versorgungsverträge von Tageshospizen und palliativmedizinischen Tageskliniken werden untersucht sowie Versorgungsumfang und Ausstattungsmerkmale zwischen bezuschussten und nicht bezuschussten Einrichtungen verglichen. Methodik Alle Allgemeinen Ortskrankenkassen (AOKs) wurden zu Vertrags- und Abrechnungsdaten sowie Tages...
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Zusammenfassung Hintergrund Die Begleitung von Menschen am Lebensende ist ein zentraler Aspekt stationärer Altenpflege. Ziel der Studie war die Evaluation der Hospizkultur in Altenpflegeeinrichtungen aus Angehörigensicht. Methodik Angehörige verstorbener Bewohner*innen (n = 452) aus 18 Einrichtungen in Niedersachsen wurden zur Befragungsteilnahme e...
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Citation: Jensen, I.; Lescher, E.; Stiel, S.; Wegner, F.; Höglinger, G.; Klietz, M. Analysis of Transition of Patients with Parkinson's Disease into Institutional Care: A Retrospective Pilot Study. Abstract: Parkinson's disease (PD) is a neurodegenerative disease which gives a person a high risk of becoming care-dependent. During disease progressio...
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Zusammenfassung Hintergrund Trotz eines hohen Bedarfs an allgemeiner ambulanter Palliativversorgung (AAPV) fehlt es an konkreten Lösungsansätzen für eine zielgerichtete Integration in Hausarztpraxen. Ziel dieser Arbeit ist die Evaluation von Maßnahmen zur Verbesserung der AAPV aus Sicht hausärztlicher Praxisteams. Methoden Qualitative Evaluation de...
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Background To date, there has been no systematic research on the intermediate level service (level 2) in outpatient palliative care that was introduced in Germany in 2017. Accordingly, the Polite research project aims at: (1) investigating the current state of level 2 palliative care and (2) developing recommendations for its optimisation. Methods...
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Zusammenfassung Hintergrund Vorausschauende Versorgungsplanung ist als notwendiger Bestandteil für eine bedürfniszentrierte Betreuung von Patient*innen mit fortgeschrittenen Krebserkrankungen anerkannt. Aufgrund des seit Langem von Pflegepersonal und Ärzt*innen thematisierten Bedarfs in der onkologischen Abteilung wurde das Konzept „Behandlung im V...
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Introduction: So far there has been little evidence of the extent to which project steps can affect the timing and successful implementation of research projects in general practitioner (GP) practices. Using the example of an intervention study on palliative care, the aim of this article is to report a) how the overall course of the project turned...
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Background The SARS-CoV-2 (COVID-19) pandemic is posing major challenges for health care systems. In Germany, one such challenge has been that adequate palliative care for the severely ill and dying (with and without COVID-19), as well as their loved ones, has not been available at all times and in all settings., the pandemic has underlined the sig...
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Background Little is known about the structure, accessibility, service provision and needs of palliative and hospice day-care in Germany and abroad. Researchers, healthcare providers and policy makers would benefit from a systematic overview. Aim The aim was to identify, describe and summarise available evidence on status, demand and practice mode...
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Zusammenfassung Ziel der Studie Der Bestand von Tageshospizen und palliativmedizinischen Tageskliniken in Deutschland soll erstmals systematisch erhoben und analysiert werden. Methodik In dieser gemischt-methodischen Studie wurden Einrichtungsleitungen in leitfadengestützten Interviews (06.–07.2020) und standardisierter Fragebogenerhebung (08.–10.2...
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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...
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Background To date, the establishment and development of palliative day-care clinics and day hospices in Germany have been completely unsystematic. Research is needed to gain insight into these services and to ensure their accessibility and quality. Accordingly, the ABPATITE research project aims at: (1) identifying the characteristics of palliativ...
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Background During the current pandemic situation, the public health care system must ensure the ongoing provision of regular medical care as well as the treatment of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infected patients. Resident oncologists and their practices are equally affected.Objectives The study examines residen...
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Objective Patient–family member communication plays a decisive role in coping with an end‐of‐life situation and is strongly influenced by the dyadic relationship. There is a lack of research exploring and comparing the specifics of communication between: 1) terminally ill adult children and their parents and 2) terminally ill parents and their adul...
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Objectives The aim of the present study was to report the specific challenges pertaining to the experiences and needs of (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children, regarding their relationship and relationship roles. The study sought to identify similar and differing relationship pat...
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Little is known about support experiences and needs in the dyads of (1) terminally ill adult children and their parent caregivers and (2) terminally ill parents and their adult child caregivers. The current study aimed at investigating the experiences and needs of adult children and parents in end of life situations regarding their provision and re...
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Parkinson’s disease (PD) is a slowly progressive neurodegenerative movement disorder that leads to impairments in activities of daily living. In addition to reducing patients’ quality of life, this disease also affects caregivers’ well-being. Until recently, caregiver burden was mainly assessed by generic questionnaires, which do not take the chara...
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Zusammenfassung Hintergrund Zur Stärkung von AAPV fehlt es oftmals an Konkretisierung der Handlungsfelder für hausärztliche Praxisteams. Im Projekt „ALLPRAX“ wurde der Frage nachgegangen, welche Maßnahmen aus Sicht von Hausärzten und Medizinischen Fachangestellten das Potenzial haben, die AAPV in ihren jeweiligen Praxen zu verbessern. Methode Acht...
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Background The provision and quality of end-of-life care (EoLC) in Germany is inconsistent. Therefore, an evaluation of current EoLC based on quality indicators is needed. This study aims to evaluate EoLC in Germany on the basis of quality indicators pertaining to curative overtreatment, palliative undertreatment and delayed palliative care (PC). R...
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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...
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Objective: General practitioners (GPs) play a key role in the provision of general outpatient palliative care (AAPV) for the majority of patients at the end of life. The aim of this study was to evaluate the quality of End-of-Life Care (EoLC) from a GPs’ perspective using the German version of the General Practice End of Life Care Index (GP-EoLC-I)...
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Context Although high quality research with patients and family members is needed to improve palliative care, difficulties in recruitment are often reported. Objectives The present article analyses the authors` experiences in recruiting participants of two types of dyads for the study ‘[email protected] – Interaction at the end of life in dyads of...
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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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Background: The strengthening of the general practitioners' (GPs') role in palliative care (PC) has been identified as a top priority in order to improve PC in Germany. This study aims at exploring positive and negative experiences in PC in Germany from the perspectives of patients, relatives, and health care professionals in a primary care setting...
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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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Zusammenfassung Hintergrund Praktische Erfahrungen und Studien untermauern die Relevanz der Palliativversorgung (PV) für ältere Menschen mit lebensbegrenzenden Erkrankungen. Ziel dieser Studie ist, die hausärztliche Versorgung älterer Menschen in der letzten Lebensphase zu untersuchen. Methodik Als Teil der Ist-Analyse des Interventionsprojekts „Pr...
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Introduction. The WHO Europe Office, together with the European Association for Palliative Care, is supporting the development of an interdisciplinary core curriculum for health care professionals in the European Region, which is to be given to the countries as a recommendation. Material and methods. Between April and September 2018, a research jou...
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Zusammenfassung Hintergrund In Deutschland fehlen Instrumente zur strukturierten Beurteilung der hausärztlichen Palliativversorgung. Ziel des Projekts war die systematische Entwicklung einer deutschsprachigen Version des General Practice End of Life Care Index (GP-EoLC-I). Methodik Zur Anwendung kam das TRAPD-Modell: Translation, Review, Adjudica...
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Zusammenfassung Hintergrund Intersektionalität beschreibt die Zusammenhänge unterschiedlicher Formen und Dimensionen von Diversität. Intersektionale Ansätze können helfen, Forschungsergebnisse zu erklären, deren Validität zu verbessern und wirksame Gesundheitsprogramme abzuleiten. Ziel Der Beitrag hat zum Ziel aufzuzeigen, wie Intersektionalität in...
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A huge proportion of people with Parkinson's disease (PwP) in Germany have written an advance directive (AD). However, the content of these forms in regard to specific Parkinson's disease (PD)-related complications is rather low. There is an urgent need to specify ADs of PwP and consequently to improve decision-making concerning end-of-life aspects...
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Introduction: General practitioners (GPs) make a major contribution to outpatient palliative care (AAPV). In 2013, new fee rates for AAPV were included in the uniform assessment standard, which strengthens the financial framework conditions for outpatient palliative care by GPs. The aim of the ALLPRAX project is to improve the framework conditions...
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Erratum zu: Anaesthesist 2018 10.1007/s00101-018-0451-4 In Tab. 3 des Artikels kam es in den letzten drei Zeilen und im Text zu einem Übertragungsfehler. Ein Einfluss auf die Handlungsempfehlung und auf die inhaltliche Bewertung der Ergebnisse ergibt sich durch die Korrekturen nicht.
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Background: The implementation of the cross-sectional subject of palliative care (Q13) at medical faculties in Germany is heterogeneous. In faculties without a chair for palliative medicine, other solutions are needed. Objectives: This study describes the development and implementation process of the new educational concept in Q13 at the Hannove...
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Background.The implementation of thecross-sectional subject of palliative care(Q13) at medical faculties in Germany isheterogeneous. In faculties without a chairfor palliative medicine, other solutions areneeded.Objectives.This study describes thedevelopment and implementationprocess ofthe new educational concept in Q13 at theHannover Medical Schoo...
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Background Most people want to die in their familiar home environment. To achieve this objective, new structures have been stablished and further developed in Germany in recent years, with specialised (SAPV) and general palliative home care (AAPV). The aim of this work was to analyse, for the first time, where people die in the city and region of H...
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Background: The best possible care for frail older patients at the end of life can require the integration of geriatric and palliative approaches, possibly with different accentuations at different times. General practitioners (GP) are particularly important in this context: they provide patients with low-threshold primary care close to their home...
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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 Being terminally ill affects not only the life of patients but also that of their loved ones. Dyads of adult children and their parents at the end of life may face specific challenges with regard to their relationship and interactions that need to be further examined. Aim The aim was to identify, describe and summarise available evidenc...
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Full-text available
Parkinson's disease (PD) is a progressive neurodegenerative movement disorder with an increased morbidity and mortality. People with PD (PwP) may suffer from decreased quality of life due to various motor and nonmotor symptoms. To a huge proportion, PwP have written an advance directive (AD); however, the content of these forms in regard to PD-spec...