Sabine Twork

Technische Universität Dresden, Dresden, Saxony, Germany

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Publications (39)29.43 Total impact

  • P. Peschel · S. Twork · J. Kugler
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    ABSTRACT: The general health status of adolescents has clearly improved in the last decades. Concerning the requirement of medical services and its reasons in adolescents less is known. The article reports these aspects of Saxon adolescents aged 14 to 17 years and compares data from male and female teenagers as well as in relation to important national data from Germany. Within the school year 2009/2010 the voluntary, anonymous survey was performed on a sample of schools in Saxony with the class level 8 and 10. The questionnaire was delivered to 6.525 scholars. The questions referred to the past 12 months. The return rate was 28.8% (n=1.876). Among the five most important reasons for a medical consultation also preventive strategies were reported beside different medical conditions. There were partly sex specific differences. Girls named significantly more often a physician than boys. The pediatrician was consulate most frequently, more by girls than by boys. Concerning other medical specialists no sex related differences were found. In rural areas the family practitioner was more frequently consulted than in urban areas, especially by boys. The overall satisfaction with medical treatment was high. Questioning of adolescents regarding their spectrum of illness should run periodical. It could facilitate ongoing statements concerning prevalences and usage of outpatient services. The findings of necessary regionalization of investigation could become part of the medical specialist training.
    No preview · Article · May 2012 · Padiatrische Praxis
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    ABSTRACT: In the last years there has been a growing interest in self assessment of Health-related quality of life (HRQOL). Studies show a reduced HRQOL in patients with Multiple Sclerosis (MS). A sample of n=3 157 members of the German Multiple Sclerosis Association (71.7% women, aged 48.2 years on average) was analyzed regarding the correlation between coping styles and HRQOL in MS patients. The findings show reduced HRQOL in MS patients in comparison to the general population in West Germany. MSQOL-54- and MSIS-29-sumscales and FKV-LIS-scales "depressive coping" and "minimizing importance" correlate significant: a depressive or trivializing coping style accompanies with reduced mental and physical HRQOL.
    No preview · Article · May 2011 · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie
  • M Menning · S Twork · J Kugler
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    ABSTRACT: Lack of treatment adherence is a significant issue in multiple sclerosis (MS). The aim of this project was to examine whether establishing an observational situation in the context of a non-interventional study could positively affect the treatment adherence, quality of life as well as patient satisfaction in 206 MS patients treated with Copaxone(®). Apart from 3 standardised, anonymous surveys no further measures were taken. Self-efficacy increased in the patients, which was also reflected in a decline in physician visits in the monitoring period. The number of consultations initiated by the patient decreased very much between the second and third patient surveys. In the quality of life area "health", there was a significant improvement. After 3 months there was a discontinuation rate of 10.4%; after 6 months 8.8%. Even though this was not a controlled study, these results could indicate that, on a short-term basis, patients can be motivated to adhere--probably as a result of the psychological aspects of the observational situation. However, long-term changes in behaviour can probably only be achieved through qualified training.
    No preview · Article · May 2011 · Das Gesundheitswesen
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    ABSTRACT: Myasthenia gravis (MG) is a chronic neuromuscular disease. Advances in medical therapy have continuously increased the life expectancy of MG patients, without definitively curing the disease. To analyze life circumstances and quality of life (QoL), a large German MG cohort was investigated. In cooperation with the German Myasthenia Association, 2,150 patients with confirmed MG were asked to respond to a mailed questionnaire. The standardized questions related to demographic data, impairments, therapeutic course, use of complementary therapies, illness-related costs, and quality of life (SF-36). In total, 1,518 patients participated, yielding a response rate of 70.6%. The average age was 56.7 years, and the proportion of females 58.6%. Despite receiving recommended therapy, many patients still suffered from MG-related impairments. In particular, mobility and mental well-being were reduced; moreover, quality of life was markedly reduced. Stepwise linear regression analysis revealed illness stability, impairments, mental conditions, comorbid diseases, and employment to be determinants of QoL. Results indicate that despite prolonged life expectancy among MG patients, health-related quality of life is low. This outcome resulted mainly from impaired mobility and depression. Physical and mental well-being might be improved by additional therapy options. Additionally, health care resources could be used more efficiently in these patients.
    Full-text · Article · Nov 2010 · Health and Quality of Life Outcomes

  • No preview · Article · Sep 2010 · Das Gesundheitswesen

  • No preview · Article · Sep 2010 · Das Gesundheitswesen
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    ABSTRACT: Progression in disability as measured by increase in the Expanded Disability Status Scale (EDSS) is commonly used as outcome variable in clinical trials concerning multiple sclerosis (MS). In this study, we addressed the question, whether there is a linear relationship between disability status and health related quality of life (HRQOL) in MS. 7305 MS patients were sent a questionnaire containing a German version of the "Multiple Sclerosis Quality of Life (MSQOL)-54" and an assessment of self-reported disability status analogous to the EDSS. 3157 patients participated in the study. Patients were allocated to three groups according to disability status. Regarding the physical health composite and the mental health composite as well as most MSQOL-54 subscales, the differences between EDSS 4.5-6.5 and EDSS > or = 7 were clearly smaller than the differences between EDSS < or = 4 and EDSS 4.5-6.5. These results indicate a non-linear relationship between disability status and HRQOL in MS. The EDSS does not seem to be interval scaled as is commonly assumed. Consequently, absolute increase in EDSS does not seem to be a suitable outcome variable in MS studies.
    Full-text · Article · Jun 2010 · Health and Quality of Life Outcomes
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    ABSTRACT: The role of treadmill training for people with Parkinson's disease in improving gait parameters is unclear. Gait hypokinesia is typically one of the primary movement disorders associated with Parkinson's disease. It is an important determinant of disability and quality of life for people with mild to moderate Parkinson?s disease. Treadmill training uses specialised machines to facilitate gait rehabilitation. This review identified eight trials including 203 participants which evaluated this type of therapy. Treadmill training did improve gait speed, stride length and walking distance; cadence did not improve. Acceptability of treadmill training for study participants was good and adverse events were rare. It is not, however, clear if such devices should be applied in routine rehabilitation or when and how often they should be used.
    Full-text · Article · Jan 2010 · Cochrane database of systematic reviews (Online)
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    ABSTRACT: Patients regard health care professionals as role models for leading a healthy lifestyle. Health care professionals' own behaviour and attitudes concerning healthy lifestyle have an influence in counselling patients. The aim of this study was to assess consumption of alcohol, cigarettes and illegal substances among physicians and medical students in two German states: Brandenburg and Saxony. Socio-demographic data and individual risk behaviour was collected by an anonymous self-administered questionnaire. Physicians were approached via mail and students were recruited during tutorials or lectures. 41.6% of physicians and 60.9% of medical students responded to the questionnaire; more than 50% of the respondents in both groups were females. The majority of respondents consumed alcohol at least once per week; median daily alcohol consumption ranged from 3.88 g/d (female medical students) to 12.6 g/d (male physicians). A significantly higher percentage of men (p < 0.05) reported hazardous or harmful drinking compared to women. A quarter of all participating physicians and one third of all students indicated unhealthy alcohol-drinking behaviour. The majority of physicians (85.7%) and medical students (78.5%) were non-smokers. Both groups contained significantly more female non-smokers (p < 0.05). Use of illegal substances was considerably lower in physicians (5.1%) than medical students (33.0%). Male students indicated a significantly (p < 0.001) higher level of illegal drug-use compared to female students. More than one third of the medical students and health care professionals showed problematic alcohol-drinking behaviour. Although the proportion of non-smokers in the investigated sample was higher than in the general population, when compared to the general population, medical students between 18-24 reported higher consumption of illegal substances.These results indicate that methods for educating and promoting healthy lifestyle, particularly with respect to excessive alcohol consumption, tobacco use and abuse of illegal drugs should be considered.
    Full-text · Article · Dec 2009 · BMC Health Services Research
  • Thomas Hoffmann · Sabine Twork · Joachim Kugler
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    ABSTRACT: Over the last years, the importance of the internet concerning patient information and communication has increased. This tendency is especially seen among patients with multiple sclerosis (MS). However, in spite of its popularity the internet lacks of regulations with respect to quality and sufficiency for the medical communication process. There is a need for an evaluation of the quality of websites and for the development of quality tools. From the literature, a score consisting of 10 items was derived. Analysis of 10 internet sites of patient organizations from Germany revealed only a moderate quality of websites for patients with multiple sclerosis. The implementation of a mandatory certification for patient websites or of a general seal of quality should be discussed.
    No preview · Article · Nov 2009 · Heilberufe
  • T. Hoffmann · S. Twork · D. Pöhlau · J. Kugler

    No preview · Article · Sep 2009 · Aktuelle Neurologie
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    ABSTRACT: As described in the Millennium Development Goals, malnutrition is one of the major obstacles to sustainable socioeconomic development and poverty reduction, especially in developing countries. These are first results from a cross- sectional study in Amppipal hospital (Gorkha District) which provides health care for about 200.000 inhabitants from Gorkha, Lamjung and Tanahun district. During first 5 months of data collection 950 children aged 0 to 15 years seek medical aid in Amppipal Hospital (57,75% male, 42,25% female children, missing percent= missing data). Data concerning Health Care provision during last attendance were available from 606 children. Reasons for present consultation: infectious diseases 51,2%, non-infectious diseases 21,40% , 14,5% injuries, perinatal conditions 1,2%, 5,0% other. Mostly they suffered from infectious diseases of the respiratory tract and gut (40,7% and 17.5% of all diagnosed infectious diseases). Reasons for seeking medical aid last time: 62,1% due to high fever, diarrhea or cough, 22,8% for immunization, 15% for other reasons. 29,1% of the 0 to 5 years and 18,9% of the 6- 15 years aged children suffered from a BMI below 3rd percentile. 48,8% of all children needed health care during the last 30 days and 48,8% between 1 month and 1 year ago. Providing meals during last illness by the mother: 0,4% more than usual, 24,0% about the same, 65,2% less than usual, 3,1% stopped food, 6,4% never gave food (exclusively breast feeding). The children mostly presented with infectious diseases and seek medical aid for similar health problems during the last year. A considerable number of children suffer from a serious low BMI. However, it is discussable, whether parents should be better informed about supporting prevention of infectious diseases and child`s reconvalescence by appropriate provision of fluid and food and if this can help to mitigate the vicious circle of malnutrition, morbidity and poverty.
    No preview · Conference Paper · Apr 2009
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    Sabine Twork · Joachim Kugler
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    ABSTRACT: Background: Although, multiples sclerosis is a frequent neurological disease, population based studies concerning quality of life are quite rare in Germany. Aim of this study was to assess quality of life and its determinants in multiple sclerosis patients from four different federal groups of the German Multiple Sclerosis Association (GMSA). Methods: By means of a standardized questionnaire the Department of Public Health of the Technical University of Dresden in cooperation with the corresponding federal group of the GMSA conducted a representative survey. To evaluate determinants of quality of life, regression analysis was used. Results: The different areas of quality of life were quite low in all of the assessed patient groups. The regression analysis showed a strong influence of disease specific factors as well as psychological factors and those concerning finances, care and satisfaction on physical and mental well being. Conclusions: The results point to important aspects of care to improve quality of life of patients with multiple sclerosis. Therefore, the interindividual course of the disease, symptoms and psychosocial consequences should be in the center of care. A solution might be integrated care.
    Full-text · Article · Jan 2009 · Heilberufe
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    ABSTRACT: To perform a systematic review about the effect of using clinical pathways on length of stay (LOS), hospital costs and patient outcomes. To provide a framework for local healthcare organisations considering the effectiveness of clinical pathways as a patient management strategy. As participants, we considered hospitalized children and adults of every age and indication whose treatment involved the management strategy "clinical pathways". We include only randomised controlled trials (RCT) and controlled clinical trials (CCT), not restricted by language or country of publication. Single measures of continuous and dichotomous study outcomes were extracted from each study. Separate analyses were done in order to compare effects of clinical pathways on length of stay (LOS), hospital costs and patient outcomes. A random effects meta-analysis was performed with untransformed and log transformed outcomes. In total 17 trials met inclusion criteria, representing 4,070 patients. The quality of the included studies was moderate and studies reporting economic data can be described by a very limited scope of evaluation. In general, the majority of studies reporting economic data (LOS and hospital costs) showed a positive impact. Out of 16 reporting effects on LOS, 12 found significant shortening. Furthermore, in a subgroup-analysis, clinical pathways for invasive procedures showed a stronger LOS reduction (weighted mean difference (WMD) -2.5 days versus -0.8 days)).There was no evidence of differences in readmission to hospitals or in-hospital complications. The overall Odds Ratio (OR) for re-admission was 1.1 (95% CI: 0.57 to 2.08) and for in-hospital complications, the overall OR was 0.7 (95% CI: 0.49 to 1.0). Six studies examined costs, and four showed significantly lower costs for the pathway group. However, heterogeneity between studies reporting on LOS and cost effects was substantial. As a result of the relatively small number of studies meeting inclusion criteria, this evidence base is not conclusive enough to provide a replicable framework for all pathway strategies. Considering the clinical areas for implementation, clinical pathways seem to be effective especially for invasive care. When implementing clinical pathways, the decision makers need to consider the benefits and costs under different circumstances (e.g. market forces).
    Full-text · Article · Jan 2009 · BMC Health Services Research
  • Thomas Hoffmann · Sabine Twork · Joachim Kugler

    No preview · Article · Jan 2009 · Heilberufe
  • Sabine Twork · Joachim Kugler

    No preview · Article · Jan 2009 · Heilberufe

  • No preview · Article · Dec 2008 · PiD - Psychotherapie im Dialog

  • No preview · Article · Dec 2008 · PiD - Psychotherapie im Dialog
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    ABSTRACT: Less is known about reasons for seeking medical aid for children and parental supportive behaviour in rural Nepal. These are first results from a cross-sectional study in the Amppipal hospital (Gorkha district) which provides health care for about 200.000 inhabitants from the Gorkha, Lamjung and Tanahun district. During that period 101 children aged 0 to 15 years presented there. Data concerning health care provision at the last attendance were available from 90 children averagely aged 4.0 years (56.7% male, 34.4% female children; missing percent = missing data). Reasons for seeking medical aid: 61.1% due to high fever, diarrhoea or cough, 6.7% for immunisation, 31.1% for other reasons. Time after recognising child's illness until care: 92.2% within 24 hours, 1.1% more than 24 hours. Providing fluids during last illness by the mother: 52.2% more than usual, 31.1% less than usual, 6.7% gave nothing to drink. Providing meals during last illness by the mother: 18.9% more than usual, 2.2 about the same, 37.8% less than usual, 23.3 stopped providing food, 1.1% never gave food (exclusively breast feeding). The children presented with typical health problems for that age, mostly with infectious diseases of the gut and respiratory tract accompanied by fever. However, it is discussable whether parents should be better informed about supporting child's reconvalescence by appropriate provision of food and fluid.
    No preview · Conference Paper · Oct 2008
  • K Voigt · F Kühne · S Twork · A Göbel · J Kugler · A Bergmann
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    ABSTRACT: OBJECTIVE AND METHODS: A complete vaccination status against infectious diseases is important for protecting health care professionals as well as patients. A survey based on a written questionnaire was conducted to record the actual vaccination status against diphtheria, hepatitis A und B, mumps, measles, poliomyelitis, rubella and tetanus. 642 general practitioners (family physicians and surgeons), 298 medical students and 962 nursing students from areas of eastern Germany completed the questionnaire. RESULTS AND CONCLUSIONS: There was no complete vaccination status against those diseases covered by the survey. Physicians had a good immunisation rate against tetanus (96.2%) and diphtheria (91.8%). The number of physicians without immunisation against measles (42.9%), HA (29.3%) and HB (12.7%) was unsatisfactory. Less than 50% of nursing students and medical students could show a complete vaccination status against MMR. In both student groups there were also gaps for vaccines against tetanus, diphtheria, HA and HB. Complete vaccination status was found to be in the range of 74-81% for tetanus, 51-66% for diphtheria, 47-63% for HA and 62-73% for HB. Furthermore, there is a need for actions to raise the immunisation rates and for improving the health protection for all persons involved (professionals and patients) in the health care system.
    No preview · Article · Aug 2008 · Das Gesundheitswesen

Publication Stats

283 Citations
29.43 Total Impact Points

Institutions

  • 2007-2011
    • Technische Universität Dresden
      • Institut für Medizinische Informatik und Biometrie
      Dresden, Saxony, Germany
  • 2010
    • Klinik Bavaria Kreischa
      Крајша, Saxony, Germany
  • 2009
    • Carl Gustav Carus-Institut
      Pforzheim, Baden-Württemberg, Germany
  • 2007-2009
    • Hospital Dresden-Friedrichstadt
      Dresden, Saxony, Germany