Karena Leppert’s research while affiliated with Universitätsklinikum Jena and other places

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Publications (44)


Resilience in chronic heart failure
  • Article

March 2014

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272 Reads

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10 Citations

DMW - Deutsche Medizinische Wochenschrift

N Lossnitzer

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E Wagner

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B Wild

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[...]

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Background and objective: The study investigated correlates of resilience in chronic heart failure (CHF) patients suffering from a high somatic symptom burden and/or a clinical relevant depression. Furthermore, the resilience of the sample was compared to a representative sample of the German general population. Methods: 186 patients with CHF and high symptom burden (82 depressed and 104 non depressed) were investigated. Resilience was assessed using the Resilience Scale from Wagnild and Young. For the comparison of resilience, the sample of the general population (372 persons) was matched against the CHF sample regarding the variables age and gender. Results: There was a significant positive association of resilience with age and social support, whereas hopelessness and the inability to understand and describe emotions in the self (alexithymia) correlated negatively with resilience. Comparison with the general population revealed a significantly lower resilience in depressed CHF patients. Conclusions: Resilience seems to be predominantly associated to psychosocial variables such as age or social support rather than to disease-specific parameters such as left ventricular ejection fraction or NYHA functional class. Our finding that resilience is especially low in depressed CHF patients underscores the clinical relevance of depression in CHF, necessitating further research regarding the improvement of resilience and depression.


Wie resilient ist die Resilienz?

March 2013

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864 Reads

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16 Citations

PiD - Psychotherapie im Dialog

Seit gut 15 Jahren wird zunehmend von Resilienz gesprochen, wenn über die psychologische Widerstandsfähigkeit diskutiert wird. Dabei wird der Resilienz-Begriff mit divergenten Theorien erklärt, woraus sich unter-schiedliche Konsequenzen für psychosoziale oder psychotherapeutische Interventionen ergeben. Dieser Artikel stellt ausgewählte Diskussionsas-pekte in einer Übersicht dar. Die Autoren gehen dabei auf Resilienzkonzep-te aus Entwicklungs-und Persönlichkeitspsychologie ein und stellen kli-nisch relevante Ergebnisse vor, die mit der Resilienzskala erhoben wurden.


Die Rolle von Resilienz für die Bewältigung von Belastungen im Kontext von Altersübergängen

October 2011

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255 Reads

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17 Citations

Zeitschrift für Gerontologie + Geriatrie

Persönlichkeitsmerkmale bestimmen die Entwicklung über die Lebensspanne mit, so auch Resilienz, die als emotionale Widerstandsfähigkeit definiert ist. In diesem Beitrag wird eine Querschnittsanalyse, die den protektiven Charakter von Resilienz in verschiedenen Lebensaltern prüft, vorgestellt. An einer Stichprobe im Altersbereich von 30 bis 80 Jahren kann gezeigt werden, dass Resilienz als zuverlässiger Schutzschild gegen Depressivität funktioniert, jedoch im hohen Alter ( >70 Jahre) seine protektive Wirkung einbüßt. Vor allem ist Resilienz bei einer gravierenden Lebenslaufzäsur im hohen Alter, dem Übergang in die Pflegebedürftigkeit und damit Abhängigkeit, nicht mehr als Copingmechanismus funktionell.


The role of resilience for coping in different age groups

September 2011

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199 Reads

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4 Citations

Zeitschrift für Gerontologie + Geriatrie

Personality traits, e.g., resilience, which is defined as emotional strength, have a strong impact on lifespan development. In this paper, a cross-sectional study examining the protective character of resilience in aging is presented. In a sample of persons ranging in age from 30-80 years, a significant negative association between resilience and depression was observed for the oldest group of our sample (age > 70 years). Thus, resilience might serve as a "safe-guard" against depression over the life course that, however, was found to disappear when people are faced with a transition into dependency and being in need of care.



Cognitive Function Is Not Associated With Recurrent Foot Ulcers in Patients With Diabetes and Neuropathy
  • Article
  • Full-text available

March 2009

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61 Reads

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33 Citations

Diabetes Care

To study whether there is an association between cognitive impairment and the relapse rate of foot ulcers in diabetic patients and those with previous foot ulcers. This single-center prospective study assessed the association of cognitive function and risk for ulcer relapse in 59 patients with diabetes (mean age 65.1 years, diabetes duration 16.5 years, and A1C 7.4%), peripheral neuropathy, and a history of foot ulceration. Premorbid and current cognitive functions were measured (multiple-choice vocabulary test [Lehrl], number-symbol test, mosaic test [HAWIE-R], and trail-making tests A and B [Reitan]). Prevalence of depression was evaluated retrospectively (diagnoses in patient files or use of antidepressive medication). Patients were re-examined after 1 year. Three patients (5%) died during follow-up (one of sepsis and two of heart problems). The remaining 56 patients (48%) developed 27 new foot ulcerations (78% superficial ulcerations [Wagner stage 1]). Characteristics of patients with and without ulcer relapse were not different. In a binary logistic regression analysis, cognitive function is not predictive of foot reulceration. Cognitive function is not an important determinant of foot reulceration.

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Denial of the climacteric – A pilot study of a common clinical phenomenon

October 2007

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29 Reads

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4 Citations

Females visiting a gynecological practice with the assumption of being pregnant despite clear signs of commencing climacteric seem to be not uncommon. Despite a huge amount of research on the psychosocial aspects of menopause and the female climacteric, scientific reports on denial of the climacteric cannot be found. Based upon some case examples, a pilot study comparing females clearly denying the onset of the climacteric with women accepting the climacteric was performed. The patients were investigated with a personality inventory and questionnaires measuring the attitudes towards their own body, sexual attitudes, and perimenopausal complaints and beliefs. The study indicates that women who deny their climacteric are characterized by higher scores in neuroticism, a more negative experience of their body and more conservative sexual attitudes. In addition, the subgroup of the deniers was characterized by a lower educational and professional status. The results may serve to motivate further research on the issue and may help to sensitize gynecologists for the problem.


The influence of resilience on fatigue in cancer patients undergoing radiation therapy (RT)

September 2007

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124 Reads

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117 Citations

Journal of Cancer Research and Clinical Oncology

The primary goal of the study was to determine if resilience influences fatigue in a consecutive sample of cancer patients treated with radiotherapy (RT) at the beginning and at the end of the treatment. Out of an initial sample of 250 patients, 239 could be assessed at the beginning of their RT. Two hundred and eight patients were reassessed at the end of RT 4-8 weeks later. Measures comprised the Resilience Scale (RS), the Multidimensional Fatigue Inventory (MFI), and the SF-12 as a measure of health related Quality of Life (QoL). Medical data were continuously registered. As hypothesized, the sample revealed higher scores in the MFI and lower scores in the SF-12 than normative samples. Resilience scores were higher than in the norm population. Fatigue increased during RT. Using multiple regression analyses, fatigue scores at the beginning of treatment were shown to be higher in inpatients and patients undergoing palliative treatment. Initial fatigue was best predicted by the patients' initial resilience scores. Changes of fatigue scores during RT depended on initial scores, decrease in Hb and the patients' experience with RT. Resilience could not be determined as a predictor of changes in fatigue during RT. The study confirmed that fatigue is an important problem among RT patients. Resilience turned out to powerfully predict the patients' fatigue at least early in RT. This result is in line with other studies, showing resilience to be an important psychological predictor of QoL and coping in cancer patients. On the other hand, resilience seems to have little influence on treatment related fatigue during RT.



Citations (29)


... The evaluation was made on a five-tier polarity scale (2 = "fully correct" [e.g., high quality], 1 = "rather correct" [e.g., high quality], 0 = "neither one nor the other", -1 = "rather correct" [e.g., low quality], -2 = "fully correct" [e.g., low quality]). The scale was developed by the authors according to the work of Menold and Bogner [57], Prüfer et al. [58], Goldhammer and Hartig [59] and Giersdorf et al. [60]. Before the main survey started, a pretest was carried out. ...

Reference:

Comparing “Leaf-to-Root”, “Nose-to-Tail” and Other Efficient Food Utilization Options from a Consumer Perspective
Entwicklung eines Fragebogens zur Partizipativen Entscheidungsfindung

... A 2014 systematic review (Walker et al., 2014) examining the treatment of depression in cancer patients only identified 7 publications that met the inclusion criteria. Two of the studies examined the effect of pharmacologic therapies (Pezzella et al., 2001;Costa et al., 1985) and 1 explored pharmacologic versus psychologic treatment effects (Veitenhansl et al., 2004). Recently, the relationship between depression and inflammation was explored in cancer patients treated for depression. ...

Neuro-glial dysfunction in retinae of (mREN-2)27 rats during diabetes

Diabetologia

... Participants responded to items such as "I usually manage one way or another" on a scale ranging from 1 (I disagree) to 7 (I agree). The RS-11 demonstrated good reliability and convergent validity in a German sample [25]. The measurement invariance of resilience is established as partial strong [16]. ...

The Resilience Scale - A questionnaire to assess resilience as a personality characteristic
  • Citing Article
  • January 2005

Zeitschrift für klinische Psychologie, Psychiatrie und Psychotherapie / im Auftrag der Görres-Gesellschaft

... Es handelt sich somit also um eine positive Adaptation an widrige Lebenserfahrungen oder -umstände (Lindert, Schick, Reif, Kalisch, & Tüscher, 2018;Kalisch, Müller, & Tüscher, 2015;Kalisch, et al., 2017). (Sameroff & Chandler, 1975;Masten A. S., 1989) Als Begründer und erste Vertreter der Forschung zu Resilienz gelten die US-Amerikaner Jan Block (1924Block ( -2010 und Norman Garmezy (1918Garmezy ( -2009 (Leppert, Richter, & Strauß, 2013;Kalisch, et al., 2017). In den ca. ...

Wie resilient ist die Resilienz?
  • Citing Article
  • March 2013

PiD - Psychotherapie im Dialog

... In 2002, a representative survey of the German population as a whole showed that only 2.5% of respondents had a living will in 2001 [25]. Three years later, von Oorschot et al. found that although the proportion of living wills in palliative cancer patients was significantly higher than in the general population at 26%, it was still unexpectedly low in the overall patient spectrum [26]. A retrospective study of intensive care patients found that out of 658 patients who died, 12% had an LW. ...

Patientenverf??gungen aus Patientensicht: Ergebnisse einer Befragung von palliativ behandelten Tumorpatienten
  • Citing Article
  • May 2004

Ethik in der Medizin

... In such a case, joint decisions are hardly possible and, particularly in emergency situations, decision-making is delegated to third-party physicians [33]. A collaborative relationship between the older patient and the patient's main doctor (usually the family physician) enables participatory decision-making and sustains the vulnerable patient's autonomy and dignity [34]. ...

Patienten als Partner in der letzten Lebensphase: Erste Ergebnisse und Perspektiven eines Modellvorhabens
  • Citing Article
  • October 2004

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz

... In this context, Ebrahimi Belil et al. reported that patients with chronic disorders could be resilient in light of hopefulness and positive thinking, which resulted from incompatibility with the condition, acceptance of the resultant outcomes, and making attempts for its management (33). Lossnitzer et al. also showed a positive relationship between hopefulness and resilience (34). ...

Resilience in chronic heart failure
  • Citing Article
  • March 2014

DMW - Deutsche Medizinische Wochenschrift

... As an emotional strength or resource, resilience may serve as a protective health factor in aging. For instance, in a sample of adults (30-80 years), a significant inverse association between resilience and depression was observed for persons over 70 years (Leppert and Strauss, 2011). On the other hand, population-based investigations on this issue are scarce, especially regarding people in late adulthood. ...

Die Rolle von Resilienz für die Bewältigung von Belastungen im Kontext von Altersübergängen
  • Citing Article
  • October 2011

Zeitschrift für Gerontologie + Geriatrie

... Durchschnittlich sterben etwa ein Fünftel aller Menschen zu Hause [6,7]. Ausnahmen sind Rheinland-Pfalz [24] mit einem erhöhten Anteil von 39,8% im Jahr 1995 und Jena mit 33,7% in den Jahren 2003/04 [26]. In Brüssel fällt der Anteil von Sterbenden im privaten Heim mit 15,1% hingegen besonders niedrig aus [22]. ...

Sterben, Sterbehilfe und Therapieverzicht aus Angehörigensicht - Ergebnisse einer Hinterbliebenenbefragung

PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie

... Studies of solid tumors show that 40-89% of patients desire a common decision-making process, especially concerning the choice of therapy or also concerning the general framework of the treatment (e.g. when the treatment should begin) [13]. The following have been described as influencing factors for a greater desire for participating in treatment decisions: young age, higher educational level, higher competency in health issues, and others, with interactive effects-especially concerning age and educational level-also playing a role, along with current treatment conditions and illness associated factors [8,[14][15][16]. Possible, and often short-term, effects of shared decision making are seen in discussions of a greater satisfaction with treatment, less fear, depression, and conflicts of decision, a better compliance (also resulting from a greater loyalty to therapy based on better information), or a higher quality of life [2,17,18]. ...

Ein Werkstattbericht über die Entwicklung eines Kommunikationstrainings für Ärzte - Patientenpartizipation in der Palliativsituation
  • Citing Article
  • January 2007

Der Klinikarzt