Olaf von dem Knesebeck's research while affiliated with University Medical Center Hamburg - Eppendorf and other places

Publications (318)

Article
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Objectives Although public stigma imposes a great burden on those affected with manifold negative consequence there is not much known about public stigma related to fatigue. Therefore, this study addresses the following research questions: (1) What is the magnitude of public stigma toward individuals with fatigue? (2) Are there differences in publi...
Article
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Background: Governments across Europe deployed non-pharmaceutical interventions to mitigate the spread of coronavirus disease 2019 (COVID-19), which not only showed clear benefits but also had negative consequences on peoples' health. Health inequalities increased, disproportionally affecting people with higher age or lower education. This study a...
Article
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Objectives: We analyze whether the prevalence of depressive symptoms differs among various migrant and non-migrant populations in Germany and to what extent these differences can be attributed to socioeconomic position (SEP) and social relations. Methods: The German National Cohort health study (NAKO) is a prospective multicenter cohort study (N =...
Article
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Background The huge increase of refugees to Germany caused a great challenge to the health system. We aimed to examine the level of patient-centredness in medical consultations with refugee patients, aided by video interpreters in primary care walk-in clinics (PCWC) in Hamburg. Methods Videotaped consultations (N = 92) of 83 patients from 2017 to...
Article
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Low-threshold e-health approaches in prevention to reduce suicide stigma are scarce. We developed an online program containing video reports on lived experience of suicide and evidence-based information on suicidality. We evaluated the program by a mixed methods design. We examined pre-post-changes of program completers (n = 268) in suicide literac...
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Introduction Some studies indicate that persistent somatic symptoms (PSS) are more prevalent among individuals with a low socioeconomic status (SES) and a migration background. However, factors explaining social inequalities in PSS are largely unknown. It is expected that aggravating factors of PSS like illness perception, illness beliefs (health l...
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Population-level data on predictors for attitudes towards sexual behavior are missing for Germany. The current study investigated sexual attitudes in the German population with regard to sociodemographic and sociocultural factors. Data originated from the German Health and Sexuality Survey (GeSiD; N = 4,955) carried out from October 2018 to Septemb...
Preprint
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Background: Until now a comprehensive, consensus-based tool that can be used by a variety of health care organizations for assessing their organizational health literacy (OHL) is missing. Therefore, we aimed to develop and test a literature- and consensus-based self-assessment tool. Methods: The study is based on a literature review that was previo...
Article
Zusammenfassung Ziel der Studie Entwicklung und psychometrische Überprüfung eines 6-Item-Instruments zur Erfassung von Selbstwirksamkeitserwartung, sich in psychisch belastenden Situationen Unterstützung suchen zu können (SWEP). Methodik Entwicklung von Items, Ermittlung von Verteilungscharakteristika, Faktorenstruktur und interner Konsistenz der S...
Article
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Background At the University Medical Center Hamburg-Eppendorf (UKE), health care research has been established as one of five research priorities recommended by the Research Council with the founding of the Center for Health Care Research (CHCR) in 2006. The CHCR was involved in numerous research projects with the focus on strengthening regional ne...
Chapter
Während gesundheitliche Ungleichheiten in der deutschen Medizinsoziologie seit Längerem verbreitet beforscht werden, gibt es von Vertreter:innen des Faches vergleichsweise wenige systematische Studien zu sozialen Ungleichheiten in der gesundheitlichen Versorgung. Das Hamburger Institut für Medizinische Soziologie hat vor etwa 10 Jahren begonnen, si...
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Background There is evidence that perceived urgency of medical complaints is associated with emergency care utilization. Patients’ perception of urgency can differ from physicians’ assessment. This study explored public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease and analyzed variations in perception...
Chapter
Seit etwa 10 Jahren befasst sich das Hamburger Institut für Medizinische Soziologie mit der Erforschung von Stigmatisierung psychischer Erkrankungen. In telefonischen Umfragen wurde die Allgemeinbevölkerung zu ihren Einstellungen gegenüber Depression, Schizophrenie, Essstörungen, oder Suizidabsicht befragt. Dabei wurde eine Verknüpfung von Stigma-...
Article
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Background Health anxiety exists on a continuum ranging from the absence of health awareness to the obsessive fear of having a serious illness despite reassurance. Its pathological manifestation can be diagnosed as hypochondriacal or illness anxiety or somatic symptom disorder. Health anxiety is associated with psychological distress and adverse li...
Article
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A majority of the workforce in the humanitarian aid consists of volunteers who partly suffer from health problems related to their voluntary service. To date, only a fraction of the current research focuses on this population. The aim of this qualitative explorative study was to identify burdening and protective organisational factors for health an...
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This study examines how work stress affects the misuse of prescription drugs to augment mental performance without medical necessity (i.e., cognitive enhancement). Based on the effort-reward imbalance model, it can be assumed that a misalignment of effort exerted and rewards received increases prescription drug misuse, especially if employees overc...
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Objective: Governments across the world have deployed a wide range of non-pharmaceutical interventions (NPI) to mitigate the spread of COVID-19. Certain NPIs, like limiting social contacts or lockdowns, had negative consequences for mental health in the population. Especially elder people are prone to mental illnesses during the current pandemic. T...
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Objectives Men and women at any age show similar symptoms and signs of heart failure (HF). Since early HF symptoms are ambiguous, doctors may overlook HF as possible cause and misinterpret the signs. The aim was to analyse differences in general practitioners’ (GPs) HF diagnosis and diagnostic certainty by patient age and gender and to identify rea...
Article
Background : In a healthcare system, which aims to empower the patient, self-management becomes increasingly important. In Multiple Sclerosis, an effective self-management is associated with various favorable health-related outcomes like improvement in quality of life, the reduction of depression and anxiety symptoms, and reduced healthcare costs....
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Objectives To examine variations in intended healthcare utilisation in severe cases of COVID-19 and inflammatory gastrointestinal disease (IGD). Design Representative cross-sectional telephone survey. Setting and participants 1207 randomly drawn adults of the city of Hamburg, Germany, between November 2020 and January 2021. Outcome measures Diff...
Article
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Introduction Migration background is an important predisposing characteristic of health service use (HSU). In this cross-sectional survey, we aim to explore the association between migration background and HSU in the context of sexual health. Methods In a population-representative sample of 4,955 persons from all German federal states (data collec...
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Introduction Persistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients’ needs for effective treatment are far from being met. Initial evidence indicates that, in addi...
Article
Background Previous studies on public depression stigma did not include different severity levels and thus, did not adequately consider the continuum notion of depressive disorders. Aims We address the following research questions: 1. Are there differences in public depression stigma according to different severity levels? 2. Is stigma associated...
Article
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Background: Knowledge and beliefs about health and health care are part of the general concept of health literacy. Studies demonstrated that large parts of the population report inadequate health literacy. There are only few studies specifically addressing public knowledge and beliefs about emergency care. We examine magnitude and social variations...
Article
Objective Empowerment is critical for cancer patients to make informed choices, to manage medication, and to navigate through the oncological care system. Cancer peer support provides patients with information, emotional relief and may promote empowerment. This paper provides a systematic review of the literature examining the impact of cancer peer...
Article
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Zusammenfassung Bei Suizidalität können die Angst, von anderen stigmatisiert zu werden, sowie Selbststigmatisierung und unzureichende Informationen dazu führen, dass Hilfsangebote weniger oder gar nicht in Anspruch genommen werden. E‑Mental-Health-Interventionen sind eine Möglichkeit, niederschwellig viele Betroffene über die Thematik zu informiere...
Article
Objective The association between a low socioeconomic status and poor health, also known as social inequalities in health, has been shown in numerous studies. This also applies to most mental illnesses, such as somatization or anxiety disorders. It is unclear, however, whether social inequalities are evident in health anxiety as well. Therefore, th...
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Introduction: European populations are becoming older and more diverse. Little is known about the health differences between the migrant and non-migrant elderly in Europe. The aim of this paper was to analyse changes in the health patterns of middle- and older-aged migrant and non-migrant populations in Europe from 2004 to 2017, with a specific fo...
Article
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Objectives Current oral health literacy (OHL) instruments vary in focus, methodology, administration time and burden. The widely used word recognition tests fail to encompass important OHL domains, while others exceed time frames for use in practical settings, require an interviewer or mainly measure self-assessments. This paper describes the devel...
Article
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Background Organizational health literacy (OHL) aims to respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply. This scoping review primarily maps criteria characterizing health literate health care organizations. Secondary outcomes are the concepts and t...
Article
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Introduction: The notion that depression is a disorder that moves along a continuum is well-established. Similarly, the belief in the continuity of mental illness is considered an important element in the stigma process. Against this background, it is the aim of this study to examine whether public continuum beliefs vary with the severity of depres...
Article
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Stigmatization from work-related COVID-19 exposure has not been investigated in detail yet. Therefore, we systematically searched three databases: Medline, Embase, and PsychInfo (until October 2020), and performed a grey literature search (until February 2021). We identified 46 suitable articles from 24 quantitative and 11 qualitative studies, 6 sy...
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Background Collaborative and stepped care (CSC) models are recommended for mental disorders. Their successful implementation depends on effective collaboration between involved care providers from primary and specialist care. To gain insights into the collaboration experiences of care providers in CSC against the backdrop of usual mental health car...
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Background Shared decision-making (SDM) between patients and healthcare professionals (HCPs) is a key component of patient-centred care. To implement SDM in clinical practice and to evaluate its effects, it is helpful to know about HCPs’ perception of SDM barriers. The measure IcanSDM was developed in Canada and assesses the perception of SDM barri...
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Objectives: In this study, we examine the public’s knowledge about different levels of depression severity in Germany. Methods: Data stem from a national telephone survey in Germany. A total of 1,009 persons participated, response rate was 46.8%. A vignette was presented with signs of mild, moderate or severe depression. Participants were asked wha...
Article
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Purpose The aim of this observational study was firstly, to assess the Health-related Quality of Life (HrQoL) among migrants and German natives in Hamburg, Germany, using the SF-12 mental and physical summary scores and secondly, to evaluate the contribution of selected sociodemographic and socioeconomic variables to explain the variance in mental...
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Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried ou...
Article
Background While a growing number of studies analyze the magnitude and predictors of mental health literacy, little is known about suicide-specific knowledge and beliefs (“suicide literacy”). Aims To examine suicide literacy among the German population and to investigate associations between suicide literacy and suicide stigma. Methods Telephone...
Chapter
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Im Rahmen der psychosozialen Erklärungsansätze von gesundheitlicher Ungleichheit ist die Bedeutung von verschiedenen Aspekten sozialer Beziehungen hervorgehoben und diskutiert worden. An dieser Stelle setzt der vorliegende Beitrag an. Der Begriff der sozialen Beziehungen wird dabei als eine Oberkategorie verstanden, unter der verschiedene Konzepte...
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Introduction: Adults Born Very Preterm (ABP) are an underperceived but steadily increasing patient population. It has been shown that they face multiple physical, mental and emotional health problems as they age. Very little is known about their specific health care needs beyond childhood and adolescence. This article focuses on their personal pers...
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Objective: The COVID-19 outbreak means far-reaching changes in the organization of daily lives. Disease-related literacy and factors such as age, gender, or education play a major role in shaping individual practices of protective behavior. This paper investigates different types and frequency of practicing protective behaviors, as well as socio-de...
Article
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Background Some studies, mainly coming from the U.S., indicate disparities in heart failure (HF) treatment according to migration/ethnicity. However, respective results are inconsistent and cannot be transferred to other health care systems. Thus, we will address the following research question: Are there differences in the diagnosis and management...
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Background: Previous systematic reviews of the impact of multi-component community-based health promotion interventions on reducing health inequalities by socio-economic status (SES) were restricted to physical activity and smoking behavior, and revealed limited and rather disillusioning evidence. Therefore, we conducted a comprehensive review wor...
Article
Objectives: The study investigates the impact of the COVID-19 pandemic on health services with and without specific health care of COVID-19 patients through the eyes of leading physicians at the University Medical Center Hamburg-Eppendorf (UKE). Methods: From April 30 to May 12, 2020, four interviewers conducted 38 expert interviews via telephon...
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Background: This study examines if education, income, and loneliness are associated with physical functioning and optimism in an ageing population in Germany. Furthermore, time trends of physical functioning and optimism as well as of associations with social inequality and loneliness are analyzed. Methods: The German Ageing Survey (DEAS), a longit...
Article
Zusammenfassung Ziel der Studie Deutsche Übersetzung und psychometrische Überprüfung der Stigma of Suicide Scale – Short Form (SOSS-SF). Methodik Ermittlung von Verteilungscharakteristika, Faktorenstruktur und interner Konsistenz der SOSS-SF-D. Basis war eine telefonische Befragung (N = 2002). Ergebnisse Aus der Hauptkomponentenanalyse gingen 3 Sub...
Article
Objective To examine differences in the anamnesis in heart failure patients by patient and physician gender. Methods A factorial experimental design with video vignettes was applied. While the dialog of an initial encounter because of heart failure symptoms was identical in all videos, patients, played by professional actors, differed in terms of...
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Over the past few decades, a community-based approach was seen to be the “gold standard” for health promotion and disease prevention, especially in the field of socially deprived neighborhoods in urban areas. Up to the beginning of the 2000s, earlier reviews provide valuable information on activities in this context. However, in their conclusions t...
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Objective: Suicidal persons often face public stigmatization which affects help-seeking behavior and may lead to an additional suicide risk. There is not much known about differences in stigmatizing attitudes concerning characteristics of affected persons. The present study investigates public stigma toward suicidal persons in Germany by focussing...
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Objective Stepped and collaborative care with outpatient psychotherapy as one treatment step is guideline-recommended for mental health care. To date, the experiences and evaluation of psychotherapists regarding collaboration and stepped care have been neglected. In order to improve collaborative mental health care, this qualitative study aimed at...
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The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general popula...
Article
Zusammenfassung Ziel der Studie Durch den Masterplan Medizinstudium 2020 und die Entwicklung des Nationalen Kompetenzbasierten Lernzielkatalogs Medizin (NKLM) wurden bedeutsame Veränderungen in der universitären Medizin angestoßen. Ziel der Studie war eine systematische Erfassung des Standes und der Perspektiven der Fächer Medizinische Psychologie...
Article
Objectives: Two research questions will be addressed: (1) What does the German public think about possible causes of somatic symptom disorder (SSD) and are there differences in causal attributions according to symptom and course of SSD? (2) Are causal attributions associated with beliefs about treatment and stigmatizing attitudes? Methods: Two v...
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This paper investigates the associations between social relationships, age and the use of preventive health services among German adults. Data stem from the German Ageing Survey (10,324 respondents). The use of preventive health services was assessed by asking for regular use of flu vaccination and cancer screening in the past years. Predictors of...
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Introduction Mental healthcare is one of the biggest challenges for healthcare systems. Comorbidities between different mental disorders are common, and patients suffer from a high burden of disease. While the effectiveness of collaborative and stepped care models has been shown for single disorders, comorbid mental disorders have rarely been addre...
Conference Paper
Background The evidence on inequalities in health clearly shows that people with lower socioeconomic status (SES) have poorer health and higher mortality. Nevertheless, generalized evidence for inequalities in healthcare is lacking. So far, the international literature was only summarised with regard to inequalities in the utilisation of disease-sp...
Article
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Background: Time constraints during patient visits play a major role for the work stress of primary care physicians.Several studies suggest that there is a critical situation in terms of time constraints in primary care in Germany.Therefore, the following research questions are addressed: (1) What is the time allocated and needed for differenttypes...
Poster
Hintergrund: Obwohl die Herzinsuffizienz (HI) bei Frauen häufiger diagnostiziert wird, ist die Sterberate höher als bei Männern. Es ist bekannt, dass Männer eher leitliniengerecht behandelt werden. Fragestellung: Inwiefern unterscheiden sich hausärztliche Diagnose, Diagnosesicherheit und Medikation nach Geschlecht der Patient*innen in der Hausarzt...
Article
Objectives Differences in public beliefs about causes of obesity between the USA and Germany are analyzed. We additionally examine the relevance of social characteristics of individuals with obesity for causal attributions in the two countries. Methods National telephone surveys were conducted in both countries (total sample = 2802). Vignettes des...
Chapter
Das vorliegende Kapitel führt in die Grundlagen der Sozialepidemiologie ein und stellt zentrale Ergebnisse bisheriger sozialepidemiologischer Forschung dar. Dabei orientiert sich der Beitrag an dem Modell der sozialen Determinanten, welches die unterschiedlichen Zusammenhänge zwischen sozialen Faktoren und Gesundheit illustriert. Neben den Zusammen...
Conference Paper
Einleitung: Vereinzelte internationale Studien legen nahe, dass es Geschlechterunterschiede im diagnostischen Vorgehen bei Herzinsuffizienz gibt. Ziel der Studie ist es, diese Disparitäten im Hinblick auf die anamnestische Vorgehensweise erstmals systematisch in Deutschland zu untersuchen. Methode: Es wurde ein faktorielles Design unter Verwendung...
Article
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Introduction: Over the past decades, obesity stigma has become a substantial public health issue as studies have highlighted its negative consequences for mental and physical health. However, comparative studies are scarce. In this cross-national study, we focus on the following research questions: (1) Are there differences in the magnitude of pub...
Article
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Ergebnisse aus der vom Bundesministerium für Gesundheit geförderten Studie zur "Gesundheitsbezogenen Selbsthilfe in Deutschland - Entwicklungen, Wirkungen, Perspektiven" - SHILD.
Article
Background: While there is evidence for educational health inequalities in Europe, studies on time trends and on the explanatory contribution of social relations are less consistent. It has been shown that the use of welfare state typologies can be helpful to examine health inequalities in a comparative perspective. Against this background, analys...
Chapter
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Die vom Bundesministerium für Gesundheit geförderte Studie zur "Gesundheitsbezogenen Selbsthilfe in Deutschland - Entwicklungen, Wirkungen, Perspektiven" - kurz: SHILD - wurde im Juni 2018 nach über fünfeinhalb Jahren abgeschlossen. Das SHILD-Modul zu den Wirkungen der Selbsthilfe untersuchte unter anderem die Gesundheitskompetenz und den Umgang mi...