Koschack, Janka

[["dc.bibliographiccitation.firstpage","801"],["dc.bibliographiccitation.issue","543"],["dc.bibliographiccitation.journal","British Journal of General Practice"],["dc.bibliographiccitation.lastpage","807"],["dc.bibliographiccitation.volume","57"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Himmel, Wolfgang"],["dc.contributor.author","Stanske, Beate"],["dc.contributor.author","Scherer, Franziska"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.date.accessioned","2018-11-07T10:57:56Z"],["dc.date.available","2018-11-07T10:57:56Z"],["dc.date.issued","2007"],["dc.description.abstract","Background Psychological distress is a common phenomenon in patients with heart failure. Depressive symptoms are often under-diagnosed or inadequately treated in primary care. Aim To analyse anxiety and/or depression in primary care patients with heart failure according to psychosocial factors, and to identify protective factors for the resolution of psychological distress. Design of study Longitudinal observation study. Setting Primary care practices in lower Saxony, Germany. Method In 291 primary care patients with heart failure the following factors were measured using validated questionnaires at baseline and 9 months later: anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), quality of life (Minnesota Living with Heart Failure Questionnaire), coping with illness (Freiburg questionnaire for coping with illness), and social support (social support questionnaire). Severity of heart failure (New York Heart Association [NYHA] classification and Goldman's Specific Activity Scale), and sociodemographic characteristics were documented using self-report instruments. Results Twenty-six (32.5%) of the 80 patients who were distressed at baseline had normal HADS scores 9 months later, while the remainder stayed distressed. In logistic regression, baseline distress (odds ratios [OR] 5.51; 95% confidence intervals [Cl] = 2.56 to 11.62), emotional problems (OR = 1.08; 95% Cl = 1.00 to 1.17), social support (OR = 0.54; 95% Cl = 0.35 to 0.83), and NYHA classification (OR = 1.70; 95% Cl = 1.05 to 2.77) independently predicted distress at follow up. High social support contributed to a resolution of anxiety or depression, while partnership and low levels of emotional problems protected patients who began the study in a good emotional state from psychological distress. Conclusion In everyday practice it is important to consider that a high NYHA classification and emotional problems may contribute to anxiety or depression, while high social support and living in a relationship may positively influence the psychological health of patients with heart failure."],["dc.identifier.isi","000250860300008"],["dc.identifier.pmid","17925137"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/50369"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0960-1643"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Psychological distress in primary care patients with heart failure: a longitudinal study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","14"],["dc.bibliographiccitation.journal","BMC Family Practice"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Luers, Claus"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Wetzel, Dirk"],["dc.contributor.author","Kleta, Sibylle"],["dc.contributor.author","Pouwels, Claudia"],["dc.contributor.author","Wachter, R. Rolf"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Pieske, Burkert M."],["dc.contributor.author","Binder, Lutz"],["dc.date.accessioned","2018-11-07T11:18:13Z"],["dc.date.available","2018-11-07T11:18:13Z"],["dc.date.issued","2008"],["dc.description.abstract","Background: Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods: N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results: 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92) with a sensitivity of 0.91 (95% CI, 0.71 to 0.98) and a specificity of 0.46 (95% CI, 0.41 to 0.50). AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91) with a sensitivity of 0.91 (95% CI, 0.71 to 0.98) and a specificity of 0.64 (95% CI, 0.59 to 0.67). 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p < 0.001) that was based on the higher specificity of the clinical risk score. Conclusion: The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients."],["dc.identifier.doi","10.1186/1471-2296-9-14"],["dc.identifier.isi","000254051900001"],["dc.identifier.pmid","18298821"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8928"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/54989"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1471-2296"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","Das Gesundheitswesen"],["dc.bibliographiccitation.volume","67"],["dc.contributor.author","Scherer, M."],["dc.contributor.author","Stanske, Beate"],["dc.contributor.author","Wetzel, D."],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.date.accessioned","2018-11-07T09:12:22Z"],["dc.date.available","2018-11-07T09:12:22Z"],["dc.date.issued","2005"],["dc.format.extent","578"],["dc.identifier.isi","000231627100254"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/26934"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Georg Thieme Verlag Kg"],["dc.publisher.place","Stuttgart"],["dc.relation.issn","0941-3790"],["dc.title","Mental cosymptomatics of family doctor patients with heart failure - Baseline results of the MedViP study"],["dc.type","conference_abstract"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","European Heart Journal"],["dc.bibliographiccitation.volume","27"],["dc.contributor.author","Luers, Claus"],["dc.contributor.author","Kleta, Sibylle"],["dc.contributor.author","Wachter, R. Rolf"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Pieske, Burkert M."],["dc.contributor.author","Binder, L."],["dc.contributor.author","Kochen, Michael M."],["dc.date.accessioned","2018-11-07T09:28:05Z"],["dc.date.available","2018-11-07T09:28:05Z"],["dc.date.issued","2006"],["dc.format.extent","844"],["dc.identifier.isi","000240668406063"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/30691"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Oxford Univ Press"],["dc.publisher.place","Oxford"],["dc.relation.conference","28th Congress of the European-Society-of-Cardiology/World Congress of Cardiology"],["dc.relation.eventlocation","Barcelona, SPAIN"],["dc.relation.issn","1522-9645"],["dc.relation.issn","0195-668X"],["dc.title","Impact of NTproBNP and NTproANP for the diagnosis of diastolic or systolic dysfunction"],["dc.type","conference_abstract"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","347"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Herz"],["dc.bibliographiccitation.lastpage","354"],["dc.bibliographiccitation.volume","31"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Stanske, Beate"],["dc.contributor.author","Wetzel, Dirk"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.date.accessioned","2018-11-07T09:45:04Z"],["dc.date.available","2018-11-07T09:45:04Z"],["dc.date.issued","2006"],["dc.description.abstract","Background and Purpose: Psychosocial distress is a common phenomenon in patients with heart failure (HF). The aim of this study was to analyze psychosocial co-symptoms and their relationship with clinical and sociodemographic factors. Methods: In 363 primary care patients with HF, anxiety, depression and negative affectivity (HADS, DS-14), disease coping (FKV) and social support (F-SozU) were measured by validated questionnaires. Severity of HF (according to NYHA classification and Goldman's Specific Activity Scale) and sociodemographic characteristics were documented by self-report instruments. Results: Increased anxiety and/or depression was found in 29.2% of patients. Anxiety and depression scores were significantly higher than in the German general population (P < 0.005). They were furthermore associated with NYHA and Goldman class (anxiety: p = 0.001; depression: p = 0.001). One third of the sample showed the type D personality pattern, which has been associated with increased mortality in cardiac patients. While HF severity correlated positively with psychological distress, patients living together with other persons had lower HF class than those living alone. Using regression analysis, sociodemographic and psychological variables predicted perceived severity of HF in 20.3% if measured by Goldman's scale (significant for sex, age, depressive symptoms and disease coping), and in 18.6% if measured by NYHA (significant for anxiety). Discussion: Severity of HF symptoms and psychosocial factors are interrelated. Self-reported severity of HF is substantially influenced by demographic and psychological variables. In this, it is not relevant if severity is measured by a nonvalidated (NYHA) or a validated instrument (Goldman). Conclusion: In primary care patients with HF, psychosocial co-symptoms are frequent and interfere with perceived severity of disease. Psychological distress should be considered important in diagnostics and treatment, especially in patients living alone."],["dc.identifier.doi","10.1007/s00059-006-2742-9"],["dc.identifier.isi","000239392900009"],["dc.identifier.pmid","16810475"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/34535"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0340-9937"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Psychische Kosymptomatik von hausärztlichen Patienten mit Herzinsuffizienz"],["dc.title.alternative","Psychosocial co-symptoms in primary care patients with heart failure"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","217"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Clinical Research in Cardiology"],["dc.bibliographiccitation.lastpage","226"],["dc.bibliographiccitation.volume","99"],["dc.contributor.author","Luers, Claus"],["dc.contributor.author","Wachter, R. Rolf"],["dc.contributor.author","Kleta, Sibylle"],["dc.contributor.author","Uhlir, Marc"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Binder, Lutz"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Zapf, Antonia"],["dc.contributor.author","Kulle, Bettina"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Pieske, Burkert M."],["dc.date.accessioned","2018-11-07T08:44:25Z"],["dc.date.available","2018-11-07T08:44:25Z"],["dc.date.issued","2010"],["dc.description.abstract","The diagnostic value of natriuretic peptides in asymptomatic patients at risk for diastolic or systolic HF is controversial. We tested (1) the prevalence of preclinical LV dysfunction in an at-risk cohort; (2) the diagnostic accuracy of natriuretic peptides alone or in combination with clinical parameters for predicting asymptomatic left ventricular systolic or diastolic dysfunction. 542 primary care patients (mean age 63 +/- A 11 years, 42% female) without prediagnosed HF, but with risk factors for left ventricular dysfunction, underwent thorough cardiological workup, including echocardiography and analysis of natriuretic peptides. 23 patients (4%) showed reduced systolic function (EF < 50%), and 15 patients (3%) had severe diastolic dysfunction. All natriuretic peptides significantly increased with decreasing ejection fraction and with increasing degree of diastolic dysfunction. For natriuretic peptides, receiver operating characteristics analysis yielded good results for the detection of systolic dysfunction or severe diastolic dysfunction. Combining clinical parameters with natriuretic peptide data improved the diagnostic accuracy and largely reduced the number of needed screening echoes to identify patients with LV systolic or diastolic dysfunction. The prevalence of preclinical diastolic dysfunction is high in primary care patients at risk, but the relative prevalence of severe diastolic dysfunction and systolic dysfunction is only 7%. High-risk individuals may be screened most efficiently by using a score system incorporating clinical data and NT-proBNP."],["dc.description.sponsorship","German Federal Ministry of Education and Research [FKZ 01GI0205]"],["dc.identifier.doi","10.1007/s00392-009-0108-z"],["dc.identifier.isi","000275788300002"],["dc.identifier.pmid","20052479"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/4174"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/20192"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1861-0684"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]