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Objectives: The limitations in teaching resulting from the Covid-19 epidemic were the rational for transferring the course in Medical Psychology and Medical Sociology (doctor-patient communication) into an asynchronous e-learning course. For this purpose, ten exercises were developed to be downloaded by the students and the solutions returned to the course lecturer on a weekly basis. In addition, two students individually recorded via video one of eight doctor-patient exercise conversations, which were then evaluated by four other students and the respective lecturer.Methods: For evaluation, the students filled out an exercise and an effect-related questionnaire with 21 items.Results: The questionnaire was completed by n=203 (98%) students (59% female, 41% male). The video-based situation analyses (91%) helped most of them to become rather closely or very well acquainted with medical conversation practice. 76% rated the exercise "Enlightenment Conversation/SPIKES Protocol" as fairly helpful or very helpful in respect to the practicing concepts of medical conversation. When asked about the effects, most of them found the idea of patient orientation in medicine to be quite helpful or very helpful (83%). About a quarter of them (24%) stated that the online course could not, or only slightly, replace face-to-face teaching. This assessment was less pronounced among female students than among male students (Wilcoxon test p

Increased food intake, termed “comfort eating”, is a pathologic coping mechanism in chronic stress. Cortisol reactivity under stress is a potent predictor of stress-induced eating behavior affecting the body mass index (BMI). However, cortisol reactivity and food intake under stress in people with obesity has not been evaluated. The aim of this study was to investigate the effect of high/low cortisol reactivity on food intake in people with obesity and healthy weight test controls, following standardized stress induction and a resting condition. Thirty-six men and women with obesity (BMI: 33.00 ± 3.23 kg/m²), as well as 36 age- and gender-matched healthy weight controls (BMI: 21.98 ± 1.81 kg/m²) were categorized into high cortisol reactors (HCR) and low cortisol reactors (LCR) in the Trier Social Stress Test (TSST). Following the TSST and a resting condition, the food intake of all participants was recorded in a standardized laboratory meal. Obese HCR demonstrated a significantly higher food intake than LCR (t (34) = −2.046, p ≤ 0.05). However, there were no significant differences between HCR and LCR in the healthy weight controls (p = 0.26). In addition, HCR of the people with obesity showed lower values in the emotion coping strategy of cognitive reappraisal than obese LCR (t (32) = 2.087, p ≤ 0.05). In conclusion, the magnitude of the cortisol reactivity to stress predicts stress-induced food intake in people with obesity, but not in the healthy weight controls. Limited use of cognitive reappraisal in emotion regulation in the obese HCR may be a marker of vulnerability to stress-induced eating. © 2020, The Author(s).

Objective: Preoperative anxiety influences the result of the treatment in patients. To assess preoperative anxiety the Amsterdam Preoperative Anxiety and Information Scale (APAIS) was developed. The APAIS measures anxiety and the need-for-information with 6 items, with good reliability and validity. This article presents the first test of the German version of this screening instrument.Methods: The German version of the APAIS was tested on 68 patients questioned before surgery on the lower extremities in the Orthopaedic Department of a University Hospital. From 68 patients, 47 (69%) were female and the average age was 55 years. Besides the APAIS, several additional questionnaires with similar or divergent content were administered for testing the convergent and discriminant validity of the APAIS (HADS, SCL-9-K, KASA, COSS, STOA).Results: The two scales anxiety and need-for-information could be replicated by a factor analysis and had high reliability (anxiety: Cronbachs Alpha = 0.92; need-for-information: Cronbachs Alpha = 0.86). As expected the scales of the APAIS correlated highly with different standard questionnaires which measure anxiety (KASA, STOA) and low with questionnaires of divergent contents (HADS depression, COSS). The APAIS-scales are independent of sex, age or previous surgeries. Patients with a higher need-for-information show higher anxiety (r=0.59) prior to surgery.Conclusions: During its first trial the German version of the APAIS proved to be a reliable and valid instrument. Furthermore, it is a good screening instrument to assess preoperative anxiety and need-for-information in clinical practice, especially due to its brevity. In further studies the predictive validity has to be examined in large heterogeneous samples. Zielsetzung: Das präoperative Angstniveau eines Patienten kann entscheidenden Einfluss auf das Behandlungsergebnis haben. Zur Erfassung präoperativer Angst wurde 1996 die Amsterdam Preoperative Anxiety and Information Scale (APAIS) vorgestellt. Dieses Instrument soll die Skalen "Angst vor Anästhesie und Operation" und "Informationsbedürfnis" mit nur sechs Items valide und reliabel erfassen. Dargestellt wird die erste Überprüfung einer deutschen Version dieses Screeninginstruments.Methodik: Die Erprobung erfolgte an 68 Patienten einer orthopädischen Universitätsklinik vor einer Operation an den unteren Extremitäten. 47 (69%) waren weiblich, das Durchschnittsalter betrug 55 Jahre. Zur Prüfung der konvergenten und diskriminanten Validität wurden weitere inhaltsähnliche bzw. -fremde Fragebogenverfahren eingesetzt (HADS, SCL-9-K, KASA, COSS, STOA).Ergebnisse: In der Faktorenanalyse konnten die beiden Skalen repliziert werden. Sie besitzen eine hohe Reliabilität (Angst: Cronbachs Alpha = 0,92; Informationsbedürfnis: Cronbachs Alpha = 0,86). Die Skalen der APAIS korrelieren erwartungsgemäß hoch mit anderen spezifischen Angstfragebögen (KASA, STOA) und niedriger mit inhaltsferneren Verfahren (HADS Depressivität, COSS). Die APAIS-Skalen sind nicht abhängig von Geschlecht, Alter oder bisherigen Operationserfahrungen. Patienten mit einem höheren Informationsbedürfnis haben auch ein höheres Angstniveau (r=0,59).Fazit: In der ersten Erprobung erwies sich die deutsche Version der APAIS als reliables und valides Instrument, das aufgrund seiner Kürze sehr gut zum Screening von präoperativer Angst und Informationsbedürfnis im klinischen Alltag geeignet ist. Weitere Studien, insbesondere zur prädiktiven Validität, müssen an umfangreicheren, heterogeneren Stichproben erfolgen.