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10. Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators

Author

Douma, E., Wirtz, S., Fernandez, M.S., Schäfer, H., Widdershoven, J.W.M.G., Habibovic, M., Gil, C.P., Bosch, J.A., Schmitz, B., Kop, W.J., Douma, E., Wirtz, S., Fernandez, M.S., Schäfer, H., Widdershoven, J.W.M.G., Habibovic, M., Gil, C.P., Bosch, J.A., Schmitz, B., and Kop, W.J.

Abstract

Background Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR to patient preferences is needed to further enhance CR. Purpose To identify preferred behavior change techniques (BCTs) as well as barriers and facilitators for the different health behaviors targeted in eHealth-based CR among patients who have been referred to CR. Methods Thirty-nine patients were interviewed in nine focus groups in The Netherlands, Germany, and Spain. A thematic analysis, using a combined deductive and inductive approach to coding, was conducted to identify BCTs and barriers and facilitators to behavior change. Behaviors under investigation included physical activity, medication adherence, eating a cardiac healthy-diet, stress reduction and smoking cessation. Results The perceived helpfulness of BCTs depended on the specific behavior targeted. Common barriers were negative emotional state and physical limitations. A desire to feel physically or mentally well and having experienced a cardiac life event were the most common facilitators across health behaviors. Specific BCTs, barriers and facilitators were found for each of the health behaviors. Conclusions Behavior change techniques that patients preferred for each health behavior targeted in eHealth-based CR were identified. A negative emotional state, experiencing a life event, and improving physical functioning are important barriers and facilitators in multiple behaviors targeted in eHealth-based CR programs. Additional tailoring of interventions to patient preferences for BCTs and patient-specific barriers and facilitators per health behavior could lead to further improvement of eHealth-based CR.

Published
2024

38. European small portable rainfall simulators: A comparison of rainfall characteristics

Author

Iserloh, T., Ries, J.B., Arnáez, J., Boix-Fayos, C., Butzen, V., Cerdà, A., Echeverría, M.T., Fernández-Gálvez, J., Fister, W., Geißler, C., Gómez, J.A., Gómez-Macpherson, H., Kuhn, N.J., Lázaro, R., León, F.J., Martínez-Mena, M., Martínez-Murillo, J.F., Marzen, M., Mingorance, M.D., Ortigosa, L., Peters, P., Regüés, D., Ruiz-Sinoga, J.D., Scholten, T., Seeger, M., Solé-Benet, A., Wengel, R., and Wirtz, S.

Published
2013
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41. The European Union: Legal Response to Covid-19

Author

Hervey, Tamara K., Röttger-Wirtz, S., King, Jeff, Ferraz, Octavio, International and European Law, RS: FdR - CERiM, RS: FdR Studio Europa Maastricht, RS: FdR Institute MCEL, RS: FdR Research Group Globalization & Law Network, and RS: FdR IC Integratie

Published
2022

42. The influence of obstructive sleep apnea and continuous positive airway pressure on the nasal microbiome.

Author

LENK, C., MESSBACHER, M. E., ABEL, J., MUELLER, S. K., MANTSOPOULOS, K., GOSTIAN, A. O., SIEVERT, M., WIRTZ, S., MARXREITER, F., WINKLER, J., IRO, H., and TRAXDORF, M.

Abstract

OBJECTIVE: The aim of this study was to investigate the influence of obstructive sleep apnea and continuous positive airway pressure on the nasal microbiome. PATIENTS AND METHODS: Endonasal swabs from the olfactory groove of 22 patients with moderate and severe obstructive sleep apnea (OSA) and a control group of 17 healthy controls were obtained at the Department of Otorhinolaryngology of the Friedrich-Alexander-Universität Erlangen-Nürnberg. 16S rRNA gene sequencing was performed to further evaluate the endonasal microbiome. In a second step, the longitudinal influence of continuous positive airway pressure (CPAP) therapy on the nasal microbiome was investigated (3-6 and 6-9 months). RESULTS: Analysis of the bacterial load and ß-diversity showed no significant differences between the groups, although patients with severe OSA showed increased a-diversity compared to the control group, while those with moderate OSA showed decreased a-diversity. The evaluation of longitudinal changes in the nasal microbiota during CPAP treatment showed no significant difference in a- or ß-diversity. However, the number of bacteria for which a significant difference between moderate and severe OSA was found in the linear discriminant analysis decreased during CPAP treatment. CONCLUSIONS: Long-term CPAP treatment showed an alignment of the composition of the nasal microbiome in patients with moderate and severe OSA as well as an alignment of biodiversity with that of the healthy control group. This change in the composition of the microbiome could be both part of the therapeutic effect in CPAP therapy and a promoting factor of the adverse side effects of the therapy. Further studies are needed to investigate whether the endonasal microbiome is related to CPAP compliance and whether CPAP compliance can be positively influenced in the future by therapeutic modification of the microbiome. [ABSTRACT FROM AUTHOR]

Published
2023

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