% Encoding: UTF-8 @COMMENT{BibTeX export based on data in FAU CRIS: https://cris.fau.de/} @COMMENT{For any questions please write to cris-support@fau.de} @article{faucris.228452291, author = {Ostgathe, Christoph and Klein, Carsten}, doi = {10.1007/s00101-019-00665-w}, faupublication = {yes}, journal = {Anaesthesist}, note = {CRIS-Team WoS Importer:2019-10-29}, peerreviewed = {Yes}, title = {62-year-old male with condition following emergency tracheotomy in metastasized hypopharyngeal cancer {Preparation} for the medical specialist examination: part 39}, year = {2019} } @article{faucris.216337023, abstract = {
Vital parameters are key indicators for the assessment of health. Conventional methods rely on direct contact with the patients’ skin and can hence cause discomfort and reduce autonomy. This article presents a bistatic 24 GHz radar system based on an interferometric six-port architecture and features a precision of 1 µm in distance measurements. Placed at a distance of 40 cm in front of the human chest, it detects vibrations containing respiratory movements, pulse waves and heart sounds. For the extraction of the respiration rate, time-domain approaches like autocorrelation, peaksearch and zero crossing rate are compared to the Fourier transform, while template matching and a hidden semi-Markov model are utilized for the detection of the heart rate from sphygmograms and heart sounds. A medical study with 30 healthy volunteers was conducted to collect 5.5 h of data, where impedance cardiogram and electrocardiogram were used as gold standard for synchronously recording respiration and heart rate, respectively. A low root mean square error for the breathing rate (0.828 BrPM) and a high overall F1 score for heartbeat detection (93.14%) could be achieved using the proposed radar system and signal processing.}, author = {Michler, Fabian and Shi, Kilin and Schellenberger, Sven and Steigleder, Tobias and Malessa, Anke and Hameyer, Laura and Neumann, Nina and Lurz, Fabian and Ostgathe, Christoph and Weigel, Robert and Kölpin, Alexander}, doi = {10.3390/s19112492}, faupublication = {yes}, journal = {Sensors}, peerreviewed = {Yes}, title = {{A} {Clinically} {Evaluated} {Interferometric} {Continuous}-{Wave} {Radar} {System} for the {Contactless} {Measurement} of {Human} {Vital} {Parameters}}, url = {https://www.mdpi.com/1424-8220/19/11/2492}, volume = {19}, year = {2019} } @inproceedings{faucris.106234964, abstract = {Vital sign monitoring systems play a crucial role in the medical environment. Patients in palliative and intensive care can especially benefit from continuous observation by detecting sudden changes in health status allowing the medical staff to promptly provide intensified symptom amelioration at the end-of-life. However, machine based monitoring like electrocardiography requires the patient being permanently wired to the device. This circumstance severely restricts the independence and mobility of the patient, leading to a decrease in the quality of life. For this reason, palliative care stations currently usually avoid continuous monitoring. After a comprehensive literature survey and background research, this paper presents a novel approach by using a single radar system to perform continuous and above all contactless monitoring of respiration and heartbeat. A continuous wave radar using the Six-Port technology is introduced and its feasibility, performance and real-time capability are validated in long-term measurements on different test persons. In comparison to gold standard reference devices a correlation of 97.6% was achieve}, author = {Shi, Kilin and Will, Christoph and Steigleder, Tobias and Michler, Fabian and Weigel, Robert and Ostgathe, Christoph and Kölpin, Alexander}, booktitle = {2018 Annual IEEE International Systems Conference (SysCon)}, date = {2018-04-23/2018-04-26}, doi = {10.1109/SYSCON.2018.8369507}, faupublication = {yes}, peerreviewed = {unknown}, title = {{A} {Contactless} {System} for {Continuous} {Vital} {Sign} {Monitoring} in {Palliative} and {Intensive} {Care}}, venue = {Vancouver, Kanada}, year = {2018} } @article{faucris.242322780, abstract = {Using Radar it is possible to measure vital signs through clothing or a mattress from the distance. This allows for a very comfortable way of continuous monitoring in hospitals or home environments. The dataset presented in this article consists of 24 h of synchronised data from a radar and a reference device. The implemented continuous wave radar system is based on the Six-Port technology and operates at 24 GHz in the ISM band. The reference device simultaneously measures electrocardiogram, impedance cardiogram and non-invasive continuous blood pressure. 30 healthy subjects were measured by physicians according to a predefined protocol. The radar was focused on the chest while the subjects were lying on a tilt table wired to the reference monitoring device. In this manner five scenarios were conducted, the majority of them aimed to trigger hemodynamics and the autonomic nervous system of the subjects. Using the database, algorithms for respiratory or cardiovascular analysis can be developed and a better understanding of the characteristics of the radar-recorded vital signs can be gaine}, author = {Schellenberger, Sven and Shi, Kilin and Steigleder, Tobias and Malessa, Anke and Michler, Fabian and Hameyer, Laura and Neumann, Nina and Lurz, Fabian and Weigel, Robert and Ostgathe, Christoph and Kölpin, Alexander}, doi = {10.1038/s41597-020-00629-5}, faupublication = {yes}, journal = {Scientific Data}, keywords = {Vital signs; Radar; Database; Reference signals}, peerreviewed = {Yes}, title = {{A} dataset of clinically recorded radar vital signs with synchronised reference sensor signals}, url = {https://www.nature.com/articles/s41597-020-00629-5}, year = {2020} } @article{faucris.315096515, author = {Klein, Carsten and Ostgathe, Christoph}, doi = {10.1007/s15006-023-3146-y}, faupublication = {yes}, journal = {MMW Fortschritte der Medizin}, note = {CRIS-Team Scopus Importer:2023-12-15}, pages = {58-61}, peerreviewed = {unknown}, title = {{Aktuelle} {Empfehlungen} für die gezielte {Sedierung} am {Lebensende}}, volume = {165}, year = {2023} } @article{faucris.217910960, author = {Peters, Joachim and Dykes, Nathan and Heckel, Maria and Ostgathe, Christoph and Habermann, Mechthild}, doi = {10.1089/jpm.2019.0027}, faupublication = {yes}, journal = {Journal of Palliative Medicine}, peerreviewed = {Yes}, title = {{A} {Linguistic} {Model} of {Communication} {Types} in {Palliative} {Medicine}: {Effects} of {Multidrug}-{Resistant} {Organisms} ({MDRO}) {Colonization} or {Infection} and {Isolation} {Measures} in {End} of {Life} on {Family} {Caregivers}’ {Knowledge}, {Attitude} and {Practices}.}, url = {https://www.liebertpub.com/doi/pdf/10.1089/jpm.2019.0027}, volume = {22}, year = {2019} } @article{faucris.120882564, abstract = {Palliative care (PC) involves many health care providers leading to a high complexity of structures that requires efficient coordination as provided by case management (CM). Our study aimed to evaluate the effects of CM newly implemented in a specialised palliative care unit by evaluating team members' tasks and time resources before (T0) and after implementation (T1). It was hypothesised that team members would be able to spend less time on organisational and administrative tasks and more time on patient care.A prospective pre-post study design was used. Time distribution of different tasks at T0 and T1 was compared between three different professional groups: physicians, nursing staff and social work. To document their tasks and time required, a documentation form with several items for each profession was developed. Data was analysed using t tests for independent samples.After Bonferroni correction, a significant pre-post difference was found for the time spent on "discharge interview and discharge" as rated by the physicians (p < .001) with less time spent on this activity after CM implementation. The nursing staff had significantly more time for "conversations with patients" (p < .001) after CM implementation. Moreover, they spent significantly less time on "patient-related requests/advice by telephone" (p < .001) and "discussions with relatives/participation in family discussions" at post-assessment (p < .001). The social worker had significantly more time for "patient advice and support services" (p = .013) after CM implementation.Integrating CM can be time efficient and ensures team members to spend more time on their core tasks in patient care.}, author = {Strupp, Julia and Dose, Christina and Kuhn, Ulrike and Galushko, Maren and Duesterdiek, Anne and Ernstmann, Nicole and Pfaff, Holger and Ostgathe, Christoph and Voltz, Raymond and Golla, Heidrun}, doi = {10.1007/s00520-017-3893-3}, faupublication = {yes}, journal = {Supportive Care in Cancer}, note = {EVALuna2:26217}, pages = {673-679}, peerreviewed = {Yes}, title = {{Analysing} the impact of a case management model on the specialised palliative care multi-professional team}, volume = {26}, year = {2018} } @article{faucris.115694964, abstract = {Background: Patients with advanced cancer are highly susceptible to infections. The decision whether to treat an active or suspected infection or to withhold or withdraw an antibiotic treatment in end-of-life care may be difficult. In order to quantify the antimicrobial prescribing practices and decision-making processes in palliative care units in Germany, a survey was performed as part of the Hospice and Palliative Evaluation in 2006. Method: With a specifically designed questionnaire, 448 patients for whom an active or suspected infection and antibiotic treatment was discussed were documented. Data on the use of and indication for antibiotic treatment and the decision-making on withdrawal or withholding of antibiotic therapy were collected. Results: 286 (63.8%) received an antibiotic therapy. In 88 cases, withdrawal of an ongoing treatment was documented. The most frequent reasons for withdrawal were: deterioration of general status (41.4%), inefficiency of therapy (25.7%), and explicit wish of patient (14.3%; multiple answers possible). Outcome of antimicrobial therapy was rated poor or very poor for a fifth of the cases and accordingly, antibiotics were more likely to be withdrawn if the clinical success was considered to be poor. The initiation of therapy was often decided by physicians solely, whereas withdrawing and withholding therapy demanded more often involvement of other team members in the decision-making process. Conclusion: The initiation of therapy seems to be easier than withdrawing and withholding, as involvement of other team members in the decision-making process was then sought more often. When antibiotics were given until death, the indication should be reconsidered because of a possibly undesirable prolongation of the dying process. Clinical practice may benefit from clear definitions of treatment goals and outcome criteria to better evaluate the necessity for and success of antimicrobial treatment. © 2011 Springer-Verlag.}, author = {Stiel, Stephanie and Krumm, Norbert and Pestinger, Martina and Lindena, Gabriele and Nauck, Friedemann and Ostgathe, Christoph and Radbruch, Lukas and Elsner, Frank}, doi = {10.1007/s00520-011-1084-1}, faupublication = {yes}, journal = {Supportive Care in Cancer}, keywords = {Antibiotics; Decision making; Indication; Palliative medicine; Therapy withdrawal; Therapy withholding}, pages = {325-333}, peerreviewed = {Yes}, title = {{Antibiotics} in palliative medicine-results from a prospective epidemiological investigation from the {HOPE} survey}, volume = {20}, year = {2012} } @article{faucris.247794925, author = {Fiedler, Georg and Drinkmann, Arno and Hauth, Iris and Lenz, Philipp and Letsch, Anne and Lewitzka, Ute and Maier, Bernd Oliver and Mueller-Pein, Hannah and Nauck, Friedemann and Ostgathe, Christoph and Radbruch, Lukas and Reif, Andreas and Rolke, Roman and Stanze, Henrikje and Teising, Martin and Weber, Martin and Wolfersdorf, Manfred}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, month = {Jan}, note = {CRIS-Team WoS Importer:2021-01-15}, pages = {20-22}, peerreviewed = {unknown}, title = {{ARD} shows "{GOTT}": {Open} {Letter} from {Palliative} {Medicine} & {Suicide} {Prevention} to {Ferdinand} von {Schirach}}, volume = {22}, year = {2021} } @article{faucris.298891578, abstract = {Background/Objective Finding the right time for offering specialized palliative care to patients with incurable cancer remains challenging. The aim of the scoping review was to identify appropriate entity-specific criteria. Method A scoping review was conducted in the online databases PubMed and Scopus in February 2020. The aim of the literature search was to identify original English- and German-language papers published between 2009 and February 2020 providing evidence on which entity-specific and entity-independent criteria of non- curable cancers are used to integrate affected patients into specialized palliative care in a timely manner. A total of 13 relevant articles were identified. In accordance with the method of the scoping review, a formal assessment of the methodological quality of the included literature was not performed. Results The relevant publications included six reviews and seven original articles. None of the publications analysed explicitly cited characteristic criteria related to specific cancer entities. Incurability/advanced tumour disease, quality of life, distressing symptoms, ECOG status, psychosocial needs, comorbidities, tumour-associated complications, treatment decision/ no treatment options, and limited lifetime prognosis were used or suggested as criteria for integration into specialized palliative care independently of cancer entity. Tools were used to elicit the criteria. No specific characteristic scores were specified for the tools that could detect an expression of the criteria relevant for integration into specialized palliative care. Conclusion To determine the moment of timely integration of specialized palliative care for non-curable cancers, there are no entity-specific criteria and parameters to date. However, it can be deduced from the analysis that all patients with a non-curable or advanced cancer suffering from a reduction/loss of their quality of life and a complex symptom burden, especially depression and pain, should receive the offer of specialized palliative care, irrespective of their entity. Defining criteria in general as characteristic values and consecutively defining a measured value or cutoff value could be a possibility to facilitate a timely integration of palliative care via e. g., a scoring system. So far, it is unclear which combinations of survey instruments or screening tools could serve to capture timely integration.}, author = {Gahr, Susanne and Brunner, Sarah and Heckel, Maria and Ostgathe, Christoph}, doi = {10.1055/a-2054-1201}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, note = {CRIS-Team WoS Importer:2023-05-05}, peerreviewed = {No}, title = {{Are} {There} {Entity}-{Specific} {Criteria} for {Initiation} of {Specialized} {Palliative} {Care} for {Incurable} {Cancer}? {A} {Scoping} {Review}}, year = {2023} } @article{faucris.243604398, abstract = {BACKGROUND: International studies indicate deficits in end-of-life care that can lead to distress for patients and their next-of-kin. The aim of the study was to translate and validate the "Care of the Dying Evaluation" (CODE) into German (CODE-GER). METHODS: Translation according to EORTC (European Organisation for Research and Treatment of Cancer) guidelines was followed by data collection to evaluate psychometric properties of CODE-GER. Participants were next-of-kin of patients who had died an expected death in two hospitals. They were invited to participate at least eight, but not later than 16 weeks after the patient's death. To calculate construct validity, the Palliative care Outcome Scale (POS) was assessed. Difficulty and perceived strain of answering the questionnaire were assessed by a numeric scale (0-10). RESULTS: Out of 1137 next-of-kin eligible, 317 completed the questionnaire (response rate: 27.9%). Data from 237 main sample participants, 38 interraters and 55 next-of-kin who participated for repeated measurement were analysed. Overall internal consistency, α = 0.86, interrater reliability, ICC (1) = 0.79, and retest-reliability, ICC (1, 2) = 0.85, were good. Convergent validity between POS and CODE-GER, r = -.46, was satisfactory. A principal component analysis with varimax rotation showed a 7-factor solution. Difficulty, M = 2.2; SD ± 2.4, and perceived strain, M = 4.1; SD ± 3.0, of completing the questionnaire were rather low. CONCLUSION: The results from the present study confirm CODE-GER as a reliable and valid instrument to assess the quality of care of the dying person. More over our study adds value to the original questionnaire by proposing a deepened analysis of obtained data. The development of seven subscales increases its potential for further surveys and research. TRIAL REGISTRATION: This study was registered retrospectively on the 25th of January 2018 at the German Clinical Trials Register ( DRKS00013916 ).}, author = {Vogt, Annika and Stiel, Stephanie and Heckel, Maria and Goebel, Swantje and Mai, Sandra Stephanie and Seifert, Andreas and Gerlach, Christina and Ostgathe, Christoph and Weber, Martin}, doi = {10.1186/s12955-020-01473-2}, faupublication = {yes}, journal = {Health and Quality of Life Outcomes}, keywords = {Hospital; Proxy; Quality of health care; Terminal care; Validation studies, outcome assessment}, note = {CRIS-Team Scopus Importer:2020-10-09}, pages = {311-}, peerreviewed = {Yes}, title = {{Assessment} of the quality of end-of-life care: translation and validation of the {German} version of the "{Care} of the {Dying} {Evaluation}" ({CODE}-{GER}) - a questionnaire for bereaved relatives}, volume = {18}, year = {2020} } @article{faucris.219338194, abstract = {Objective: Radar technology promises to be a
nervous system (ANS) and provides crucial information on the health status of a person, would
provide great benefits for both patients and doctors during prevention and aftercare. However, gold
standard devices to record the HRV, such as the electrocardiograph, have the common disadvantage
that they need permanent skin contact with the patient. Being connected to a monitoring device
by cable reduces the mobility, comfort, and compliance by patients. Here, we present a contactless
approach using a 24 GHz Six-Port-based radar system and an LSTM network for radar heart sound
segmentation. The best scores are obtained using a two-layer bidirectional LSTM architecture. To
verify the performance of the proposed system not only in a static measurement scenario but also
during a dynamic change of HRV parameters, a stimulation of the ANS through a cold pressor test is
integrated in the study design. A total of 638 minutes of data is gathered from 25 test subjects and
is analysed extensively. High F-scores of over 95% are achieved for heartbeat detection. HRV indices
such as HF norm are extracted with relative errors around 5%. Our proposed approach is capable to
perform contactless and convenient HRV monitoring and is therefore suitable for long-term recordings
in clinical environments and home-care scenario}, author = {Shi, Kilin and Steigleder, Tobias and Schellenberger, Sven and Michler, Fabian and Malessa, Anke and Lurz, Fabian and Rohleder, Nicolas and Ostgathe, Christoph and Weigel, Robert and Kölpin, Alexander}, doi = {10.1038/s41598-021-81101-1}, faupublication = {yes}, journal = {Scientific Reports}, keywords = {hrv, radar, vitalparameter, herztöne, berührungslos, herzratenvariabilität}, peerreviewed = {Yes}, title = {{Contactless} analysis of heart rate variability during cold pressor test using radar interferometry and bidirectional {LSTM} networks}, url = {https://www.nature.com/articles/s41598-021-81101-1}, volume = {11}, year = {2021} } @inproceedings{faucris.314595737, abstract = {Continuous wave (CW) radar has been used to detect motions in various scenarios. In this paper, we first present a data-driven method to classify in-bed movement from various scales with CW radar. Data augmentation techniques are used to address the small sample size problem, resulting in a significant improvement of over 10% in accuracy. Three machine learning classifiers, namely random forest, k-nearest neighbor (k-NN), and multilayer perceptron (MLP), are evaluated, with random forest demonstrating the highest accuracy of 81.94% and relative improvement of 22.5% compared to k-NN. The movement sitting up from the bed can be classified with 97.5% accuracy. Additionally, the method can classify two types of movements involving only arm and leg movements, which are not visible to the radar, by detecting small-scale joint movements from the back with an accuracy of 74.8%.}, author = {Lu, Hui and Wenzel, Marvin and Steigleder, Tobias and Klinger, Isabell and Ostgathe, Christoph and Koelpin, Alexander}, booktitle = {20th European Radar Conference, EuRAD 2023}, date = {2023-09-20/2023-09-22}, doi = {10.23919/EuRAD58043.2023.10289241}, faupublication = {yes}, isbn = {9782874870743}, keywords = {continuous wave radar; data augmentation; feature selection; machine learning; movement classification}, note = {CRIS-Team Scopus Importer:2023-12-01}, pages = {306-309}, peerreviewed = {unknown}, publisher = {Institute of Electrical and Electronics Engineers Inc.}, title = {{Contactless} {In}-{Bed} {Movement} in {Various} {Scales} {Classification} with {CW} {Radar}}, venue = {Berlin}, year = {2023} } @article{faucris.106836224, author = {Adelhardt, Thomas and Hessemer, Stefanie and Docter, Katrin and Sieber, Cornel and Ostgathe, Christoph and Schöffski, Oliver}, doi = {10.1055/s-0043-101517}, faupublication = {yes}, journal = {Gesundheitswesen}, keywords = {cost analysis; end-of-life; geriatrics; methicillin-resistant staphylococcus aureus; MRSA}, peerreviewed = {Yes}, title = {{Costs} of {Medial} {Care} of {MRSA} {Patients} at the {End}-of-{Life} in a {Geriatric} {Ward} {Die} {Kosten} von {MRSA} in der stationären geriatrischen {Versorgung} von {Patienten} am {Lebensende} ({End}-of-{Life} {Care})}, year = {2017} } @article{faucris.277084164, abstract = {Background: During the SARS-CoV-2 pandemic's initial waves, bans on visiting and isolation measures placed limits on providing services for seriously ill and dying people and their relatives. Pandemic response teams at governmental level (macro), at federal state and municipal level (meso) and in healthcare facilities (micro) played their role in pandemic management procedures. Aim: To explore pandemic-related challenges and solutions of pandemic response teams regarding the provision of care to seriously ill and dying people and their relatives. Findings were to be integrated into a national strategy (PallPan). Design: Semi-structured expert interviews (10/2020-2/2021) analysed via structured content analysis. Setting/Participants: We interviewed 41 members, who discussed the work of 43 German pandemic response teams (micro n = 23; meso n = 20; no members were available at macro level) from 14 German federal states. Results: Twenty-nine of 43 teams took account of the needs of seriously ill and dying. Their main challenges resulted from pandemic-related legal requirements in hospitals and long-term care facilities. The implementation of such was in the remits of the meso level. Dysfunctional or non-existent communication between the levels was reported to be challenging. To foster patient-related solutions the micro level pandemic response teams supported individual decisions to enable patient-relative contact for example, visiting and saying goodbye outside, meeting via digital solutions. Conclusions: Pandemic response teams evidently struggled to find appropriate solutions to ease pandemic-related impact on the care of seriously ill and dying patients and their relatives. We recommend bringing palliative care expertise on board.}, author = {Klinger, Isabell and Heckel, Maria and Shahda, Sophie and Kriesen, Ursula and Schneider, Carolin and Kurkowski, Sandra and Junghanss, Christian and Ostgathe, Christoph}, doi = {10.1177/02692163221099114}, faupublication = {yes}, journal = {Palliative Medicine}, keywords = {Qualitative research; palliative care; COVID-19; public health; SARS-CoV-2}, note = {CRIS-Team WoS Importer:2022-06-24}, peerreviewed = {Yes}, title = {{COVID}-19: {Challenges} and solutions for the provision of care to seriously ill and dying people and their relatives during {SARS}-{CoV}-2 pandemic - perspectives of pandemic response team members: {A} qualitative study on the basis of expert interviews (part of {PallPan})}, year = {2022} } @inproceedings{faucris.211728082, author = {Peters, Joachim and Heckel, Maria and Ostgathe, Christoph and Habermann, Mechthild}, booktitle = {12. Kongress der Deutschen Gesellschaft für Palliativmedizin}, date = {2018-09-05/2018-09-08}, doi = {10.1055/s-0038-1669222}, faupublication = {yes}, peerreviewed = {unknown}, title = {{Die} {Entstehung} einer professionalisierten {Fachkultur} in der {Palliativmedizin} - sprachwissenschaftliche {Perspektiven}}, venue = {Berlin}, year = {2018} } @article{faucris.247777303, author = {Ostgathe, Christoph}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, month = {Jan}, note = {CRIS-Team WoS Importer:2021-01-15}, pages = {5-6}, peerreviewed = {unknown}, title = {{EAPC} 2020 {Research} {Congress}: {From} {Palermo} to virtual}, volume = {22}, year = {2021} } @inproceedings{faucris.242719216, abstract = {Fragestellung: Der Bedarf an spezialisierter ambulanter Palliativversorgung (SAPV) steigt bei abnehmenden Ressourcen. Um eine flächendeckende Versorgung zu gewährleisten, können digitale Systeme Patienten und Fachpersonal unterstützen. Wir erforschen eine Smartphone Applikation (App) und Web-Interface (WI) die gewährleisten sollen, dass Patienten und SAPV Zugriff auf biometrische und psychometrische Daten haben, um die Versorgung möglichst Ressourcen-effizient zu gestalten.
Studiendesign: Explorative Anwendungs- und Proof-of-Concept-Studie mit Probanden
Methodik: App und WI Entwurf nach klinisch-medizinischen Vorgaben von erfahrenen Palliativmedizinern integriert psychometrische (MIDOS{\_}2) und exemplarische biometrische Messung (Körpergewicht (KG), Körperflüssigkeitsanteil (KFA), Blutdruck (BD)) mit automatischer (Bluetooth) und manueller Eingabe; Evaluation des ersten Design-Modells der App in begleitender Beobachtung; offenes Interview mit n = 2 Probanden (männlich, Alter 70-85);Implementierung des Feedbacks; Pilotierung mit n = 6 Probanden (2 weiblich, Alter 23-30);
Ergebnis: Erster Entwurf nach klinisch-medizinischen Vorgaben: App: KG des Patienten wird automatisch und KF, BD, MIDOS{\_}2 manuell eingegeben. Die Daten werden in App und WI visuell individuell anpassbar dargestellt. App wurde nach begleitender Beobachtung hinsichtlich Akzeptanz und Nutzbarkeit überarbeitet: vereinfachte Nutzerschnittstelle. Pilotierung mit Probanden: Dateneingabe, -übertragung, -abruf und webbasierter Zugriff erfolgten in 100 % der Fälle fehlerfrei. Anwendungsdauer für KG, KFA, BD, MIDOS{\_}2 betrug im Durchschnitt 4 min.
Diskussion: Austausch von psychometrischen und biometrischen Daten zwischen Patient (App) und SAPV-Team (WI) werden ermöglicht und so können SAPV Teams bei ihrer Behandlungsplanung unterstützet werden.
Take Home Message für die Kongressbesucher: App und WI kann die SAPV effizienter gestalten. Weitere Untersuchungen mit Patienten sind notwendi},
author = {Sternemann, Ulla and Suchantke, Insa and Schmidt, Klaus-Günther and Höfner, Patrick and Wagner, Daniel and Ollenschläger, Malte and Heckel, Maria and Ostgathe, Christoph and Eskofier, Björn and Steigleder, Tobias},
booktitle = {Zeitschrift für Palliativmedizin 2020; 21(05)},
date = {2020-09-09/2020-09-12},
doi = {10.1055/s-0040-1714998},
faupublication = {yes},
keywords = {Palliativmedizin; SAPV; Smartphone},
peerreviewed = {unknown},
publisher = {Georg Thieme Verlag KG},
title = {{Entwicklung} einer {Applikation} zum {Home}-{Monitoring} des {Gesundheitszustandes} von {Palliativpatienten} - eine {Proof}-of-{Concept}-{Studie}},
url = {https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1714998#info},
venue = {Wiesbaden},
year = {2020}
}
@article{faucris.245470441,
abstract = {Introduction: In 2017, a national recommendation on multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care was published. In order to monitor the implementation in a hospital-based palliative care unit, a dedicated multidisciplinary working group on MDRO was established. It developed a standard operating procedure and a documentation template (checklist). The aim of the present study is to evaluate the implementation status after one year. Methods: A mixed-methods approach was selected. The status of implementation was identified through a survey among staff members. A retrospective routine data analysis was performed. A focus group discussion with members of the working group focused on previous steps, factors conducive to implementation and on remaining problems. Results: Almost all (18 out of 20) participants (20 out of 29 eligible staff members) knew the national recommendations. Twelve out of 27 recommendations had a high degree of implementation after one year, another 13 recommendations were seen as at least partly integrated into daily routine. For two recommendations the degree of implementation was rated low: (i) ”Taking into account any additional time constraint imposed by protection and isolation measures when planning for personnel and bed occupancy”, and (ii) ”Facilitating the patient's ability to distinguish and recognize team members and family caregivers”. Working group members reported improvements since the implementation, whilst reporting some uncertainty prevailing among both staff members and visitors. Inhibitory factors were said to include the complexity of the standard operating procedure, inadequate usage and poor usability of the checklist. Behavioural and cognitive barriers such as anxieties related to transmission and the sense of security caused by the routine use of protective clothing were considered to be strong. Improving the checklist and the standard operating procedure as well as anchoring procedures in daily routine were considered to be the next important steps. Discussion: The implementation of recommendations is an iterative process and requires the ongoing development of appropriate measures for implementation in the respective institution. A multidisciplinary working group with monitoring tasks is an advantage.},
author = {Heckel, Maria and Illig, Annabell and Brunner, Sarah and Ostgathe, Christoph},
doi = {10.1016/j.zefq.2020.10.005},
faupublication = {yes},
journal = {Zeitschrift für Evidenz, Fortbildung und Qualitat im Gesundheitswesen},
keywords = {End-of-life care; Evaluation research; Infection control; Palliative care; Patient safety},
note = {CRIS-Team Scopus Importer:2020-11-20},
peerreviewed = {Yes},
title = {{Evaluating} the implementation of national recommendations on multidrug-resistant bacterial microorganisms in end-of-life care},
year = {2020}
}
@article{faucris.269460426,
abstract = {Background The National Hospice and Palliative Registry is a database for palliative care facilities documenting a core data set for quality assurance and scientific evaluations. Objectives The study aims identifying differences between patients in palliative care units treated in Comprehensive Cancer Centers (CCC) or other hospitals (OH) focussing on sociodemographic and health/disease-related characteristics. Methods Descriptive data analysis using IBM SPSS Statistics 21 included patients treated from 2014 to 2018. Comparisons included sociodemographic data, diagnoses, ECOG status and treatment duration. Results 12,922 patient data were analyzed (CCC n = 4975/OH = 7947). In CCCs 79.8% had a tumor diagnosis, in other hospitals 85.1%. The proportion of patients with ECOG 4 was higher in CCCs than in other hospitals. The average length of stay in CCCs was 12.6 days, in other hospitals 11.3 days (p = 0.023). Conclusions Data show differences between patients in palliative care implicating CCCs treating more complex palliative care patients than other hospitals.},
author = {Brunner, Sarah and Heckel, Maria and Zenz, Daniel and Ostgathe, Christoph and Gahr, Susanne},
doi = {10.1007/s10354-021-00910-1},
faupublication = {yes},
journal = {Wiener Medizinische Wochenschrift},
month = {Jan},
note = {CRIS-Team WoS Importer:2022-02-11},
peerreviewed = {No},
title = {{Health}- and disease-related data of inpatients in palliative care units of the {Comprehensive} {Cancer} {Centers} and other hospitals in comparison-{Data} from the {Hospice} and {Palliative} {Care} {Register}},
year = {2022}
}
@article{faucris.246697522,
abstract = {Background: Palliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients' loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones' perspectives on need for improvements. Aim: To identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire. Design: Within the validation study of the questionnaire â € Care of the Dying Evaluation' (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring. Setting/participants: Loved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017. Results: 993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient's and/or loved one's will, involvement in decision-making at the end of life (patient's volition) and having the possibility to say goodbye. Conclusions: It is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients' will and to be emotionally supported. Trial registration number: This study was registered at the German Clinical Trials Register (DRKS00013916).},
author = {Kurkowski, Sandra and Radon, Johannes and Vogt, Annika R. and Weber, Martin and Stiel, Stephanie and Ostgathe, Christoph and Heckel, Maria},
doi = {10.1136/bmjspcare-2020-00239},
faupublication = {yes},
journal = {BMJ Supportive & Palliative Care},
keywords = {hospital care; quality of life; service evaluation; social care; supportive care; terminal care},
note = {CRIS-Team Scopus Importer:2020-12-11},
peerreviewed = {Yes},
title = {{Hospital} end-of-life care: {Families}' free-text notes},
year = {2020}
}
@article{faucris.266558602,
abstract = {The world of healthcare constantly aims to improve the lives of people while nurturing their health and comfort. Digital health and wearable technologies are aimed at making this possible. However, there are numerous factors that need to be addressed such as aging, disabilities, and health hazards. These factors are intensified in palliative care (PC) patients and limited hospital capacities make it challenging for health care providers (HCP) to handle the crisis. One of the most common symptoms reported by PC patients with severe conditions is dyspnoea. Monitoring devices with sufficient comfort could improve symptom control of patients with dyspnoea in PC. In this article, we discuss the proof-of-concept study to investigate a smart patch (SP), which monitors the pulmonary parameters: (a) breathing rate (BR) and inspiration to expiration ratio (I:E); markers for distress: (b) heart rate (HR) and heart rate variability (HRV), and (c) transmits real-time data securely to an adaptable user interface, primarily geared for palliative HCP but scalable to specific needs. The concept is verified by measuring and analyzing physiological signals from different electrode positions on the chest and comparing the results achieved with the gold standard Task Force Monitor (TFM).
Gerade bei der Behandlung von Menschen am Ende des Lebens ergibt sich hieraus ein Spannungsverhältnis zwischen Effizienz auf der einen und bestmöglicher Pflege bzw. Begleitung von Patienten auf der anderen Seite. Untersuchungen zeigten auch, dass auf Palliativstationen die Prävalenz von multiresistenten Erregern wie zum Beispiel MRSA-Kolonisationen gegenüber dem Krankenhausdurchschnitt deutlich erhöht ist.
Eine systematische Literaturrecherche zu diesem Thema ergab, dass mit Ausnahme einer Studie keine Publikationen zur Analyse der durch multiresistente Erreger zusätzlich verursachten Kosten im palliativen bzw. geriatrischen Kontext existieren. Die benannte Veröffentlichung betrachtet dabei die Kostensituation bei der Behandlung von Patienten am Lebensende auf einer geriatrischen Station. Anhand der hier vorliegenden Studie werden die zusätzlich durch MRE entstehenden Kosten bei der Behandlung von Patienten am Ende des Lebens auf einer Palliativstation analysiert und mögliche Kostentreiber identifiziert.
Die vorliegende Analyse wurde im Rahmen des multizentrischen Projekts „Untersuchung der Auswirkungen von Infektionen oder Kolonisationen mit MRSA oder anderen multiresistenten Erregern auf Patienten am Lebensende“ durchgeführt. Hintergrund des Gesamtprojektes, „MRSA in End-of-Life Care“ (M-EndoL, BMBF-Projektnummer 01GY1314), ist die Entwicklung eines wissenschaftlich fundierten, patienten- und familienzentrierten Ansatzes zum Umgang mit hospitalisierten Patienten mit MRE-Nachweis am Lebensend}, author = {Adelhardt, Thomas and Hessemer, Stefanie and Heckel, Maria and Herbst, Franziska A. and Stiel, Stephanie and Ostgathe, Christoph and Schöffski, Oliver}, doi = {10.1055/a-0651-6448}, faupublication = {yes}, journal = {Gesundheitsökonomie und Qualitätsmanagement}, peerreviewed = {Yes}, title = {{Kosten} von multiresistenten {Erregern} in der stationären {Palliativversorgung}}, year = {2018} } @article{faucris.123402224, author = {Will, Christoph and Shi, Kilin and Schellenberger, Sven and Steigleder, Tobias and Michler, Fabian and Weigel, Robert and Ostgathe, Christoph and Kölpin, Alexander}, doi = {10.1109/JERM.2017.2766567}, faupublication = {yes}, journal = {IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology}, pages = {81-89}, peerreviewed = {Yes}, title = {{Local} {Pulse} {Wave} {Detection} using {Continuous} {Wave} {Radar} {Systems}}, volume = {1}, year = {2017} } @article{faucris.211349304, author = {Ostgathe, Christoph and Lang, Frieder and Bogdan, Christian and Sieber, Cornel and Schöffski, Oliver and Stiel, Stephanie and Heckel, Maria and Tiedtke, Johanna and Sturm, Alexander and Adelhardt, Thomas}, doi = {10.1055/s-0034-1374204}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, peerreviewed = {No}, title = {{M}-{EndoL}: {MRSA} in der {Versorgung} am {Lebensende} - {Untersuchung} der {Auswirkungen} von {MRSA}- (oder andere multiresistente {Keim}-) {Kolonisation} oder {Infektion} auf {Patienten} am {Lebensende}, deren {Angehörige}, {Teammitglieder} und {Einrichtungen}}, volume = {15}, year = {2014} } @article{faucris.211351214, author = {Peters, Joachim and Dykes, Nathan and Habermann, Mechthild and Ostgathe, Christoph and Heckel, Maria}, faupublication = {yes}, journal = {Metaphor and the Social World}, pages = {221-241}, peerreviewed = {Yes}, title = {{Metaphors} for multidrug-resistant bacteria in {German} newspaper articles, 1995-2015. {A} computer-assisted qualitative study.}, volume = {9}, year = {2019} } @article{faucris.116045864, abstract = {Hintergrund: Die Auswirkungen von Kolonisation oder Infektion mit multiresistenten Erregern (MRE) und der Isolationsmaßnahmen auf Patienten am Lebensende, deren Angehörige sowie andere Beteiligte innerhalb des Gesundheitswesens sind unbekannt.
Ziel der Studie: Die vorliegende Studie beschäftigt sich mit der Frage, inwieweit die speziellen Anforderungen von Patienten am Ende des Lebens in den aktuellen Leitlinien der beteiligten Krankenhäuser Berücksichtigung finden. Langfristig sollen dabei gewonnene Erkenntnisse über Struktur und Aufbau der analysierten Dokumente dazu beitragen, innerhalb des Gesamtprojekts allgemeingültige Verfahrensanweisungen für die oben angeführte Problematik zu definieren und zu etablieren.
Methodik: Eine Dokumentenanalyse der Leitfäden und Informationsunterlagen von 2 deutschen Krankenhäusern zum Umgang mit MRE-positiven Patienten wurde durchgeführt. Nach Zuordnung zu Dokumentensets erfolgte eine Analyse mittels inhaltsanalytischem Vorgehen. Die daraus entstandene Codestruktur wurde deskriptiv und inhaltlich bezüglich der Zielgruppen der Dokumente analysiert.
Ergebnisse: Insgesamt wurden 23 interne Dokumente analysiert. Am häufigsten fanden sich Textstellen zuSchutzmaßnahmen, Material sowie Screening. Das Thema MRE bei Patienten am Lebensende fand kaum Erwähnung.
Schlussfolgerungen: In Dokumenten zur Versorgung von MRE-positiven Patienten liegt der Fokus auf allgemeingültigen Verfahrensanweisungen mit vorrangig praktischen Themen wie zur Pflege benötigtes Material bzw. Schutzmaßnahmen gegen MRE. Die Versorgung von Patienten am Lebensende spielt eine untergeordnete Rolle, weshalb dieses Thema zukünftig in Verfahrensanweisungen stärker fokussiert werden sollt}, author = {Adelhardt, Thomas and Heckel, Maria and Stiel, Stephanie and Ostgathe, Christoph and Schöffski, Oliver}, doi = {10.1055/s-0041-110168}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, keywords = {Palliativversorgung; multiresistente Erreger; MRSA; klinische Guidelines; Dokumentenanalyse}, pages = {30-37}, peerreviewed = {No}, title = {{MRE}-{Kolonisation} oder -{Infektion} in der {Versorgung} von {Menschen} am {Lebensende} ({End}-of-{Life} {Care}): {Handlungsanweisungen} und {Informationsmaterialien} in zwei deutschen {Krankenhäusern} - {Eine} {Dokumentenanalyse}}, url = {https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0041-110168}, volume = {17}, year = {2016} } @inproceedings{faucris.107042364, author = {Malessa, Anke and Steigleder, Tobias and Shi, Kilin and Will, Christoph and Michler, Fabian and Kölpin, Alexander and Ostgathe, Christoph}, booktitle = {Wissenschaftliche Arbeitstage der DGP}, date = {2018-03-09/2018-03-10}, faupublication = {yes}, peerreviewed = {Yes}, title = {{Neue} {Wege} in der {Palliativmedizin} – {Herausforderungen} bei der {Entwicklung} einer berührungslosen, nicht-belastenden {Messung} von {Vitalparametern}}, venue = {Göttingen}, year = {2018} } @article{faucris.296075046, abstract = {Background Palliative care is an integral part of health care, which in term has become increasingly technologized in recent decades. Lately, innovative smart sensors combined with artificial intelligence promise better diagnosis and treatment. But to date, it is unclear: how are palliative care concepts and their underlying assumptions about humans challenged by smart sensor technologies (SST) and how can care benefit from SST?
Aims The paper aims to identify changes and challenges in palliative care due to the use of SST. In addition, normative guiding criteria for the use of SST are developed.
Methods The principle of Total Care used by the European Association for Palliative Care (EAPC) forms the basis for the ethical analysis. Drawing on this, its underlying conceptions of the human and its socio-ethical aspects are examined with a phenomenological focus. In the second step, the advantages, limitations, and socio-ethical challenges of using SST with respect to the Total Care principle are explored. Finally, ethical-normative requirements for the application of SST are derived.
Results and Conclusion First, SST are limited in their measurement capabilities. Second, SST have an impact on human agency and autonomy. This concerns both the patient and the caregiver. Third, some aspects of the Total Care principle are likely to be marginalized due to the use of SST. The paper formulates normative requirements for using SST to serve human flourishing. It unfolds three criteria according to which SST must be aligned: (1) evidence and purposefulness, (2) autonomy, and (3) Total Care.
Chronic illnesses and multi-morbidity can threaten competence and independence, particularly in old age. Autonomy becomes increasingly important in the context of sedation, as in this case medication leads to (further) changes of consciousness. The study aimed to identify possible age-related differences in the perspectives of healthcare professionals on patients’ autonomy, in the context of sedation in specialised palliative care.
Method
Secondary analysis of interviews with healthcare professionals, analysed by qualitative content and linguistic conversation analysis. The interviews analysed span 51 healthcare professionals in specialised palliative care across 17 centres (adult inpatient and specialist palliative home care services) in Germany.
Results
The study shows that the perspectives of healthcare professionals on patients’ autonomy differs according to the age of the patient in the context of sedation in specialised palliative care. The different perspectives may lead to different ways of treating the patients, for example a greater space of autonomy and decision-making for younger patients.
Conclusion
In particular, measures that may restrict consciousness (e.g. sedation) and thus influence patients’ ability to fully exercise their autonomy and fully participate in decision-making require special attention by healthcare professionals with respect to possible influences on treatment, such as different perceptions by healthcare professionals based on the patient’s age or age-related stereotype},
author = {Kurkowski, Sandra and Heckel, Maria and Pfaller, Larissa and Peters, Joachim and Jeremias, Bazata and Eva, Schildmann and Ostgathe, Christoph},
doi = {10.1186/s12904-022-00963-y},
faupublication = {yes},
journal = {BMC Palliative Care},
keywords = {End of life care; Palliative care; Age; Ageing; Autonomy; Qualitative content analysis; Linguistic conversation analysis},
peerreviewed = {Yes},
title = {{Possible} age-related differences in healthcare professionals’ perspectives on younger and older patients’ autonomy and decision-making in the context of sedation in specialised palliative care: exploratory secondary qualitative content and linguistic conversation analysis of interviews with healthcare professionals},
url = {https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-022-00963-y},
volume = {21},
year = {2022}
}
@article{faucris.116514244,
abstract = {Introduction: An algorithm to convert from any other opioid to oral levo-methadone was developed in Germany, the German model of levo-methadone conversion (GMLC). According to this GMLC, the pre-existing opioid is stopped, then titration of oral levo-methadone is initiated with a starting dose of 5 mg orally q 4 h (plus prn q 1 h). If necessary, levomethadone dose is increased (pain) or decreased (side effects) by 30% q 4 h (plus prn q 1 h). After 72 h, the achieved single dose is maintained, but the dosing interval increases twofold to q 8 h (plus prn q 3 h). The aim of this study was to obtain information about the practicability, safety, and efficacy of the GMLC in clinical routine. Methods: A retrospective, systematic chart review of levomethadone conversions for the treatment of pain in inpatient palliative care was performed. Results: Fifty-two patients were analyzed. The dosing interval was increased correctly after 72 h as demanded by the GMLC in 60% of patients. In 85% of the patients, opioid medication with levo-methadone could be maintained until the end of the inpatient stay. In three patients (6%), levo-methadone administration had to be stopped due to side effects. No serious adverse events could be detected during opioid rotation. Pain intensity was reduced significantly (p<0.001) after conversion concerning mean (NRS 0.9; range 0-4) and maximum pain over the day (NRS 3.9; range 0-10). Conclusion: The presented study indicates that the GMLC provides a practical and reasonably safe approach to perform opioid rotation to levo-methadone in a palliative care setting. © Springer-Verlag 2011.},
author = {Ostgathe, Christoph and Voltz, Raymond and Van Aaaken, Annika and Klein, Carsten and Sabatowski, Rainer and Nauck, Friedemann and Gaertner, Jan},
doi = {10.1007/s00520-011-1320-8},
faupublication = {yes},
journal = {Supportive Care in Cancer},
keywords = {Conversion; Levo-methadone; Opioid; Opioid rotation; Pain; Palliative care},
pages = {2105-2110},
peerreviewed = {Yes},
title = {{Practicability}, safety, and efficacy of a "{German} model" for opioid conversion to oral levo-methadone},
volume = {20},
year = {2012}
}
@article{faucris.245003934,
author = {Peters, Joachim and Dykes, Nathan and Heckel, Maria and Ostgathe, Christoph and Habermann, Mechthild},
doi = {10.1055/a-1689-7524},
faupublication = {yes},
journal = {Zeitschrift für Palliativmedizin},
pages = {46-53},
peerreviewed = {Yes},
title = {{Präsentation} von {Palliativstationen} und {SAPV}-{Teams} im {Internet} - eine korpusbasierte {Metaanalyse} von {Webseiten}},
volume = {23},
year = {2022}
}
@inproceedings{faucris.261563539,
address = {AMSTERDAM},
author = {Allner, Moritz and Gostian, M. and Balk, Matthias and Rupp, Robin and Hecht, Markus and Ostgathe, Christoph and Mueller, Sarina K. and Iro, Heinrich and Gostian, Antoniu-Oreste},
booktitle = {ORAL ONCOLOGY},
faupublication = {yes},
note = {CRIS-Team WoS Importer:2021-07-16},
peerreviewed = {unknown},
publisher = {ELSEVIER},
title = {{Precautionary} documents in patients with head and neck cancer - status quo and factors influencing their creation},
year = {2021}
}
@article{faucris.263666730,
abstract = {We propose a novel knowledge extraction method based on Bayesian-inspired association rule mining to classify anxiety in heterogeneous, routinely collected data from 9,924 palliative patients. The method extracts association rules mined using lift and local support as selection criteria. The extracted rules are used to assess the maximum evidence supporting and rejecting anxiety for each patient in the test set. We evaluated the predictive accuracy by calculating the area under the receiver operating characteristic curve (AUC). The evaluation produced an AUC of 0.89 and a set of 55 atomic rules with one item in the premise and the conclusion, respectively. The selected rules include variables like pain, nausea, and various medications. Our method outperforms the previous state of the art (AUC = 0.72). We analyzed the relevance and novelty of the mined rules. Palliative experts were asked about the correlation between variables in the data set and anxiety. By comparing expert answers with the retrieved rules, we grouped rules into expected and unexpected ones and found several rules for which experts' opinions and the data-backed rules differ, most notably with the patients' sex. The proposed method offers a novel way to predict anxiety in palliative settings using routinely collected data with an explainable and effective model based on Bayesian-inspired association rule mining. The extracted rules give further insight into potential knowledge gaps in the palliative care field.},
author = {Haas, Oliver and Lopera Gonzalez, Luis Ignacio and Hofmann, Sonja and Ostgathe, Christoph and Maier, Andreas and Rothgang, Eva and Amft, Oliver and Steigleder, Tobias},
doi = {10.3389/fdgth.2021.724049},
faupublication = {yes},
journal = {Frontiers in Digital Health},
keywords = {anxiety; machine learning; association rule mining; palliative care; routine data; questionnaire},
peerreviewed = {Yes},
title = {{Predicting} {Anxiety} in {Routine} {Palliative} {Care} {Using} {Bayesian}-{Inspired} {Association} {Rule} {Mining}},
volume = {3},
year = {2021}
}
@article{faucris.202373734,
abstract = {This paper introduces heart sound detection by radar systems, which enables touch-free and continuous monitoring of heart sounds. The proposed measurement principle entails two enhancements in modern vital sign monitoring. First, common touch-based auscultation with a phonocardiograph can be simplified by using biomedical radar systems. Second, detecting heart sounds offers a further feasibility in radar-based heartbeat monitoring. To analyse the performance of the proposed measurement principle, 9930 seconds of eleven persons-under-tests' vital signs were acquired and stored in a database using multiple, synchronised sensors: a continuous wave radar system, a phonocardiograph (PCG), an electrocardiograph (ECG), and a temperature-based respiration sensor. A hidden semi-Markov model is utilised to detect the heart sounds in the phonocardiograph and radar data and additionally, an advanced template matching (ATM) algorithm is used for state-of-the-art radar-based heartbeat detection. The feasibility of the proposed measurement principle is shown by a morphology analysis between the data acquired by radar and PCG for the dominant heart sounds S1 and S2: The correlation is 82.97 ± 11.15% for 5274 used occurrences of S1 and 80.72 ± 12.16% for 5277 used occurrences of S2. The performance of the proposed detection method is evaluated by comparing the F-scores for radar and PCG-based heart sound detection with ECG as reference: Achieving an F1 value of 92.22 ± 2.07%, the radar system approximates the score of 94.15 ± 1.61% for the PCG. The accuracy regarding the detection timing of heartbeat occurrences is analysed by means of the root-mean-square error: In comparison to the ATM algorithm (144.9 ms) and the PCG-based variant (59.4 ms), the proposed method has the lowest error value (44.2 ms). Based on these results, utilising the detected heart sounds considerably improves radar-based heartbeat monitoring, while the achieved performance is also competitive to phonocardiography.
},
author = {Will, Christoph and Shi, Kilin and Schellenberger, Sven and Steigleder, Tobias and Michler, Fabian and Fuchs, Jonas and Weigel, Robert and Ostgathe, Christoph and Kölpin, Alexander},
doi = {10.1038/s41598-018-29984-5},
faupublication = {yes},
journal = {Scientific Reports},
peerreviewed = {Yes},
title = {{Radar}-{Based} {Heart} {Sound} {Detection}},
year = {2018}
}
@inproceedings{faucris.314919511,
abstract = {The accurate detection and quantification of activities of daily life (ADL) are crucial for assessing the health status of palliative patients to allow an optimized treatment in the last phase of life. Current evaluation methods heavily rely on subjective self-reports or external observations by clinical staff, lacking objectivity. To address this limitation, we propose a radar-based approach for recognizing ADLs in a palliative care context. In our proof of concept study, we recorded five different ADLs relevant to palliative care, all occurring within a hospital bed, from N=14 healthy participants (57% women, aged 28.6 ± 5.3years). All movements were recorded using two frequency-modulated continuous wave radar systems measuring velocity, range, and angle. A convolutional neural network combined with long short-term memory achieved a classification accuracy of 99.8 ± 0.4% across five cross-validation folds. Furthermore, we compare our initial approach, which takes into account all dimensions of the available radar data, to a simplified version, where only velocity information over time is fed into the network. While these results demonstrate the high potential of radar-based sensing to automatically detect and quantify activities in a palliative care context, future work is still necessary to assess the applicability to real-world hospital scenarios.
75% agreement), (122) were original EAPC recommendations with 13 new recommendations included emerging specialisms: neonatal, geriatric and dementia care, and better care practices. Seven statements failed to reach consensus and four were removed as irrelevant or repetition. Conclusions: Most recommendations on standards and norms for palliative care in Europe remain unchanged since 2009. Evolving concepts in palliative care can be used to support advocacy.},
author = {Payne, Sheila and Harding, Andrew and Williams, Tom and Ling, Julie and Ostgathe, Christoph},
doi = {10.1177/02692163221074547},
faupublication = {yes},
journal = {Palliative Medicine},
note = {CRIS-Team WoS Importer:2022-02-25},
peerreviewed = {Yes},
title = {{Revised} recommendations on standards and norms for palliative care in {Europe} from the {European} {Association} for {Palliative} {Care} ({EAPC}): {A} {Delphi} study},
year = {2022}
}
@article{faucris.307308586,
abstract = {BACKGROUND: The appropriate provision of sedation as a last resort for the relief of suffering in palliative care is dealt with variably in actual practice. This article is intended as an overview of practically relevant information found in treatment recommendations and guidelines.
METHODS: A systematic literature search was conducted in the PubMed, Scopus, and Google Scholar databases, and a manual search was carried out online. Recommendations that were not available in either German or English, or that were specific to pediatric practice, were excluded. Publication quality was assessed with the AGREE II instrument (Appraisal of Guidelines for Research & Evaluation II). The recommendations in the documents were qualitatively evaluated.
RESULTS: 29 publications (11 journal articles, 18 other) of varying quality according to AGREE II were included. All recommendations and guidelines were essentially based on expert consensus. The common indications for sedation are otherwise intractable delirium, dyspnea, and pain, in patients with a life expectancy of no more than two weeks. Existential distress is a controversial indication. The drug of first choice is midazolam. As the sedating effect of opioids is hard to predict, they should not be used as sedatives. The risks of sedation include respiratory and circulatory depression, as well as the loss of communicative ability, control, and autonomy. It is generally recommended that the patient's symptom burden and depth of sedation should be monitored; clinical and technically supported monitoring are recommended in some publications as well, depending on the situation.
CONCLUSION: There is a broad consensus in favor of sedation to relieve suffering in the last days and hours of life. Recommendations vary for patients with a longer life expectancy and for those with existential distress, and with respect to monitoring.},
author = {Klein, Carsten and Voss, Rafaela and Ostgathe, Christoph and Schildmann, Jan Ansgar},
doi = {10.3238/arztebl.m2023.0034},
faupublication = {yes},
journal = {Deutsches Ärzteblatt international},
note = {EVALuna2:537178},
pages = {235-242},
peerreviewed = {Yes},
title = {{Sedation} in {Palliative} {Care}.},
volume = {120},
year = {2023}
}
@inproceedings{faucris.215822199,
abstract = {Sounds caused by the action of the heart reflect both its health as well as deficiencies and are examined by physicians since antiquity. Pathologies of the valves, e.g. insufficiencies and stenosis, cardiac effusion, arrhythmia, inflammation of the surrounding tissue and other diagnosis can be reached by experienced physicians. However, practice is needed to assess the findings correctly. Furthermore, stethoscopes do not allow for long-term monitoring of a patient. Recently, radar technology has shown the ability to perform continuous touchless and thereby burden-free heart sound measurements. In order to perform automated classification of the signals, the first and most important step is to segment the heart sounds into their physiological phases. This paper examines the use of different Long Short-Term Memory (LSTM) architectures for this purpose based on a large dataset of radar-recorded heart sounds gathered from 30 different test persons in a clinical study. The best-performing network, a bidirectional LSTM, achieves a sample-wise accuracy of 93.4% and a F1 score for the first heart sound of 95.8%.
„SOPs zur palliativen Versorgung von Patienten im Netzwerk der deutschen Comprehensive Cancer Center“, erstellt von der AG Palliativmedizin der von der Deutschen Krebshilfe geförderten Comprehensive Cancer Center (CCC}, author = {Ostgathe, Christoph and Stachura, Peter and Heckel, Maria and Brunner, Sarah and Gahr, Susanne and Hofmann, Sonja and Van Oorschot, Birgitt and Oechsle, Karin and Bogdan, Christian and Kunz, Bernd and Foertsch, Baerbel and Klein, Carsten}, doi = {10.1007/s00761-022-01201-z}, faupublication = {yes}, journal = {Die Onkologie}, note = {CRIS-Team WoS Importer:2022-10-07}, peerreviewed = {unknown}, title = {{SOP} - {Management} of multiresistent {Pathogens} in the {Palliative} {Care} {Unit}}, year = {2022} } @article{faucris.311090985, author = {Hense, J. and Przyborek, M. and Rosenbruch, J. and Ostgathe, Christoph and Wolf, C.}, doi = {10.1007/s00761-023-01409-7}, faupublication = {yes}, journal = {Die Onkologie}, note = {CRIS-Team Scopus Importer:2023-09-29}, peerreviewed = {Yes}, title = {{SOP} – {Subkutane} {Medikamentengabe} und {Infusionen} in der erwachsenen {Palliativmedizin} {Version} {II}}, year = {2023} } @article{faucris.213515481, author = {Peters, Joachim and Heckel, Maria and Ostgathe, Christoph and Habermann, Mechthild}, doi = {10.1055/a-0873-4234}, faupublication = {yes}, journal = {Zeitschrift für Palliativmedizin}, pages = {125-131}, peerreviewed = {Yes}, title = {{Sprache} in {Bewegung} – {Schlüsselbegriffe} der {Palliativmedizin} im {Wandel} der {Zeit}}, volume = {20}, year = {2019} } @article{faucris.261571229, abstract = {Background: Cancer patients account for a large segment of the German healthcare system, with a 5-year prevalence of around 1.7 million persons. Advances in oncological treatment, now frequently performed on an outpatient basis, are granting many of these individuals a longer life span. At the same time, cancer patients often suffer disease-related symptoms and adverse effects from their tumor treatment, which may strongly impair their quality of life despite the improved techniques for management of side effects.}, author = {Tewes, Mitra and Baumann, Freerk and Teufel, Martin and Ostgathe, Christoph}, doi = {10.3238/arztebl.m2021.0028}, faupublication = {yes}, journal = {Deutsches Ärzteblatt international}, note = {CRIS-Team WoS Importer:2021-07-16}, pages = {291-+}, peerreviewed = {Yes}, title = {{Symptoms} {During} {Outpatient} {Cancer} {Treatment} and {Options} for their {Management}}, volume = {118}, year = {2021} } @article{faucris.239816026, abstract = {Patients diagnosed with tuberculosis (TB) continue to experience clinical uncertainty and high mortality and to bear a high burden of symptoms and other concerns. Additional concerns may be family support needs and stigma, particularly the latter, as TB and human immunodeficiency virus (HIV) coinfection are common. Human rights covenants, global health policy and the End TB Strategy all recommend palliative care as an essential component of care services. As established in the resolution adopted by the World Health Assembly (WHA) on "Strengthening of palliative care as a component of comprehensive care throughout the life course", there is a "need for palliative care across disease groups (non-communicable diseases, and infectious diseases, including HIV and multidrug-resistant tuberculosis), and across all age groups". We address the ethical imperative to respect the dignity and fundamental rights of people with TB by providing palliative care. We review the evidence for the need for person-centred palliative care and highlight novel models that utilise the skills and training functions of specialist palliative care to achieve better care. We outline simple recommendations for the delivery of specialist and generalist palliative care, offer suggestions on how to ensure optimal coverage by enabling access to appropriate good-quality palliative care at all points of the health system, including alongside treatment. Finally, we set out the current priorities for research and policy to ensure that quality care is delivered to all who need it irrespective of treatment outcome, to minimise distress and to optimise engagement in treatment and care.}, author = {Harding, R. and Snyman, L. and Ostgathe, Christoph and Odell, S. and Gwyther, L.}, doi = {10.5588/ijtld.18.0240}, faupublication = {yes}, journal = {International Journal of Tuberculosis and Lung Disease}, note = {CRIS-Team Scopus Importer:2020-06-30}, pages = {3-8}, peerreviewed = {Yes}, title = {{The} ethical imperative to relieve suffering for people with tuberculosis by ensuring access to palliative care}, volume = {24}, year = {2020} } @article{faucris.115652944, abstract = {The aim of palliative care is to relieve suffering and stabilize or improve quality of life. Prolongation of life and focus on quality of life seem to be at first glance mutually exclusive. However, in daily clinical routine they occasionally do simultaneously occur, when further medical treatment to prolong life is not successful, not appropriate, or simply refused by the patient. In general, basic competencies in palliative care should be offered by the intensive care unit teams. In complex cases, it can be reasonable to integrate a palliative care team (PCT) which can support treatment for those patients with regard to symptom-oriented therapy. They also facilitate referral of seriously ill patients to a hospice or home. Palliative care consultation is recommended, if distressing symptoms can not be alleviated sufficiently or support for referral of terminally ill patients is sought. In addition, a PCT can provide support in discussions about withdrawal of life-prolonging treatments and the aims of therapy. © 2012 Springer-Verlag.}, author = {Ostgathe, Christoph and Klein, Carsten and Heckel, Maria and Hofmann, Sonja and et al.}, author_hint = {Klein C., Heckel M., Treibig T., Hofmann S., Ritzer-Rudel I., Ostgathe C.}, faupublication = {yes}, journal = {Medizinische Klinik - Intensivmedizin und Notfallmedizin}, keywords = {Communication; Palliative care; Palliative care team; Quality of life; Therapy}, pages = {240-243}, peerreviewed = {No}, support_note = {Author relations incomplete. You may find additional data in field 'author{\_}hint'}, title = {{The} palliative care team in the intensive care unit}, url = {https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84879567479∨igin=inward}, volume = {107}, year = {2012} } @article{faucris.238596422, abstract = {Purpose: Providing high-quality care for the dying is essential in palliative care. Quality of care can be checked, compared, and improved by assessing responses from bereaved next-of-kin. The objectives of this study are to examine quality of care in the last 2 days of life of hospitalized patients considering specific aspects of their place of care. Methods: The “Care of the Dying Evaluation” (CODE™) questionnaire, validated in German in 2018 (CODE-GER), examines quality of care for the patient and support of next-of-kin, allocating values between 0 (low quality) and 4 (high quality). The total score (0–104) is divided into subscales which indicate support/time given by doctors/nurses, spiritual/emotional support, information/decision-making, environment, information about the dying process, symptoms, and support at the actual time of death/afterwards. Next-of-kin of patients with an expected death in specialized palliative care units and other wards in two university hospitals between April 2016 and March 2017 were included. Results: Most of the 237 analyzed CODE-GER questionnaires were completed by the patient’s spouse (42.6%) or children (40.5%) and 64.1% were female. Patients stayed in hospital for an average of 13.7 days (3–276; SD 21.1). Half of the patients died in a specialized palliative care unit (50.6%). The CODE-GER total score was 85.7 (SD 14.17; 25–104). Subscales were rated significantly better for palliative care units than for other wards. Unsatisfying outcomes were reported in both groups in the subscales for information/decision-making and information about the dying process. Conclusion: The overall quality of care for the dying was rated to be good. Improvements of information about the dying process and decision-making are needed. Trial registration: DRKS00013916}, author = {Heckel, Maria and Vogt, Annika R. and Stiel, Stephanie and Radon, Johannes and Kurkowski, Sandra and Goebel, Swantje and Ostgathe, Christoph and Weber, Martin}, doi = {10.1007/s00520-020-05465-2}, faupublication = {yes}, journal = {Supportive Care in Cancer}, keywords = {Caregivers; Death; Outcome assessment (healthcare); Palliative care; Quality; Surveys}, note = {CRIS-Team Scopus Importer:2020-05-22}, peerreviewed = {Yes}, title = {{The} quality of care of the dying in hospital—next-of-kin perspectives}, year = {2020} } @article{faucris.241514568, abstract = {Background: For intensive care patients with limited life expectancy the integration of palliative care in intensive care may be beneficial. However, little is known about the extent of this interdisciplinary collaboration. Objectives: The support given by palliative medicine in German oncological centers and used by the intensive care units should be recorded. Material and methods: A descriptive survey was conducted in all of the 16 Comprehensive Cancer Centers (CCC) funded by German Cancer Aid. The questionnaires were sent to the head of department of the CCCsʼ specialized palliative care teams. Data were collected for the year 2016. Quantitative data were analysed to establish frequencies, given as mean and median. A qualitative section asked for trigger factors, i.e., patient characteristics triggering a palliative care consultation. Evaluation was inductively carried out by content analysis according to Mayring. Results: Data from 15 of the 16 CCCs (94%) were obtained between July and August 2017. In 2016, the median of intensive care patients with palliative care consultations was 33 (minimum 0, maximum 100). The median of nine patients were transferred from an intensive care unit to a palliative care unit (minimum 1, maximum 30). Multidisciplinary ward rounds by both intensive and palliative care staff were available in two CCCs on a regular basis. Two CCCs implemented screening tools to integrate specialized palliative care into intensive care. From 23 responses concerning triggers, three categories were established, i.e., “team’s decision and attitude”, “patient’s condition” and “desires of patients and relatives”. Conclusions: Palliative care is available in German CCCs. However, the degree of integration of specialized palliative care into intensive care units is low. Screening tools are available to identify patients with complex needs and to trigger a palliative care consultation. These tools, as well as joint ward rounds of intensive and palliative care staff, can improve the quality of patient centred care.}, author = {Berendt, Julia and Ostgathe, Christoph and Simon, S. T. and Tewes, M. and Schlieper, D. and Schallenburger, M. and Meier, S. and Gahr, Susanne and Schwartz, J. and Neukirchen, M.}, doi = {10.1007/s00063-020-00712-0}, faupublication = {yes}, journal = {Medizinische Klinik - Intensivmedizin und Notfallmedizin}, keywords = {Intensive care patient; Interdisciplinary collaboration; Palliative care consultation service; Therapeutic goal setting; Trigger factors}, note = {CRIS-Team Scopus Importer:2020-08-14}, peerreviewed = {Yes}, title = {{Zusammenarbeit} von {Intensivmedizin} und {Palliativmedizin}: {Eine} {Bestandsaufnahme} an den deutschen onkologischen {Spitzenzentren}}, year = {2020} }