Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

Background: Currently, there is limited knowledge about the association between a migration background and loneliness among middle-aged and older individuals in Germany. The aim was therefore to examine the association between migration background and loneliness in this group.

Methods: Data were taken from the German Ageing Survey (Wave 7, November 2020 to March 2021), a representative sample of middle-aged and older individuals. The sample comprised 4145 individuals, and the mean age was 63.8 years. Of the respondents, 93.2% had no migration background, approximately 5.9% had a migration background with personal migration experience, and 0.9% had a migration background but no personal migration experience. The De Jong Gierveld tool was used to quantify loneliness.

Results: Multiple linear regressions showed that individuals with a migration background and their own migration experience have significantly higher levels of loneliness (β = 0.15, 95% confidence interval (CI): 0.004 to 0.30, p < 0.05) compared to individuals without a migration background, whereas individuals with a migration background without their own migration experience have significantly lower levels of loneliness (β = -0.27, 95% CI: -0.52 to -0.02 p < 0.05).

Conclusions: Individuals with a migration background and their own migration experience appear to represent a risk group for high loneliness among middle-aged and older adults in Germany. In this respect, this group should be given special consideration in corresponding measures. Against the background of current (and potential future) migration movements, the results are of great importance as these groups in particular could be affected by loneliness.

Background: Population-based studies on the relationship between social isolation and obesity, which also include younger adults, are still lacking in Germany. The aim of this study is to investigate the prevalence of social isolation in people with and without obesity. In addition, socially isolated people with and without obesity are examined with regard to socio-demographic and socio-economic factors as well as with regard to depressive symptoms.

Methods: This study was based on baseline data from the LIFE Adult Study (18-79 years) from the 2011-2014 study period. The sample comprised n = 8350 participants. In addition to socio-demographic characteristics and socio-economic status (SES), data on social isolation (LSNS-6), depression (ADS), and body mass index (BMI) were collected. Evaluations were carried out using inferential statistical analyses.

Results: Overall, 13.1% of the total sample were affected by social isolation. Participants with obesity (20.4%) had a significantly (p < 0.001) higher prevalence compared to those without obesity (11.4%). A better social integration was significantly associated with younger age (p < 0.001), female sex (p < 0.001), being married (and cohabiting) (p < 0.001), higher socioeconomic status (p < 0.001), and lower depressive symptoms (p < 0.001).

Discussion: A higher BMI was not associated per se with poorer social integration. However, the present study showed that socially isolated people with obesity represent a special risk group for impaired mental health and had twice the prevalence of social isolation compared to those without obesity.

Advanced incurable diseases are often accompanied by numerous losses and burdens as the disease progresses, leading to a loss of autonomy, self-determination, and dignity for those affected, all of which can subsequently promote feelings of loneliness at the end of life. Declining health, increasing symptom burden, loss of social roles, and the fear of death and dying are among the key risk factors for loneliness towards the end of life. In this article, we provide an overview of the different dimensions of loneliness experienced at the end of life. We discuss existential loneliness alongside emotional and social loneliness, explore causes and health implications of loneliness at the end of life, suggest diagnostic tools for assessing loneliness, and finally provide recommendations for addressing emotional, social, and existential loneliness at the end of life. The loneliness of caregivers is also discussed. We suggest that addressing social and emotional loneliness early in the course of a terminal illness is crucial. Palliative, psychological, and spiritual support can strengthen interpersonal relationships, foster a sense of meaning and purpose, and alleviate the adverse effects of loneliness on mental and physical health as well as quality of life. In contrast, existential loneliness is considered an expression of profound emotional maturity and can offer opportunities for inner growth, contributing to a more refined sense of self while reinforcing identity, dignity, and transcendence at the end of life.

The extent of loneliness differs internationally. Especially in the developed welfare states of Northern Europe, loneliness levels in the population are comparatively low. However, the increase in loneliness in many countries shows that existing concepts are not sufficient to provide effective protection against loneliness. Younger people also need to be strengthened so that they do not withdraw when they experience social exclusion and loneliness. This requires qualified specialists in kindergartens, schools, sports clubs, and other leisure facilities who help children and young people to establish social contacts. Friendship and neighborhood models have proven to be successful when it comes to strategies to combat loneliness. Greater identification with the neighborhood and a feeling of security help build social networks and reduce loneliness. For older people it is important to be able to stay in their usual social environment and maintain their social contacts. To this end, accessible public spaces must be combined with home care and support services that are tailored to the needs and wishes of older people.

Background: Recently, the phenomenon of loneliness has received increasing attention. Loneliness is widespread and can have adverse consequences for mental and physical health if prolonged. Internet-based interventions (IBIs) for self-help have proven to be effective for a variety of psychological disorders. Due to several specific aspects, IBIs are also a relevant option for loneliness. This systematic review aims to present the current research on self-help IBIs for reducing loneliness.

Methods: A systematic literature search was conducted in the databases Web of Science, PubMed, Scopus, PsycInfo, MedLine, PsycIndex, Cochrane Library and PsyArXiv between December 2023 and early January 2024. We included original German or English studies that addressed IBIs for self-help to reduce loneliness.

Results: In total, eight studies published between 2017 and 2024 were included in the qualitative analysis. All studies were conducted in high-income countries, included predominantly well-educated female adults and were mostly satisfactory regarding their internal validity.

Discussion: The results of this review suggest that self-help IBIs may be a promising option for alleviating loneliness. However, the work also points to the need for further research. Future studies should consider larger samples and people of different ages, genders and education levels in order to generalise the results of the present review.

Background: Loneliness is widespread and has negative health consequences. The present study seeks to answer the following questions: (1) how many people in Germany are highly lonely, (2) how has loneliness changed in Germany over time-in particular with regard to the COVID-19 pandemic, and (3) how is loneliness distributed regionally in Germany today?

Methods: The present study uses data from the 2013, 2017, and 2021 waves of the Socio-Economic Panel, a population representative panel study from Germany. Based on the University of California, Los Angeles (UCLA) loneliness scale, we estimate prevalences for high loneliness for different risk groups in Germany. Further, using multi-level models, we estimate the changes in loneliness from 2013 to 2021. Finally, we generate regional maps to display the relative regional distribution of loneliness in Germany over the three assessment waves.

Results: The results show that around 2% of all people living in Germany are highly lonely, and this proportion has not changed during the COVID-19 pandemic. However, mean overall loneliness in Germany increased in the last decade, particularly during the pandemic. Additionally, the regional distribution of loneliness also changed. While eastern Germany was particularly affected by loneliness in 2013, western Lower Saxony, Rhineland-Palatine, and Hesse were the most affected regions during the pandemic.

Discussion: Reasons for these changes could be structural changes in the German society over the past 10 years or the COVID-19 pandemic and the different measures implemented to combat the spread of the COVID-19 virus. However, since the latest representative data on loneliness stems from 2021, further data collection is urgently needed to depict the current state of loneliness in Germany.

Background: Recent studies show the high prevalence of child maltreatment in Germany and that assaults by hospital staff also pose a problem. Since 2020, the Joint Federal Committee has been calling for institutional safeguarding measures (ISM) to protect and support those affected in hospitals. The aim of this study is to analyze the level of knowledge and action competencies regarding child maltreatment among hospital staff and the extent to which ISM are implemented in hospitals.

Methods: A survey was administered to 1011 participants before they took part in two online courses on child protection and protection measures in hospitals, with questions regarding self-assessed level of knowledge and competence on child protection and the occurrence of cases of maltreatment and protective measures in their own institution. Data were analyzed using descriptive methods.

Results: It becomes apparent that the knowledge and competencies of hospital staff regarding child protection are in the middle range. In hospitals, cases of maltreatment that occur outside the institution are particularly common, but violence by staff or other patients of the same age also plays a significant role. Of the respondents, 93.6% stated that their institution had already developed at least one element of an ISM, but only 1.0% of respondents reported that all the elements surveyed had already been fully developed.

Discussion: Hospitals in Germany seem to be largely on the path to better protect children and adolescents from maltreatment and to support those affected. However, there are still deficits in the competencies of employees and the implementation of the ISM elements. More resources need to be made available by hospital operators and the public sector for this purpose.

Loneliness is a relatively new topic in the field of health and social policy. A pivotal requirement for the formulation of effective policies addressing loneliness in Germany lies in the access to comprehensive, longitudinal data.In 2024, the first "Loneliness Barometer" was conducted by the Loneliness Network Germany (KNE) at the Institute for Social Work and Social Pedagogy e. V. (ISS e. V.) on behalf of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ). It is a report on the long-term development of loneliness within the German population (18 years and older), for which representative data from the German Socio-Economic Panel (SOEP, 1992-2021) were analysed. The loneliness barometer is also intended to provide evidence-based statements on the long-term development of loneliness burdens in Germany in the future.This article provides an insight into the decisions made in the development of the Loneliness Barometer methodology and presents selected key findings from the first Loneliness Barometer. Leveraging data from the German Socio-Economic Panel (SOEP), the Loneliness Barometer underscores the multifaceted disparities faced by individuals grappling with heightened loneliness levels. These disparities manifest across various domains: diminished health outcomes, constrained social and financial resources encompassing education and employment, reduced economic participation, curtailed political engagement and heightened scepticism towards democratic institutions. The article concludes with considerations of the limitations and future development possibilities of the Loneliness Barometer.

Mit dem Begriff Fatigue werden Zustände ungewöhnlicher Müdigkeit und Erschöpfung beschrieben, die in Zusammenhang mit verschiedenen körperlichen Erkrankungen, insbesondere bei Krebs, multipler Sklerose, Parkinson und rheumatoider Arthritis, auftreten können. Im Gegensatz zu Erschöpfungszuständen bei Gesunden ist diese Form der Fatigue dadurch gekennzeichnet, dass sie über längere Zeiträume andauern kann, in keinem angemessenen Verhältnis zu vorangehenden Aktivitäten steht und sich durch Erholungsphasen nicht zurückbildet. Diese Form der Müdigkeit wird als ein multidimensionales Problem beschrieben, das physische, emotionale und kognitive Aspekte umfasst und mit einem hohen subjektiven Leidensdruck verbunden ist. Je nach Ausprägung und Verlauf der Symptomatik führt Fatigue zu einer starken Beeinträchtigung der Lebensqualität und schränkt die Teilhabe und Alltagsbewältigung ein. Ebenso kommt es häufig zu Einschränkungen der Arbeits- und Erwerbsfähigkeit. Wenngleich die Ursachen der Fatigue immer noch nicht vollständig geklärt sind, ist die Fatigue in Zusammenhang mit körperlichen Erkrankungen vor dem Hintergrund eines multifaktoriellen biopsychosozialen Modells zu verstehen. Die Möglichkeiten der Diagnostik und eine Übersicht über verschiedene Verfahren zur Abklärung der Fatigue werden dargestellt. Ebenso werden die Herausforderungen für die medizinische Versorgung skizziert und Hinweise für den Umgang im klinischen Alltag gegeben.