Chair of Medical Sociology
Short description
The Chair of Medical Sociology was newly established at the Faculty of Medicine at the University of Cologne in February 2023 and is led by Prof. Dr. Lena Ansmann.
We examine medical sociological issues in the field of health care and conduct research at the intersection between medical sociology and health services research.
The chair is dedicated to three central areas of research:
- Research into complex environments and contexts of health care at the micro level (individual and interaction), meso level (organizations), and macro level (society). The focus is primarily on the meso level, i.e. organization-related health services research.
- Studies on the design and framework conditions of person-centered healthcare, with a particular focus on staff-patient interaction.
- Analyses of social inequalities in health care.
Our interdisciplinary team uses a broad spectrum of methodological approaches in empirical social research. Our expertise includes a variety of qualitative and quantitative methods and their integration in mixed-method designs. Our expertise also includes methods for the careful evaluation and implementation of complex interventions in healthcare. We are continuously working on the further development of methods for our areas of research. In addition, we have expertise in the application of theories related to medical sociology, organizational research, and health services research. This methodologically pluralistic and theory-based approach enables us to gain profound insights into the complex interrelationships within healthcare.
In regards to our teaching, we train students of Medicine, Health Services Research, and Health Economics at the Medical Faculty of the University of Cologne in the subject of Medical Sociology and in the cross-sectional area of Prevention and Health Promotion.
Team
Prof. Dr. Lena Ansmann
Chair of Medical Sociology
Saskia Blütgen
Research associate
Dr. Ibrahim Demirer
Research associate
Dr. Thilo Dietz
Research associate
Till Hansen
Research associate
Tamara Schwertel
Research associate
Dr. Anna Zinkevich
Research associate
Projects
Scientific project management of the external evaluation
Operatival project management
Administrative project management
Projektbeschreibung
Background
Patient surveys are an important and informative tool for improving patient and health care. Every year, breast centers in North Rhine-Westphalia participate in a mandatory patient survey using a standardized, validated questionnaire as part of the (re)certification process according to the requirements catalog “Procedures for the Certification of Breast Centers in North Rhine-Westphalia.” Since 2006, the Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR) of the Faculty of Human Sciences and Medicine at the University of Cologne has surveyed patients with primary breast carcinoma who have undergone surgery in one of the North Rhine-Westphalian breast centers certified by the Medical Association of Westphalia-Lippe. The survey takes place every year over a period of six months.
Survey instrument
The survey instrument and data collection procedure were developed by the “Quality Development” working group – an association of all partners in the concerted action against breast cancer in NRW – in collaboration with the Department of Medical Sociology at Cologne University Hospital. A pretest indicated that the Cologne Patient Questionnaire – Breast Cancer (KPF-BK) and the procedure are well suited for the annual routine examination (see EBZ study).
In developing the questionnaire, relevant modules of the Cologne Patient Questionnaire (KPF) were selected and supplemented with additional breast cancer-specific questions. The breast cancer-specific Cologne Patient Questionnaire (KPF-BK) includes modules on hospital organization, doctor-patient and nurse interaction, patient information and satisfaction.
Data collection procedure
Data is collected through a postal survey of patients who have undergone primary breast cancer surgery in one of the certified breast cancer centers in North Rhine-Westphalia and have a confirmed diagnosis and at least one postoperative histology. The Cologne Patient Questionnaire – Breast Cancer (KPF-BK) is distributed between February 1 and July 31 of each year.
Shortly before discharge from the breast centers, patients are asked if they are willing to participate in the survey. The corresponding consent forms are sent to IMVR at the end of a week. The survey takes place the following week by post, i.e. the patient receives the questionnaire at home from IMVR after discharge.
Results
The data are collected at IMVR, quality-assured and then evaluated. The institute is committed to strict compliance with EU data protection regulations. Item parameters and response rates are reviewed as part of the quality assurance process. The mean values (on a scale of 1 to 6) of the validated scales used and the frequencies of selected individual items are then calculated for each breast center. The data are analyzed using SPSS and STATA statistical software.
The heads of the operative sites of the breast centers receive the results of the data annually in the form of a report. The results can be used from a clinical breast center perspective to monitor treatment success and symptoms over time to improve the quality of care for breast cancer patients.
Follow-up-Study
Breast cancer patients who participated in the routine survey can also give their consent to participate in a follow-up survey. In this follow-up study, breast cancer patients are asked again in writing about their experiences 12 months after breast cancer surgery. The goal of the study is to examine the quality of life and long-term needs of breast cancer patients.
Information on nutrition
In cooperation with the Center for Integrated Oncology (CIO) Cologne-Bonn, an information fact sheet on nutrition for breast cancer patients was developed.
Publications
- Lubasch, J.S.; Lee, S.; Kowalski, C.; Beckmann, M.; Pfaff, H.; Ansmann, L. Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study. Int. J. Environ. Res. Public Health 2021, 18, 8224. https://doi.org/10.3390/ijerph18158224
- Cecon, N., Pfaff, H., Lee, S., Dresen, A., Gross, S.E. Development of the health behaviour scale for cancer patients (HBSCP), analysis of its factorial structure and evaluation of its psychometric properties. European Journal of Cancer Care 2021. https://doi.org/10.1111/ecc.13386
- Cecon, N., Pfaff, H., Lee, S., Dresen, A. A salutogenic model predicting the need for psycho‐oncological care and its utilisation – The role of generalised resistance resources and sense of coherence. European Journal of Cancer Care 2020. https://doi.org/10.1111/ecc.13335
- Groß, S.E., Weidner, D., Cecon, N. et al. Does basic information concerning nutrition improve the information needs of breast cancer patients? An evaluation. Support Care Cancer 2020. https://doi.org/10.1007/s00520-020-05385-1
- Scheibler, F., Pfaff, H., Kowalski, C., Ansmann, L. Shared Decision Making in Brustzentren in NRW: Ergebnisse einer 10-Jahres-TrendanalyseShared decision making in breast care centres in North Rhine-Westphalia: Results of a 10-year trend analysis. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 2019. https://doi.org/10.1016/j.zefq.2019.09.003
- Lee, S., Groß, S.E., Pfaff, H., Dresen, A. Waiting time, communication quality, and patient satisfaction: An analysis of moderating influences on the relationship between perceived waiting time and the satisfaction of breast cancer patients during their inpatient stay. Patient Education and Counseling 2019; DOI: 10.1016/j.pec.2019.11.018
- Lee, S., Groß, S.E., Pfaff, H., Dresen, A. Waiting time, communication quality, and patient satisfaction: an analysis of moderating influences of perceived long waiting time on the satisfaction of breast cancer patients during their inpatient stay. Patient Education and Counseling 2019; DOI: 10.1016/j.pec.2019.11.018
- Lee, S., Groß, S.E., Pfaff, H., Dresen, A. Differences in perceived waiting time by health insurance type in the inpatient sector: an analysis of breast cancer patients in Germany. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:1-11. DOI: 10.1177/0046958019875897.
- Nowak, M., Lee, S., Karbach, U., Pfaff, H., Groß, S.E. Short length of stay and the discharge process: Preparing breast cancer patients appropriately. Patient Education and Counseling 2019. DOI: 10.1016/j.pec.2019.08.012.
- Barteldrees, K.; Pfaff, H.; Groß, S. E.; Ansmann, L.: Gibt es einen Zusammenhang zwischen den Auditergebnissen und den Patientinnenerfahrungen in Brustzentren in Nordrhein-Westfalen? (Is there an association between audit results and patient experiences at breast centres in North Rhine-Westphalia?). Das Gesundheitswesen. DOI: 10.1055/a-0795-3388.
- Diekmann, A.; Heuser, C.; Ernstmann, N.; Geiser, F.; Groß, S. E.; Midding, E.; Pfaff, H.; Ansmann, L.: How do breast cancer patients experience multidisciplinary tumor conferences?– A description from the patient perspective. The Breast. 44:66-72. DOI: 10.1016/j.breast.2018.12.012.
Scientific project leaders
Operative project management (IMVR)
Project team (IMVR)
Student assistant (IMVR)
Duration
Funding institution
Projektbeschreibung
Oncological disease, its treatment and associated side effects are a major burden for patients and can significantly reduce their quality of life. Numerous studies have shown the potential of regular exercise therapy as a supportive measure during and after cancer. Individualized exercise reduces side effects and improves quality of life. However, the provision of exercise therapy is still inadequate across Germany. Patients are often highly stressed and uncertain due to the many disease-related side effects and usually do not receive enough information about the benefits and opportunities of exercise in the context of their oncological care.
The collaborative project MOVE-ON(KO), funded by the German Cancer Aid, aims to enable patient referral into cancer-specialized exercise programs. Together with the project management in Heidelberg (PD. Dr. Joachim Wiskemann) and seven locations in three model regions (Rhine-Main-Neckar, Berlin-Dresden, and Black Forest region), innovative and specific exercise counselling and guidance will be implemented as a new component of oncological care. As a basis, oncology professionals will be sensitized to the topic of exercise and exercise guides and experts will be trained. In addition, a digital information and communication platform will be developed to facilitate the exchange between specialists and patients. The aim of the study is to improve physical activity-related health competences of healthcare professionals and patients and to facilitate the transition from clinical oncology care to quality-assured sport and exercise therapy services.
An essential component of MOVE-ON(KO) is the scientific evaluation of structures and processes at the participating sites as well as of the implementation success and the effects of the multiprofessional care approach. The evaluation is carried out by the Chair of Medical Sociology at the IMVR (Prof. Dr. Lena Ansmann) together with the University of Heidelberg (Prof. Dr. Michel Wensing) in an accompanying mixed-methods study in three phases.
The final roll-out phase will test nationwide provision and accessibility in Germany and extend the range of exercise oncology services to other target groups (paediatrics) and sectors.
More information on the project is available at move-onko.de (https://move-onko.de/), as well as in a press release on the MOVE-ON(KO) and IMPLEMENT projects: https://www.presseportal.de/pm/116010/5574988
Scientific project leaders
Operative project management (IMVR)
Duration
Funding institution
Projektbeschreibung
The interdisciplinary research project INHECOV aims to investigate the direct and indirect effects of the COVID-19 pandemic on health inequalities and to derive concrete options for future pandemic planning.
The IMVR is involved in INHECOV with a subproject led by Prof. PD. Dr. Timo-Kolja Pförtner and in collaboration with Dr. Ibrahim Demirer on the indirect effects of the COVID-19 pandemic on health inequality.
The subproject “Health inequality due to precarious employment in the context of indirect effects of non-pharmaceutical interventions” addresses, among other things, the social and health consequences of non-pharmaceutical interventions for precarious workers. It will examine whether health inequalities have increased as a function of precarious employment status during the pandemic, the health impact of the social consequences of non-pharmaceutical interventions on precarious workers, and the impact of pandemic-related job loss on the health of precarious workers.
A description of all sub-projects can be found on the project website.
The following publications from the subproject have already been published:
- Demirer, I., Pförtner, TK. (2023): The Covid-19 pandemic as an accelerator of economic worries and labor-related mental health polarization in Germany? A longitudinal interacted mediation analysis with a difference-in-difference comparison. SSM – population health 23, S. 101469. https://doi.org/10.1016/j.ssmph.2023.101469
- Pförtner, TK., Demirer, I. (2023): Erwerbsarmut und subjektive Gesundheit während der COVID-19-Pandemie: Eine Zeitvergleichsstudie mit Daten des Soziooekonomischen Panels 1995–2021. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. https://doi.org/10.1007/s00103-023-03734-z.
- Pförtner, TK., Dohle, S. & Hower, K.I. (2022). Trends in educational disparities in preventive behaviours, risk perception, perceived effectiveness and trust in the first year of the COVID-19 pandemic in Germany. BMC Public Health 22, 903. https://doi.org/10.1186/s12889-022-13341-3