Skip to main content

Advertisement

SpringerLink
Log in

Lebensstiländerungen zur Förderung der kardiovaskulären Gesundheit in Deutschland und Schweden

Eine qualitative Interviewstudie

Lifestyle modification programs protecting cardiovascular health in Germany and Sweden

A qualitative interview study

  • Originalien und Übersichten
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Die Zunahme chronischer Erkrankungen in Europa, die durch angemessene Verhaltensweisen minimiert werden könnte, erfordert die konsequente Umsetzung evidenzbasierter Präventionsempfehlungen. Die Präventionsstrategien innerhalb der Mitgliedsstaaten der Europäischen Union unterscheiden sich jedoch aufgrund der unterschiedlichen Gesundheitssysteme zum Teil enorm. Schwedischen Gesundheitsförderungskonzepten wurde in diesem Zusammenhang wiederholt Modellcharakter zugesprochen. Vor dem Hintergrund der epidemiologischen Bedeutung von Herz-Kreislauf-Erkrankungen erfolgte in der vorliegenden explorativen Interviewstudie ein Vergleich zwischen Verhaltensmodifikationsprogrammen in Deutschland und Schweden. In der qualitativen Datenanalyse zeigt sich, dass in der Betreuung von Hochrisikogruppen für kardiovaskuläre Ereignisse zunehmend aus verschiedenen Verhaltensebenen (Nikotinkonsum, körperliche Aktivität, Ernährung, psychosoziale Faktoren) resultierende Risiko- sowie Protektivfaktoren Berücksichtigung finden. Zur Bewältigung dieser Herausforderung findet vorrangig die individuelle Verhaltensprävention Anwendung. Diese wird insbesondere in Schweden zunehmend durch verhältnispräventive Ansätze ergänzt. Da betroffene Menschen zunehmend ambulant versorgt werden, ist eine systematische Vernetzung der einzelnen Gesundheitsexperten erforderlich. Das Modell des gesundheitsfördernden Krankenhauses bildet in diesem Zusammenhang eine Schnittstelle zwischen verschiedenen Akteuren des Gesundheitswesens, die es gilt zu nutzen, um synergistische Effekte der Verhaltens- und Verhältnisprävention zu erzielen.

Abstract

A large amount of evidence, including neurohumoral, inflammatory, and metabolic physiological adaptations, emphasize the importance of the individual lifestyle as a public health concern. The related burden of chronic diseases in the European Union, which could be minimized by appropriate lifestyles, requires consistent transfer of evidence-based prevention guidelines. Due to the epidemiologic importance of cardiovascular diseases and innovative health-promoting strategies in Sweden, a comparative analysis between German and Swedish practices preventing cardiovascular events in high-risk populations is presented in this paper. This qualitative analysis demonstrates that lifestyle-related risk and protective factors based on smoking, physical activity, nutrition, and psychosocial determinants are of growing importance in cardiac death prevention. Especially in Sweden, behavioral prevention is joined by condition prevention. In Germany, intersectoral rehabilitation concepts improve patient adherence to behavioral recommendations but interdisciplinary communication between different health experts needs to be improved. The health-promoting hospital composes a health professional’s interface, which is based on the understanding that behavioral risk factors are not only highly interrelated, but also require sophisticated healthcare delivery to optimize health management effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Notes

  1. KHK: koronare Herzkrankheit.

Literatur

  1. Djousse L, Driver JA, Gaziano JM (2009) Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA 302:394–400

    Article  CAS  PubMed  Google Scholar 

  2. Rozanski A, Blumenthal JA, Davidson KW et al (2005) The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol 45:637–651

    Article  PubMed  Google Scholar 

  3. Graham I, Atar D, Borch-Johnsen K et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J 28:2375–2414

    Article  PubMed  Google Scholar 

  4. Rechel B, McKee M (2009) Health reform in central and eastern Europe and the former Soviet Union. Lancet 374:1186–1195

    Article  PubMed  Google Scholar 

  5. Meyer C, Muhlfeld A, Drexhage C et al (2008) Clinical research for patient empowerment – a qualitative approach on the improvement of heart health promotion in chronic illness. Med Sci Monit 14:CR358-CR365

    PubMed  Google Scholar 

  6. Mayring P (2000) Retirement as crisis or good fortune? Results of a quantitative-qualitative longitudinal study. Z Gerontol Geriatr 33:124–133

    Article  CAS  PubMed  Google Scholar 

  7. Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952

    Article  PubMed  Google Scholar 

  8. Bellman C, Hambraeus K, Lindback J, Lindahl B (2009) Achievement of secondary preventive goals after acute myocardial infarction: a comparison between participants and nonparticipants in a routine patient education program in Sweden. J Cardiovasc Nurs 24:362–368

    PubMed  Google Scholar 

  9. Horch K, Hölling H, Klars G et al (2009) Evaluating the health target „Increasing health competence, strengthening patient sovereignty“. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 52:889–896

    CAS  Google Scholar 

  10. Klars G, Kramer T (2010) Activities of the consortium Gesundheitsziele.de concerning the health target „Reduce tobacco consumption“. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 53:103–107

    Article  CAS  Google Scholar 

  11. Kroger C, Mons U, Klars G et al (2010) Assessing the health target „Reduce tobacco consumption“. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 53:91–102

    Article  CAS  Google Scholar 

  12. Maschewsky-Schneider U, Klars G, Ryl L et al (2009) gesundheitsziele.de. Results of criteria analysis to select a new health target in Germany. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 52:764–774

    Article  CAS  Google Scholar 

  13. Stewart S, Blue L, Walker A et al (2002) An economic analysis of specialist heart failure nurse management in the UK; can we afford not to implement it? Eur Heart J 23:1369–1378

    Article  CAS  PubMed  Google Scholar 

  14. Iestra JA, Kromhout D, Schouw YT van der et al (2005) Effect size estimates of lifestyle and dietary changes on all-cause mortality in coronary artery disease patients: a systematic review. Circulation 112:924–934

    Article  CAS  PubMed  Google Scholar 

  15. Peter R, Siegrist J, Hallqvist J et al (2002) Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP study. J Epidemiol Community Health 56:294–300

    Article  CAS  PubMed  Google Scholar 

  16. Siegrist J (2001) Psychosocial factors influencing development and course of coronary heart disease. Herz 26:316–325

    Article  CAS  PubMed  Google Scholar 

  17. Kivimaki M, Virtanen M, Elovainio M et al (2006) Work stress in the etiology of coronary heart disease – a meta-analysis. Scand J Work Environ Health 32:431–442

    PubMed  Google Scholar 

  18. Albus C, Siegrist J (2005) Primary prevention-psychosocial aspects. Z Kardiol 94(Suppl 3):III/105–III/112

    Article  PubMed  Google Scholar 

  19. Kotseva K, Wood D, De BD et al (2009) Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 373:929–940

    Article  PubMed  Google Scholar 

  20. Walther C, Gaede L, Adams V et al (2009) Effect of increased exercise in school children on physical fitness and endothelial progenitor cells. A Prospective randomized trial. Circulation 120:2251–2259

    Article  PubMed  Google Scholar 

  21. Reinehr T, Schaefer A, Winkel K et al (2010) An effective lifestyle intervention in overweight children: findings from a randomized controlled trial on „Obeldicks light“. Clin Nutr 29:331–336

    Article  CAS  PubMed  Google Scholar 

  22. Pelikan JM, Krajic K, Dietscher C (2001) The health promoting hospital (HPH): concept and development. Patient Educ Couns 45:239–243

    Article  CAS  PubMed  Google Scholar 

  23. Anand SS, Islam S, Rosengren A et al (2008) Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. Eur Heart J 29:932–940

    Article  PubMed  Google Scholar 

  24. CasalinoLP (2005) Disease management and the organization of physician practice. JAMA 293:485–488

    Article  Google Scholar 

  25. Coulter A, Ellins J (2007) Effectiveness of strategies for informing, educating, and involving patients. BMJ 335:24–27

    Article  PubMed  Google Scholar 

  26. Brotons C, Bjorkelund C, Bulc M et al (2005) Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med 40:595–601

    Article  PubMed  Google Scholar 

  27. Kolip P (2008) Gender sensitive health promotion and prevention. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 51:28–35

    Article  CAS  Google Scholar 

  28. Horowitz CR, Robinson M, Seifer S (2009) Community-based participatory research from the margin to the mainstream: Are researchers prepared? Circulation 119:2633–2642

    Article  PubMed  Google Scholar 

  29. Riegel B, Moser DK, Anker SD et al (2009) State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation 120:1141–1163

    Article  PubMed  Google Scholar 

  30. Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114:e385–e484

    Article  PubMed  Google Scholar 

  31. Wood DA, Kotseva K, Connolly S et al (2008) Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial. Lancet 371:1999–2012

    Article  CAS  PubMed  Google Scholar 

  32. Meyer C, Rassaf T, Schauerte P et al (2008) Health management as global challenge. Beyond the 19th world conference on health promotion and education. J Public Health (Bangkok) 16:71–73

    Article  Google Scholar 

  33. Meyer C, Schueller P, Rodenbeck A et al (2009) Primary and secondary prevention of ventricular arrhythmias in dilated cardiomyopathy. Int Heart J 50:741–751

    Article  PubMed  Google Scholar 

  34. Johnstone PL (2004) Mixed methods, mixed methodology health services research in practice. Qual Health Res 14:259–271

    Article  PubMed  Google Scholar 

  35. Davison SN, Simpson C (2006) Hope and advance care planning in patients with end stage renal disease: qualitative interview study. BMJ 333:886

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    C. Meyer M.A., C. Heiss, M. Kelm & T. Rassaf

  2. EUMAHP-Konsortium, FB Sozial- und Gesundheitswesen der Fachhochschule Magdeburg-Stendal, Magdeburg-Stendal, Deutschland

    E. Göpel

  3. Institut für Medizinische Soziologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland

    J. Siegrist

Authors
  1. C. Meyer M.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Göpel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Siegrist
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Heiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Kelm
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. Rassaf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Meyer M.A..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, C., Göpel, E., Siegrist, J. et al. Lebensstiländerungen zur Förderung der kardiovaskulären Gesundheit in Deutschland und Schweden. Bundesgesundheitsbl. 54, 213–220 (2011). https://doi.org/10.1007/s00103-010-1202-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00103-010-1202-0

Schlüsselwörter

Keywords

Search

Navigation