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Dr. Maria-Dorothea Heidler

Diplom-Sprechwissenschaftlerin &

Fachtherapeutin für Kognitives Training

 


Postanschrift:

Dr. Maria-Dorothea Heidler

Brandenburg Klinik

Neurologisches Rehabilitationszentrum (NRZ-N1)

Johann-Strauß-Str. 4

16321 Bernau-Waldsiedlung

Email:heidler@brandenburgklinik.de

 

 


Vita

 

1991-1996: Studium der Sprechwissenschaft an der Humboldt-Universität zu Berlin (Institut für Rehabilitationswissenschaften)

seit 1996: Tätig als akademische Sprachtherapeutin in der neurologischen Abteilung der Brandenburg Klinik (Bernau-Waldsiedlung)

2004: Ausbildung zur "Fachtherapeutin für Kognitives Training" an der Akademie für Kognitives Training nach Dr. med. Franziska Stengel in Stuttgart

2005: Promotion zum Thema "Kognitive Dysphasien" an der Humboldt-Universität zu Berlin

2008: Gründungsmitglied der Communication Academy Berlin www.communication-academy.org

2012-2017: Wissenschaftliche Mitarbeiterin an der Professur für Rehabilitationswissenschaften an der Universität Potsdam

 

 

Salzwedel, A., Heidler, M.-D., Meng, K., Schikora, M., Wegscheider, K., Reibis, R. & Völler, H. (2019): Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event. European Journal of Preventive Cardiology, 26 (1), 46-55

 

Abstract

Background: Although associations between cardiovascular diseases and cognitive impairment are well known, theimpact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far.

Design: Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation.

Method: At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.5_6.3 years, 80% men) following an acute coronary syndrome and/or coronary artery bypass graft was tested using the Montreal Cognitive Assessment. Patients’ disease-related knowledge was determined using a quiz (22 items for medical knowledge and 12 items for healthy lifestyle and behaviour) at both times and at follow-up. The change in knowledge after cardiac rehabilitation was analysed in multivariable regression models. Potentially influencing parameters (e.g. level of education, medication, cardiovascular risk factors, coronary artery bypass graft, comorbidities, exercise capacity) were considered.

Results: During cardiac rehabilitation, disease-related knowledge was significantly enhanced in both scales. At follow-up, the average level of medical knowledge was significantly reduced, while lifestyle knowledge remained at a stable level. The maintenance of knowledge after cardiac rehabilitation was predominantly predicted by prior knowledge, cognitive performance at discharge from cardiac rehabilitation and, in the case of medical knowledge, by coronary artery bypass graft.

Conclusion: Patient education in cardiac rehabilitation led to enhanced disease-related knowledge, but the maintenance of this essentially depended on patients’ cognitive performance, especially after coronary artery bypass graft. Therefore, patient education concepts in cardiac rehabilitation should be reconsidered and adjusted as needed.


 

Heidler, M.-D. (2019): Dysphagie bei tracheotomierten Patienten nach Langzeitbeatmung. Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie, 54, 218-222

 Zusammenfassung: Unabhängig von der Art der kritischen Erkrankung haben tracheotomierte Patienten ein hohes Risiko für die Entwicklung einer Schluckstörung. Diese ist potenziell lebensbedrohlich, da sie zu Aspiration und Pneumonie führen kann. Vor einer oralen Nahrungsgabe sollte daher unbedingt eine Schluckdiagnostik mittels Bolusfärbetest und/oder FEES durchgeführt werden. Da ein physiologischer Luftstrom durch den Larynx und ein adäquater subglottischer Druck Schlüsselkomponenten eines effektiven Schluckaktes sind, sollte eine Oralisierung bei geblockter Trachealkanüle möglichst vermieden werden.

 Abstract: Independent of the type of critical illness, tracheostomized patients have a high risk of developing a dysphagia. This is potentially life-threatening as it can lead to aspiration and pneumonia. It is therefore essential to perform swallowing diagnostics by means of a bolus dyeing test and / or FEES before oral feeding. Since a physiological airflow through the larynx and adequate subglottic pressure are key components of an effective swallowing act, oralisation should be avoided as far as possible with a blocked tracheal cannula.