The Early Intervention in the Workplace (friaa) project is funded by the Federal Ministry of Education and Research (BMBF, funding code: BMBF-01GX1902A) and will be realised over a period of 4 years.

A total of 8 co-operation partners throughout Germany are involved in the friaa project, with the project being coordinated at the Ulm site. The aim of friaa is to develop and manualise a modularised work-related psychotherapeutic intervention as a first step.

The aim of the intervention is to reach employees with psychological stress as early as possible in order to provide them with work-related psychotherapy. One aim of work-related psychotherapy is, if possible, to ensure that they remain in employment or to facilitate their return to work. In addition to the extraordinarily early intervention, a special feature is the networking of prevention, acute care and rehabilitation for the care of mentally ill employees.

The intervention is being carried out at five locations (Berlin/Teltow, Düsseldorf, Erlangen, Hildesheim and Ulm). The intervention will be publicised via various regional networks, such as chambers of industry and commerce and company doctors. A total of almost 520 people from small, medium-sized and large companies from as many different sectors as possible are to be recruited to take part in the intervention. The Institute of Medical Biometry and Informatics at Heidelberg University Hospital will act as a co-operation partner to ensure compliance with the highest standards of clinical studies. In addition to the clinical evaluation of the intervention, a health economic evaluation of the intervention will be carried out by the Department of Psychiatry and Psychotherapy II (Günzburg/Ulm), as well as a formative evaluation by the Federal Institute for Occupational Safety and Health (BAuA, Berlin).

• Clinic for Psychiatry and Psychotherapy II, Günzburg

• Institute for Occupational, Social and Environmental Medicine at the University of Düsseldorf

• Department of Psychosomatics and Behavioural Therapy, Seehof Rehabilitation Centre and Psychosomatic Rehabilitation Research Group at Charité - Universitätsmedizin Berlin

• Federal Institute for Occupational Safety and Health, Berlin

• Institute of Psychology at the University of Hildesheim

• Institute for Medical Biometry and Informatics at the University of Heidelberg

• Psychosomatic and Psychotherapeutic Department of the University Hospital Erlangen

2020 - 2024

The "egePan" network is establishing a national pandemic management system to be able to recognise and treat COVID-19 patients even faster and better in future, prevent infections and be prepared for future pandemics. The aim is to monitor local outbreaks and assess them in the context of the overall German and European situation. The network brings together and analyses action plans, diagnostic and treatment strategies of the university hospitals and develops and evaluates concepts.

The overarching objectives are to ensure adequate resource management within the regions and to safeguard the healthcare system's ability to act in the face of rising infection rates and growing numbers of patients requiring hospitalisation. Maintaining or restoring the ability to work and the physical and mental health of medical staff is a key prerequisite for successfully coping with the Covid-19 pandemic and possible future pandemics. The EVIPan project therefore aims to safeguard the health of medical staff during the pandemic. The VOICE sub-project, a collaboration between the university hospitals in Ulm, Erlangen, Bonn, Cologne and Dresden, has recently completed the fourth web-based survey wave on mental stress, work stress, health and personal resources of medical staff.

Health, the development and progression of illnesses are determined by very different factors. The professional environment in particular shapes a large number of these factors, both in a positive sense, such as the opportunity to experience recognition, to be creative and productive, to establish social contacts and to use them as a resource for coping with stressful situations. But also in a negative sense, for example when the modern, condensed world of work consisting of diverse demands creates feelings of excessive demands or alienation. However, especially in the diverse working areas of hospitals and clinics, which have undergone enormous change in recent decades, particularly in terms of working conditions, for example due to cost-cutting measures, there is a lack of systematic occupational health management that can favourably influence the various factors at different levels.

The aim of this two-stage collaborative project is to develop a complex intervention based on behavioural and behavioural prevention measures, test its effectiveness and put it into practice.

In Phase I (2 years), the following five intervention modules (sub-projects 1.A-E) will be developed individually, evaluated differently depending on the format and study situation, and strategies for their subsequent implementation will be tested:

Sub-project 1.A: Sensitisation of senior managers (chief physicians and nursing area managers) for occupational health management in the clinic, sub-project located at the Heinrich Heine University Düsseldorf - Centre for Health and Society (CHS) - Institute for Occupational, Social and Environmental Medicine, project management: PD. Dr A. Müller

Sub-project 1.B Ways out of dilemmas that cause illness - dilemma competence for middle managers in the healthcare sector. Sub-project located at the University Hospital of Heidelberg University, Centre for Psychosocial Medicine (ZPM), Institute for Medical Psychology, project management: Prof. Dr J. Schweitzer-Rothers

Sub-project 1.C Strengthening the relationship-preventive and interprofessional leadership skills of middle managers to reduce the psychological stress of their employees in hospital; sub-project located at the Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy, project management: Dr F. Junne

Life-stage-specific interventions in middle and old age:

Sub-project 1.D Improving the compatibility of work and family in hospitals to reduce the psychological stress of those affected and teams, sub-project located at the University Hospital of the University of Ulm, Department of Child and Adolescent Psychiatry and Department of Psychosomatic Medicine and Psychotherapy, project management: Dr Eva Rothermund

Sub-project 1.E Healthy ageing in the nursing profession (GAP) - development and evaluation of an intervention module to promote successful ageing in the profession. Sub-project located at the University Hospital of the Ruprecht-Karls-University Heidelberg, Clinic for General Internal Medicine. Project management: Dr I. Maatouk

Sub-project 2: In Phase II (years 3+4), the participatory implementation of the above-mentioned components into a complex intervention is being carried out at three hospital sites. Their effectiveness in terms of well-being will be evaluated in a cluster-randomised study. The results will be used to produce manuals for future implementation and for discussion at health policy level. Project management Prof Dr Harald Gündel

Sub-project 3: A cross-phase I and II business management sub-project supports the change in the hospitals and develops key figures (e.g. employer attractiveness, productivity) in order to measure the success of behavioural and behavioural prevention measures in terms relevant to decision-makers. Based at Heinrich Heine University Düsseldorf, Chair of Business Administration, in particular Organisation and Human Resources. Project management Prof. Dr Stefan Süß

09/2017 - 09/2021

University Hospital Ulm, Heinrich Heine University Düsseldorf, University Hospital Heidelberg, University Hospital Tübingen

The current situation of the COVID-19 pandemic is unknown to all of us and is associated with various types of stress, especially for employees in the healthcare sector: Overcrowding of intensive care beds due to COVID-19 patients, vacancies in entire wards and surgeries, uncertainty about the course of the pandemic, fears for one's own health, stress due to the difficult work-life balance and many more.

Various studies show that during epidemics such as SARS or MERS, employees in the healthcare professions are under particular strain and are also extremely vulnerable in terms of their mental health. At the same time, however, many of them also have structural, social and very personal resources from which they draw strength and support.

Our multidisciplinary working group from the university hospitals in Erlangen, Bonn and Ulm has developed an online survey in order to record the current stress and resources during the Covid-19 pandemic in a broad sample and thus be able to offer targeted help to affected colleagues during and after the crisis as quickly as possible.

The aim of the study is to identify specific stresses and anxieties in the context of the COVID-19 crisis (e.g. fear of infection, stress due to changes in tasks, etc.) as well as sources of personal resilience in the structural, social and spiritual areas and, if necessary, to record any resulting stress symptoms such as sleep disorders, but also indications of traumatisation, depression, anxiety disorders and their severity. At the same time, working conditions and aspects of work-life balance and resources are to be surveyed. The data will be used to identify possible correlations between stress/resources and mental health/quality of life as well as possible differences between genders/specialisms/settings. We also want to analyse typical courses of coping processes.

To this end, data from two survey waves (spring and late autumn 2020) will be analysed and a third survey wave is planned. At T1 > 8000 participants took part in the survey, at T2 > 6000 participants. Further qualitative interviews are also planned.

Prof. Yesim Erim (spokesperson) and Dr.rer.medic. Dipl. Psych. Dipl. Theol. Eva Morawa, Psychosomatic and Psychotherapeutic Department, University Hospital Erlangen

Prof. Dr med Dipl.-Psych. Franziska Geiser, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy and Prof. Dr med Lukas Radbruch, Clinic for Palliative Medicine, University Hospital Bonn

PD Dr Petra Beschoner and PD Dr bio.hum. Lucia Jerg-Bretzke, Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Hospital

Since mid-April 2020, data has been collected online in anonymised form. The data collected does not allow any conclusions to be drawn about the respective individuals; the longitudinal data is collated using an anonymous code.
A positive ethics vote and approval from the data protection officer have been obtained.

To date, over 5000 employees in the healthcare sector have completed the questionnaire online.

• Prof Dr Christian Albus, Clinic and Polyclinic for Psychosomatics and Psychotherapy, University Hospital Cologne

• Prof Dr Kerstin Weidner, Clinic and Polyclinic for Psychotherapy and Psychosomatics, University Hospital Carl Gustav Carus Dresden

• Prof Dr Christoph Herrmann-Lingen, Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Göttingen

• Prof. Dr Hans Drexler, Institute and Polyclinic for Occupational, Social and Environmental Medicine, Department of Occupational Medicine, University of Erlangen-Nuremberg,

• Prof Eberhard Hauschildt, Institute for Practical Theology, University of Bonn

• Prof. Dr Thomas Kühlein, Institute of General Medicine, University Hospital Erlangen Clinic Forchheim - Franconian Switzerland

• Prof Dr Christian Maihöfner, Neurological Clinic, Fürth Hospital

• Dr Irmgard Pfaffinger, Professional Association of Specialists in Psychosomatic Medicine and Psychotherapy e.V.

• Prof Dr Ceren Acartürk, Koc University Istanbul, Turkey

Scientific studies show that epidemics and pandemics, such as the H1N1 pandemic in 2009, lead to an increase in mental stress among medical staff (Matsuishi 2012, Maunder 2006). Initial data on mental stress among healthcare workers during the SARS-CoV-2 outbreak and the associated coronavirus disease 2019 (COVID-19) in China point in the same direction and report enormous mental stress, including sleep disorders, depression, anxiety disorders (Huang 2020) and post-traumatic stress disorder (Liu 2020, Sun 2020). With regard to predictive factors for high levels of stress, Brooks et al. (2018) identified working conditions such as the type of job, whether there is contact with infected people, measures to prepare employees for the situation (Brooks 2018). Social isolation or social support and loss of control were other specific factors associated with increased psychological stress (Brooks 2018). Medical staff working in areas with a high risk of infection during the SARS epidemic in 2003 were significantly more likely to show symptoms of post-traumatic stress disorder than staff in less risky areas (Wu 2009).

The COVID-19 pandemic is now also posing major challenges for Europe. Due to the rapid increase in infections, far-reaching changes had to be made to work processes in hospitals (emergency operation). The number of COVID-19 patients in hospitals is rising, as is the number of cases requiring intensive care and the number of deaths from COVID-19. This places high demands on healthcare staff. In order to be able to deal with the resulting mental stress and crises both preventively and therapeutically during and after the crisis, a well-founded assessment of the specific stress and prevalence is needed in order to derive targeted offers of help.

2020 - 2021

Current publications (WHO listing)