Gesundheits- und Pflegewissenschaften
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The purpose of this study is to examine the relationship between contextual work-related factors in terms of job demands (workload-WL) and job resources (work flexibility-WF), work-life conflict (WLC) and the burnout dimension emotional exhaustion (EE) in a large population-based sample. Building on the job demands resources model (JDRM), we have developed the hypothesis that WL has an indirect effect on EE that is mediated by WLC. We conducted a secondary analysis using data from the Dresden Burnout Study (DBS, N = 4246, mean age (SD) = 42.7 years (10.5); 36.4% male). Results from structural equation modelling revealed that EE is positively associated with WL (β = 0.15, p = 0.001) and negatively associated with WF (β = -0.13, p = 0.001), also after accounting for potential confounding variables (demography, depressive symptoms, and lifetime diagnosis of burnout). Both effects are mediated by WLC (β = 0.18; p = 0.001 and β = 0.08; p = 0.001, respectively) highlighting the important role of WLC in employee health. In summary, WF may help to reduce burnout symptoms in employees, whereas WL may increase them. Study results suggest that both associations depend on WLC levels.
Abstract: The demand for thorough disinfection within ambulances is essential, given the in-vehicle medical procedures and the potential high risk of infections due to patients' open wounds. One solution that can address this hygiene challenge involves the application of reactive products generated from atmospheric (air) oxygen and water vapor, activated through the use of cold plasma. Cold plasma's charged particles perforate the cell membranes of microorganisms. This process does not work in human cells, as proteins in the form of enzymes within the body break down the cold plasma and protect the cells. The study was done on an ambulance that was contaminated in eight places. Samples were taken from each site, and two surfaces measuring approximately 8 × 8 cm were carefully sealed and marked. These surfaces were deliberately contaminated by applying an Enterococcus faecium suspension of 8.5 × 107 CFU/mL using a sterile cotton swab. It was followed by the disinfection procedure, that was initiated with the PLASMOCAR device. It was positioned on the front workspace and operated for a duration of 30 min, utilizing the vehicle's onboard voltage. Throughout the operation, all doors and windows were closed and the vehicle's air conditioning system remained active. After the completion of the disinfection process, samples were collected from the surfaces for bacterial counts. A reduction of 3.73 log levels in initial bacteria was accomplished within the rescue vehicle for Enterococcus faecium, equivalent to a 10–fourfold reduction in bacteria, eliminating up to 99.99% of the initial microorganisms. This success makes the process well-suited and convenient as an ongoing "background" procedure to enhance the established disinfection procedures. The established disinfection procedures outlined in the hygiene plan must be promptly implemented whenever mechanical surface cleaning is required. The use of PLASMOCAR offers an extra layer of protection and security, significantly decreasing the risk of microorganism transmission through cross-contamination and aerosols. This is a significant benefit for the well-being of both staff and patients.
Sustainable Integration of Digitalisation in Nursing Education - An International Scoping Review
(2024)
Analgesic drug use of recreational and competitive badminton players: Starting points for prevention
(2021)
Objectives: Evidence-based clinical guidelines play an important role in healthcare and can be a valuable source for quality indicators (QIs). However, the link between guidelines and QI is often neglected and methodological standards for the development of guideline-based QI are still lacking. The aim of this qualitative study was to get insights into experiences of international authors with developing and implementing guideline-based QI.
Setting: We conducted semistructured interviews via phone or skype (September 2017–February 2018) with guideline authors developing guideline-based QI.
Participants: 15 interview participants from eight organisations in six European and North American countries.
Methods: Organisations were selected using purposive sampling with a maximum variation of healthcare settings. From each organisation a clinician and a methodologist were asked to participate. An interview guide was developed based on the QI development steps according to the ‘Reporting standards for guideline-based performance measures’ by the Guidelines International Network. Interviews were analysed using qualitative content analysis with deductive and inductive categories.
Results: Interviewees deemed a programmatic approach, involvement of representative stakeholders with clinical and methodological knowledge and the connection to existing quality improvement strategies important factors for developing QI parallel to or after guideline development. Methodological training of the developing team and a shared understanding of the QI purpose were further seen conducive. Patient participation and direct patient relevance were inconsistently considered important, whereas a strong evidence base was seen essential. To assess measurement characteristics interviewees favoured piloting, but often missed implementation. Lack of measurability is still experienced a serious limitation, especially for qualitative aspects and individualised care.
Conclusion: Our results suggest that developing guideline-based QI can succeed either parallel to or following the guideline process with careful planning and instruction. Strategic partnerships seem key for implementation. Patient participation and relevance, measurement of qualitative aspects and piloting are areas for further development.
Trial registration number: German Clinical Trials Registry (DRKS00013006).
Background
Stroke is one of the most frequent causes of death in Germany and the developed countries. After a stroke, those affected often suffer particularly from functional motor restrictions of the upper extremities. Newer techniques such as the BCI-FES systems aim to establish a communication channel between the brain and external devices with a neuromuscular intervention. The electrical activity of the brain is measured, processed, translated into control signals and can then be used to control an application.
Methods
As a mixed-methods design (exploratory design), eight guideline-based expert interviews were conducted first. For the quantitative expert survey, 95 chief physicians from the field of neuromedicine in rehabilitation facilities nationwide were subsequently invited to participate in an online survey.
Results
In our data analysis, we found that doctors are largely open-minded towards new technical rehabilitation systems. In addition to the proper functioning of the system, they consider the understanding of the functionality and the meaningfulness of the system to be particularly important. In addition, the system should be motivating for individuals, generate meaningful movements, be easy to use, evidence-based and quick to set up. Concerns were expressed regarding the understanding of the system’s processes, especially in the acute phase after a stroke, as well as the excessive expectation of results from the system on the part of the persons. The experts named stroke patients in rehabilitation phase C, which is about mobilization and recovery, as well as all persons who can understand the language requirements as benefiting groups of people.
Conclusion
The present study shows that more research should and must be done in the field of BCI-FES interfaces, and various development trends have been identified. The system has the potential to play a leading role in the rehabilitation of stroke patients in the future. Nevertheless, more work should be done on the improvement and implementation as well as the system’s susceptibility to interference in everyday patient life.
Context
VR as an application to enhance well-being is sparsely researched in the elderly population. The aim of the pilot study was to analyze the effect of 360° videos of different categories on the state of mind of seniors in nursing facilities. Furthermore, for the implementation in everyday life, the usability of the system and the experience for seniors should be evaluated.
Methods
The VR experience was used as a supplement to existing care services in three facilities on eight subjects. Mood state was assessed using the Questionnaire for the Assessment of Happiness before and after the intervention. Demographic data and technology acceptance were collected beforehand. After the intervention, subjects were interviewed about confounding factors and side effects, and nursing home staff were interviewed about the usability of the system and the organizational concept of implementation.
Results
There was a positive effect on state of mind. Gender and spatial mobility turned out to be influencing factors. Categories containing people, animals and action achieved the highest increases in the state of mind. Interest in using technical devices correlated negatively with the change in mood state. None of the subjects found the VR goggles distracting or reported motion sickness. Very good usability was indicated by the employees.
Conclusion
A very high willingness to use this technology was found among nursing staff and residents. The tendencies of the positive effect of 360° videos on the state of mind, as well as differentiation based on the mentioned characteristics gender and spatial mobility, should be verified by a larger sample to empirically validate the use of this technology to increase the quality of life.
Hintergrund
Die Studienzeit ist eine Phase, in der die jungen Erwachsenen mit spezifischen Anforderungen konfrontiert werden. Studierende der Medizin gelten als besonders psychisch belastet. Untersuchungen, in denen sie diesbezüglich mit Studienfächern der gleichen Branche verglichen werden, sind jedoch rar.
Fragestellung
Ziel der Untersuchung war es, die psychische Gesundheit von Medizinstudierenden sowie von Gesundheits- und Pflegemanagementstudierenden zu untersuchen und zu vergleichen.
Material und Methoden
Untersucht wurden Studierende der Studiengänge Gesundheits- sowie Pflegemanagement (WHZ) und Medizinstudierende der (TU Dresden). Verschiedene Aspekte psychischer Gesundheit wurden mithilfe eines Online-Fragebogens erhoben. Dieser beinhaltete die Instrumente zur Erfassung der Prüfungsängstlichkeit (TAI-G-Kurzskala) und psychischen Belastung (BSI-18), sowie ein Item zur Ermittlung der subjektiv wahrgenommenen Studienbelastung. 258 Studierende nahmen an der Befragung teil.
Ergebnisse
Es konnten keine signifikanten Unterschiede hinsichtlich des Gesamtscores der Prüfungsängstlichkeit und der psychischen Belastung zwischen den Studierenden beider Studienfächer festgestellt werden. Dahingegen gaben Medizinstudierende an, dass sie im Vergleich zu Studierenden der anderen beiden Studienfächer eine signifikant höhere Studienbelastung wahrnehmen.
Schlussfolgerung
Die ermittelten Gesamtscores lagen teilweise über den Werten in vergleichbaren Studien. Die Studierenden sollten bereits präventiv unterstützt werden, um eigene Bewältigungsstrategien zu entwickeln. Nicht nur die Bereitstellung von Hilfen ist notwendig, sondern vielmehr das aktive Eingreifen mithilfe von gesundheitsfördernden Maßnahmen durch die Institution Hochschule, in die die Studierenden frühzeitig integriert werden sollten.
Introduction: In the spring of 2020, coronavirus disease 2019 posed a substantial challenge for countries and their healthcare systems. In Germany, over 70% of all cancer patients are treated in an outpatient setting, so gynecologic oncology practices are the guarantors of optimal patient care. We developed a survey to evaluate the management of gynecologic oncology patients.
Methods: The survey consisted of 38 questions and was sent to the members of the Berufsverband Niedergelassener Gynäkologischer Onkologen in Deutschland e.V. (BNGO), a professional association of gynecologic oncologists in the outpatient sector in Germany.
Results: The survey was completed by 54 out of 133 (41%) gynecologic oncologists from 14 out of 15 (93%) federal states where the BNGO is represented. Facing the pandemic, popular measures were mask requirements (100%), restriction of access to practices (94%), increased number of disinfectant dispensers (85%), installment of panes of acrylic glass (76%), or spatial alterations (67%). For most patients the pandemic had no influence on prioritization of therapies (82%) or prescribed systemic treatments (87%). Despite an increase in perceived psychological burden among the staff (72%), 85% (45/54) of the practices were not offered any additional psychological support.
Discussion and Conclusion: As most cancer patients in Germany are treated in an outpatient setting, a suitable reaction of oncology centers to the new circumstances was crucial to secure optimal treatment and patient care. Nevertheless, the low prioritization of mental health or distress of healthcare workers poses a serious threat to the maintenance of optimal medical care in further waves of the pandemic.
Hintergrund: Wenn professionelle Unterstützung fehlt, erkennen pflegende Angehörige selten eigene Überlastungssituationen und nehmen Unterstützungsleistungen bei Pflegebedürftigkeit daher unzureichend in Anspruch.
Ziel: Die Studie untersucht die Versorgung von Menschen mit Pflegebedarf, den Kenntnisstand zu Entlastungsleistungen sowie Belastungsfaktoren bei der Übernahme pflegerischer Leistungen aus Sicht informell Pflegender und Nicht-Pflegender.
Methode: Es wurde eine Querschnittstudie mittels standardisierter Computer Assisted Telephone Interviews (CATI) mit Personen ab dem 18. Lebensjahr in Sachsen durchgeführt. Deskriptive und bivariate Statistiken wurden berechnet.
Ergebnisse: Die Versorgung durch einen ambulanten Pflegedienst oder durch pflegende Angehörige bewerteten von 601 Teilnehmenden 259 informell Pflegende gegenüber 342 Nicht-Pflegenden signifikant besser ( N = 601). Weiterhin hatten die informell Pflegenden und die Nicht-Pflegenden unterschiedliche Kenntnisse über den nächstgelegenen Ort der Pflegeberatung und über Ausgleichzahlungen der Rentenversicherung. Schlussfolgerungen: In einzelnen Bereichen der abgefragten Beratungsleistungen und Entlastungsmöglichkeiten hat sich das Antwortverhalten von pflegenden Angehörigen gegenüber den anderen Teilnehmenden signifikant unterschieden. Es kann von einem geringen Informationsvorsprung der pflegenden Angehörigen bei der Inanspruchnahme von Unterstützungsleistungen ausgegangen werden.
This paper describes a project developed to establish strategies to minimize stigmatisation and discrimination related to tuberculosis (TB). The fact that one-third of the worlds\' population is infected by TB supported the need for this project. Stigmatization towards infected people doubles the huge burden of the disease. Strong negative consequences, such as economic, social and psychological impact on individuals\' lives are well documented. Stigma prevents patients from seeking health care attention and prohibits providers from delivering effective treatment and high quality care. To understand the context of TB stigmatisation, a global survey was implemented to collect expert views on the main causes, consequences and methods to reduce TB related stigma. Survey findings influenced the development of strategies to minimize TB related stigma and discrimination, and have been integrated into an information and action toolkit developed for nurses around the world. The toolkit, titled - TB and Stigma: A Double Burden -, will be published by the International Council of Nurses in late 2005. Key methods will be available in the - Global TB/MDR-TB Resource Centre - at the following web link: http://www.icn.ch/tb/index.html
Diese empirische Diplomarbeit in englischer Sprache wirft einen Blick auf den Status Quo des Estnischen HIV/AIDS Präventionssystems und entwirft Hypothesen und Vorschläge, dessen Wirkung zu verbessern. Die Grundlage bilden qualitative Interviews mit Schlüsselpersonen, welche die Phänomene Konsens, Kooperation und Kapazitätenschaffung sowie deren Bedeutung für die Estnische HIV/AIDS Prävention untersuchen. Bei diesen Phänomenen handelt es sich um wichtige und bisher unbestimmte Problemfelder, welche zum Teil den Widerspruch zwischen einer erfolgreichen politischen und ökonomischen Transition Estlands und der hohen HIV Prävalenzrate erklären. Die Ergebnisse dieser Arbeit beziehen sich auf das existierende Qualitätsmanagement von NGOs, die horizontale Kooperation von NGOs und die vertikale Kooperation von Staat und NGOs. Darüber hinaus wird der Aspekt der Führung sowie das Estnische Präventionsprogramm aus Mitteln des Globalen Found zur Bekämpfung von AIDS, Tuberkulose und Malaria betrachtet.