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Background: Currently, to the best of our knowledge, no findings exist concerning the needs of professionals in specialized pediatric palliative care (PPC) regarding electronic health records (EHRs). Several studies have highlighted benefits concerning the use of EHRs in pediatrics. However, usability is strongly affected by the degree of adaptivity to the context of application. The aim of this study is to examine the needs of professionals concerning an EHR in the specialized PPC inpatient and outpatient settings. Methods: A qualitative research design was chosen to address the complex aspects of user demands. Focus group interviews and semi-structured one-on-one interviews were conducted with PPC professionals. N = 23 participants from inpatient and N = 11 participants from outpatient settings of specialized PPC representing various professions took part in the study. Results: The findings could be grouped into four categories: (1) attitude towards the current methods of documentation, (2) attitude towards electronic documentation in general, (3) general requirements for an EHR, and (4) content requirements for an EHR. Conclusions: Professionals in specialized PPC expect and experience many benefits of using electronic documentation. Their requirements for an EHR for inpatient and outpatient settings of PPC are largely consistent with EHRs for pediatrics. However, individual specifications and adaptations are necessary for this particular setting.
Background: Pediatric palliative care (PPC) is characterized by years of multisectoral and multi-professional care. Sharing information between PPC professionals is, therefore, essential for quality care. The evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. Methods: Guided by design thinking, first, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Based on the needs stated in the interviews, prototypes of the ECHR were developed and discussed in the FGs. The indicated needs were supplemented and specified in an iterative process. The prototypes were further adapted according to these results. The unified theory of acceptance and use of technology was the basic model in the evaluation of needs. Results: Across seven main categories, past and current medication, emergency view, and messaging functions were identified as the participants’ desired core components of an ECHR. Utilizing design thinking facilitated the explicit articulation of user needs. Conclusions: Developing an ECHR with the content identified would allow for real-time data during emergencies, tracking what other PPC professionals have done, and making the applied treatments visible to others. This would offer a broader picture of the complex conditions common to PPC.
Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements.
Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.
Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen
(2021)
AbstractMany digital interventions rely on the participation of their users to have a positive impact. In various areas it can be observed that the use of digital interventions is often reduced or fully discontinued by the users after a short period of time. This is seen as one of the main factors that can limit the effectiveness of digital interventions. In this context, the concept of adherence to digital interventions is becoming increasingly important. Adherence to digital interventions is roughly defined as “the degree to which the user followed the program as it was designed,” which can also be paraphrased as “intended use” or “use as it is designed.” However, both the theoretical–conceptual and practical discussions regarding adherence to digital interventions still receive too little attention.The aim of this narrative review article is to shed more light on the concept of adherence to digital interventions and to distinguish it from related concepts. It also discusses the methods and metrics that can be used to operationalize adherence and the predictors that positively influence adherence. Finally, needs for action to better address adherence are considered critically.
BACKGROUND Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. OBJECTIVE In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. METHODS In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. RESULTS The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. CONCLUSIONS The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.
Steigerung der Versorgungsqualität in der Palliativversorgung durch elektronische Gesundheitsakten
(2021)
Haiku of Maladisms
(2021)
This paper presents a seminar concept for the development of communication competence in pre-service vocational education teachers with the aid of video annotations, feedback, and peer microteaching. The seminar is offered within a teacher training program for students taking a master’s degree (MEd) in vocational education at the FH Münster University of Applied Sciences, Germany, and has been conducted three times. The advantages of the seminar concept are manifold. On the one hand, we create a learning environment in which students individually prepare and conduct five peer microteaching lessons in a row and receive prompt and constructive peer feedback on every performance. On the other hand, the quality of feedback improves so that our students are professional feedback providers by the end of the seminar. The provision of teacher feedback alone does not help our students become successful feedback providers. Nor, given the resources available at the university, is it a realistic alternative in terms of time constraints. In addition, due to recordings, the students gain a better insight into their teaching skills since their lessons can be observed and approached from an outside perspective.
Consumption Corridors: Living a Good Life within Sustainable Limits
explores how to enhance peoples’ chances to live a good life in a world of ecological and social limits.
Rejecting familiar recitations of problems of ecological decline
and planetary boundaries, this compact book instead offers a spirited explication of what everyone desires: a good life. Fundamental
concepts of the good life are explained and explored, as are forces
that threaten the good life for all. The remedy, says the book’s seven
international authors, lies with the concept of consumption corridors, enabled by mechanisms of citizen engagement and deliberative
democracy.
Across fve concise chapters, readers are invited into conversation about how wellbeing can be enriched by social change that joins
“needs satisfaction” with consumerist restraint, social justice, and
environmental sustainability. In this endeavour, lower limits of consumption that ensure minimal needs satisfaction for all are important, and enjoy ample precedent. But upper limits to consumption,
argue the authors, are equally essential, and attainable, especially in those domains where limits enhance rather than undermine essential
freedoms.
A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
As a salutogenic concept, “consumption corridors” aims to support what is necessary for sustainable wellbeing to be achieved in relation to the Earth system, with a deep consideration for justice and equity. Living in consumption corridors is a representation of everyday life whereby people live within limits, so that all people – now and in the future – can access what is needed to live a good life. In this special issue, a series of scholars and practitioners have come together to further develop the concept, engage with its ethodological implications, and relate it to consumption domains and policy implications. We begin by introducing how the concept emerged, in relation to the complexity of grappling with the societal transformations required for achieving more sustainable forms of consumption. We then present the different contributions, which demonstrate the importance of considering both maximum and minimum consumption standards, the relevance of human-need theories, as well as the difference between achieving wellbeing and the means necessary for doing so. We conclude by opening up to areas that merit further deliberation: how to relate consumption corridors to everyday-life dynamics, but also to the critical question of power relations at play in implementing consumption corridors.
Basierend auf Thierschs kritischen und gleichsam als Aufforderung zu verstehenden Worten, unternimmt die vorliegende Arbeit den Versuch, die pädagogische Authentizität insofern zu konturieren, dass sie zum greifbaren und attraktiven Diskussionsgegenstand werden kann. In diesem Zusammenhang fließen auch Sichtweisen und Erkenntnisse verschiedener Bezugsdisziplinen wie beispielsweise der Neurowissenschaft und der Bindungsforschung ein. Zusätzlich werden mögliche Anwendungsfelder der pädagogischen Authentizität benannt. Auf diese Art möchte die vorliegende Arbeit einen Beitrag zum Fachdiskurs der Sozialen Arbeit im Allgemeinen sowie zur Kompetenzdebatte im speziellen leisten.
Die vorliegende Arbeit beschäftigt sich mit Erlebnispädagogik und deren Relevanz für Erwachsene. Dabei fällt auf, dass erlebnispädagogische Träger, wie EXEO e.V. (vgl. EXEO e.V. o. D.), sich vorrangig auf Angebote für Kinder und Jugendliche spezialisiert haben. Erlebnispädagogik findet in außerschulischen Einrichtungen der Kinder- und Jugendhilfe statt. Im schulischen Kontext wird Erlebnispädagogik ergänzend zu der formalen Bildung, dem Unterricht, im Rahmen von Wandertagen, Klassenfahrten und Fortbildungen des Fachpersonals genutzt. Erlebnispädagogische Angebote wie von EXEO GmbH (vgl. EXEO GmbH o. D.) richten sich zusätzlich an Erwachsene. Die geringere Quantität der vorhandenen Fachliteratur zu nonformaler Bildung Erwachsener durch Erlebnispädagogik verdeutlicht, dass deren Altersgruppe in diesem Bildungssektor bislang wenig Aufmerksamkeit bekommen hat. Die praktische Erfahrung innerhalb des Arbeitsfeldes der Sozialen Arbeit zeigt, dass neben den Kindern und Jugendlichen, auch Erwachsene eine relevante Zielgruppe sind. Das steigende Interesse an Teamevents und Fortbildungsangeboten Erwachsener stellt neue Anforderungen an die Soziale Arbeit. So rücken diverse Methoden Sozialer Arbeit im Bereich der Erwachsenenbildung in den Vordergrund. Aus diesem Grund nimmt sich die vorliegende Arbeit dieser Altersgruppe an. Dabei entsteht die Frage, welchen Einfluss erlebnispädagogische Angebote auf die Resilienz Erwachsener hat. Inwieweit Resilienz entwickelt wird und warum diese auch für Erwachsene in ihrer Entwicklung und ihrem alltäglichen Leben vonnöten ist, wird im Laufe der Arbeit herausgearbeitet.
Ziel dieser vorliegenden Arbeit ist, Kinder mit sexuell übergriffigem Verhalten in den Blick zu nehmen und sie als Adressat*innen der stationären Jugendhilfe zu begreifen.
Dies scheint umso wichtiger, wenn bedacht wird, dass Kinder mit problematischem sexuellem Verhalten gehäuft in der Jugendhilfe repräsentiert sind (vgl. Schuhrke/Arnold 2009, S. 187). Die bundesweite Kriminalstatistik von 2019 zählt 147 angezeigte Straftaten von Kindern gegen die sexuelle Selbstbestimmung pro 100.000 Einwohner bezogen auf die 8-14-Jährigen (vgl. PKS 2019, Z. 65 f.). Dies macht eine prozentuale Gesamtmenge von 6,9% aller Sexualdelikte aus (vgl. PKS Jahrbuch 2019, S. 21). Es ist jedoch denkbar, dass viele Straftaten gar nicht erst angezeigt werden (vgl. Elsner u.a. 2008, S. 4), da Kinder bis zum vollendeten 14. Lebensjahr laut dem §19 StGB strafunfähig sind und daher die Möglichkeit besteht, dass gar nicht erst eine Anzeige gestellt wird. Demnach kann unter Umständen von einer höheren Dunkelziffer ausgegangen werden. Schon die Zahl aus dem Hellfeld ist jedoch so hoch, dass das Problem strafunmündiger sexuell übergriffiger Kinder zunehmend mehr Beachtung gefunden hat, auch in der Wissenschaft.