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,,Before, We Were Always There - Now, Everything Is Separate". On Nursing Reforms in Western Germany
(2008)
,,Liebesdienst" oder Geschäft? Zum Stellenwert des Ökonomischen im Arbeitsalltag ambulanter Pflege
(2012)
Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. DERR1-10.2196/11630
BACKGROUND Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. OBJECTIVE The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. METHODS In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. RESULTS The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. CONCLUSIONS This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11630
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.
Anleitungsprozess gestalten
(2009)
Anzeichen erkennen.
(2008)
Pathological Skin Picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls.
The present cross-sectional study (n=453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n=83), PSP without dermatological conditions (SP; n=56), dermatological conditions without PSP (DC; n=176) and skin-healthy controls (SH, n=138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups.
The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896)=19.92, Wilks’ Λ=0.78, p<.001, and mental health outcomes, F(6, 896)=16.24, Wilks’ Λ=0.81, p<.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores.
The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in skin picking disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and skin picking disorder.
Approaches to Improvement of Digital Health Literacy (eHL) in the Context of Person-Centered Care
(2022)
The skills, knowledge and resources to search for, find, understand, evaluate and apply health information is defined as health literacy (HL). If individuals want to use health information from the Internet, they need Digital Health Literacy (eHL), which in addition to HL also includes, for example, media literacy. If information cannot be found or understood by patients due to low (e)HL, patients will not have the opportunity to make informed decisions. In addition, many health apps for self-management or prevention also require (e)HL. Thus, it follows that active participation in healthcare, in terms of Person-Centered Care (PCC) is only possible through (e)HL. Currently, there is a great need to strengthen these competencies in society to achieve increased empowerment of patients and their health. However, at the same time, there is a need to train and improve competencies in the field of healthcare professionals so that they can counsel and guide patients. This article provides an overview with a focus on HL and eHL in healthcare, shows the opportunities to adapt services and describes the possible handling of patients with low (e)HL. In addition, the opportunities for patients and healthcare professionals to improve (e)HL are highlighted.
Auf dem Weg zum elektronischen Pflegebericht. PRAXiS in Verbindung mit dem Deutschen Ärzteblatt.
(2015)
Sensor‐based assessment of challenging behaviors in dementia may be useful to support caregivers. Here, we investigated accelerometry as tool for identification and prediction of challenging behaviors. We set up a complex data recording study in two nursing homes with 17 persons in advanced stages of dementia. Study included four‐week observation of behaviors. In parallel, subjects wore sensors 24 h/7 d. Participants underwent neuropsychological assessment including MiniMental State Examination and Cohen‐Mansfield Agitation Inventory. We calculated the accelerometric motion score (AMS) from accelerometers. The AMS was associated with several types of agitated behaviors and could predict subject's Cohen‐Mansfield Agitation Inventory values. Beyond the mechanistic association between AMS and behavior on the group level, the AMS provided an added value for prediction of behaviors on an individual level. We confirm that accelerometry can provide relevant information about challenging behaviors. We extended previous studies by differentiating various types of agitated behaviors and applying long‐term measurements in a real‐world setting.
Rehabilitations- und Teilhabeforschung thematisieren mit unterschiedlichen inhaltlichen und methodischen Schwerpunkten vergleichbare Untersuchungsfelder. Mit der Einführung der International Classification of Functioning, Disability, and Health (ICF) der WHO liegt ein gemeinsamer konzeptueller Anknüpfungspunkt vor. Für neue internationale Reha-Definitionen ist dabei das Konzept der Funktionsfähigkeit zentral, das auch die Komponente der Teilhabe umfasst. Während Rehabilitation auf die Unterstützung und Versorgung von individuellen Personen mit Funktionseinschränkungen zielt, setzt Teilhabeforschung in der Regel auf der gesellschaftlichen Ebene an. Aktuelle Ergebnisse der Teilhabeforschung, z.B. in Form des Teilhabeberichts der Bundesregierung bzw. des Teilhabesurveys, ermöglichen dabei wichtige Hintergrundinformationen zur Bedeutung von Umweltfaktoren bzw. Lebenslagen für die Teilhabe(chancen) von Menschen mit Behinderung, insbesondere für die Bedarfsforschung. Entsprechende Studienergebnisse werden bislang nur unzureichend in den Rehabilitationswissenschaften zur Kenntnis genommen.
Betreuung schwerstkranker und sterbender Menschen im hohen Lebensalter in Pflegeeinrichtungen.
(2012)
Body shaming (BS) is a popular term for a type of negative social interaction, which frequently occurs in social media. However, there is a lack of a clear scientific definition of BS and data on its relation to other concepts in social aggression research. The present study therefore aimed at providing a definition and classification of BS. In an exploratory online-study, 25 participants (60%) provided personal definitions of BS and rated the fit of a suggested definition. In addition, they reported similarities with and differences to related concepts (appearance teasing, cyberbullying, trolling). We conducted qualitative analyses of the verbal definitions guided by the Grounded Theory approach and quantified the fit to existing concepts in the field of social aggression. The results show that BS is perceived as an unrepeated act in which a person expresses unsolicited, mostly negative opinions/comments about a target’s body, without necessarily intending to harm him/her. Still, the target perceives the comments as negative. BS can range from well-meant advice to malevolent insults and it can occur online and offline. Participants saw similarities between BS and appearance teasing. BS can be a tool for trolling and can evolve to cyberbullying with repetition over time. Altogether, BS is a form of social aggression that has a negative impact on individuals. The definition and classification help to investigate BS and its effects on body image and mental health in future research.
Brunos Welt im Urlaub
(2014)
Visually induced motion sickness (VIMS) is a common side-effect of exposure to virtual reality (VR). Its unpleasant symptoms may limit the acceptance of VR technologies for training or clinical purposes. Mechanical stimulation of the mastoid and diverting attention to pleasant stimuli-like odors or music have been found to ameliorate VIMS. Chewing gum combines both in an easy-to-administer fashion and should thus be an effective countermeasure against VIMS. Our study investigated whether gustatory-motor stimulation by chewing gum leads to a reduction of VIMS symptoms. 77 subjects were assigned to three experimental groups (control, peppermint gum, and ginger gum) and completed a 15-min virtual helicopter flight, using a VR head-mounted display. Before and after VR exposure, we assessed VIMS with the Simulator Sickness Questionnaire (SSQ), and during the virtual flight once every minute with the Fast Motion Sickness Scale (FMS). Chewing gum (peppermint gum: M = 2.44, SD = 2.67; ginger gum: M = 2.57, SD = 3.30) reduced the peak FMS scores by 2.05 (SE = 0.76) points as compared with the control group (M = 4.56, SD = 3.52), p < 0.01, d = 0.65. Additionally, taste ratings correlated slightly negatively with both the SSQ and the peak FMS scores, suggesting that pleasant taste of the chewing gum is associated with less VIMS. Thus, chewing gum may be useful as an affordable, accepted, and easy-to-access way to mitigate VIMS in numerous applications like education or training. Possible mechanisms behind the effect are discussed.
Competence Development Assessment in Teacher Education: Design and Evaluation of Portfolio Exams
(2014)
Contact-Tracing-Apps als unterstützende Maßnahme bei der Kontaktpersonennachverfolgung von COVID-19
(2020)
Die Kontaktpersonennachverfolgung ist derzeit eine der wirksamsten Maßnahmen zur Eindämmung der COVID-19 Pandemie. Digitales Contact Tracing mittels Smartphones scheint eine sinnvolle zusätzliche Maßnahme zur manuellen Kontaktpersonennachverfolgung zu sein, um Personen zu identifizieren, die nicht bekannt oder nicht erinnerlich sind und um den zeitlichen Verzug beim Melden eines Infektionsfalles und beim Benachrichtigen von Kontaktpersonen so gering wie möglich zu halten. Obwohl erste Modellierungsstudien eine positive Wirkung in Bezug auf eine zeitnahe Kontaktpersonennachverfolgung nahelegen, gibt es bislang keine empirisch belastbaren Daten, weder zum bevölkerungsweiten Nutzen noch zum potenziellen Schaden von Contact-Tracing-Apps. Die Beurteilung der Zweckerfüllung und eine wissenschaftliche interdisziplinäre Begleitforschung sowohl zur Wirksamkeit, Risiken und Nebenwirkungen als auch zu Implementierungsprozessen (z. B. Planung und Einbezug verschiedener Beteiligter) sind wesentliche Bestandteile einer Nutzen-Risiko Bewertung. Dieser Beitrag betrachtet daher den möglichen Public-Health-Nutzen sowie technische, soziale, rechtliche und ethische Aspekte einer Contact-Tracing-App zur Kontaktpersonennachverfolgung im Rahmen der COVID-19-Pandemie. Weiterhin werden Bedingungen für eine möglichst breite Nutzung der App aufgezeigt.