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Healthy Moms, Healthy Babies and Hopeful Hearts. Geburtshilfe am Rande eines philippinischen Slums
(2012)
The PosiThera project focuses on the management of chronic wounds, which is multi-professional and multi-disciplinary. For this context, a software prototype was developed in the project, which is intended to support medical and nursing staff with the assistance of artificial intelligence. In accordance with the user-centred design, national workshops were held at the beginning of the project with the involvement of domain experts in wound care in order to identify requirements and use cases of IT systems in wound care, with a focus on AI. In this study, the focus was on involving nursing and nursing science staff in testing the software prototype to gain insights into its functionality and usability. The overarching goal of the iterative testing and adaptation process is to further develop the prototype in a way that is close to care.
Implementation and Analysis of Two Knowledge Base Approaches for the Treatment of Chronic Wounds
(2020)
IntroductionAssessment of challenging behaviors in dementia is important for intervention selection. Here, we describe the technical and experimental setup and the feasibility of long-term multidimensional behavior assessment of people with dementia living in nursing homes.MethodsWe conducted 4 weeks of multimodal sensor assessment together with real-time observation of 17 residents with moderate to very severe dementia in two nursing care units. Nursing staff received extensive training on device handling and measurement procedures. Behavior of a subsample of eight participants was further recorded by videotaping during 4 weeks during day hours. Sensors were mounted on the participants' wrist and ankle and measured motion, rotation, as well as surrounding loudness level, light level, and air pressure.ResultsParticipants were in moderate to severe stages of dementia. Almost 100% of participants exhibited relevant levels of challenging behaviors. Automated quality control detected 155 potential issues. But only 11% of the recordings have been influenced by noncompliance of the participants. Qualitative debriefing of staff members suggested that implementation of the technology and observation platform in the routine procedures of the nursing home units was feasible and identified a range of user- and hardware-related implementation and handling challenges.DiscussionOur results indicate that high-quality behavior data from real-world environments can be made available for the development of intelligent assistive systems and that the problem of noncompliance seems to be manageable. Currently, we train machine-learning algorithms to detect episodes of challenging behaviors in the recorded sensor data.
This paper describes the data mining method of association analysis within the framework of Knowledge Discovery in Databases (KDD) with the aim to identify standard patterns of nursing care. The approach is application-oriented and used on nursing routine data of the method LEP nursing 2. The increasing use of information technology in hospitals, especially of nursing information systems, requires the storage of large data sets, which hitherto have not always been analyzed adequately. Three association analyses for the days of admission, surgery and discharge, have been performed. The results of almost 1.5 million generated association rules indicate that it is valid to apply association analysis to nursing routine data. All rules are semantically trivial, since they reflect existing knowledge from the domain of nursing. This may be due either to the method LEP Nursing 2, or to the nursing activities themselves. Nonetheless, association analysis may in future become a useful analytical tool on the basis of structured nursing routine data.
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.
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.
From Surviving to Living (on): A Grounded Theory Study on Coping in People with Pancreatic Cancer
(2023)
Background and objectives: Virtual reality simulation (VRS) can be used to complement experiential learning, as it enables nursing students to further learn and refine nursing skills outside of the clinical setting. However, gathering evidence for its effectiveness as a teaching method in achieving learning outcomes is still ongoing, and thus there is a lack of systematic synthesis. The objective of this systematic literature review is to analyze VRS scenarios with a high level of immersion and their impact on learning outcomes in nursing education.
Methods: A literature search was performed in the MEDLINE, CINAHL, and ERIC databases in November 2022. As a result, fifteen studies were included and analyzed using deductive content analysis.
Results: The studies reported twelve different scenarios for virtual reality simulations with high levels of immersion, the focus of which was on acute critical care, broader nursing processes, neonatal and pediatric care, single nursing interventions, and observation of patients’ symptoms. The associated learning objectives were mainly achieved in the domains of cognition and psychomotor skills.
Conclusions: There are several VRS scenarios that show potential for use in nursing education. The VRS scenarios are effective in improving learning outcomes, particularly those related to knowledge and skills. Overall, the supportive body of evidence gained through this review may help nurse educators in integrating virtual simulations in their curricula. In the future, nursing and adult learning theories should be given greater consideration, and the aspect of affective learning could be included in design and implementation. Moreover, future research could benefit from exploring the long-term effects of learning after using VRS with a high level of immersion to provide valuable evidence for developing VRS teaching methods in nursing.
Habits are highly automated behaviors that have received renewed attention in addiction research. The Self-Report Habit Index (SRHI) is a widely used measure of habits. Two cross-sectional online studies aimed at validating a German version of the SRHI to assess two everyday health-risk behaviors: caffeine consumption and smartphone/tablet use. In both studies (N = 1310), the SRHI scales (one adapted for caffeine consumption, one for smartphone/tablet use), as well as corresponding addiction scales and health outcomes (study 1), or established validity measures (study 2), were assessed. Both SRHI scales showed satisfying item characteristics, high internal consistencies (αs > .90), adequate construct validity, and a three-factorial solution with a satisfying model fit (CFI/TLIs > .95, SRMRs ≤ 0.05). Highest correlations emerged between SRHI and addiction scales. The studies show that the German SRHI can be used to validly assess health-risk behaviors. The observed strong correlations of the SRHI scales with addiction scales suggest that (self-reported) habit is indeed an important aspect to consider in addiction research.
The introduction of the ICF model as a basis for rehabilitation provides new perspectives on rehabilitation practices. According to the ICF, participation can be enhanced via different pathways, including interventions on environmental factors.
We have conducted a document analysis, linking to the ICF environmental factor codes, expert workshops and focus groups.
The project resulted in a substantial number of different recommendations.
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.
Biofeedback
(2017)
Effects of polypharmacy on outcome in patients with schizophrenia in routine psychiatric treatment
(2012)
Editorial
(2019)
Purpose: This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter.
Method: Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7–11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker’s Experience of Stuttering–School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity.
Results: At 3 months postrandomization, the mean score changes of the OASESS differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants).
Conclusions: The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering.
Over 12 months, these changes were maintained and accompanied by
behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group.