Gabriele Müller-Mundt

Bewältigung komplexer Medikamentenregime bei chronischer Krankheit im Alter

ZusammenfassungBei chronischer Krankheit und Multimorbidität sind komplexe Medikamentenregime im Alter nahezu die Regel. Sie bringen vielfältige Herausforderungen mit sich, für deren Bewältigung es neuer, patientenaktivierender Unterstützungskonzepte bedarf, die die Eigenkompetenz und das Selbstmanagement der Erkrankten fördern. Ein solches auf die Verbesserung des Selbstmanagements bei komplexen Medikamentenregimen zielendes Konzept zu entwickeln und in der ambulanten Pflege zu erproben, war Ziel eines zum Pflegeforschungsverbund NRW gehörenden Projekts. Die in einer prospektiven Kontrollstudie überprüfte Intervention zielte zunächst auf die ambulante Pflege und darauf, dort mit einem gezielten Training die Qualifikationsvoraussetzungen für die Umsetzung des entwickelten Konzepts zu schaffen. Die Intervention umfasste außerdem die Einführung eines Praxisleitfadens für die Konzeptumsetzung. Die Evaluationsergebnisse zeigen, dass das Training zu einer als Gewinn erlebten Kompetenzerweiterung geführt hat. Auch die Nutzung der erworbenen Kompetenzen und die Konzeptumsetzung sind trotz struktureller Hürden zufriedenstellend.AbstractIn later stages of chronic disease and especially in older age, chronically ill people are often dependent on multiple medicines. Coming to terms with complex medication regimes in everyday life is a challenging task. To provide the support actually needed, patient-centered interventions are essential, not only taking into account the patients’ needs and preferences, but also promoting their ability to self manage their disease(s) and their medication regime. This paper outlines the results of a research project aimed at developing and evaluating an intervention to integrate self-management support into primary care, based on a qualitative exploration of the patients’ and professionals’ views. The findings stress that home care nurses should take an active part in self-management support but need to be prepared adequately. Therefore, a two-tier intervention was developed and evaluated in a prospective control study, consisting of a qualified training and guidelines for practice. The intervention serves to expand the nurses’ professional competence to provide the needed individually tailored self-management support in home care.

[Pain management and nursing care--results of a review of the literature].

Especially for patients with chronic conditions, the ability to cope with the experience of illness in their daily lives is essential for the quality of life. An analysis of the international literature, of German nursing textbooks and journals was carried out to determine the dissemination of the state of the art of pain management. International research findings indicate a wide gap between the state of the art and pain management practice. Multidisciplinary role model programs where nurses play a major role as change agents have proved to be an effective strategy to change the institutional practice of pain management. In Germany, pain therapy as a medical discipline as well as academic courses in nursing were only institutionalized in the last decade. As a consequence pain research and therapy remained the domain of medicine and psychology up to now. Enhancing knowledge and educative skills of nurses will not only promote the quality of care. It is a key concept of professionalization in nursing.Chronisch-degenerative Erkrankungen sind oftmals mit vielfaltigen Symptombelastungen verbunden. Die erfahrene Unterstutzung und Anleitung zur Bewaltigung der Gesundheitsbeeintrachtigungen und Folge...

Pain management in nursing care – Results of a literature review

Especially for patients with chronic conditions, the ability to cope with the experience of illness in their daily lives is essential for the quality of life. An analysis of the international literature, of German nursing textbooks and journals was carried out to determine the dissemination of the state of the art of pain management. International research findings indicate a wide gap between the state of the art and pain management practice. Multidisciplinary role model programs where nurses play a major role as change agents have proved to be an effective strategy to change the institutional practice of pain management. In Germany, pain therapy as a medical discipline as well as academic courses in nursing were only institutionalized in the last decade. As a consequence pain research and therapy remained the domain of medicine and psychology up to now. Enhancing knowledge and educative skills of nurses will not only promote the quality of care. It is a key concept of professionalization in nursing.Chronisch-degenerative Erkrankungen sind oftmals mit vielfaltigen Symptombelastungen verbunden. Die erfahrene Unterstutzung und Anleitung zur Bewaltigung der Gesundheitsbeeintrachtigungen und Folge...