Ralf Suhr

The epidemiology of skin care provided by nurses at home: a multicentre prevalence study

AIMS The aim of this study was to estimate the frequencies and patterns of skin care and applied skin care products in the home care nursing setting in Germany. BACKGROUND Skin care belongs to the core activities of nursing practice. Especially in aged and long-term care settings, clients are vulnerable to various skin conditions. Dry skin is one of the most prevalent problems. Using mild skin cleansers and the regular application of moisturizing leave-on products is recommended. Until today, there are no quantitative empirical data about nursing skin care practice at home in the community. DESIGN A multicentre cross-sectional study was conducted in July 2012. METHODS Home care clients from the German home care nursing setting were randomly selected. Instructed nurse raters performed the data collection using standardized forms. Variables included demographics, skin care needs and skin caring activities. RESULTS Approximately 60% of home care clients received skin care interventions. The majority were washed and two-thirds received a leave-on product once daily. There was large heterogeneity in cleansing and skin care product use. Most often the product labels were unknown or product types were selected haphazardly. CONCLUSION Skin care interventions play a significant role in home care and nurses have a considerable responsibility for skin health. Skin care provided does not meet recent recommendations. The importance of targeted skin cleansing and care might be underestimated. There are a confusing variety of skin care products available and often the labels provide little information regarding the ingredients or guidance about how they affect skin health.

Tablet-PC und ihr Nutzen für demenzerkrankte Heimbewohner

BACKGROUND Initial sporadic experiences in a Berlin nursing home showed that residents with dementia responded well to activating therapy with tablet computers. This innovative technology seemed to provide a differentiated and individual therapeutic access. These observations encouraged the nursing home management to contact the Institute of Medical Sociology and Rehabilitation Science at the Charité Universitätsmedizin Berlin with the aim to examine the practical experiences. The Centre for Quality in Care (ZQP) sponsored the 1 year pilot study. OBJECTIVE An examination of the feasibility and usability of tablet computers in the daily care of nursing home residents with dementia was carried out. MATERIALS AND METHODS In this study 14 residents (12 women and 2 men) of a special care unit for dementia patients were included in a 3-month intervention of tablet activation 3 times a week. Qualitative and quantitative methods were used to analyze data (e.g. observation protocols and videos, staff interviews, document analysis of nursing records and standardized resident interviews/proxy interviews). RESULTS Nursing home residents suffering from dementia showed a high degree of acceptance of tablet computers. Most notable benefits were easy handling and the variety of multifunctional applications. Sustainable therapeutic effects resulted in stimulation of communication and interaction, improvement of well-being, memory training and reduction of neuropsychiatric symptoms. Furthermore, contact to family members of several residents was improved. CONCLUSIONS The use of tablet computers was convincing as an activation therapy for nursing home residents with dementia. Further research and development of specially adapted software are required.

[Tablet computers and their benefits for nursing home residents with dementia: Results of a qualitative pilot study].

BACKGROUND Initial sporadic experiences in a Berlin nursing home showed that residents with dementia responded well to activating therapy with tablet computers. This innovative technology seemed to provide a differentiated and individual therapeutic access. These observations encouraged the nursing home management to contact the Institute of Medical Sociology and Rehabilitation Science at the Charité Universitätsmedizin Berlin with the aim to examine the practical experiences. The Centre for Quality in Care (ZQP) sponsored the 1 year pilot study. OBJECTIVE An examination of the feasibility and usability of tablet computers in the daily care of nursing home residents with dementia was carried out. MATERIALS AND METHODS In this study 14 residents (12 women and 2 men) of a special care unit for dementia patients were included in a 3-month intervention of tablet activation 3 times a week. Qualitative and quantitative methods were used to analyze data (e.g. observation protocols and videos, staff interviews, document analysis of nursing records and standardized resident interviews/proxy interviews). RESULTS Nursing home residents suffering from dementia showed a high degree of acceptance of tablet computers. Most notable benefits were easy handling and the variety of multifunctional applications. Sustainable therapeutic effects resulted in stimulation of communication and interaction, improvement of well-being, memory training and reduction of neuropsychiatric symptoms. Furthermore, contact to family members of several residents was improved. CONCLUSIONS The use of tablet computers was convincing as an activation therapy for nursing home residents with dementia. Further research and development of specially adapted software are required.

Comparing Continuous and Dichotomous Scoring of Social Desirability Scales: Effects of Different Scoring Methods on the Reliability and Validity of the Winkler-Kroh-Spiess BIDR Short Scale

Dieser Artikel analysiert auf Basis der PISA-Daten die Entwicklung der schulischen Ungleichheit in der Schweiz zwischen 2003 und 2012. Wir zeigen zunachst, dass sich die kantonalen Bildungssysteme auf zwei Ebenen unterscheiden: einerseits in Bezug auf das durchschnittliche Kompetenzniveau der Schuler am Ende der obligatorischen Schulzeit (der sogenannten «Wirksamkeit») – und andrerseits in Bezug auf die je nach sozio-okonomischer Lage ihrer Familie ungleichen Verteilung dieses erworbenen Schulwissens. Danach vergleichen wir zwei Formen, wie Schulerinnen und Schuler auf der Sekundarstufe I Leistungsklassen zugeteilt werden: einerseits solche, die gleichaltrige Schuler in mehreren, nach schulischem Niveau getrennten Schultypen unterrichten; andrerseits integrierte Systeme, die alle Leistungsniveaus in denselben Klassen einschulen. Dabei zeigt sich, dass getrennte Schulsysteme tendenziell Ungleichheiten im Erwerb von Kenntnissen zwischen den Schulern verstarken. Dies erklart sich aus der Rolle der schulischen Segregation. Schultypen, die Schulerinnen und Schuler nach dem Niveau ihrer schulischen Leistungen in getrennten Schulen und Klassen unterrichten, separieren sie indirekt auch nach ihren sozialen Merkmalen. Das hat einen Einfluss darauf, welche Bildung Schulerinnen und Schuler aus unterschiedlichen sozialen Milieus angeboten wird. Dieser Beitrag wurde im Rahmen des Forschungsprojekts « Comment organiser l’enseignement secondaire obligatoire ? Une etude des reformes scolaires et de leurs effets dans trois cantons romands » (100019_156702/1) des Schweizerischen Nationalfonds geschrieben.

Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia

Purpose To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results Although the stress-quality of life association was more pronounced in caregivers (β = -.63, p<.001) compared to patients (β = -.31, p<.001), this association was equally moderated by social support in patients (β = .14, p<.05) and in the caregivers (β = .13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.

Qualität und Qualitätsmessung in der Langzeitpflege aus Sicht der Nutzerinnen und Nutzer

Eine transparente Qualitatsbeurteilung und -berichterstattung in der stationaren Langzeitpflege setzt voraus, die Perspektiven aller relevanten Akteure zu berucksichtigen. Neben der Sicht der Experten ist dabei auch die der Nutzer und Nutzerinnen masgeblich. Dieser Beitrag geht der Frage nach, was Pflegequalitat aus Sicht von Pflegebedurftigen und ihren Angehorigen bedeutet. Auf Grundlage der aktuellen Forschungslage wird zunachst herausgearbeitet, inwiefern die Nutzerperspektive bei der Pflegequalitatsmessung bislang berucksichtigt wird. Im Mittelpunkt stehen ausgewahlte Ergebnisse der vom Institut fur Medizinische Soziologie und Rehabilitationswissenschaft der Charite durchgefuhrten und vom AOK-Bundesverband und dem Zentrum fur Qualitat in der Pflege (ZQP) geforderten Studie zur »Weiterentwicklung der Qualitatsberichterstattung in der Langzeitpflege«. Dabei werden zum einen die Qualitatsbeurteilungen von Pflegebedurftigen und deren Angehorigen und zum anderen die von ambulant und stationar versorgten Pflegebedurftigen identifiziert und vergleichend analysiert. Der Fokus liegt hierbei auf den Praferenzen in Bezug auf Qualitatsbereiche und -kriterien, die aus Sicht der verschiedenen Nutzergruppen entscheidend fur die Auswahl einer adaquaten Pflegeeinrichtung sind. Wahrend sich beim Subgruppenvergleich zwischen Angehorigen und Pflegebedurftigen nur punktuelle Differenzen herausstellen, differieren die Praferenzen der ambulant und stationar Versorgten deutlich.

Stand der Pflegeforschung in Deutschland – ein Überblick

Die Pflegeforschung in Deutschland hat sich seit 2005 rasant entwickelt. Den mit Abstand grosten thematischen Schwerpunkt stellt dabei – gemessen an der Zahl der Fachpublikationen – die „Pflege und Pflegebedurftigkeit alter und hochaltriger Menschen“ dar. Mit diesem Themenbereich befassen sich – mit steigender Tendenz – mehr als ein Drittel der Publikationen. Die Universitaten/Universitatsklinika sind innerhalb der altersbezogenen Pflegeforschung am haufigsten (rd. 45 %) beteiligt, aber auch die ubrigen Hochschulen sind mit ca. 30 % stark vertreten. Kooperationen zwischen wissenschaftlichen Einrichtungen finden nur in rund einem Drittel der Projekte statt. Thematisch liegt der Schwerpunkt hier auf der Versorgungsforschung (rd. 57 %), gefolgt von der pflegerischen Bildungs- und Berufsfeldforschung (rd. 21 %). Weniger als die Halfte der Projekte veroffentlicht ihre Ergebnisse in der Fachliteratur, in rd. einem Funftel der Falle erfolgt keinerlei Publikation.

Urinary incontinence in home care: a representative multicenter study on prevalence, severity, impact on quality of life, and risk factors

ObjectivesThe objective of the study was to determine the prevalence and severity of urinary incontinence and associated factors in patients receiving home care nursing service.MethodsFrom June to September 2015, a multicenter cross-sectional study was conducted in 923 patients from 102 home care services throughout Germany. The ICIQ-SF was used to determine the characteristics of UI and its impact on QoL. To determine the risks for UI, demographic and social risks, the Barthel Index and medical diagnoses were determined in descriptive and logistic regression analysis.ResultsThe prevalence of UI was 62.5% (95% CI 59.3–65.6). The most common reasons for UI were before getting to the toilet 27.6% and when coughing or sneezing 27.3%. If the amount of leakage was medium (high), the mean of the impact on QoL was 4.9, SD 2.7 (5.0, SD 3.6). If the frequency of UI was higher than once a day (permanent), the mean of the impact on QoL was 4.2, SD 2.7 (4.8, SD 3.2). The results of the logistic regression analysis show the highest odds ratios for mobility—inability to walk (4.49), presence of dementia (2.59), and female sex (1.81). The metric variables age (1.02), Barthel Index (0.93), and BMI (1.05) were also statistically significant.ConclusionsThe prevalence of UI in home care in Germany is high. Since UI is strongest associated with (im-) mobility, preserving or regaining patients’ mobility should play a central role in providing care to avoid/minimize UI.

Tablet-PC und ihr Nutzen für demenzerkrankte Heimbewohner@@@Tablet computers and their benefits for nursing home residents with dementia: Ergebnisse einer qualitativen Pilotstudie@@@Results of a qualitative pilot study

BACKGROUND Initial sporadic experiences in a Berlin nursing home showed that residents with dementia responded well to activating therapy with tablet computers. This innovative technology seemed to provide a differentiated and individual therapeutic access. These observations encouraged the nursing home management to contact the Institute of Medical Sociology and Rehabilitation Science at the Charité Universitätsmedizin Berlin with the aim to examine the practical experiences. The Centre for Quality in Care (ZQP) sponsored the 1 year pilot study. OBJECTIVE An examination of the feasibility and usability of tablet computers in the daily care of nursing home residents with dementia was carried out. MATERIALS AND METHODS In this study 14 residents (12 women and 2 men) of a special care unit for dementia patients were included in a 3-month intervention of tablet activation 3 times a week. Qualitative and quantitative methods were used to analyze data (e.g. observation protocols and videos, staff interviews, document analysis of nursing records and standardized resident interviews/proxy interviews). RESULTS Nursing home residents suffering from dementia showed a high degree of acceptance of tablet computers. Most notable benefits were easy handling and the variety of multifunctional applications. Sustainable therapeutic effects resulted in stimulation of communication and interaction, improvement of well-being, memory training and reduction of neuropsychiatric symptoms. Furthermore, contact to family members of several residents was improved. CONCLUSIONS The use of tablet computers was convincing as an activation therapy for nursing home residents with dementia. Further research and development of specially adapted software are required.