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Rahn AC, Peper J, Köpke S, Antony G, Liethmann K, Vettorazzi E, Heesen C. Nurse-led immunotreatment DEcision Coaching In people with Multiple Sclerosis (DECIMS) - A cluster- randomised controlled trial and mixed methods process evaluation. PATIENT EDUCATION AND COUNSELING 2024; 125:108293. [PMID: 38728999 DOI: 10.1016/j.pec.2024.108293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To evaluate a nurse-led decision coaching programme aiming to redistribute health professionals' tasks to support immunotherapy decision-making in people with multiple sclerosis (MS). METHODS Cluster-randomised controlled trial with an accompanying mixed methods process evaluation (2014 - 2018). We planned to recruit 300 people with clinically isolated syndrome or relapsing-remitting MS facing immunotherapy decisions in 15 clusters across Germany. Participants in the intervention clusters received up to three decision coaching sessions by a trained nurse and access to an evidence-based online information platform. In the control clusters, participants also had access to the information platform. The primary outcome was informed choice after six months, defined as good risk knowledge and congruent attitude and uptake. RESULTS Twelve nurses from eight clusters participated in the decision coaching training. Due to insufficient recruitment, the randomised controlled trial was terminated prematurely with 125 participants (n = 42 intervention clusters, n = 83 control clusters). We found a non-significant difference between groups for informed choice favouring decision coaching: odds ratio 1.64 (95% CI 0.49-5.53). CONCLUSIONS Results indicate that decision coaching might facilitate informed decision-making in MS compared to providing patient information alone. PRACTICE IMPLICATIONS Barriers have to be overcome to achieve structural change and successful implementation.
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Affiliation(s)
- A C Rahn
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
| | - J Peper
- Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - S Köpke
- Institute of Nursing Science, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - G Antony
- Central Information Office Marburg, Fronhausen-Bellnhausen, Germany
| | - K Liethmann
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Radiation Oncology, Kiel, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Center for integrative Psychiatry ZiP gGmbH, Psychooncology, Kiel, Germany
| | - E Vettorazzi
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Heesen
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Rajkhowa P, Kalyanpur C, K R, Dsouza VS, Pattanshetty S, Narayanan P, Saravu K, Brand H. Geospatial mapping of public sentiment and infodemic on human papillomavirus vaccination in India: An indication to formulation of strategies for effective implementation. Glob Public Health 2024; 19:2348646. [PMID: 38718287 DOI: 10.1080/17441692.2024.2348646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/22/2024] [Indexed: 08/21/2024]
Abstract
The implementation of Human Papillomavirus (HPV) vaccination is crucial for eliminating cervical cancer in India. The infodemic, characterised by misleading information, could hinder the successful implementation of the initiative. Misinformation related to the HPV vaccine, such as rumours, has been reported and circulated, contributing to an alarming pattern of vaccine hesitancy observed on social media. This study aimed to identify the public sentiment towards HPV vaccination based on the 'Behavioral and Social Drivers (BeSD)' framework through geospatial, content and sentiment analysis. A total of 1,487 tweets were extracted. After preprocessing, 1010 tweets were identified for sentiment and content analysis. The sentiments expressed towards the HPV vaccine are mixed, with a generally positive outlook on the vaccines. Within the population, there is a pervasive proliferation of misinformation, primarily focusing on vaccine safety and efficacy, contentious subjects, ethical considerations, and a prevalent sense of uncertainty in selecting the appropriate vaccine. These observations are crucial for developing targeted strategies to address public concerns and enhance vaccination rates. The insights gained from these results will guide policymakers, healthcare practitioners, and public health organisations to implement evidence-based interventions, thereby countering vaccine hesitancy and improving public health outcomes.
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Affiliation(s)
- Priyobrat Rajkhowa
- Department of Health Policy, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Cauvery Kalyanpur
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Rakshitha K
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Viola Savy Dsouza
- Centre for Regulatory Science, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Sanjay Pattanshetty
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Prakash Narayanan
- Department of Health Policy, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Kavitha Saravu
- Department of Infectious Diseases, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Helmut Brand
- Department of Health Policy, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Rajkhowa P, Patil DS, Dsouza SM, Narayanan P, Brand H. Evidence on factors influencing HPV vaccine implementation in South Asia: A scoping review. Glob Public Health 2023; 18:2288269. [PMID: 38063361 DOI: 10.1080/17441692.2023.2288269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
Cervical cancer is a significant public health concern globally, with low and middle-income countries bearing the highest burden, specifically the South Asian region. Therefore, the current scoping review aimed to highlight the factors influencing the implementation of human papillomavirus (HPV) vaccination in South Asia. Adopting the 'Arksey and O'Malley and Levac et al.' methodology, multiple electronic databases were searched to identify relevant records. The results were narratively synthesised and discussed, adopting the Consolidated Framework for Implementation Research (CFIR) model. We identified 527 records, which were assessed for eligibility based on title, abstract, and full text by three reviewers, followed by data extraction of 29 studies included for analysis in the review. Implementing HPV vaccination programs in South Asia faces various challenges, such as economic, health system, financial, health literacy, and sociocultural factors that hinder their successful implementation. To successfully implement the vaccine, a tailored risk communication strategy is necessary for these countries. Knowledge gained from the experience of South Asian nations in implementing the HPV vaccine can assist in policymaking in similar healthcare for advancing the implementation of HPV vaccination.
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Affiliation(s)
- Priyobrat Rajkhowa
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Divya Sussana Patil
- Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sherize Merlin Dsouza
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Prakash Narayanan
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Helmut Brand
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Hofmann T. Studienintentionen deutscher Retter*innen. Notf Rett Med 2022. [DOI: 10.1007/s10049-022-00996-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Holthoff-Detto V, Nienaber A, Bötel N, Rapp M. [Complex treatment of severe mental illnesses in old age]. DER NERVENARZT 2021; 92:948-954. [PMID: 34142165 DOI: 10.1007/s00115-021-01150-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The needs for assistance, support and treatment of older people with severe mental illnesses (SMI) are very high and linked to additional age-associated somatic diseases and impairments. Old people prefer to live independently in their own homes and to receive necessary treatment and support there; however, a resettlement in a residential nursing home is often necessary due to a lack of alternatives. OBJECTIVE What is the current treatment reality in Germany for old people with SMI in their own homes and in residential nursing homes? How can coercive measures in this context be prevented? METHODS Selected results from the scientific literature on psychogeriatric care models in older people with SMI are summarized and discussed. RESULTS Multiprofessional psychogeriatric complex treatment models for older patients that include home visits and are adapted to the severity of mental disease are not available in Germany due to the lack of cross-sectoral network structures. Around 30% of the 730,000 nursing home residents in Germany experience coercive practices, whereas person-centered nursing concepts as well as guideline conform and individualized nonpharmacological treatment strategies and milieu therapeutic concepts are not sufficiently available. CONCLUSION The German healthcare system is in urgent need of multiprofessional psychogeriatric home treatment models in old people with severe mental illness in order to prevent worsening of psychiatric and somatic symptoms, to maintain individual social involvement, to strengthen individual autonomy and participative decision making and to protect from coercion. Multiprofessional expertise is essential as well as effective age-appropriate service models with multiprofessional teams delivering domiciliary visits and connecting complementary services for individual treatment requirements as part of the German health care system.
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Affiliation(s)
- Vjera Holthoff-Detto
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Alexianer St. Hedwig Kliniken, Krankenhaus Hedwigshöhe, Höhensteig 1, 12526, Berlin, Deutschland.
- Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland.
| | - André Nienaber
- Münster School of Health (MSH), FH Münster - University of Applied Sciences, Münster, Deutschland
| | - Nora Bötel
- Friedrich-Husemann-KLinik, Buchenbach, Deutschland
| | - Michael Rapp
- Professur Sozial- und Präventivmedizin, Universität Potsdam, Potsdam, Deutschland
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Rahn AC. Decision Coaching ist eine Aufgabe mit Potenzial für akademisch ausgebildete Pflegefachpersonen. Pflege 2021; 34:129-130. [PMID: 34037433 DOI: 10.1024/1012-5302/a000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Reese C, Sehlbrede M, Brühmann BA, Farin-Glattacker E. How do nurses and physicians assess inter-professional collaboration in long-term care homes? A survey study. Nurs Open 2021; 8:3616-3626. [PMID: 33949811 PMCID: PMC8510727 DOI: 10.1002/nop2.912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/12/2022] Open
Abstract
Aims To assess inter‐professional collaboration between nurses and physicians in long‐term care facilities and to determine if there are differences between subgroups of nurses. Design A cross‐sectional questionnaire survey was carried out between January 2018 and January 2020. Methods 408 health professionals (345 nurses, 63 physicians) from 37 nursing homes in Baden‐Wuerttemberg (Germany) participated in the survey. For data collection, the “Team‐Scale” and “Work Situation Questionnaire for nurses/physicians” instruments were used. Furthermore, five self‐generated items were employed assessing how ward rounds and documentation are implemented. For the evaluation, descriptive analyses, one‐way variance analyses (ANOVAs) and a multilevel analysis were performed. Results Inter‐professional teamwork was rated positively overall. However, the nursing staff usually gave more critical assessments than the physicians (for example, regarding mutual appreciation). Critical assessments could be used to initiate constructive change processes.
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Affiliation(s)
- Christina Reese
- Section of Health Care Research and Rehabilitation Research (SEVERA), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research (SEVERA), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Boris A Brühmann
- Section of Health Care Research and Rehabilitation Research (SEVERA), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research (SEVERA), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Silies K, Schley A, Sill J, Fleischer S, Müller M, Balzer K. Die COVID-19-Pandemie im akutstationären Setting aus Sicht von Führungspersonen und Hygienefachkräften in der Pflege - Eine qualitative Studie. Pflege 2020; 33:289-298. [PMID: 32996862 DOI: 10.1024/1012-5302/a000756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The COVID-19-pandemic in acute inpatient setting from nursing managers' and hygiene specialists' perspective - A qualitative study Abstract. Background: The COVID-19-pandemic is an unprecedented, exceptional situation and necessitates numerous adaptations of structures and processes in the acute inpatient setting. AIM The aim of this study was to explore how acute inpatient care was influenced by the pandemic and which implications may result for the future from nursing managers' and hygiene specialists' point of view. METHODS Qualitative study based on semi-structured interviews with five nursing managers and three hygiene specialists in four German acute care hospitals. Interviews were interpreted by using content analysis. RESULTS Interviewees described how everyday routines in their hospitals were adapted to the prioritized care for COVID-19 patients. Main challenges were uncertainty and anxiety among staff, relative scarcity of equipment and workforce resources and rapid implementation of new requirements for treatment capacities. This was addressed by targeted communication and information, large efforts to ensure resources and coordinated control of all processes by cross-department, interprofessional task forces. CONCLUSIONS Adaptations made to the structures and procedures of care delivery during the pandemic hold potential for future improvements of routine care, e. g. new workplace and skill mix models. To identify detailed practical implications, a renewed and deepened data analysis is needed at a later point of time, with a larger distance to the period of the pandemic.
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Affiliation(s)
- Katharina Silies
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Angelika Schley
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Janna Sill
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Steffen Fleischer
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - Martin Müller
- Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, Technische Hochschule Rosenheim
| | - Katrin Balzer
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
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Schomberg M, Greisberger A, Salbach NM, Diermayr G. [Translation of the evidence-based practice confidence (EPIC) scale into German and its cross-cultural adaption for Switzerland, Austria and Germany]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 149:57-65. [PMID: 32139306 DOI: 10.1016/j.zefq.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 09/16/2019] [Accepted: 11/20/2019] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Evidence-based Practice Confidence (EPIC) scale is a self-report questionnaire for health professionals. The EPIC scale was developed in Canada and is based on Bandura's self-efficacy theory. It comprises 11 statements on the organization and implementation of evidence-based practice (EBP) steps. The aim of the study was to translate the EPIC scale into German, to test its comprehensibility in German-speaking countries and to interculturally adapt the scale. METHODS The translation process followed international guidelines. After two independent translations into German and two independent back translations had been conducted, an expert committee discussed discrepancies in view of intercultural comprehensibility and agreed on a preliminary German version. The comprehensibility of this version was evaluated with physical therapists from Switzerland, Austria and Germany. They were recruited using purposeful sampling and interviewed via telephone using a semi-structured questionnaire (cognitive interviewing). The interviews were recorded and analyzed independently by two authors using a structured evaluation scheme. Based on these results, the final version was created. All changes were discussed with the author of the EPIC scale. RESULTS Sixteen physical therapists of the three German-speaking countries were interviewed. Demographic data showed a balanced distribution of country of origin, age group, qualification and years of work experience. In general, participants reported a good overall comprehensibility. However, they reported that (too) many scientific terms caused comprehension problems and that some of these terms were unknown to participants. During the intercultural adaptation attention was paid to simplify and shorten sentences and to paraphrase terms that were difficult to understand. Moreover, the instructions were expanded to address partial lack of knowledge of scientific terms. CONCLUSION The EPIC scale was successfully translated and interculturally adapted to the German language. The scale evaluates self-efficacy in EBP activities and could potentially be used to assess courses or be integrated into surveys. In the next step, the validity and reliability of the German scale should be established involving other health care professionals in this process.
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Nestler N. Nursing care and outcome in surgical patients - why do we have to care? Innov Surg Sci 2019; 4:139-143. [PMID: 33977123 PMCID: PMC8059353 DOI: 10.1515/iss-2019-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/24/2019] [Indexed: 12/13/2022] Open
Abstract
Nurses have an important role in patient care. They continuously work in very close contact with patients and foster the realization of activities of daily living as well as ensure quality medical treatment. For both, a high educational level is needed. A large proportion of patients with complex health situations involving chronic illnesses and multimorbidities are treated in hospitals with shortened hospital lengths of stay, changing the caring needs and the demands on nursing. Nurses must handle complex nursing tasks for which a higher educational level is indispensable, including the ability to implement evidence-based practice. In addition, studies show a correlation between the educational level of nursing staff and the health outcomes of patients. If there are too few highly educated nurses, there is an increase in patient mortality as well as the risk of patient complications, such as falls. Also, a low number of nursing staff and a high proportion of admissions decrease the quality of nursing and result in unfavorable patient outcomes. Both developments call for the necessity of a changing nursing practice and the possibilities to transform interprofessional work.
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Affiliation(s)
- Nadja Nestler
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
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Tannen A, Feuchtinger J, Strohbücker B, Kocks A. Survey zur Einbindung von Pflegefachpersonen mit Hochschulabschlüssen an deutschen Universitätskliniken - Stand 2015. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2017; 120:39-46. [DOI: 10.1016/j.zefq.2016.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
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