@article{KlemmtHolmerHenkingetal., author = {Klemmt, Malte and Holmer, Dagmar and Henking, Tanja and Neuderth, Silke}, title = {Patient autonomy in inpatient medical rehabilitation in Germany - study protocol of a multicenter cross-sectional study}, series = {BMC Medical Ethics}, volume = {26}, journal = {BMC Medical Ethics}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {1472-6939}, doi = {10.1186/s12910-025-01340-z}, abstract = {Background The bioethical principle of respect for patients' autonomy should be implemented in every area of health care. The German rehabilitation system has some characteristics (e.g. the prevalence of inpatient rehabilitation) that make the topic particularly relevant. The aim of the study is to determine the current state of respecting patient autonomy in inpatient medical rehabilitation in Germany and to identify barriers and promoting factors from the perspective of relevant groups. Methods A multi-center, prospective, cross-sectional study is being conducted, including interviews with patients ( n  = 24), interviews with professionals ( n  = 21) and a survey of medical directors ( n  = 900). The empirical findings are then reviewed in three validation workshops. In addition, consensus recommendations for practice are derived by means of a Delphi process with experts ( n  = 30). Discussion This study will address an important gap in the empirical literature by identifying the current state and needs of patients, professionals and medical directors of rehabilitation clinics regarding the practice of respecting patient autonomy in inpatient medical rehabilitation in Germany. It is expected that the results can contribute to coming closer to the ideal of respect for patient autonomy in rehabilitation practice. Trial registration The study was registered with the German Clinical Trials Registry (ID: DRKS00035893).}, language = {en} } @article{MuellerKlemmtKochetal., author = {M{\"u}ller, Regina and Klemmt, Malte and Koch, Roland and Ehni, Hans-J{\"o}rg and Henking, Tanja and Langmann, Elisabeth and Wiesing, Urban and Ranisch, Robert}, title = {"That's just Future Medicine" - a qualitative study on users' experiences of symptom checker apps}, series = {BMC Medical Ethics}, volume = {25}, journal = {BMC Medical Ethics}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {1472-6939}, doi = {10.1186/s12910-024-01011-5}, abstract = {Background Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users' experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use? Methods A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis. Results Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others. Conclusions The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA. Trial registration German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020.}, language = {en} } @article{KlemmtHenking, author = {Klemmt, Malte and Henking, Tanja}, title = {Wishes and needs of nursing home residents and their relatives regarding end-of-life decision-making and care planning}, series = {Journal of Clinical Nursing}, volume = {29}, journal = {Journal of Clinical Nursing}, number = {13-14}, issn = {1365-2702}, pages = {2663 -- 2674}, abstract = {Aims and Objectives To explore wishes and needs, such as existing and preferred communication processes, of residents and relatives regarding medical and nursing planning at the end of life. Background Nursing home residents are a relevant target group for advance care planning (ACP) due to their high age and multimorbidity. Their relatives seem to be important partners in terms of communication and their documentation of wishes and needs. Design A qualitative descriptive design was used. Methods Thirty-two guideline-based interviews with nursing home residents (n = 24) and relatives (n = 8) were conducted in nursing homes in Germany (n = 7). All interviews were analysed by content-structured content analysis. The COREQ checklist was used to document reporting of the study. Results Residents particularly express wishes and needs regarding their health, like the desire to maintain or improve one's current state of health and to be active and mobile and also regarding their social situation, for example the well-being of relatives and beloved ones. A limited group of people was identified with whom residents spoke about issues such as preparedness and self-determination. These were mainly their relatives. Relatives themselves have a need for more communication. Various communication barriers could be identified. Conclusion Residents express diverse and partly explicit wishes and needs. Although many of the respondents had already drafted advanced directives, the demand for offers of communication to plan ahead for the end of life remains clear. The results indicate the unconditional participation of relatives and people close to the residents, if they are available. Relevance to clinical practice Derivations for a target group-related ACP concept in the study region are identified. Besides the involvement of relatives, nurses could also be involved in the communication and decision-making process of residents in nursing homes under certain conditions.}, language = {en} } @article{SchweighartKlemmtNeuderthetal., author = {Schweighart, Roxana and Klemmt, Malte and Neuderth, Silke and Teti, Andrea}, title = {Needs and needs communication of nursing home residents with depressive symptoms: a qualitative study}, series = {International Journal of Environmental Research and Public Health IJERPH}, volume = {19}, journal = {International Journal of Environmental Research and Public Health IJERPH}, number = {6}, publisher = {MDPI}, doi = {10.3390/ijerph19063678}, pages = {12}, abstract = {Nursing home residents are affected by depressive symptoms more often than elders living at home. There is a correlation between unmet needs and depression in nursing home residents, while met needs positively correlate with greater satisfaction and well-being. The study aims to examine the needs of nursing home residents with depressive symptoms and the communication of those needs, as no previous study has explicitly addressed the needs of this group of people and the way they are communicated. We conducted semi-structured interviews with 11 residents of three nursing homes and analyzed them using content-structuring content analysis. The residents reported diverse needs, assigned to 12 categories. In addition, barriers such as health impairments prevented the fulfillment of needs. As to the communication of needs, various interlocutors, facilitators, and barriers were identified. The findings reveal that residents can express their needs and are more likely to do so if the interlocutors are patient and take them seriously. However, lack of confidants, missing or non-functioning communication tools, impatience and perceived lack of understanding on the part of caregivers, and residents' insecurities limit communication of needs.}, language = {en} } @article{SchweighartO'SullivanKlemmtetal., author = {Schweighart, Roxana and O'Sullivan, Julie Lorraine and Klemmt, Malte and Teti, Andrea and Neuderth, Silke}, title = {Wishes and needs of nursing home residents}, series = {healthcare}, volume = {10}, journal = {healthcare}, number = {5}, issn = {2227-9032}, abstract = {Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting.}, language = {en} } @article{KlemmtHolmerHenkingetal., author = {Klemmt, Malte and Holmer, Dagmar and Henking, Tanja and Neuderth, Silke}, title = {Patient autonomy in inpatient medical rehabilitation in Germany—study protocol of a multicenter cross-sectional study}, series = {BMC Medical Ethics}, volume = {26}, journal = {BMC Medical Ethics}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {1472-6939}, doi = {doi.org/10.1186/s12910-025-01340-z}, abstract = {Background The bioethical principle of respect for patients' autonomy should be implemented in every area of health care. The German rehabilitation system has some characteristics (e.g. the prevalence of inpatient rehabilitation) that make the topic particularly relevant. The aim of the study is to determine the current state of respecting patient autonomy in inpatient medical rehabilitation in Germany and to identify barriers and promoting factors from the perspective of relevant groups. Methods A multi-center, prospective, cross-sectional study is being conducted, including interviews with patients ( n = 24), interviews with professionals (n = 21) and a survey of medical directors (n = 900). The empirical findings are then reviewed in three validation workshops. In addition, consensus recommendations for practice are derived by means of a Delphi process with experts (n = 30). Discussion This study will address an important gap in the empirical literature by identifying the current state and needs of patients, professionals and medical directors of rehabilitation clinics regarding the practice of respecting patient autonomy in inpatient medical rehabilitation in Germany. It is expected that the results can contribute to coming closer to the ideal of respect for patient autonomy in rehabilitation practice. Trial registration The study was registered with the German Clinical Trials Registry (ID: DRKS00035893).}, language = {en} }