Refine
Year of publication
Document Type
- Article (peer reviewed) (20)
- Conference Proceeding (6)
- Report (6)
- Contribution to a Periodical (2)
- Part of a Book (1)
- Other (1)
- Working Paper (1)
Is part of the Bibliography
- no (37)
Keywords
- Forschung (5)
- Nursing homes (5)
- Complex intervention (4)
- Contractures (4)
- Mobile Robot (4)
- Aged (3)
- Cognitive Mapping (3)
- Joint contractures (3)
- Participation (3)
- Robotic Research (3)
Institute
- Fakultät für Angewandte Gesundheits- und Sozialwissenschaften (14)
- Fakultät für Informatik (10)
- Forschung und Entwicklung (5)
- Fakultät für Angewandte Natur- und Geisteswissenschaften (2)
- Fakultät für Betriebswirtschaft (1)
- Fakultät für Ingenieurwissenschaften (1)
- Fakultät für Innenarchitektur, Architektur und Design (1)
- Zentrum für Forschung, Entwicklung und Transfer (1)
Background
The admission to a nursing home is a critical life-event for affected persons as well as their families. Admission related processes are lacking adequate participation of older people and their families. To improve transitions to nursing homes, context- and country-specific knowledge about the current practice is needed. Hence, our aim was to summarize available evidence on challenges and care strategies associated with the admission to nursing homes in Germany.
Methods
We conducted a scoping review and searched eight major international and German-specific electronic databases for journal articles and grey literature published in German or English language since 1995. Further inclusion criteria were focus on challenges or care strategies in the context of nursing home admissions of older persons and comprehensive and replicable information on methods and results. Posters, only-abstract publications and articles dealing with mixed populations including younger adults were excluded. Challenges and care strategies were identified and analysed by structured content analysis using the TRANSCIT model.
Results
Twelve studies of 1,384 records were finally included. Among those, seven were qualitative studies, three quantitative observational studies and two mixed methods studies. As major challenges neglected participation of older people, psychosocial burden among family caregivers, inadequate professional cooperation and a lack of shared decision-making and evidence-based practice were identified. Identified care strategies included strengthening shared decision-making and evidence-based practice, improvement in professional cooperation, introduction of specialized transitional care staff and enabling participation for older people.
Conclusion
Although the process of nursing home admission is considered challenging and tends to neglect the needs of older people, little research is available for the German health care system. The perspective of the older people seems to be underrepresented, as most of the studies focused on caregivers and health professionals. Reported care strategies addressed important challenges, however, these were not developed and evaluated in a comprehensive and systematic way. Future research is needed to examine perspectives of all the involved groups to gain a comprehensive picture of the needs and challenges. Interventions based on existing care strategies should be systematically developed and evaluated to provide the basis of adequate support for older persons and their informal caregivers.
In this research, we discuss the past and current trends in defining poverty to look at the topic from different perspectives and to provide an outline of future work that we aim to complete the picture on the qualitative and quantitative side. For this purpose, our focus here is to evaluate the diversity of definitions and to emphasize how important it is to combine subjective and objective approaches for practical policy analysis. As a first step of our future work, we also present the pilot study results to assess the results comparatively in the EU states and Türkiye.
Background
Vertigo, dizziness or balance disorders (VDB) are common leading symptoms in older people, which can have a negative impact on their mobility and participation in daily live, yet, diagnosis is challenging and specific treatment is often insufficient. An evidence-based, multidisciplinary care pathway (CPW) in primary care was developed and pilot tested in a previous study. The aim of the present study is to evaluate the effectiveness and safety of the CPW in terms of improving mobility and participation in community-dwelling older people with VDB in primary care.
Methods
For this multicentre cluster randomised controlled clinic trial, general practitioners (GP) will be recruited in two regions of Germany. A total of 120 patients over 60 years old with VDB will be included. The intervention is an algorithmized CPW. GPs receive a checklist for standardise clinical decision making regarding diagnostic screening and treatment of VDB. Physiotherapists (PT) receive a decision tree for evidence-based physiotherapeutic clinical reasoning and treatment of VDB. Implementation strategies comprises educational trainings as well as a workshop to give a platform for exchange for the GPs and PTs, an information meeting and a pocket card for home care nurses and informal caregivers and telephone peer counselling to give all participants the capability, opportunity and the motivation to apply the intervention. In order to ensure an optimised usual care in the control group, GPs get an information meeting addressing the national guideline. The primary outcome is the impact of VDB on participation and mobility of patients after 6 month follow-up, assessed using the Dizziness Handicap Inventory (DHI) questionnaire. Secondary outcomes are physical activity, static and dynamic balance, falls and fear of falling as well as quality of life. We will also evaluate safety and health economic aspects of the intervention. Behavioural changes of the participants as well as barriers, facilitating factors and mechanisms of impact of the implementation will be investigated with a comprehensive process evaluation in a mixed-methods design.
Discussion
With our results, we aim to improve evidence-based health care of community-dwelling older people with VDB in primary care.
The annual instructional virtual team Project X brings together professors and students from across the globe to engage in client projects. The 2020 project was challenged by the global disruption of the COVID-19 pandemic. This paper draws on a quantitative dataset from a post-project survey among 500 participating students and a qualitative narrative inquiry of personal experiences of the faculty members. The findings reveal how innovative use of a variety of collaboration and communication technologies helped students and their professors in building emotional connection and compassion to support each other in the midst of the crisis, and to accomplish the project despite connectivity disruptions. The results suggest that the role of an instructor changed to a coach and mentor, and technology was used to create a greater sense of inclusion and co-presence in student-faculty interactions. Ultimately, the paper highlights the role of technology to help the participants navigate sudden crisis affecting a global online instructional team project. The adaptive instructional teaching strategies and technologies depicted in this study offer transformative potential for future developments in higher education.
Real-world domestic electricity demand datasets are the key enabler for developing and evaluating machine learning algorithms that facilitate the analysis of demand attribution and usage behavior. Breaking down the electricity demand of domestic households is seen as the key technology for intelligent smart-grid management systems that seek an equilibrium of electricity supply and demand. For the purpose of comparable research, we publish DEDDIAG, a domestic electricity demand dataset of individual appliances in Germany. The dataset contains recordings of 15 homes over a period of up to 3.5 years, wherein total 50 appliances have been recorded at a frequency of 1 Hz. Recorded appliances are of significance for load-shifting purposes such as dishwashers, washing machines and refrigerators. One home also includes three-phase mains readings that can be used for disaggregation tasks. Additionally, DEDDIAG contains manual ground truth event annotations for 14 appliances, that provide precise start and stop timestamps. Such annotations have not been published for any long-term electricity dataset we are aware of.
Background
Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital.
Objectives
We developed a simple screening scale – the home environment checklist (HEC) – to identify any mismatch between an individual's abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC.
Methods
The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach's alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score.
Results
The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach's alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ2 = 13.2, P = 0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (P < .01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC.
Conclusions
The HEC has good reliability and validity, which supports its utility in rehabilitation clinics.
Background
Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation.
Methods
The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis.
Results
Seven nursing homes (n = 4 intervention groups, n = 3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers.
Conclusion
The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial.
Trial registration
German clinical trials register, DRKS00010037. Registered 12 February 2016.
Implementation of robotic devices in nursing care. Barriers and facilitators: an integrative review
(2020)
Background: Robots in healthcare are gaining increasing attention; however, their implementation is challenging due to the complexity of both interventions themselves and the contexts in which they are implemented. The objective of this integrative review is to identify barriers to and facilitators of the implementation of robotic systems in nursing.
Methods: Articles published from 2002 to 2019 reporting on projects to implement robotic devices in nursing care were searched on Medline (via PubMed), CINAHL and databases on funded research projects (Community Research and Development Information Services and Technische Informationsbibliothek) and in journals for robotic research in November 2017 and July 2019 for an update. No restrictions regarding study designs were imposed. All included articles underwent quality assessments with design-specific critical appraisal tools. Barriers to and facilitators of implementation were classified using the Context and Implementation of Complex Interventions framework.
Results: After removing all duplicates, the search revealed 11 204 studies, of which 17 met the inclusion criteria and were included in the synthesis. The majority of the studies dealt with the implementation of robots designed to support individuals, either living at home or in nursing homes (n=11). The studies were conducted in Europe, the USA and New Zealand and were carried out in nursing homes, individual living environments, hospital units and laboratories. The quality of reporting and quality of evidence were low in most studies. The most frequently reported barriers were in socioeconomic and ethical domains and were within the implementation outcomes domain. The most frequently reported facilitators were related to the sociocultural context, implementation process and implementation strategies.
Discussion: This review identified barriers to and facilitators of the implementation of robotic devices in nursing within different dimensions. The results serve as a basis for the development of suitable implementation strategies to reduce potential barriers and promote the integration of elements to facilitate implementation.
PROSPERO registration number: CRD42018073486.
Generating a more detailed understanding of domestic electricity demand is a major topic for energy suppliers and householders in times of climate change.
Over the years there have been many studies on consumption feedback systems to inform householders, disaggregation algorithms for Non-Intrusive-Load-Monitoring (NILM), Real-Time-Pricing (RTP) to promote supply aware behavior through monetary incentives and appliance usage prediction algorithms. While these studies are vital steps towards energy awareness, one of the most fundamental challenges has not yet been tackled: Automated detection of start and stop of usage cycles of household appliances. We argue that most research efforts in this area will benefit from a reliable segmentation method to provide accurate usage information.
We propose a SVM-based segmentation method for home appliances such as dishwashers and washing machines. The method is evaluated using manually annotated electricity measurements of five different appliances recorded over two years in multiple households.