scholarly journals Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany – results of a nationwide cross-sectional survey study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elisabeth Diehl ◽  
Sandra Rieger ◽  
Stephan Letzel ◽  
Anja Schablon ◽  
Albert Nienhaus ◽  
...  

Abstract Background Palliative care in Germany is divided into general (GPC) and specialised palliative care (SPC). Although palliative care will become more important in the care sector in future, there is a large knowledge gab, especially with regard to GPC. The aim of this study was to identify and compare the burdens, resources, health and wellbeing of nurses working in GPC and SPC. Such information will be helpful for developing prevention programs in order to reduce burdens and to strengthen resources of nurses. Methods In 2017, a nationwide cross-sectional survey was conducted. In total, 437 nurses in GPC and 1316 nurses in SPC completed a questionnaire containing parts of standardised instruments, which included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Patient Health Questionnaire (PHQ-2), the Resilience Scale (RS-13) Questionnaire, a single question about back pain from the health survey conducted by the Robert Koch Institute as well as self-developed questions. The differences in the variables between GPC and SPC nurses were compared. Results SPC nurses reported higher emotional demands as well as higher burdens due to nursing care and the care of relatives while GPC nurses stated higher quantitative demands, i.e. higher workload. SPC nurses more often reported organisational and social resources that were helpful in dealing with the demands of their work. Regarding health, GPC nurses stated a poorer health status and reported chronic back pain as well as a major depressive disorder more frequently than SPC nurses. Furthermore, GPC nurses reported a higher intention to leave the profession compared to SPC nurses. Conclusions The findings of the present study indicate that SPC could be reviewed as the best practice example for nursing care in Germany. The results may be used for developing target group specific prevention programs for improving health and wellbeing of nurses taking the differences between GPC and SPC into account. Finally, interventional and longitudinal studies should be conducted in future to determine causality in the relationship of burdens, resources, health and wellbeing.

2018 ◽  
Vol 56 (6) ◽  
pp. e92-e93
Author(s):  
Maarten Vermogen ◽  
Aline De Vleminck ◽  
Kathleen Leemans ◽  
Lieve Van den Block ◽  
Chantal Van Audenhove ◽  
...  

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101078
Author(s):  
Marijanne Engel ◽  
Andrée van der Ark ◽  
Lia van Zuylen ◽  
Agnes van der Heide

BackgroundAdvance care planning (ACP) can help to enhance the care of patients with limited life expectancy. Despite physicians’ key role in ACP, the ways in which physicians estimate and communicate prognosis can be improved.AimTo determine how physicians in different care settings self-assess their performance in estimating and communicating prognosis to patients in palliative care, and how they perceive their communication with other physicians about patients’ poor prognosis.Design & settingA survey study was performed among a random sample of GPs, hospital physicians (HPs), and nursing home physicians (NHPs) in the southwest of the Netherlands (n = 2212).MethodA questionnaire was developed that had three versions for GPs, HPs, and NHPs. Each specialism filled in an appropriate version.ResultsA total of 547 physicians participated: 259 GPs, 205 HPs, and 83 NHPs. In the study, 61.1% of physicians indicated being able to adequately estimate whether a patient will die within 1 year, which was associated with use of the Surprise Question (odds ratio [OR] = 1.65, P = 0.042). In the case of a prognosis of <1 year, 75.0% of physicians indicated that they communicate with patients about preferences regarding treatment and care, which was associated with physicians being trained in palliative care (OR = 2.02, P=0.007). In cases where patients with poor prognosis are discharged after hospital admission, 83.4% of HPs indicated that they inform GPs about these patients’ preferences compared with 29.0% of GPs, and 21.7% of NHPs, who indicated that they are usually adequately informed about the preferences.ConclusionThe majority of physicians indicated that they believe they can adequately estimate patients’ limited life expectancy and that they discuss patients’ preferences for care. However, more physicians should be trained in communicating about patients’ poor prognosis and care preferences.


10.2196/28311 ◽  
2021 ◽  
Vol 5 (12) ◽  
pp. e28311
Author(s):  
Roman Shrestha ◽  
Celia Fisher ◽  
Jeffrey A Wickersham ◽  
Antoine Khati ◽  
Rayne Kim ◽  
...  

Background The use of mobile health (mHealth), including smartphone apps, can improve the HIV prevention cascade for key populations such as men who have sex with men (MSM). In Malaysia, where stigma and discrimination toward MSM are high, the mHealth platform has the potential to open new frontiers for HIV prevention efforts. However, little guidance is available to inform researchers about privacy and confidentiality concerns unique to the development and implementation of app-based HIV prevention programs. Objective Given the lack of empirical data in this area, we aim to understand the privacy and confidentiality concerns associated with participation in a hypothetical app-based research study for HIV prevention efforts. Methods A cross-sectional, web-based survey was conducted between June and July 2020 among 355 Malaysian MSM. The survey included demographic and sexual health questions and a series of short videos describing a hypothetical app-based HIV prevention program, followed by questions related to privacy and confidentiality concerns in each step of the app-based program (ie, recruitment, clinical interaction, risk assessment, and weekly reminder). Multivariable logistic regression models were used to identify the correlates of willingness to use such an app-based program. Results Most of the participants (266/355, 74.9%) indicated their willingness to participate in a hypothetical mHealth app–based HIV prevention program. Participants expressed concerns about privacy, confidentiality, data security, and risks and benefits of participating in all stages of the app-based HIV research process. Multivariate analyses indicated that participants who had a higher degree of perceived participation benefits (adjusted odds ratio [aOR] 1.873; 95% CI 1.274-2.755; P=.001) were more willing to participate. In contrast, participants who had increased concerns about app-based clinical interaction and e-prescription (aOR 0.610; 95% CI 0.445-0.838; P=.002) and those who had a higher degree of perceived risks of participating (aOR 0.731; 95% CI 0.594-0.899; P=.003) were less willing to participate. Conclusions Overall, our results indicate that mHealth app–based HIV prevention programs are acceptable for future research on Malaysian MSM. The findings further highlighted the role of privacy and confidentiality, as well as the associated risks and benefits associated with participation in such a program. Given the ever-evolving nature of such technological platforms and the complex ethical–legal landscape, such platforms must be safe and secure to ensure widespread public trust and uptake.


2021 ◽  
pp. 1-7
Author(s):  
Shana E. Harrington ◽  
Sean McQueeney ◽  
Marcus Fearing

Context: Training loads, injury, and injury prevention in the Para sports population has not been well established. Objective: The purpose of this study was to survey elite-level swimming, cycling, and athletic Para sport athletes in the United States who were competing in the 2016 US Paralympic trials to better understand common injuries among athletes in each sport and to determine whether injury prevention programs were being utilized. Design: Cross-sectional, survey study. Setting: The 2016 US Paralympic trials for swimming, cycling, and athletics. Participants: Athletes who competed in swimming, cycling, and/or athletics at the 2016 US Paralympic trials (N = 144; 83 males and 61 females). Main Outcome Measures: Participants completed electronic survey using Qualtrics XM (Qualtrics, Provo, UT) with questions pertaining to average number of hours trained per week, number of cross-training hours performed each week, descriptive information regarding sport-related injuries, pain, whether athletes received treatment for injuries, and descriptive information regarding whether the athletes had participated in an injury prevention program. Results: Over 64% of respondents reported training greater than or equal to 11 hours per week, and 45% of athletes reported spending greater than or equal to 6 hours per week cross-training. Forty-two percent of athletes reported currently having pain with 34% reporting missing a competition because of injury. Only 24% of respondents reported having participated in an injury prevention program. Conclusions: Many Para sport athletes train at similar durations as able-bodied counterparts and have pain that interferes with their ability to train and compete, however, only a small percentage consistently perform injury prevention programs.


2021 ◽  
Author(s):  
Roman Shrestha ◽  
Celia Fisher ◽  
Jeffrey A Wickersham ◽  
Antoine Khati ◽  
Rayne Kim ◽  
...  

BACKGROUND The use of mobile health (mHealth), including smartphone apps, can improve the HIV prevention cascade for key populations such as men who have sex with men (MSM). In Malaysia, where stigma and discrimination toward MSM are high, the mHealth platform has the potential to open new frontiers for HIV prevention efforts. However, little guidance is available to inform researchers about privacy and confidentiality concerns unique to the development and implementation of app-based HIV prevention programs. OBJECTIVE Given the lack of empirical data in this area, we aim to understand the privacy and confidentiality concerns associated with participation in a hypothetical app-based research study for HIV prevention efforts. METHODS A cross-sectional, web-based survey was conducted between June and July 2020 among 355 Malaysian MSM. The survey included demographic and sexual health questions and a series of short videos describing a hypothetical app-based HIV prevention program, followed by questions related to privacy and confidentiality concerns in each step of the app-based program (ie, recruitment, clinical interaction, risk assessment, and weekly reminder). Multivariable logistic regression models were used to identify the correlates of willingness to use such an app-based program. RESULTS Most of the participants (266/355, 74.9%) indicated their willingness to participate in a hypothetical mHealth app–based HIV prevention program. Participants expressed concerns about privacy, confidentiality, data security, and risks and benefits of participating in all stages of the app-based HIV research process. Multivariate analyses indicated that participants who had a higher degree of perceived participation benefits (adjusted odds ratio [aOR] 1.873; 95% CI 1.274-2.755; <i>P</i>=.001) were more willing to participate. In contrast, participants who had increased concerns about app-based clinical interaction and e-prescription (aOR 0.610; 95% CI 0.445-0.838; <i>P</i>=.002) and those who had a higher degree of perceived risks of participating (aOR 0.731; 95% CI 0.594-0.899; <i>P</i>=.003) were less willing to participate. CONCLUSIONS Overall, our results indicate that mHealth app–based HIV prevention programs are acceptable for future research on Malaysian MSM. The findings further highlighted the role of privacy and confidentiality, as well as the associated risks and benefits associated with participation in such a program. Given the ever-evolving nature of such technological platforms and the complex ethical–legal landscape, such platforms must be safe and secure to ensure widespread public trust and uptake.


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