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1.
Frontiers in public health ; 9, 2021.
Article in English | EuropePMC | ID: covidwho-1564663

ABSTRACT

The COVID-19 pandemic has posed an extraordinary challenge for public health and health policy. Questions have arisen concerning the main strategies to cope with this situation and the lessons to be learned from the pandemic. This conceptual paper aims to clarify these questions via sociological concepts. Regarding coping strategies used during the pandemic, there is a strong tendency for health policymakers to rely on expert knowledge rather than on evidence-based knowledge. This has caused the evidence-based healthcare community to respond to urgent demands for advice by rapidly processing new knowledge. Nonetheless, health policymakers still mainly rely on experts in making policy decisions. Our sociological analysis of this situation identified three lessons for coping with pandemic and non-pandemic health challenges: (1) the phenomenon of accelerating knowledge processing could be interpreted from the organizational innovation perspective as a shift from traditional mechanistic knowledge processing to more organic forms of knowledge processing. This can be described as an “organic turn.” (2) The return of experts is part of this organic turn and shows that experts provide both evidence-based knowledge as well as theoretical, experiential, and contextual knowledge. (3) Experts can use theory to expeditiously provide advice at times when there is limited evidence available and to provide complexity-reducing orientation for decisionmakers at times where knowledge production leads to an overload of knowledge;thus, evidence-based knowledge should be complemented by theory-based knowledge in a structured two-way interaction to obtain the most comprehensive and valid recommendations for health policy.

2.
Int J Environ Res Public Health ; 18(21)2021 10 27.
Article in English | MEDLINE | ID: covidwho-1512285

ABSTRACT

The relationship between nurse staffing, physical outcomes of residents, as well as quality of care receives major attention. The impact of staffing levels on residents' ability to organize their everyday life and maintain social contacts, however, has not been analyzed to date. This study examines whether a relationship between the staff-to-resident ratio for registered nurses and nursing home residents with and without dementia aged over 80 exists. Secondary data collected in the project inQS (indikatorengestützte Qualitätsförderung) were used (n = 1782, mean age = 88.14). The analyzed cross-sectional data were collected in winter 2019 in facilities of the Diocesan Caritas Association in Germany. A sum score formed from variables measuring residents' abilities to independently organize their everyday life and maintain social contacts functioned as the dependent variable. A multi-level regression analysis was performed. The results revealed that the ability of residents without dementia was significantly associated with the staff-to-resident ratio of registered nurses. This was not true for residents with dementia. For the latter, however, whether the facility offers a segregated care unit turned out to be significant. Additional and longitudinal research is indispensable to explain the inequality between the two groups analyzed.


Subject(s)
Dementia , Inpatients , Aged , Aged, 80 and over , Cross-Sectional Studies , Humans , Nursing Homes , Workforce
3.
J Public Health (Oxf) ; 43(3): e435-e437, 2021 Sep 22.
Article in English | MEDLINE | ID: covidwho-1219366

ABSTRACT

In the course of the coronavirus disease 2019 pandemic, long-term nursing care facilities are faced with general and pandemic-specific demands. In our study, we examined their burden from the perspective of managers in long-term nursing care facilities and how it differed in outpatient and inpatient settings. A cross-sectional online survey of long-term care managers was conducted in April 2020 (n = 503) and December 2020/January 2021 (n = 294). Burdens have increased over the course of the pandemic especially for outpatient facilities and in terms of general demands referring to staff (e.g. (staff shortages and overload) and work organization (e.g. compliance with regulations on working hours or staffing ratio). Concerns about infections of people in need of care and of employees remain the highest burden in the course of the pandemic. This knowledge helps us to draw implications from the pandemic and to prepare for future crises.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Germany/epidemiology , Humans , Long-Term Care , SARS-CoV-2
4.
J Public Health (Oxf) ; 43(3): e431-e434, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1140009

ABSTRACT

The Corona pandemic poses major demands for long-term care, which might have impacted the intention to quit the profession among managers of long-term care facilities. We used cross-sectional data of an online survey of long-term care managers from outpatient and inpatient nursing and palliative care facilities surveyed in April 2020 (survey cycle one; n = 532) and between December 2020 and January 2021 (survey cycle two; n = 301). The results show a significant association between the perceived pandemic-specific and general demands and the intention to leave the profession. This association was significantly stronger for general demands in survey cycle two compared with survey cycle one. The results highlight the pandemic's immediate impact on long-term care. In view of the increasing number of people in need of care and the already existing scarcity of specialized nursing staff, the results highlight the need for initiatives to ensure the provision of long-term care, also and especially in such times of crisis.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Germany/epidemiology , Humans , Intention , Long-Term Care , SARS-CoV-2 , Surveys and Questionnaires
5.
J Med Internet Res ; 22(10): e22716, 2020 10 29.
Article in English | MEDLINE | ID: covidwho-810055

ABSTRACT

BACKGROUND: Internet hospitals show great potential for adequately fulfilling people's demands for high-quality outpatient services, and with the normalization of the epidemic prevention and control of COVID-19, internet hospitals play an increasingly important role in delivering health services to the public. However, the factors that influence patients' intention to use the online inquiry services provided by internet hospitals remain unclear. Understanding the patients' behavioral intention is necessary to support the development of internet hospitals in China and promote patients' intention to use online inquiry services provided by internet hospitals during the prevention and control of the COVID-19 epidemic. OBJECTIVE: The purpose of this study is to identify the determinants of patients' intention to use the online inquiry services provided by internet hospitals based on the theory of planned behavior (TPB). METHODS: The hypotheses of our research model were developed based on the TPB. A questionnaire was developed through patient interviews, verified using a presurvey, and used for data collection for this study. The cluster sampling technique was used to include respondents with chronic diseases. Structural equation modeling was used to test the research hypotheses. RESULTS: A total of 638 valid responses were received from patients with chronic diseases. The goodness-of-fit indexes corroborated that the research model was a good fit for the collected data. The model explained 45.9% of the variance in attitude toward the behavior and 60.5% of the variance in behavioral intention. Perceived behavioral control and perceived severity of disease had the strongest total effects on behavioral intention (ß=.624, P=.004 and ß=.544, P=.003, respectively). Moreover, perceived convenience, perceived information risk, emotional preference, and health consciousness had indirect effects on behavioral intention, and these effects were mediated by attitude toward the behavior. Among the four constructs, perceived convenience had the highest indirect effect on behavioral intention (ß=.207; P=.001). CONCLUSIONS: Perceived behavioral control and perceived severity of disease are the most important determinants of patients' intention to use the online inquiry services provided by internet hospitals. Therefore, internet hospitals should further optimize the design of online service delivery and ensure a reasonable assembly of high-quality experts, which will benefit the promotion of patients' adoption intention toward online inquiry services for health purposes. Perceived convenience, emotional preference, and perceived risks also have effects on behavioral intention. Therefore, the relevant quality control standards and regulations for internet hospitals should be further developed and improved, and the measures to protect personal information should be strengthened to ensure the patient safety. Our study supports the use of the TPB in explaining patients' intention to use online inquiry services provided by internet hospitals.


Subject(s)
Health Knowledge, Attitudes, Practice , Intention , Internet , Patient Education as Topic , Patients/psychology , Adolescent , Adult , Attitude , COVID-19 , China/epidemiology , Chronic Disease , Coronavirus Infections/epidemiology , Female , Hospitals , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , Young Adult
6.
Medizinrecht ; 38(8): 637-644, 2020.
Article in German | MEDLINE | ID: covidwho-728155
7.
Pflege ; 33(4): 207-218, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-722563

ABSTRACT

Nursing care in times of COVID-19: Online survey of leaders on challenges, burdens, and coping strategies Abstract. Aim: In light of the dynamic developments and consequences of the COVID-19 pandemic for the care of people in need of long-term care the following questions arise: How do leaders of care facilities perceive the challenges, how burdened are they and how do they cope with these? METHODS: Leaders from outpatient and inpatient nursing and hospice care facilities were contacted by e-mail to participate in an online survey. Closed questions were analysed descriptively, open information was analysed by content analysis. RESULTS: From of 4,333 nursing facilities contacted, usable information was available from 525 persons. The greatest pandemic-related, interdependent challenges include concern about infections of patients and employees, procurement of protective equipment, compliance with hygiene regulations, inconsistency and lack of transparency of information and guidelines that are important for work, and loss of income and lead to a cascade of burdens. Around 40 % of respondents are uncertain whether they can cope with these. According to the respondents, the well-being and presenteeism of the leaders surveyed has deteriorated in the course of the pandemic outbreak and they appeared to be more often ill at work. Financial and structural measures, the strengthening of social cohesion and explanation were mentioned as coping strategies. CONCLUSIONS: The results show an increase in challenges and illustrate interdependent pandemic-related burdens. These are mainly met by overtime and additional effort, especially on the part of leaders. It remains unclear what long-term consequences are to be expected from the burden situation.


Subject(s)
Coronavirus Infections/epidemiology , Nurse Administrators/psychology , Pandemics , Pneumonia, Viral/epidemiology , Skilled Nursing Facilities/organization & administration , COVID-19 , Humans , Surveys and Questionnaires
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