[The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study]. / Das doppelte Kompetenzprofil: Ein Beitrag für die Zusammenarbeit von Praxis und Wissenschaft.

The dual competence profile: A support of collaboration between practice and science. A qualitative descriptive study Abstract. Background: To ensure orientation towards needs existing in the realm of practice, the dual competence profile is mandatory at universities of applied sciences (UAS): in addition to academic qualifications, entrenchment in professional practice is demanded. However, it is unclear how needs, attitudes, and expectation of clinical practice regarding the interface between UAS and practice looks like. Thus, it is necessary to shed light on the cross-institutional and cross-divisional cooperation as well as on its participants. Aim: This article shows what needs and attitudes people from clinical practice have with regard to cooperation with the UAS and what they expect from persons with a dual competence profile. Methods: Guided individual and focus group interviews with 24 selected representatives from acute, rehabilitation and geriatric care institutions took place. The interviews address the following five block themes: "current state", "need for change", "areas for action", "needs" and "sustainability". Results: Practice institutions demonstrated a clear need for networking and knowledge circulation with the UAS, with a bilateral influence of four subcategories: overall goal, staff development, resources and general regulations. Conclusions: Persons with dual competency profiles provide a valid way for interconnecting higher education and practice institutions in a concrete manner. Their complex work environments require meaningful frameworks, shared goals, and the inclusion of key stakeholders.

A self-management intervention for people with multiple sclerosis: The development of a programme theory in the field of rehabilitation nursing.

BACKGROUND: People with multiple sclerosis (PwMS) have recurrent stays in rehabilitation clinics because of progressive disease. Nurses are key players in supporting PwMS through self-management interventions. However, little is known about the effectiveness, or sustainability of nursing interventions. The aim of this study was to develop a nurse-led self-management intervention and its programme theory for PwMS in one Swiss rehabilitation clinic. METHODS: On the basis of the Medical Research Council framework, we developed a theory-based programme for a nurse-led intervention. As key element of the intervention, we created a consulting guidance. RESULTS: As part of the programme theory, we created a systematic plan (action model) to illustrate how contextual resources (e.g., skills of the MS nurse and responsibilities of the multidisciplinary team) need to be coordinated. The change model shows how changes in the intervention lead to the achievement of outcomes (e.g., increased self-efficacy). The consulting guidance was refined by PwMS and four Swiss MS experts. CONCLUSIONS: An initial programme theory is a solid foundation for the next phases of the theory-based evaluations to refine the programme theory and sustainable implementation of the intervention.

Effectiveness and content components of nursing counselling interventions on self- and symptom management of patients in oncology rehabilitation-A systematic review.

AIM: To synthesize the evidence on the effectiveness and content components of nurse-led counselling interventions on the self-and symptom management of patients in oncology rehabilitation. DESIGN: A systematic review METHODS: The electronic databases MEDLINE, CINAHL, Cochrane Library and Grey Literature were searched for randomized controlled trials or quasi-experimental trials. Following data extraction, a quality assessment was performed using the Joanna Briggs Institute checklist and the Cochrane risk-of-bias tool. The findings were synthesized in narrative and tabular formats. RESULTS: Seven studies were included in the analysis. Two RCTs measured a statistically significant increase in self-efficacy compared to the control group, and one quasi-experimental study showed a statistically significant increase compared to the pre-intervention period. Symptom anxiety was statistically significantly reduced in two RCTs and one quasi-experimental trial. Self-management similarities in the components of the interventions were seen as identifying patients' concerns, setting goals, developing action plans and evaluating the goals and giving patient-tailored information.

"I would stress less if I knew that the nurse is taking care of it": Multiple Sclerosis inpatients' and health care professionals' views of their nursing-experience and nursing consultation in rehabilitation-a qualitative study.

BACKGROUND: Nurses play a crucial role in the multidisciplinary team in the rehabilitation of multiple sclerosis (MS) patients. However, little is known about patients' and health care professionals' (HCP) experiences (physicians, therapists) with nurses in rehabilitation. The aim of this qualitative study is (i) to describe the rehabilitation nursing care from the perspective of MS patients and HCPs and their view of a nursing consultations (ii) to elaborate similarities and differences of patients' and HCP's views. METHODS: We used a qualitative approach and selected the participants purposively. We conducted semi-structured individual MS patient (n = 15) and two focus groups interviews with HCPs (n = 8) in an inpatient rehabilitation clinic in Switzerland. We analysed the data using a structuring content analysis approach. First, we analysed patients' and HCPs' perspectives separately. Afterwards we elaborated similarities and differences descriptively. RESULTS: Main categories of patients' perspectives were "need for nursing care" and "relationship between nurses and MS patient". MS patients have mentioned the following points according to a nursing consultation: (i) nurses as advocates, (ii) involvement of relatives (iii) peer groups (iv) contact person. "Nurses in their scope of practice", "nurses as a part of the multidisciplinary team" and "the specifications in the treatment of MS patients" were main categories of HCPs' perspective. MS patients and HCPs demonstrated similarly the importance to have a nurse as a contact person in the multidisciplinary team and the need to integrate a nurse-led peer group in a nursing consultation. While HCPs prefer that relative always be included in nursing consultations, patients provided reasons when inclusion was not desirable. CONCLUSION: The results indicate that continuity in the nursing care for MS patients could contribute to a trusting nurse-patient relationship. This facilitates nurses to create a deeper understanding of MS patients and their needs in daily rehabilitation. The need for MS patients to share their concerns and receive scientifically proven knowledge from peers could addressed with a nurse-led peer group.

Nursing Interventions Focusing on Self-efficacy for Patients With Multiple Sclerosis in Rehabilitation: A Systematic Review.

BACKGROUND: Rehabilitative nursing interventions are vital in the treatment of multiple sclerosis (MS), but there is a lack of evidence on the effectiveness of such interventions. This review aims to summarize outcomes of nurse-led rehabilitation interventions for patients with MS, focusing on patients' self-efficacy and self-management and their satisfaction with the intervention. This review is the first step of our overarching goal of developing, implementing, and evaluating a research-supported nursing consultation intervention in inpatient rehabilitation. METHODS: We searched 3 databases from their dates of inception until April 2020 (and performed another search in August 2021) for studies involving adult patients diagnosed as having MS. We focused on studies with interventions aimed at self-efficacy and self-management of MS and studies on intervention satisfaction. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS: We included 4 studies in this review with a total of 271 participants. All interventions were educational and included training programs. All studies assessed self-efficacy, and all identified an improvement in self-efficacy, particularly through group training interventions. One study focused on self-management, reporting an improvement resulting from the intervention. Two studies evaluating satisfaction with the intervention obtained good overall satisfaction scores from participants, and 1 study's program was strongly recommended by participants. CONCLUSIONS: This review indicates that self-efficacy and self-management abilities may be effectively promoted, particularly through group training interventions. An intervention tailored and adapted to the needs of patients with MS may promote satisfaction with the intervention and might consequently improve adherence to rehabilitation interventions.

Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention-An intervention study.

AIM: The study aimed to implement and measure effectiveness of a systematic continence management intervention in people suffering a stroke in undertaking rehabilitation. DESIGN: An intervention study was conducted. METHODS: In the first part of the study, patients were included in the control group and observed. After the training of the nursing staff, participants were assigned to the intervention group. The intervention consisted of screening, assessment, treatment, communication and evaluation. RESULTS: Forty-six patients took part in the study, of which 35 were in the control and 11 in the intervention groups. Within the two groups, significant improvements in outcomes were mostly seen during the study. For the Incontinence Quality of Life Social Embarrassment scale, a significantly higher increase was observed for the intervention group. The improvement between admission and discharge in the intervention group was notably larger for the outcome's incontinence and quality of life.

Promoting urinary continence with nonpharmacological interventions in Parkinson's disease.

Background: The evidence of nonpharmacological interventions promoting urinary continence in Parkinson's disease is low and rehabilitation nurses do not give it a high priority. Aim: To examine the effects of a urinary incontinence management program on continence and quality of life in persons with Parkinson's disease in inpatient rehabilitation. The acceptance of the intervention and the knowledge of the nurses were also of interest. Methods: A nonrandomized experimental study was conducted. The data collection commenced with a control group followed by an intervention group. A structured urinary incontinence management was performed in the intervention phase. This includes incontinence assessment, care planning, individual interventions, discharge planning, and telephone support at home. Results: Urinary continence and quality of life were enhanced in both groups; however, improvements were higher in the intervention group but the differences were not significant. Knowledge of the nurses about urinary incontinence improved during the study duration. The acceptance of the intervention was high. Conclusions: A structured urinary continence management may improve urinary continence in persons suffering from Parkinson's disease. In clinical practice it is important to perform a detailed assessment to identify problems regarding urinary incontinence.

Effectiveness of a group-walking intervention for people with dementia based on quality of life and caregivers' burden.

AIMS: To test the effectiveness of a 28-week group-walking intervention for person with dementia. Participants were accompanied by trained volunteers. The effectiveness was assessed according to the quality of life, ability to perform activities of daily living, independence, mobility, cognition, challenging behaviours and the burden on their caregiving relatives. DESIGN: Quasi-experimental, one-group, pretest-posttest trial. METHODS: Thirty-two persons with dementia and their caregiving relatives were recruited. The nursing intervention consists on easy walking tours lasting three and a half hours. The walks were performed biweekly and each person with dementia had support from one or two trained volunteer helpers. RESULTS: The quality of life was stable through all seasons. The secondary outcomes were uneven. While the impairment (WHODAS) and the dependence (IADL) increased, the challenging behaviours and the burden on the caregivers were stable through all seasons.

Die Rolle von Pflegefachpersonen in der onkologischen Rehabilitation.

Nurse's role in oncological rehabilitation - A scoping review Abstract. Background: For people with cancer the offer for inpatient or outpatient oncological rehabilitation is more and more increasing. Oncological rehabilitation has an interdisciplinary approach to prepare people with cancer for their life at home. Nurses are part of the interdisciplinary team, but little is known about their special role in this setting. Objective: The aim of this study is to identify the role of nurses and their functions in cancer rehabilitation. Methods: A scoping review was conducted. A literature search was conducted in MEDLINE via PubMed and CINAHL, Google Scholar and in reference lists. There was no limitation of publication period. After evaluation of the included publications a thematic analysis was undertaken. Results: All in all, 7 publications (1 qualitative study, 1 editorial book, 1 white paper, 1 article and 3 literature reviews) were included. Through thematic analysis 3 main topics were identified: nurse's role as emotional and psychological support, coach and part of the interdisciplinary team. In addition to general care, they promote self-management, advise and train, carry out symptom management and take on a coordinative function. Conclusion: This scoping review offers a first overview about the role of nurses in oncological rehabilitation. The focus is on preparation of cancer survivors for their new and changed life.

Urinary incontinence in stroke survivors - Development of a programme theory.

AIMS AND OBJECTIVES: To develop, in an inpatient rehabilitation setting, a programme theory that promotes continence in people who have suffered a stroke. BACKGROUND: Urinary incontinence in stroke survivors impacts the quality of life, rehabilitation outcomes and ultimately incurred costs of the patient. Different approaches are available for developing and testing complex interventions. DESIGN: Building a research-based programme theory. METHODS: To elaborate the intervention, a guidance for developing a complex intervention for nursing was chosen and the sources that should be considered were defined. Subsequently, a research-based programme theory was generated that was represented via a theoretical approach logic model. This study was guided by the checklist for reporting theory of change in public health interventions. RESULTS: The intervention consists of six parts with three outcome chains on interconnected levels, which are oriented towards patients and nurses. The important aspects of the programme theory are communication, individually tailored measures and the definition of interdisciplinary objectives. CONCLUSION: Developing a programme theory and representing it via a logic model help clarify the initial intervention and ensure that implementation strategies are well thought out. RELEVANCE TO CLINICAL PRACTICE: By employing detailed reflection and using previous research, it is expected that the intervention can be implemented successfully and its effectiveness can be investigated in more depth.

Post-Cerebrovascular Accident Unpredictable Incontinence: A Qualitative Analysis of an Interdisciplinary Rehabilitation Team's Perspective.

PURPOSE: This study investigates experiences of the interdisciplinary rehabilitation team in the treatment of patients with urinary incontinence after stroke. DESIGN: A qualitative approach was chosen. Ten members of an interdisciplinary treatment team were interviewed in a neurological inpatient rehabilitation setting. METHODS: Data were obtained via focus groups with nurses, physicians, physiotherapists, and occupational therapists in a rehabilitation clinic. The analysis followed the principles of qualitative content analysis. FINDINGS: According to the interdisciplinary treatment team, professionals and patients prioritize incontinence treatment differently. Challenges surrounding collaboration, communication, structural conditions, and the perception of intervention success were identified as barriers to promoting continence. CONCLUSION: To overcome this discrepancy in treatment priority, awareness of poststroke urinary incontinence must be improved. CLINICAL RELEVANCE: A key component is communication about urinary incontinence with patients and among team members.

(Can) Not talk about it - Urinary incontinence from the point of view of stroke survivors: a qualitative study.

PURPOSE: The current study intends to gain an in-depth understanding of stroke survivors' lived experience of urinary incontinence and its treatment in an inpatient rehabilitation clinic. METHODS: A qualitative approach was chosen. Semi-structured individual interviews with ten stroke survivors suffering from urinary incontinence were conducted in an inpatient rehabilitation clinic and analysed using qualitative content analysis with an inductive approach. RESULTS: '(Can) not talk about it' was identified as the first main category. The affected persons do not talk about urinary incontinence because they are ashamed. At the same time, no one asks them about this issue. Psychological strain is so high that patients feel the need to talk about incontinence, but from their point of view, conversations with nurses - if they indeed occur - are superficial or nurses do not listen. Therefore, patients' needs and concerns are not properly considered. 'Trying to command incontinence' was also identified as a main category. Participants reported that they try to command incontinence and to develop their own strategies in order to hide urinary incontinence and prevent shameful situations. However, this proved mostly unsuccessful and resulted in resignation to their condition. CONCLUSION: It is important to raise awareness within the treatment team of urinary incontinence in stroke survivors. Team members should be able to communicate about urinary incontinence in an open and empathic way. Obviously, there is great potential for supporting stroke survivors in dealing with incontinence.

Incontinence in nursing home residents with dementia : Influence of an educational program and nursing case conferences.

BACKGROUND: Up to 90 % of nursing home residents with dementia suffer from urinary incontinence with adverse effects on the quality of life. Nurses are often insufficiently prepared for incontinence management and their knowledge is incomplete. Urinary incontinence management for people with dementia is complex due to the multifactorial nature of the disease and cognitive impairment. OBJECTIVE: This study explored the effects of an educational program and subsequent nursing case conferences on urinary incontinence and quality of life of nursing home residents with dementia. METHODS: The stepped-wedge trial design was used and seven nursing homes were included. In total 140 people were included in the study. The intervention consisted of an educational program and six case conferences at each ward. Urinary incontinence and quality of life were measured at baseline, after 2 and 6 months as well as at the end of the study. Univariate analysis of variance (ANOVA), repeated measures ANOVA and linear regression were used to compare the groups and the results at different times of measurement. The responsible ethics committees approved the study. RESULTS: After 6 months urinary incontinence decreased or was approximately equal to the initial measurement. At the end of the study urinary incontinence was slightly but not significantly higher. In the whole sample the quality of life increased in seven out of nine categories up to the end of the study. CONCLUSION: Urinary incontinence management for people with dementia is complex and an educational program and case conferences during 6 months proved to be effective in reducing urinary incontinence and improve the quality of life in nursing home residents with dementia.

Effectiveness of non-pharmacological interventions to promote urinary continence in stroke survivors ­ a systematic literature review / Wirksamkeit von nichtmedikamentösen Interventionen zur Förderung der Urinkontinenz bei Menschen nach einem cerebro-vaskulären Insult - eine systematische Literaturübersicht

Background: Around half of the people who survive a cerebrovascular insult are suffering from urinary incontinence. This is a predictor for functional outcomes and affects the quality of life negatively. Until now, it is not clear, which the optimal method of treatment is. A systematic review of 2008 showed an insufficient data situation and couldn't make a recommendation. Research question: Which non-pharmacological interventions are effective to promote urinary continence in adult persons who have suffered a cerebrovascular insult? Method: To answer the question a systematic literature review was performed. The literature search was conducted in the databases PubMed, CINAHL, CENTRAL and PsycInfo. The period from March 2007 to May 2015 was taken into account. Results: There were a total of six studies included which examined 732 persons. The following interventions were explored for their effectiveness: transcutaneous electrical nerve stimulation, urodynamic assessment with recommendation of bladder emptying method and interventions that consist of several components (e. g. toilet training). All studies showed a positive effect in at least one outcome. Conclusions: There is limited evidence for interventions to promote urinary continence in people suffering a cerebrovascular insult. An intervention consisting of assessment and individual adapted measures currently appear to be the best treatment method.

[Trapped in the body - lived experience and coping of individuals having Parkinson and their relatives with changed movement pattern caused by the disease]. / Im Körper gefangen sein - Das Erleben und die Bewältigung der krankheitsbedingt veränderten Bewegungsmuster von Menschen mit Parkinson und ihren Angehörigen.

People with Parkinson's disease suffer from various symptoms. Changed movement patterns frequently represent the prevailing symptom experience and influence the everyday life of the affected persons and their relatives. This qualitative study explores how persons with Parkinson's disease and their relatives experience the changed movement patterns and how they manage the consequential problems in their daily life. Eight persons with Parkinson's disease and six partners were interviewed. The interviews were analysed by means of content analysis according to Mayring. The qualitative analysis resulted in two main categories: "effects on the changed movement patterns on everyday life" and "coping skills for dealing with changed movement patterns". The experience of the affected person can be characterised by "being trapped in the body" as well as by a constantly slowing down daily life. The coping strategies are diverse, but all respondents seek to maintain mobility. Partners naturally support the affected persons and take over many tasks. This is associated with elevated distress and the feeling of having to be permanently present. Various coping strategies have to be promoted and included in daily care for people with Parkinson's disease. Consideration of the individual experience of the changed movement patterns is very important in the development of strategies and also the support of the affected persons and relatives that they can keep up with their movements.