Effects of Implementing a Brief Family Nursing Intervention With Hospitalized Oncology Patients and Their Families in Germany: A Quasi-Experimental Study.

Family nursing, based on the Calgary Family and Intervention Models, was implemented in a German oncological inpatient unit to promote effective family functioning in the context of cancer care. The objective of this study was to investigate the effects of implementing family nursing care on several psychological and physical outcomes of patients and their family members. A quasi-experimental study with 214 patients with a cancer diagnosis and 122 family members was conducted. Findings indicate that the superiority of family nursing, when compared to traditional care, could not be confirmed with respect to patients' outcomes (psychological burden, social support, satisfaction with care) and family members' outcomes (psychological burden, physical complaints, satisfaction with care). Various factors, such as country-specific structures and challenges in implementing family nursing care on an inpatient unit, may have contributed to these findings. Further replication attempts in similar settings in other countries are needed to shed light on the factors impairing or promoting the implementation of family nursing in practice settings.

A scoping review of augmented reality in nursing.

BACKGROUND: Augmented reality (AR) has the potential to be utilized in various fields. Nursing fulfils the requirements of smart glass use cases, and technology may be one method of supporting nurses that face challenges such as demographic change. The development of AR to assist in nursing is now feasible. Attempts to develop applications have been made, but there has not been an overview regarding the existing research. OBJECTIVE: The aim of this scoping review is to provide an overview of the current research regarding AR in nursing to identify possible research gaps. This led to the following research question: "To date, what research has been performed regarding the use of AR in nursing?". A focus has been placed on the topics involving cases, evaluations, and devices used. METHODS: A scoping review was carried out with the methodological steps outlined by Arksey and O'Malley (2005) and further enhanced by Levac et al. (2010). A broad range of keywords were used systematically in eight databases including PubMed, Web of Science and ACM to search for topics in nursing. RESULTS: The search led to 23 publications that were included in the final analysis. The majority of the identified publications describe pilot studies. The methods used for identifying use cases and evaluating applications differ among the included studies. Furthermore, the devices used vary from study to study and may include smart glasses, tablets, and smart watches, among others. Previous studies predominantly evaluated the use of smart glasses. In addition, evaluations did not take framing conditions into account. Reviewed publications that evaluated the use of AR in nursing also identified technical challenges associated with AR. CONCLUSIONS: These results show that the use of AR in nursing may have positive implications. While current studies focus on evaluating prototypes, future studies should focus on performing long-term evaluations to take framing conditions and the long-term consequences of AR into consideration. Our findings are important and informative for nurses and technicians who are involved in the development of new technologies. They can use our findings to reflect on their own design of case identification, requirements for elicitation and evaluation.

[Self-design and prevention potential for older people in institutional long-term care]. / Selbstgestaltungs- und Präventionspotenziale hochaltriger Menschen in der stationären Langzeitversorgung.

Healthcare in inpatient long-term care facilities (nursing homes) should not be limited to medical curative measures, but should also include strengthening social participation, autonomy, self-responsibility and joint responsibility of the residents. Prevention and rehabilitation should therefore be even more integrated into care concepts.This article first introduces various areas of prevention physical activity, nutrition, cognitive competence, psychosocial health, abuse, and freedom-removing measures and then discusses their evidence. Essential for the implementation and the success of such measures is the ability and willingness of people in need of care to engage actively in these therapies; here, appropriate and motivating information plays an important role.Subsequently, geriatric rehabilitation is referred to. In the 2013-2017 empirical study Organization and Rehabilitation for Residents in the Nursing Home to Improve Independence and Participation (ORBIT), 215 people in need of care participated in three-month therapeutic interventions, which were followed by three-months of rehabilitative care. Improvements in mobility and quality of life (Barthel index, QOL-AD) could be demonstrated compared to a control group (n = 28). The results have to be considered against the background of a worsening health and reduced functional capacities in old age. A stronger integration of prevention and rehabilitation services into long-term institutional care is functional for strengthening participation and independence - an important condition for the residents' certainty that their dignity will be respected, competence and strive for self-responsibility and self-determination.

[Evaluation of the implementation process of family nursing in oncology]. / Implementation und Evaluation einer familienzentrierten Pflege in der Onkologie.

Evaluation of the implementation process of family nursing in oncology Abstract. BACKGROUND: The confrontation with a life-threatening cancer disease and the resulting consequences are a great burden for patients as well as for their family members. Family nursing based on the Calgary Model was implemented on a German oncological inpatient unit in order to strengthen the family's ability to self-help. AIM: The objectives were a) to systematically record, evaluate and if necessary to modify the implementation process, b) to highlight promoting and inhibiting factors and c) to derive recommendations for transferability to other oncological units. METHODS: The implementation process was examined by means of two group interviews with nurses, five interviews with other members of the treatment team, and observations of, in each case four, family assessments, family interviews and family-related team meetings. RESULTS: Family nursing could be implemented in a modified form. Genograms and ecomaps have become part of the admission interview. In family interviews, needs of the entire family were determined with the help of circular communication. Family-related team meetings were carried out according to an adapted method of the reflecting team. The complete implementation of family nursing was impeded by the lack of professional consulting competences of the nursing staff, the system of nursing care delivery and lack of time. CONCLUSION: An implementation of family nursing in other oncological units is recommended under modified preconditions.

Smart Glasses in Nursing - Situation Change and Further Usages Exemplified on a Wound Care Application.

Smart Glasses are a promising technology that can be leveraged to improve flexible service processes. Especially in the field of nursing where practitioners are facing complex tasks and challenges. Introducing such pervasive computing devices in service processes may have both positive and negative consequences. This leads us to the following research questions: How does the usage of the Smart Glass applications change the caring situation? Which ideas for future usage of Smart Glasses do nurses have? To answer these questions we followed a design science research approach to design a prototype for support of wound care management in nursing. We evaluated the prototype in a real life situation. Five nurses used the application in a real world setting to perform a wound documentation. Afterwards, we conducted semi-structured interviews with the nurses. The intent of the interviews was not only to get information on the current prototype, but to generate knowledge about dimensions of changing the caring situation which should be considered further. The nurses gave the application an overall positive evaluation. They stated that they would expect an improvement of the quality of the wound documentation when using the device. In addition, they mentioned a change in the communication structure with the patient would be necessary. Furthermore, opinions regarding further use cases did differ.

Augmented Reality in Nursing: Designing a Framework for a Technology Assessment.

During the last decade, research emphasized the wide range of possibilities of augmented reality (AR). At the same time, Information Technology usage in nursing increased. The question occurs if AR can have reasonable fields of application in nursing. Nursing hinges strongly on the emotional and physical relationship between patients and their nurses. This may lead to ethical conflicts while implementing AR leading to special challenges. Therefore the realization of a technology assessment (TA) seams to be reasonable. We designed a framework for a TA of AR in nursing through workshops with nursing scientists and practical partners. The framework is designed to address ethical aspects of AR in nursing through techno-ethical scenarios, a plausibility assessment, and a participatory approach.

Working with a domestic assessment system to estimate the need of support and care of elderly and disabled persons: results from field studies.

This article describes the results of field studies performed over a period between five months and 24 months. The objectives of these studies were to collect long-term real-life data to evaluate how these data can be mapped to items on standardized assessment tests and which presentation method is most suitable to inform caregivers about critical situations and changes in health or care needs. A Home-monitoring system which uses modern sensor technologies was developed for and used in these field studies. It was installed in living environments of seven people (three who were not in need of care, two in need of care, and two with mental disabilities). The data were generated by sensor data acquisition and questionnaire reporting. Four types of data analysis and representation were evaluated to support caregivers. Results show that sensor data can be used to determine information directly or indirectly, which can be mapped to relevant assessment items and presented with different degrees of granularity. It is also feasible to determine and present additional information of potential interest which cannot be directly mapped to any assessment item. Sensor data can also be displayed in a live view. This live data representation led to a decrease in the caregivers' workload when assessed according to the German version of the Perceived Stress Questionnaire.

Multimodal activity monitoring for home rehabilitation of geriatric fracture patients--feasibility and acceptance of sensor systems in the GAL-NATARS study.

BACKGROUND: Demographic change will lead to a diminishing care workforce faced with rising numbers of older persons in need of care, suggesting meaningful use of health-enabling technologies, and home monitoring in particular, to contribute to supporting both the carers and the persons in need. OBJECTIVES: We present and discuss the GAL-NATARS study design along with first results regarding technical feasibility of long-term home monitoring and acceptance of different sensor modalities. METHODS: Fourteen geriatric participants with mobility-impairing fractures were recruited in three geriatric clinics. Following inpatient geriatric rehabilitation, their homes were equipped with ambient sensor components for three months. Additionally, a wearable accelerometer was employed. Technical feasibility was assessed by system and component downtimes, technology acceptance by face-to-face interviews. RESULTS: The overall system downtime was 6%, effected by two single events, but not by software failures. Technology acceptance was rated very high by all participants at the end of the monitoring periods, and no interference with their social lives was reported. DISCUSSION AND CONCLUSIONS: Home-monitoring technologies were well-accepted by our participants. The information content of the data still needs to be evaluated with regard to clinical outcome parameters as well as the effect on the quality of life before recommending large-scale implementations.

Needs of relatives of breast cancer patients: the perspectives of families and nurses.

PURPOSE: Breast cancer is not only a stressful event for those afflicted, but also for their family and friends. In Germany, attention and support from professional nurses is almost exclusively given to the patient. But even relatives require information and support in order to keep their anxiety levels low and strength up. The aim of this study is to survey those needs and the current level of satisfaction, as well as to ascertain which needs are perceived by nurses. METHOD: Data were collected in a German-wide descriptive cross-sectional study surveying 242 relatives and 356 nurses from 150 randomly chosen certified breast care centers between August 2008 and February 2009. Two questionnaires developed for this study were used. RESULTS: The findings indicate that relatives need above all a) security and trust, followed by b) partnership of care and c) emotional support. Regarding satisfaction, relatives consider the need for "security and trust" to be most satisfied. Least fulfilled were those for "partnership of care" and "emotional support". The nurses regarded the importance of most of the relatives' needs to be higher than the relatives themselves. Even the fulfillment of needs was over-estimated. CONCLUSIONS: The targeted and professional involvement of relatives in the care of breast cancer patients is still not common practice. An initial step toward better family nursing is viewing families as an integral part of the patient and intentionally planning contact.

The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies.

Worldwide, ageing societies are bringing challenges for independent living and healthcare. Health-enabling technologies for pervasive healthcare and sensor-enhanced health information systems offer new opportunities for care. In order to identify, implement and assess such new information and communication technologies (ICT) the 'Lower Saxony Research Network Design of Environments for Ageing' (GAL) has been launched in 2008 as interdisciplinary research project. In this publication, we inform about the goals and structure of GAL, including first outcomes, as well as to discuss the potentials and possible barriers of such highly interdisciplinary research projects in the field of health-enabling technologies for pervasive healthcare. Although GAL's high interdisciplinarity at the beginning slowed down the speed of research progress, we can now work on problems, which can hardly be solved by one or few disciplines alone. Interdisciplinary research projects on ICT in ageing societies are needed and recommended.

Environments for ageing, assistive technology and self-determination: ethical perspectives.

The development of information and communication technologies for design of environments for ageing is of great importance considering demographic trends in the future. There is a realistic hope for the preservation of self-determination and independence in the long term. However, some risks like a gradual loss of privacy should not be underestimated. The article discusses some ethical problems within this context. At the same time, the article demonstrates that the development and implementation of these technologies might be discussed for instance under some ethical assumptions of personal self-responsibility as well as social responsibility for the widest independence in advanced age.

Stress and nursing care needs of women with breast cancer during primary treatment: a qualitative study.

PURPOSE: The primary surgical therapy for breast cancer represents a special phase in the course of the disease. The aim of this study was to find out the specific strains influencing the women affected during this time, and the needs and expectations they had of the nurses. METHOD: In a semistructured interview, 42 women at an early stage of breast cancer were asked about their strains and care needs. RESULTS: The results show that the women interviewed suffer more from psychological strains than physical ones, and express the wish for, above all, emotional support. Analysis of the interviews provides 4 categories of strains: immediate strains regarding the surgery, fear through uncertainty, change of self-perception and the strains caused by the social environment. Care needs can be divided into 3 main areas: wishes for (a) the relationship to the nurses, (b) professional competence and (c) the external conditions of care. CONCLUSIONS: Nurses can support the women well by listening to them, accepting their emotions and informing them in detail. Therewith, they can convey a sense of security to the women and help them to maintain hope and the ability to deal with reality.

[Self-rating and external rating of how women cope with breast cancer in the perioperative phase]. / Coping bei Frauen mit Brustkrebs im perioperativen Bereich - Selbst- und Fremdeinschätzung.

Little is known both about how women suffering from breast cancer cope with their illness in the perioperative phase and about the ability of nurses to assess this. By means of the self-rating and external rating versions respectively of the Bernese Coping Modes (BEFO), it was determined how breast cancer patients cope with their illness during primary surgical therapy. External rating was carried out by the nurses and two researchers. The nurses' rating based on their daily care experiences, and the researcher's rating based on a half-standardized interview. Participants were given the BEFO self-rating questionnaire. As with the patients themselves, the nurses and team members rated attention and care (H(A) 90,5-100%), tackling (H(A) 66,7-100%), passive co-operation (H(A) 59,5-100%) and acceptance/stoicism (H(A) 64,3-97,6%) as the strongest forms of coping. In ranking order of coping modes the researchers rated dissimulation and isolation/suppression and the nurses rated altruism much higher than the patients themselves. Several forms of coping revealed a clear dependence on age. The discrepancy between the ranking order of the nurses' rating versions and the patients' self-ratings were discussed on the basis of empirical findings on communication events between nurses and patients.

[Qualitative investigation into the strain endured by breast cancer patients in initial in-patient therapy]. / Qualitative Untersuchung zu Belastungen von Brustkrebspatientinnen in stationärer Ersttherapie.

In-patient hospital stays and primary breast cancer operations put a strain on the affected women, about which little is known to date. In order to gain a better understanding of this stress situation, 42 primary operated breast cancer patients were surveyed in qualitative interviews during their in-patient hospital stay. Besides suffering from existential anxieties and uncertainties, typical stresses for the perioperative area are the fear of the anaesthesia and operation, the uncertainty felt while waiting for the histological findings, the first change of dressing and the fitting of a prothesis as well as post-operative physical ailments. The area of psychological strain by far exceeds that of physical strain. For this reason, professional care in the perioperative senological area should include the qualified psychosocial support of the affected women, in addition to their classic physical care.

[The needs of breast cancer patients for nursing support during initial stationary treatment]. / Bedürfnisse von Brustkrebspatientinnen nach pflegerischer Unterstützung während der stationären Erstbehandlung.

The aim of this study is to explore the subjective care needs, specially directed at nurses, of women with breast cancer during primary surgical therapy. Investigations have revealed that psychosocial support of affected women can have a positive effect on how they cope with the disease and on the course of the disease. Guideline-aided qualitative interviews with 42 affected women were conducted for the study. Data analysis was performed according to the criteria of an embracing content analysis. The needs of those women interviewed concern three levels: the emotional level encompassing the aspects of nurturance, emotional support and communication in line with patients' needs, the problem level, in which reliable and professionelly correct care is important, and the organisational level, which stands for a patient-friendly organisational culture. Patients' expectations and needs toward nurses are varied, encompassing a wide spectrum of professional nursing care.

[Burden and coping strategies of women suffering from breast cancer during their surgical primary therapy--the view of nurses]. / Belastungen und Bewältigungsstrategien von Frauen mit Brustkrebs in der Phase der chirurgischen Primärtherapie--die Sicht der Pflegenden.

The findings illustrated in this article, are part of a larger research project funded/financed by the Deutsche Krebshilfe e.V., with the aim of gaining understanding of the stresses and strains, coping strategies and needs of women suffering from breast cancer during their surgical primary treatment. Breast cancer leads to a variety of burden for women and their families. To cope with the disease women use different strategies. External assessment and self-assessment of burden and coping sometimes result in different outcomes, such as experts overestimating their patients' fear or depression or uncovering coping strategies oblivious to the interviewees. Qualitative interviews with twelve nurses in three Northern German hospitals were conducted. The content analysis of the interviews followed Mayring's approach. Uncertainty and anxiety are common characteristics for the affected women. The observed strategies can be classified into five categories: to deny the disease, to withdraw from others, to communicate, to comprehend the disease, to accept the disease. Coping strategies such as withdrawal and denial present a challenge to the nurses' communication behaviour. The findings of the survey at hand indicate a demand for suitable care interventions, further education, and training for professionals nursing women with breast cancer. Scientifically supported nursing concepts and specialised nurses are expected to comply with the affected women's special requirements.