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Background: Digital, assistive technologies (DAT) are finding their way into care processes. There are no concepts for introducing nursing professionals DAT in a structured manner. A structured concept makes sense for a sustainable implementation of DAT. This paper suggests a guideline to train nurses in dealing with DAT. Aim: The work addresses the question of how nursing professionals experience and evaluate a structured approach of sensitization, qualification and testing with respect to DAT. This is also intended to assess the extent to which a transformative learning approach changes the willingness of nurses to use DAT. Method: In a long-term inpatient facility, nurses have been made aware of DAT and instructed in its use. The nurses were trained in using two robotic systems and a passive exoskeleton. The experience and perception of the structural design of the educational approach were surveyed through interviews. Evaluation took place by qualitative content analysis according to Kuckartz. Results: All 5 nurses surveyed had completed 3 years of training in nursing care. 2 of the interviewees perform tasks in the management of the care unit. All interviewee rated the structured approach positively. The approach increases the interest to think about an integration of DAT. It turns out that the accuracy of fit of DAT to care-related problems as well as the necessity to make DAT available by employers are crucial prerequisites for DAT integration into practice. Conclusion: A structured concept can sustainably increase the willingness of nurses to use DAT. Poor implementation of DAT is based on a lack of knowledge and concepts for education and training. The reflection that has been initiated enables DAT to be checked for specific care problems.
RESUMO
OBJECTIVES: Genetic defects associated with bicuspid aortopathy have been infrequently analysed. Our goal was to examine the prevalence of rare genetic variants in patients with a bicuspid aortic valve (BAV) with a root phenotype using next-generation sequencing technology. METHODS: We investigated a total of 124 patients with BAV with a root dilatation phenotype who underwent aortic valve ± proximal aortic surgery at a single institution (BAV database, n = 812) during a 20-year period (1995-2015). Cross-sectional follow-up revealed 63 (51%) patients who were still alive and willing to participate. Systematic follow-up visits were scheduled from March to December 2015 and included aortic imaging as well as peripheral blood sampling for genetic testing. Next-generation sequencing libraries were prepared using a custom-made HaloPlex HS gene panel and included 20 candidate genes known to be associated with aortopathy and BAV. The primary end-point was the prevalence of genetic defects in our study cohort. RESULTS: A total of 63 patients (mean age 46 ± 10 years, 92% men) with BAV root phenotype and mean post-aortic valve replacement follow-up of 10.3 ± 4.9 years were included. Our genetic analysis yielded a wide spectrum of rare, potentially or likely pathogenic variants in 19 (30%) patients, with NOTCH1 variants being the most common ( n = 6). Moreover, deleterious variants were revealed in AXIN1 ( n = 3), NOS3 ( n = 3), ELN ( n = 2), FBN1 ( n = 2) , FN1 ( n = 2) and rarely in other candidate genes. CONCLUSIONS: Our preliminary study demonstrates a high prevalence and a wide spectrum of rare genetic variants in patients with the BAV root phenotype, indicative of the potentially congenital origin of associated aortopathy in this specific BAV cohort.
