Professional and Volunteer Refugee Aid Workers-Depressive Symptoms and Their Predictors, Experienced Traumatic Events, PTSD, Burdens, Engagement Motivators and Support Needs.

In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement motivators, perceived distress in refugee work and training needs were examined. Moreover, depressive symptoms, the prevalence of traumatic experiences and symptoms of posttraumatic stress disorder were explored. Participants named helping others as the highest motivating factor for their work with refugees and communication problems as the main burden. Thirteen aid workers (10.1%) showed clinically relevant depressive symptoms. In total, 91.4% of refugee aid workers had experienced at least one traumatic event personally or as a witness but only three (3.6%) fulfilled the psychometric requirements of a PTSD diagnosis. These three participants all belonged to the professional aid workers (6.3%). More severe symptoms of depression were significantly associated with female gender (ß = 0.315, p = 0.001), higher perceived burdens of refugee work (ß = 0.294, p = 0.002), and a larger number of experienced traumatic events (ß = 0.357, p < 0.001). According to our results, we recommend psychological trainings and regular screenings for psychological stress in order to counteract possible mental illnesses.

Nursing Assessment of Patients Requiring Enteral and Gastric Feeding Tubes: An Exploratory Approach.

There is insufficient information available in the current literature regarding how nurses assess, intervene, and advocate for patients with indwelling gastric and enteral tube feedings. To understand ways in which nurses could be more supportive, a survey, distributed through private online social media groups, was designed to elicit preliminary data from patients who are currently, or had recently been treated, with a feeding tube. This survey examines nurse behaviors that patients identify as actually or potentially helpful with the physical, emotional, social, and logistical aspects of having a feeding tube. The results of the survey reveal that, although some patients report feeling cared for by nurses and believe that their nurses were compassionate, a greater number of respondents express that their nurses were less informed and less able to provide help with their emotional challenges. Further investigation is needed to assess how nurses can better support these patients and better identify the successful and transformative interventions that would be helpful to them.

[Distress, Main Burdens, Engagement Motivators and Needs of Fulltime and Volunteer Refugee Aid Workers]. / Psychische und kontextuelle Belastungen, Motivationsfaktoren und Bedürfnisse von haupt- und ehrenamtlichen Flüchtlingshelfern.

In the psychosomatic department of the University Hospital of Erlangen trainings were conducted for active refugee aid workers with start in January, 2016. Meanwhile 49 helpers participated in the training and 45 of them filled out a survey questionnaire. Perceived distress when providing care for refugees, as well as engagement motivation and further training needs were explored. Furthermore, depressive symptoms as well as the prevalence of traumatic experiences were investigated. The main burden was experienced through lacking freedom of action on the background of legal regulations. Furthermore dissociative symptoms (15.4%) and aggressive behavior (26.9%) of refugees were reported as distress factors. To help others proved to be the highest motivator for their work with refugees. Only 2 workers (4.4%) showed elevated depressive symptom manifestations. In contrast, 93.3% of refugee helpers had experienced a traumatic event personally or as a witness. For the helpers the greatest training needs were the recognition of mental health problems and to learn concrete intervention strategies to help those affected.

Shackled: the challenge of caring for an incarcerated patient.

Hospice care for inmates is widely recognized as an important way of providing efficient, cost-effective palliative care to a growing number of dying inmates. The case presented here is of a 34-year-old inmate who was admitted to a tertiary-care hospital for diagnostic tests and treatment of non-small cell lung cancer. While he was in the hospital, his clinical status rapidly deteriorated and it was clear that palliative care was most appropriate. Prison restrictions prevented the health care team from sharing the patient's clinical status with his family. He was forbidden many interventions that would have improved his comfort, such as watching television. The problems illustrated by this case occur many times in United States tertiary-care hospitals, and it is hoped that by describing it, more compassionate care for inmate patients, regardless of location, can be provided.

The pitfalls of tribal thinking in health care.

Transcending 'groupthink' to achieve true teamwork for patients' benefit.