[Social inequality in home care: A scoping review on the impact of socio-economic resources on home care arrangements]. / Soziale Ungleichheit in der häuslichen Pflege: ein Scoping-Review zum Einfluss sozioökonomischer Ressourcen auf die Gestaltung häuslicher Pflegearrangements.

INTRODUCTION: Inequalities in long-term home care are still rarely considered in the discourse on health inequalities, although there is reason to assume that opportunities for a successful home care arrangement are not equally distributed among those in need of it. This paper pursues the question how socio-economic resources of people in need of care and their family caregivers are influencing the utilization of care services in Germany. METHODS: A scoping review has been conducted to analyse the current state of research. To identify relevant papers the online databases CINAHL including MEDLINE, PubMed, LIVIVO and Web of Science were searched and supplemented by internet research. According to Bourdieu, the research studies included were arranged in economic, educational and social resources. RESULTS: 29 qualitative and quantitative research papers were included in the analysis. 14 papers represent quantitative research results, nine papers are based on qualitative research. Six further papers are analyses based on an international data record. The utilization of care services increases with the level of income and wealth as well as education. On closer examination of individual care services, however, the evidence is inconsistent and only the so-called 24-hour care service is distinguishable as a care arrangement for high-status groups. A compensation of the lower utilization of professional care by informal support cannot be described in quantitative terms. Caregivers with low income and education levels seem to be more likely to not only provide care but also to provide higher-intensity care. DISCUSSION: Despite increasing research reflected in the literature, the evidence remains incomplete and shows inconsistencies so that a valid statement on the degree of inequalities in care provision is not possible. A conceptual basis for the definition of social inequality in the context of long-term home care is lacking as well as a common understanding of equity in care provision. The perspective of people in need of care and their caregivers has hardly been addressed. CONCLUSION: Home care is not only determined by individual need but seems to be decisively influenced by socio-economic restrictions. For a more targeted approach, further research on the use of care services depending on socio-economic resources is needed, explicitly taking into account the user perspective.

[Homecare arrangements: examining the use of support services in relation to socioeconomic status]. / Häusliche Pflegearrangements: Untersuchung der Inanspruchnahme von Unterstützungsleistungen im Zusammenhang mit dem sozioökonomischen Status.

BACKGROUND: National and international findings indicate that homecare arrangements are influenced by socioeconomic factors. Demographic and social developments justify the assumption of an increasing number of people in need of care from resource-pour groups and therefore a continuously increasing importance of home-based long-term care. OBJECTIVE: It is examined whether income and education of people in need of care and their caregivers are related to the use of support services in homecare arrangements. MATERIAL AND METHODS: Quantitative secondary data analysis of a survey among members of the social association VdK (Sozialverband VdK). The statistical evaluation includes descriptive analyses as well as the investigation of correlations between socioeconomic characteristics and characteristics of the care arrangement. RESULTS: A correlation between income and the use of support services exists regarding so-called 24-hour care, which is more common with high incomes. Other income effects can be seen in the extent to which care services and home help services are used and in measures to adapt the home environment. A higher level of education is related to an increased use of counselling services. The assessment of the care situation is more negative the lower the income. CONCLUSIONS: The results point out that phenomena of social inequality in care exist and that the options for shaping homecare are influenced by socioeconomic factors. The study also shows challenges in dealing with social inequality and provides orientation for further research, which is becoming increasingly important in view of current trends.

[Occupational safety and health promotion in the context of nurse staffing: A scoping review]. / Arbeitsschutz und Gesundheitsförderung im Kontext von Personalbemessung in der Pflege.

Occupational safety and health promotion in the context of nurse staffing: A scoping review Abstract. Background: Increasing workload has led to a rise in mental and physical burden among nurses. In order to prevent this, it should be investigated, whether and to what extent aspects of occupational safety and health promotion can be integrated into nurse-staffing ratios. Aims: The objective of this scoping review was to identify ways and approaches of including occupational safety and health promotion into existing nurse-staffing ratios. Methods: A scoping review was conducted. The literature search took place in relevant professional databases. Articles in English and German language published between January 2015 and April 2020 with a focus on (care) organisations, staffing, occupational safety and/or health promotion, and person-related services were included. Results: Fifteen articles met the inclusion criteria. Three main topics were identified: staffing methods, leadership and control, and work organisation and design. No evidence was found regarding the inclusion of occupational health and safety and health promotion in staffing procedures. However, there is a demand for consideration of aspects "beyond numbers". Conclusions: In the further development of staffing-ratios, factors should be included that go beyond quantifiable measures and, by doing so, also address occupational safety and health promotion.

[Tracking systems in people with dementia in long-term care - an integrative review]. / Tracking-Systeme bei Menschen mit Demenz in der stationären Langzeitpflege.

Tracking systems in people with dementia in long-term care - an integrative review Abstract. Schlüsselwörter: Tracking-Systeme, Überwachungssysteme, Personenortung, Demenz, stationäre Langzeitpflege Tracking systems in people with dementia in long-term care - an integrative review Background: Tracking systems are used increasingly in long-term care settings. However, their use is controversial. AIM: This paper examines how tracking systems are used to monitor people with dementia in long-term care facilities and what the consequences are for both residents and staff. METHODS: A systematic literature review was conducted in the PubMed, CINAHL, Livivo, ScienceDirect data bases and a hand search also took place. Included were studies, reviews and research reports in German and English from 2013 onwards. RESULTS: A total of eight references were included in the analysis. The results point to an ambivalent use of tracking systems in nursing. Nursing professionals face challenges in the areas of trust and distrust as well as autonomy and security. For residents, this means new opportunities for mobility and self-determination, but also more pressure due to continuous monitoring. CONCLUSIONS: The results show that the current debate on the use of tracking systems for people with dementia in long-term care settings concentrates mostly on the economic aspects, whereas aspects of person-centered care, ethical conflicts or the experience of those affected are given less attention. A core finding is that the use of technology changes the work processes and roles of professional carers.

Technikbereitschaft in der ambulanten Pflege.

Technology commitment in outpatient care Abstract. Background: New technologies are becoming increasingly important in outpatient care. The willingness of professional carers to use new technologies is often considered to be low, especially where older and female carers are concerned who play a large role in outpatient care. However, reliable data on technology commitment in outpatient care are not yet available for German-speaking countries. AIM: This paper aims to provide insights into the state of technology commitment in outpatient care. METHODS: For data collection, the standardised assessment of technology commitment was used, which determines technology readiness via the facets "technology acceptance", "technology competence conviction" and "technology control conviction" (26-2Neyer et al., 2012). A first data collection (2013) concentrated on nursing services in the federal state of Lower Saxony (n = 263), a second data collection (2017) was carried out with a nationwide care service provider (n = 593). RESULTS: For the first time, the results of the present investigations provide differentiated insights into questions of technology commitment in outpatient care in Germany. In particular, there are indications of differences in the willingness to use technology in outpatient care depending on the age group of the interviewees. CONCLUSION: The introduction of new technologies into the everyday life of caregivers requires demographically sensitive concepts for preparing and supporting the users.

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.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies--outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL).

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human-machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific "GAL technology", providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL's highly inter- and multidisciplinary aspects, with respect to research into GAL's application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.

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.

Monitoring systems for the support of home care.

In this article, the design of a system for the ambient, unobtrusive and automatic monitoring of Activities of Daily Living (ADL) is described. In the context of the growing imbalance between (potentially young) caregivers and (most often older) people receiving care, technical monitoring systems may help to organise care more efficiently and to identify degrading abilities very early to trigger preventive measures. To improve the acceptance of the system described in this article, the selection process of the sensors to be integrated into the flat or to be worn by the older people has been steered by the results of focus group interviews with older people, their relatives and professional caregivers. The interviews revealed that these people would in general accept such systems, but security, mobility and communication aspects have to be clearly and appropriately addressed. In an experimental study the recognition rate of the activity 'preparation and intake of food or beverages' has been measured with two age groups (6 subjects, age between 25 and 40/mean 30 years and 5 subjects, age between 72 and 84/mean 75.3 years). The food preparation was detected with a sensitivity of 74.7% and a specificity of 84.2% using a vision sensor.

[Nursing and technology--a closer look at a high tension topic. Essay on the current situation. Part 2]. / Pflege und Technik--Annäherung an ein spannungsreiches Verhältnis Zum gegenwärtigen Stand der internationalen Diskussion. 2. Teil.

Due to substantial changes in society and reform processes in health care, Professional Nursing practice today is facing great challenges. Nursing Sciences can be considered as an answer to these challenges. One of Nursing Sciences' pressing tasks is the discussion of the relationship between nursing and technology in a health care environment with an ever increasing level of technology. A detailed discussion and analysis of this problem in the German speaking countries is yet to happen. This article's intent is to summarize critically the current state of the international debate on the relationship between technology and nursing and thus to stimulate the discussion. While the paper's first part focused on traditional, essentialist interpretation this second part depicts the current international arguments in view of the dialectic relationship between nursing and technology.

[Nursing and technology--a closer look at a high tension topic. Essay on the current situation. Part 1]. / Pflege und Technik--Annäherung an ein spannungsreiches Verhältnis Zum gegenwärtigen Stand der internationalen Diskussion. 1. Teil.

Due to substantial changes in society and reform processes in health care, Professional Nursing practice today is facing great challenges. Nursing Sciences can be considered as an answer to these challenges. One of Nursing Sciences'pressing tasks is the discussion of the relationship between nursing and technology in a health care environment with an ever increasing level of technology. A detailed discussion and analysis of this problem in the German speaking countries is yet to happen. In order to start the above-mentioned discussion this article will critically summarize the current status of the international debate on the relationship of technology and nursing. This first part focuses on traditional, essentialist interpretation. The second part will depict the current international arguments in view of the dialectic relationship of nursing and technology.