"Qualitative evaluation of a digital software solution for documentation and training in 24-hour home care".

Owing to its cost-efficiency, 24-hour home care is increasing and represents a cornerstone in the care of elder people in Austria. A software solution to support 24-hour caregivers in their daily routine was developed facilitating a user-centered design process. It includes electronic documentation, an e-learning platform, emergency management, and a communication tool. To evaluate the usability and acceptance of the developed software solution, a qualitative survey including focus groups (FG), a group interview (GI), and a usability walkthrough (UW) were conducted. This paper describes the findings of the qualitative survey which indicate that the e-learning platform as well as the e-documentation support 24-hour caregivers in their daily work with their clients. Participants with less technical affinity needed support to use the tool proficiently. 24-hour caregivers appreciate the fact that the solution unites all the needed information in one place.

Digital support for quality assurance in 24-hour caregiving at home: a randomized controlled trial investigating the effects on quality of life and professional skills of paid 24h-caregivers.

BACKGROUND: Regarding the care of older adults, 24-h home-care represents a cornerstone, with > 32,000 service users in Austria. Our research project 24hQuAALity aimed to develop and evaluate a distributed client-server software solution for the support and quality assurance of this home-care service. In this trial, we investigated the effects of this intervention on the quality of life and professional skills of paid 24h-caregivers in Austria. METHODS: The application used in our study comprises an e-learning platform, an integrated emergency management, networking opportunities, and an electronic care documentation system in the native language of the 24h-caregivers. The trial was conducted using a parallel three-arm study design to evaluate (i) a control group, which performed usual home care, (ii) a partial intervention group, which used the e-learning and networking platforms, and (iii) a full intervention group, which used the entire intervention (e-learning platform, networking platform, and digital care documentation). Primary self-reported outcomes were the standardized ASCOT for Carers score and a score based on responses to project-specific efficacy questions. RESULTS: Among the 110 24h-caregivers who were randomly classified into the three groups, ASCOT for Carers score data were available for 57 and 35 24h-caregivers at 5- and 9-month follow-up examinations, respectively. At 9 months, 24h-caregivers receiving any intervention rated the ASCOT for Carers score (not significantly) better than the controls (p = 0.05, ηp2 = 0.15), mainly in the domain "feeling encouraged and supported". At 9 months, 24h-caregivers receiving any intervention rated the project-specific Efficacy score significantly better than the controls (p = 0.02, ηp2 = 0.20), mainly due to better ratings in the subitems "satisfaction with current docu", "docu supports doing my job", " I'm well prepared for emergencies", "my professional skills are adequate for doing my job", and "communication with contacts". CONCLUSIONS: Providing e-learning and e-documentation devices to 24h-caregivers improved their care-related quality of life, mainly because they felt more encouraged and supported. Moreover, these interventions improved their self-perceived professional skills. As an extrapolation of findings, we found that these interventions could empower 24h-caregivers and improve the quality of home-care services provided by them. TRIAL REGISTRATION: Digital Support for Quality Assurance in 24-h Caregiving at Home was registered and posted on the ClinicalTrials.gov public website (ClinicalTrials.gov Identifier: NCT04581538).

The lived experience of adolescent users of mental health services in Vienna, Austria: A qualitative study of personal recovery.

PROBLEM: In Austria, one in four adolescents suffers from a mental health problem, yet there is a lack of adequate care structures. Therefore, the personal recovery of these adolescents is of particular interest. The aim of the study was to explore, from a Child and Adolescent Psychiatric Mental Health Nursing (CAPMHN) perspective, how adolescent users of mental health services in Vienna, Austria experienced personal recovery after a stay in hospital, and to discover what had influenced the personal recovery of adolescent users of mental health services in Vienna. METHODS: Ten episodic interviews with adolescents were conducted. Nine of them were analyzed following the content analysis of Mayring (2015). FINDINGS: The findings of the survey indicate that the personal recovery of the participants was influenced by personal and external factors. Personal factors were the subjective experience of illness and recovery, optimism, resources, and ambivalence. External factors were family, peers, and treatment. The findings suggest that personal recovery of adolescents with a mental health problem is affected by youth-specific aspects. CONCLUSIONS: CAPMHNs can support the personal recovery of adolescent users of mental health services, so providing recovery-oriented care, adequate care structures, and specific nursing skills is crucial.

[Quality characteristics in 24-hour care from the perspective of those affected - Results of a pilot study in Austria]. / Qualitätsmerkmale in der 24 h-Betreuung aus der Perspektive der Betroffenen - Ergebnisse einer Pilotbefragungsstudie in Österreich.

Quality characteristics in 24-hour care from the perspective of those affected. Results of a pilot study in Austria Abstract. Background: Of the almost 460 000 recipients of care allowance in Austria, 80 % are cared for at home. In 2018, more than 32 000 people were cared for at home by a total of almost 65 000 24-hour caregivers. Isolated work situations in combination with complex illnesses of the clients, often inadequate training and a lack of language skills of the personal carers have a challenging effect on the quality of care. Aim: The aim of the pilot study is to describe quality characteristics in 24-hour personal care from the perspective of the actors involved. The research question relates firstly to the individual experience and secondly to the desired quality of care. Methods: The survey method used is an individual survey along a guideline; the summarising content analysis has been chosen as the evaluation method. Results: A total of 32 interviews were conducted (14 relatives, 1 client, 8 caregivers and 9 DGKP). In the analysis process, it was possible to map all the aspects mentioned using the developed main category "field of action-oriented quality characteristics". These relate to comprehensive everyday care, specialist nursing and medical activities, individual care, language skills and communication, as well as initial and continuing training and interface management. Conclusions: The development of binding quality criteria together with continuous external support is essential to ensure sustainable quality of care. This could be taken over by the established social associations.

[Influence and correlation of attitude, availability and institutional support to research implementation in nursing practice ­ results from an exploratory, cross-sectional quantitative study]. / Einfluss und Zusammenhang von Einstellung, Verfügbarkeit und institutioneller Unterstützung auf die Anwendung von Forschungsergebnissen in der pflegerischen Praxis - Ergebnisse einer explorativen quantitativen Querschnittstudie.

BACKGROUND: The concrete application of research findings in nursing practice is a multidimensional process. In Austria, there are currently no results available that explain the impact of and association with the implementation of research in hospitals. OBJECTIVE: The aim of the study was to investigate influences and relationships of individual attitudes towards research utilization, availability of research results and institutional support of nurses in Austrian hospitals with respect to research application. METHODS: In a non-experimental quantitative cross-sectional design a multi-centre study (n = 10) was performed in 2011. RESULTS: The sample comprises 178 certified nurses who were interviewed with a survey questionnaire. The multiple regression analysis shows that a positive attitude towards research use (ß = 0.388, p < 0.001), the availability of processed research results (ß = 0.470, p < 0.001), and an adequate institutional support (ß = 0.142, p < 0.050) has a significant influence on the application of research results. The path analysis proves that course attendance in evidence-based nursing has a strong positive influence towards research application (ß = 0.464; p < 0.001). CONCLUSIONS: Health institutions are, according to legal instructions, called on to make use of the positive attitude and supply supporting measures in order to introduce research results into the daily nursing practice.

Validity and reliability of the "German Utilization Questionnaire-Dissemination and Use of Research" to measure attitude, availability, and support toward implementation of research in nursing practice.

BACKGROUND AND PURPOSE: In nursing practice, research results have to undergo a systematic process of transformation. Currently in Austria, there is no empirical data available concerning the actual implementation of research results. An English validated questionnaire was translated into German and tested for validity and reliability. METHOD: A survey of 178 registered nurses (n = 178) was conducted in a multicenter, quantitative, cross-sectional study in Austria in 2011. RESULTS: Cronbach's alpha values (.82-.92) were calculated for 4 variables ("use," "attitude," "availability," "support") after the reduction of 7 irrelevant items. Exploratory factor analysis was calculated with Kaiser-Meyer-Olkin (KMO) ranging from .78 to .92; the total variance ranged from 46% to 56%. CONCLUSION: A validated German questionnaire concerning the implementation of research results is now available for the nursing practice.

[Evaluation of the nursing diagnosis "social isolation" and the use of evidence-based nursing]. / Evaluierung von Interventionen aufgrund der Pflegediagnose "Soziale Isolation" und Anwendung der Methode Evidence-based Nursing.

In home nursing care, professionally qualified personnel have to make many decisions based on the best available evidence. The systematic review "social isolation" was carried out to evaluate the nursing diagnosis as used by the home care provider Red Cross Austria. It was examined if the interventions of the diagnosis "social isolation" were based on scientific evidence. The interventions reviewed were exclusively for home care clients. "Evidence Based Nursing" was used as the scientific approach. Individual interventions of the selected diagnosis's were compared to the Nursing Interventions Classification (NIC) to get standardized English search terms. The 10 selected research papers showed that social isolation is a growing problem for people being cared for at home. According to the scientific literature it can be recommended that a number of multi variant initiatives should be initiated either as a prophylactic or specific intervention. The use of appropriate assessment instruments should lead to effective interventions. Furthermore, in cases of particular need a tailor-made group solution can be helpful. One new aspect that surfaces in the literature is the social isolation of the relatives of the person in care. The social isolation of the relatives in turn has a strong influence on the person in care and nursing care personnel should include this in the intervention plan. Home care nursing personnel play a key role in identifying social isolation and taking the first initiatives to resolve the problem.

[Diagnosis "risk of pneumonia" evidence-based evaluation and comparison of nursing interventions]. / Pflegediagnose "Gefahr einer Pneumonie". Evaluierung und Vergleich evidenzbasierter und pflegepraktischer Interventionen.

In home nursing care, professionally qualified nurses make decisions on their own which must be based on the latest scientific research. The goal of this systematic literature review was to examine if the interventions of the diagnosis "Risk of Pneumonia" as used by a home care service provider in Austria are based on scientific evidence. Based on the research question "Can the interventions of the diagnosis 'risk of pneumonia' be found in the scientific nursing literature?", four evidence-based guidelines from various databases and institutes were identified and evaluated using a standardized checklist. The result of the analysis is that the majority of the Nursing diagnosis interventions can be found in the guidelines. It is also recommended in the guidelines to advise and support clients to stop smoking and inoculate against influenza/pneumonia. Similarly, assessment tools should be used to estimate the severity of pneumonia. The intervention of oral hygiene as a prophylactic intervention against pneumonia should get particular attention.