Acceptance of Telepresence Robotics, Telecare and Teletherapy Among Stroke Patients, Relatives and Therapy Staff.

BACKGROUND: Stroke as a cause of disability in adulthood causes an increasing demand for therapy and care services, including telecare and teletherapy. OBJECTIVES: Aim of the study is to analyse the acceptance of telepresence robotics and digital therapy applications. METHODS: Longitudinal study with a before and after survey of patients, relatives and care and therapy staff. RESULTS: Acceptance of the technology analysed is high in all three groups. Although acceptance among patients declined in parts of the cases in the second survey after having used telerobotics, all in all approval ratings remained high. With regard to patients no significant correlation was found between the general technology acceptance and the acceptance of use of telerobotics. CONCLUSION: Accepted new telecare and teletherapies can be offered with the help of telepresence robotics. This requires knowledge of and experience with the technology.

[Knowledge and attitudes towards sharing of health data: Results of a population survey]. / Wissen und Einstellung zur Speicherung und Nutzung von Gesundheitsdaten: Ergebnisse einer Bevölkerungsbefragung.

OBJECTIVE: The article tackles various issues arising in the context of the process of digitalization in the health sector. The communication and availability of health data, health registers, the electronic health record, consent procedures for the transfer of data and access to health data for research are considered. METHODS: The study is based on a computer-assisted telephone survey (dual-frame) of a random sample of adult people living in Germany. Data was collected in the period between June 01 and June 27, 2022 (n = 1,308). RESULTS: The level of knowledge concerning the transmission of health data to health insurers is good, whereas the existence of central death-, vaccination- and health registers as well as the access to health data by treating physicians is overestimated. The general acceptance of medical registers is very high. Half the population is unfamiliar with the electronic health record, and the willingness to use it is rather low. An opt-in procedure is preferred when transferring data, and more than eighty percent would release data in their electronic health file for research purposes. Three quarters would consent that their health data be handed over to general research, especially if reserach facilities were situated at German universities, under the condition that their data be treated confidentiallly. The willingness to release data correlates with the level of trust in the press as well as in universities and colleges and decreases when a data leak is considered to be serious. DISCUSSION AND CONCLUSION: In Germany, as in other European countries, we observe a great willingness of people to release health data for research purposes. However, the propensity to use the electronic health file is comparatively low, as is the acceptance of an opt-out procedure, which in the literature is considered a prerequisite for the successful implementation of electronic health records in other countries. Unsurprisingly, a general trust in research and government agencies that process health data is a key factor.

[Pacemaker, organ or walking stick? Pre-op association with and post-op subjective perception of a deep brain stimulation device]. / Herzschrittmacher, Organ oder Gehstock? Vorher-Nachher-Befragung zur subjektiven Wahrnehmung eines Gerätes zur Tiefen Hirnstimulation.

AIM OF THE STUDY: This study was conducted in a pre-post design with a survey of patients who had undergone deep brain stimulation (DBS) as treatment for a neurological movement disorder. The aim of the study was to compare patients' expectations and beliefs before a DBS intervention with patients' subjective experience of this intervention. METHODOLOGY: The longitudinal study of patients (n=132) with an indication for DBS therapy was based on a written survey at the time points of preoperative screening (pre-op) and one-year follow-up (post-op). RESULTS: Preoperatively, a clear majority of respondents believed DSB to be similar to a pacemaker intervention, but one year after the intervention less than one third did so, as they compared DBS to using a walking stick or glasses. CONCLUSION: The experience of DBS in the patient's own body seems to be comparable by means of individually different associations, whereby the comparison with non-invasive aids predominates postoperatively. The discussion of these descriptions in the educational interview can contribute to a realistic horizon of patients' expectations before DBS.

[Opportunities and Challenges of Digitalization in Rehabilitation: Results of a Survey of Rehabilitation Facilities]. / Chancen und Herausforderungen der Digitalisierung bei der Rehabilitation ­ Ergebnisse einer Befragung von Rehabilitationseinrichtungen.

PURPOSE: The aim of this study was to measure the status of digitalization and the opportunities and challenges for rehabilitation facilities connected to telematics infrastructure. METHODS: A partially standardized online survey of all providers of rehabilitation facilities in Bavaria (n=33) was carried out. The questionnaire with 36 questions included a scale based on the Electronic Medical Record Adoption Model (EMRAM). RESULTS: The level of digitization was reported as level 0 in 70% of the rehabilitation facilities (level model to 7). The transmission of patient-related data (incoming and outgoing) is often analogue, whereas the processing within the facility is already predominantly digital in many cases. When connecting to the telematics infrastructure, installation, training of staff and adaptation of work organization required quite a bit of effort. CONCLUSION: Changes in the legal-financial situation in Germany open up new opportunities for increased digitalization of rehabilitation facilities. Hurdles are related to IT security requirements, staff training, and the low level of digitalization in hospitals, among doctors, and patients, which make digital data transmission difficult.

Analyzing factors determining vaccination willingness against COVID-19 in Germany 2020.

The study is based on a German single-topic population survey on vaccination willingness against COVID-19 (VWC) by the authors (2020, n = 2014). The single-topic survey allowed us to test several competing explanations for VWC, as discussed in the literature. The VWC in the sample was 67.3%. Logistic regression was used to identify factors affecting VWC. Being at high risk from COVID-19 and having received flu vaccination have a positive impact on VWC. Perceived VWC of friends has a strong positive effect on respondents' VWC. Bivariate relationships of gender, age, and level of education with VWC were no longer significant in a multivariate analysis. Trust in alternative medicine and belief in conspiracy theories have a negative effect on VWC.

At risk of reproductive disadvantage? Exploring fertility awareness among migrant women in Germany.

This study examined awareness about fertility among immigrant women and non-migrants in Germany. The social relevance of infertility and fertility treatment is increasing in Western countries due to continually low overall birth rates, a high rate of childlessness, and a gap between the desired and actual numbers of children. While there is growing interest in infertility and reproductive medicine in general, previous studies have rarely included immigrant or ethnic minorities in Europe. This study investigated whether knowledge on the age-related fertility decline (ARFD) varies between migrant groups and the majority group, and the role of education. Working hypotheses were drawn from theoretical considerations on frameworks of migrant assimilation. The analysis was based on data collected in a social science pilot study on reproductive medicine, representative of the general population ('NeWiRe' 2014-2015). The sample included 962 women aged 18-50 years living in Germany. Approximately 81% of the sample were immigrants who originated from Turkey, Poland, the Balkan countries or countries of the (post-Soviet) Commonwealth of Independent States. While rather poor overall, knowledge on ARFD was found to be significantly lower in the migrant groups compared with the majority group. This minority-group disadvantage cannot be explained by sociodemographic or cultural variables. Future research should include minority groups in empirical studies on awareness about fertility in order to better understand the causes of this disadvantage, and the potential reproductive needs of migrants.

[Parents' Willingness to Vaccinate with a COVID-19 Vaccine]. / Impfbereitschaft von Eltern mit einem COVID-19-Vakzin: Die Rolle von Elternschaft und Geschlecht.

BACKGROUND: Parents are faced with a vaccination decision in the context of their own vaccination and that of their children with a COVID-19 vaccine. At present, there is no (complete) vaccination recommendation. RESEARCH QUESTION: The study investigates the willingness to vaccinate of parents of minors and people without children who are minors, in which gender differences in particular are examined. METHODS: The study is based on a random sample (telephone survey, n = 2,014, collected between 12 November and 10 December 2020). The evaluation is primarily based on the sub-sample of people with minors in the household (n = 461). RESULTS: Parents of minors consistently show a lower willingness to be vaccinated with a COVID-19 vaccine than respondents without minors (54.1% vs 71.1%). Fathers show a stronger willingness to be vaccinated than mothers. Furthermore, men are more willing to get their own child vaccinated with a COVID-19 vaccine than are women. CONCLUSIONS: Among parents and especially mothers, a considerable misrepresentation of vaccination risks and frequent beliefs in vaccination conspiracy theories can be observed. Clear and easily understandable information on the effects and side effects of vaccination with a COVID-19 vaccine by relevant institutions and physicians is recommended.

[Factors Influencing Willingness to be Vaccinated with a COVID-19 Vaccine: Results of a CATI Population Survey]. / Impfbereitschaft mit einem COVID-19-Vakzin und Einflussfaktoren. Ergebnisse einer telefonischen Bevölkerungsbefragung.

OBJECTIVE: The study examines the willingness to be vaccinated with a COVID-19 vaccine using a random sample of the general population and its determinants (perceived risks of disease, perceived side effects and general attitudes towards vaccination, trust in institutions, socio-structural factors, influence of social reference groups). METHODS: The study was based on a telephone, one-topic population survey (n=2,014) on willingness to be vaccinated (before the approval of a COVID-19 vaccine in Germany in November/December 2020). RESULTS: The willingness to be vaccinated was about 67% and increased with the proportion of peers and acquaintances who were willing to be vaccinated and had trust in the Robert Koch Institute; willingness was higher in members of a risk group, and in cases where there was an expectation of dangerous consequences of an infection. Experience with infection among the respondents or in peer-groups increased the willingness to be vaccinated. Men had a higher willingness to be vaccinated. The willingness to be vaccinated increased consistently with the level of formal education (with the exception of people with a technical college entrance qualification). Overestimating the likelihood of severe side effects of influenza vaccinations reduced the willingness to be vaccinated against COVID-19. Findings of considerable overestimations of the frequency of serious vaccination side effects were striking. CONCLUSION: Implications for a target group-appropriate information campaign and risk communication are derived. Efforts to promote the willingness of the population to be vaccinated should focus in particular on disadvantaged population groups.

[The first steps after a proximal femoral fracture : Sensor-based mobility exploration in geriatric trauma patients]. / Die ersten Schritte nach einer hüftnahen Fraktur : Sensorbasierte Bewegungsexploration bei geriatrischen Traumapatient/-innen.

BACKGROUND: Sensor-based monitoring allows continuous observations of patient mobilization after proximal femoral fractures. A wrist-worn motion tracker allows long-term observation that is low in interruption and constraints for subjects. OBJECTIVE: Description of steps development after hip fracture surgery on a specialized geriatric trauma ward and beyond. MATERIAL AND METHODS: In the explorative long-term field research study, an applicable motion tracker observed steps per day of 20 patients (80% female, mean age 85.2 years ± 7.86 years) for 10 weeks. Weekly mean values (days 1-7, 8-14 etc.) of steps per day formed the database for descriptive analysis (mean, SD, min, max, median). RESULTS: During observation weeks (ow) a positive development of steps took place. A mean increase factor of 1.285 (±0.351) occurred from ow 1 (M = 353.57 ± 310.15) to ow 10 (M = 2482.07 ± 1374.12). The highest increase by a factor of 1.8 could be reported from ow 2 (M = 556.27 ± 478.11) to ow 3 (M = 1024.86 ± 921.24) as well as from ow 6 (M = 1268.21 ± 880.47) to 7 (M = 2367.14 ± 1680.08). A slight decrease of steps occurred from ow 4 (M = 1208.27 ± 1210.45) to ow 5 (0.99-fold) and from ow 9 (M = 2689.98 ± 2339.71) to 10 (0.92-fold). High ranges and standard deviations in relation to the mean occurred constantly. The presence of several step development groups could be presumed. CONCLUSION: Motion tracker and the variable steps per day can represent the ability to walk within an everyday environment, with a possible underestimation of < 10%. Differences regarding observation lengths and disruptions occurred. Cluster analysis should detect group attributes of different courses of development in subsequent studies.

Comparing Monitoring Results of Two Motion Trackers for Geriatric Patients.

BACKGROUND: Fitbit and Garmin motion tracker devices are highly used in research. The validity and reliability of these devices is proven for healthy adults between 18 and 64. OBJECTIVES: Comparing data output of two devices. METHODS: Observational case study on a test track and in the domestic environment of a 80- year-old female multimorbide geriatric patient. RESULTS: High significant correlation of the devices on the test track [r=.776, p≤.001, Bca-CI-95% (.618;.874), N=33], but significant different in the domestic environment over time (z=4.840, p≤.001). CONCLUSION: The dominant/non-dominant body side and further sources of error may play a role in monitoring steps with these devices.

Exploratory Analysis of Motion Tracking Data in the Rehabilitation Process of Geriatric Trauma Patients.

BACKGROUND: This article is based on an ongoing long-term study, in which customary motion trackers measure steps during rehabilitation of geriatric trauma patients (Med=86 years). OBJECTIVES: Exploring steps after 28 days of measurement. Finding similarities in the data by running cluster analysis and formulating linear regressions models to predict steps through time. METHODS: Two types of motion trackers (FitBitAlta HR and Garmin vívofit 3) have been used to measure patients' (N=24) steps after hip fracture in two study groups. Cluster analysis detected three clusters for progress in number of steps that were tested for group differences with ANOVA. Regression analysis tested models for individual patients. RESULTS: Three-cluster solutions showed significant differences for the average amount of steps after 5, 14, 21 and 28 days. Regression models could predict 71 % of the individual patients' progress in study group 2. CONCLUSION: The long-term study will provide more data in the future to examine the three-cluster solution and to find out in what stage of rehabilitation the measurement of the steps could be used to predict individual rehabilitation.

How to Measure Physical Motion and the Impact of Individualized Feedback in the Field of Rehabilitation of Geriatric Trauma Patients.

BACKGROUND: This preparatory study accelerates an implementation of individualized monitoring and feedback of physical motion using conventional motion trackers in the rehabilitation process of geriatric trauma patients. Regaining mobility is accompanied with improved quality of life in persons of very advanced age recovering from fragility fractures. OBJECTIVES: Quantitative survey of regaining physical mobility provides recommendations for action on how to use motion trackers effectively in a clinical geriatric setting. METHODS: Method mix of quantitative and qualitative interdisciplinary and mutual complementary research approaches (sociology, health research, philosophy/ethics, medical informatics, nursing science, gerontology and physical therapy). While validating motion tracker use in geriatric traumatology preliminary data are used to develop a target group oriented motion feedback. In addition measurement accuracy of a questionnaire about quality of life of multimorbid geriatric patients (FLQM) is tested. CONCLUSION: Implementing a new technology in a complex clinical setting needs to be based on a strong theoretical background but will not succeed without careful field testing.