Exploring experiences of times without care and encounters in dementia: protocol for a living and adaptive evidence map.

INTRODUCTION: Individuals with dementia spend most of the day without care, without encounters, and usually without activity. Although this has been proven in studies, there is a knowledge gap on how individuals with dementia experience these periods of time. Such knowledge would be highly relevant for health professionals and relatives to develop adequate strategies for dealing with these periods of time. The FreiZeit study aims to reconstruct periods of time without care and encounters from the perspective of individuals with dementia and formal and informal carers. The specific objective of this review is to provide a continuously updated overview of the topical evidence that may be used to guide data synthesis and interpretation within the FreiZeit study. METHODS AND ANALYSIS: We conduct a living evidence map, based on a comprehensive systematic literature search in MEDLINE/PubMed, CINAHL, PsycINFO/Ovid and Web of Science Core Collection, citation-based searches and web searches. We include studies on times without care and encounters of individuals with dementia from the perspective of individuals with dementia themselves and formal or informal caregivers of any observational study design that were conducted in the institutional and domestic long-term care setting and published as journal article in English, French or German language without any restriction of the publication year. One reviewer screens titles, abstracts and full texts and extracts data. Key characteristics and results of the included studies are charted in a tabular format. The searches will be run and continuously updated throughout the duration of the overarching FreiZeit study (every 6 months for 2 years from 2023 to 2025). ETHICS AND DISSEMINATION: Ethics approval is not required for this evidence map. We disseminate our findings via journal articles and conference proceedings as well as other formats. REGISTRATION DETAILS: This review protocol is uploaded on Open Science Framework (OSF; DOI 10.17605/OSF.IO/GDYZ9).

Effect of an educational intervention on nurses' competence in activities of daily living support in end-of-life care using a pretest-posttest repeated measures design.

BACKGROUND: Most patients in specialized palliative care units need nursing support to perform activities of daily living (ADL), such as using a toilet or transferring out of a bed or chair. To deliver high-quality ADL support that facilitates patients' movement and protects nurses' musculoskeletal health, nurses need appropriate knowledge and skills. The objective of this study is to investigate the impact of education based on the "Advanced Kinaesthetics in Palliative care (AdKinPal) program" on the competence in Kinaesthetics, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints of nurses from specialist palliative care units. METHODS: A pretest-posttest repeated measures design was applied. The study took place in three specialised units for palliative care in Switzerland between June 2018 and April 2020. All the nurses who worked in participating wards (n = 62) and fulfilled the inclusion criteria were asked to participate. The intervention - the AdKinPal program - is an education-based training program conducted for six months. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, repeated measurement analysis of variance (ANOVA) and independent-samples t-tests, we analysed the participants' demographic characteristics as well as developments over time and relationships between the three outcome variables: Kinaesthetics competence, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints. RESULTS: Fifty-nine nurses and one physiotherapist participated, and 38 participants (63%) responded to all three questionnaires. The AdKinPal training improved the nurses' perceived Kinaesthetics competence and self-efficacy regarding ADL support in end-of-life care. Participants who reported lower back, neck or shoulder pain had a significantly lower Kinaesthetics competence. CONCLUSIONS: The AdKinPal program can raise nurses' Kinaesthetics competence. Thereby, patients' autonomy and quality of life could be supported, and symptom management could be enhanced in a holistic manner. Furthermore, the AdKinPal program fosters nurses' self-efficacy in ADL support in end-of-life care. A strong sense of self-efficacy enhances professional well-being in many ways. Additionally, the nursing staff's musculoskeletal health can be promoted by enhancing their Kinaesthetics competence. TRIAL REGISTRATION: DRKS00015908. Registration Date 23.11.2018.

[Kinaesthetics competence in specialized palliative care: Process evaluation of a quasi-experimental study]. / Kinästhetikkompetenz in der spezialisierten Palliative Care.

Kinaesthetics competence in specialized palliative care: Process evaluation of a quasi-experimental study Abstract. Background: To ensure professional symptom control in the context of palliative care, specific nursing skills are required. "Advanced Kinaesthetics in Palliative Care" (AdKinPal) is an education program intending to promote nurses' kinaesthetics competence in order to improve symptom management by means of nursing interventions. Aim: The aim of this article is to illuminate the process of the AdKinPal study in order to check the program's feasibility and to determine possible outcomes. Results may serve as a basis for revising the program with regard to further implementation. Methods: The process evaluation was part of a quasi-experimental study. We collected qualitative and quantitative data (interviews, observation protocols, questionnaire). For data interpretation, we used qualitative content analysis and descriptive quantitative analysis. Results: Overall, the participants valued the workshops and practical support as beneficial. Nevertheless, there were also inhibiting factors, such as workshop scheduling and location as well as working material. The participants questioned sustainable skills development. Conclusions: The first run of the education program was successful. To ensure sustainable competence development, adjustments are necessary for further implementation.

Die Problematik der Implementierung von Kinästhetik in Einrichtungen der stationären Langzeitpflege - Eine Multiple Case-Study.

Difficulty of implementing kinaesthetics in long-term care institutions - A multiple case-study Abstract. Background: Resources have been invested from long-term care institutions for the development of nursing staffs' kinaesthetics competence for years. Recent studies have shown that implementing or sustainably promoting the kinaesthetics competence is problematic, but in-depth knowledge of the causes thereof is lacking. Aim: Which barriers impede a sustainable implementation of kinaesthetics in long-term care institutions? Method: A "multiple case-study" was carried out in three institutions located in the German-speaking part of Switzerland. The data from guide-based interviews and (case-related) literature on the external context was inductively condensed in the within-case analysis. The results were then compared in the cross-case synthesis and summarized in an abstract way. Results: The synthesis showed that the implementation of kinaesthetics can be influenced negatively at three different institutional levels - management, nursing team and individual nursing staff - as well as by external factors. Conclusions: In nursing practice and nursing science, as well as in the health care sector, a basic understanding of kinaesthetics in the context of professional nursing care is required. Especially those responsible for management and implementation must be aware of possible barriers in order to develop appropriate strategies.

Attitudes and needs of residents in long-term care facilities regarding physical activity-A systematic review and synthesis of qualitative studies.

AIMS AND OBJECTIVES: To identify the attitudes and needs of nursing home residents regarding physical activity. BACKGROUND: Nursing home residents often have mobility problems and are at high risk for further mobility impairment. From their point of view, being physically active is an important part of their perceived quality of life. However, no study has synthesised existing qualitative literature on residents' attitudes and needs regarding physical activity. DESIGN: Synthesis of qualitative studies. METHODS: A systematic review and synthesis of qualitative studies was performed, using ENTREQ statement for reporting. Three databases (PubMed, CINAHL and PsycINFO) were searched, supplemented by a hand search. Qualitative studies published in English or German were included if they addressed the attitudes and needs of residents concerning the promotion of physical activities. Finally, 12 studies were critically reviewed, and a thematic synthesis was conducted. RESULTS: Four analytical themes relating to residents' attitudes were identified: "promoting physical activity increases the quality of life," "accepting the conditions," "personal initiative is significant" and "promoting physical activity is not helpful." Relating to residents' needs, the analyses yielded five themes: "living autonomously," "continuing life as before," "competent care," "individually adapted programme and support," and "barrier-free accessibility." CONCLUSION: Nursing home residents have different attitudes and needs regarding being physically active. It is important to perceive these attitudes and needs of each resident and to offer an individually adapted programme and support. Further research should consider motivational strategies for residents who are not very much familiar with being physically active and offer exercise programmes with individual parts to address residents' preferences. RELEVANCE TO CLINICAL PRACTICE: To motivate and activate residents, institutions should be aware of residents' individual attitudes and needs regarding physical activity. Further development of interventions concerning mobility promotion activities and their implementation in long-term care settings should consider the outlined factors.

[Mutual guiding and following of movement - The interaction process in mobilisation based on the example of kinaesthetics: A qualitative study]. / Angepasste Bewegungsunterstützung ­ Interaktionsgeschehen am Beispiel einer kinästhetischen Mobilisation.

Background: Mobility impairment is often seen as a reason for needing long-term care. Thus, promoting mobility becomes increasingly significant in nursing homes. The kinaesthetic approach offers a way to support nursing home residents in using their own resources to maintain or improve their mobility. Aim: The present study intends to identify the characteristics of the interaction between nursing home residents with impaired mobility and kinaesthetic trainers during mobilisation. Methods: This secondary analysis comprises nine video sequences interpreted according to Grounded Theory-principles. The findings are described in a basic model. Results: The interaction with nursing home residents is focused on adapted movement support. This assistance shows a positive effect on residents' self-activity in the tracking process and in the context of other strategies. Intervening conditions like residents' daily constitution have an influence on nurses' kinaesthetic strategies. Thereby, nurses have to be highly competent in self-perception. Conclusion: Adapted movement support proves to be a phenomenon basing on the nurse-resident-interaction and allowing residents to actively participate in collaborative action.