[COVID-19 protective measures in nursing homes: Between autonomy and care - Results of an interview study]. / Covid-19 Schutzmaßnahmen in Alten- und Pflegeheimen: zwischen Autonomie und Fürsorge ­ Ergebnisse einer Interviewstudie.

Definition of the problem: This interview study investigated ethical issues in long-term care facilities from the perspective of caregivers during the coronavirus disease (COVID-19) pandemic. Due to the explorative as well as descriptive methodological approach, interview data are available and can be assigned to four central topics, which reveal a complex and sometimes conflictual reality of work and life in long-term care during the pandemic. On the one hand, the protective measures taken by the state and the institutions, as well as the resulting restrictions on the personal freedom of the residents are critically reflected and the degree of self-determination of the residents of nursing homes in the pandemic is questioned. On the other hand - given the pandemic-related measures - nursing activities in long-term care facilities as a place of work and life are described as challenging, especially regarding the changed nursing processes and quality of care, as well as due to the changed quality of relationships with the residents. Arguments: These four topics can basically be assigned to the ethical principles of autonomy and care and present a relevant concretization of the principle-oriented ethical challenges in long-term care during the COVID-19 pandemic. In the synopsis and interpretation of the results, it becomes apparent that the interviewed caregivers closely link the observance and implementation of the autonomy principle in everyday nursing care with the principle of care and the resulting well-being of the residents. Conclusions: Our results clearly show that the paradigm shift in long-term care, which has been developed over the last few decades, was (temporarily massively) weakened by the COVID-19 pandemic. In addition, the reported moral uncertainties and conflicts make it clear that caregivers need support regarding the ethical reflection of their nursing actions and that a sustainable integration of ethics counselling in long-term care facilities may be a possible approach to a solution.

[Make nursing practice visible through nursing science in times of COVID-19]. / Pflegepraxis durch Pflegewissenschaft in Zeiten von COVID-19 sichtbar machen.

Due to coronavirus disease 2019 (COVID-19) nursing practice is facing enormous challenges. Nevertheless, nursing science was hardly actively represented as a mouthpiece for the practice in the public discussions on the COVID-19 pandemic. Therefore, the question arises which projects with a focus on nursing and COVID-19 have been carried out at Austrian universities. Overall, six projects were identified using the snowball method. Of the studies one showed that an increased wearing time of masks is associated with an increased stress level for nursing personnel. An additional study result showed that almost 50% of lay people used masks incorrectly. Individual experiences, interventions undertaken and solution approaches from the perspective of the nursing staff with respect to ethical challenges in nursing homes were collected in a further project. This and other projects show that nursing science, with its knowledge and as a voice for nursing practice, has taken the initiative and contributes to the COVID-19 discourse. Additionally, the findings of the projects can be used as a basis for making future political decisions.

The Inter-Rater Reliability of the Observation Instrument for Assessing Pain in Elderly With Dementia: An Investigation in the Long-Term Care Setting.

BACKGROUND AND PURPOSE: The Observation Instrument for Assessing Pain in Elderly With Dementia (BISAD) was developed in Germany. The instrument demonstrated high inter-rater reliability values for the original French version. So far, there are no results to that effect in the Austrian long-term care setting available. The objective of this study was to investigate agreement and inter-rater reliability of BISAD in residents with dementia. METHODS: A quantitative multicenter-descriptive cross-sectional design with a convenience sample of 71 residents. RESULTS: Analysis of all eight items demonstrated fair to moderate concordance. Absolute agreement of the total value was 25.32%. Subtotals of the observation before mobilization was 52.11%, and during mobilization 32.39%. CONCLUSION: The reliability analysis shows that the items are less reliable. Currently, BISAD does not make a reliable contribution to clinical decision making in the tested setting.

[Preventive home visits : Cross-sectional study to support an independent lifestyle for elderly people]. / Präventive Hausbesuche : Querschnittstudie zur Unterstützung der selbstständigen Lebensführung älterer Menschen.

BACKGROUND: In the interest of preventing or postponing dependency on care and assistance for as long as possible, preventive home visits to people aged over 70 years living at home were conducted by registered nurses. AIM: Assessment of the functional health of people over 70 years of age and counseling or information carried out based on the identified problem areas and resources. MATERIAL AND METHODS: A multidimensional nursing assessment through self-evaluation was applied for 345 people aged over 70 years. RESULTS: The sample of people investigated showed a high level of competence in self-care; however, a large number of functional health impairments could be identified that are reflected in the high requirement for counseling and information. DISCUSSION: It became evident that recruiting of study participants was difficult and that care by family members was an important resource for people aged over 70 years. From this it was recommended that in the future sustainable advertising efforts should be conducted and special attention needs to be given to counseling and information for family members in preventive home visits.