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  • 1
    In: Pflege, Hogrefe Publishing Group, Vol. 36, No. 3 ( 2023-06), p. 168-178
    Abstract: Zusammenfassung: Hintergrund: Die Umsetzung von Schutzmaßnahmen in Pflegeheimen während der Covid-19-Pandemie war mit dem Wegfall sozialer Teilhabeangebote in der ersten Covid-19-Welle verbunden, für die zweite Covid-Welle ist dies unzureichend untersucht. Ziel: Die Evaluation des Zusammenhangs von Schutzmaßnahmen und Einschränkungen der sozialen Teilhabe für die zweite Covid-19-Welle zur Ausarbeitung von Handlungsempfehlungen. Methode: Mixed-Methods-Online-Survey von Pflegeheimleitungen ( n = 873) in der zweiten Welle. Mithilfe binärlogistischer verallgemeinerter Schätzgleichungen wurde die Wahrscheinlichkeit für das Wegfallen sozialer Teilhabeangebote in den Pflegeheimen in Abhängigkeit gesetzlicher Schutzmaßnahmen evaluiert. Offene Antworten zur Aufrechterhaltung sozialer Teilhabe wurden inhaltsanalytisch untersucht ( n = 1042). Ergebnisse: Mehr als jede zweite Pflegeheimleitung berichtet über untersagte Gruppenveranstaltungen (66,6%), mehr als jede dritte untersagte kreative Angebote (42,3%). Besuchseinschränkungen (85,2%) waren in der zweiten Welle weit verbreitet. Der Wegfall von Teilhabeangeboten und die angeordneten Schutzmaßnahmen waren eng assoziiert. Qualitative Daten zeigten, dass zum Beispiel das Anschaffen mobiler Einkaufsläden Maßnahmen waren, der sozialen Exklusion der Bewohnenden entgegenzuwirken. Diskussion: Der Zusammenhang zwischen dem Wegfall sozialer Teilhabeangebote und der Umsetzung von Schutzmaßnahmen war deutlich ausgeprägt. Die Pflegepraxis sollte die Umsetzung von sozialer Teilhabe ermöglichen und gleichzeitig einen bestmöglichen Infektionsschutz garantieren.
    Type of Medium: Online Resource
    ISSN: 1012-5302 , 1664-283X
    RVK:
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2023
    detail.hit.zdb_id: 2077531-3
    detail.hit.zdb_id: 645005-2
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  • 2
    In: BMC Nursing, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2022-12)
    Abstract: Care homes were hit hard by the COVID-19 pandemic. Although high levels of psychosocial burden (i.e., anxiety, depression and stress) during the pandemic have been described for healthcare workers in hospitals, evidence on the psychosocial burden for nurses in care homes during the pandemic is scarce. Methods A total of 811 nurses participated in a retrospective online survey between November 2020 and February 2021. Information about the COVID-19 situation (i.e., working demands, COVID-19 cases in their facility, and COVID-19-related burden) of nurses in German care homes during the first wave of the pandemic (March 2020 to June 2020) was gathered. The Stress Scale of the Depression Anxiety and Stress Scales (SDASS-21), the Generalized Anxiety Disorder Scale-2 (GAD-2), the Patients-Health-Questionnaire-2 (PHQ-2), and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used to screen for psychosocial burden. Results Among nurses, 94.2% stated that working demands since the COVID-19 pandemic increased. Further, 59.1% showed clinically relevant levels of either stress, anxiety, and/or depression. Multiple regression analysis showed significant associations between COVID-19-related burden and qualification ( p 〈 .01), dissatisfaction with COVID-19 management of care home manager ( p 〈 .05), COVID-19-related anxiety ( p 〈 .001), and dementia as a focus of care ( p 〈 .05). Stress, depression, and anxiety showed associations with COVID-19 related burden at work ( p 〈 .01), COVID-19-related anxiety ( p 〈 .001), social support ( p 〈 .01), and sense of community ( p 〈 .05). Stress was also associated with COVID-19 cases among residents ( p 〈 .05), and size of care home ( p 〈 .05). Conclusion Short- and long-term strategies (i.e., psychosocial counseling, mandatory team meetings, more highly qualified nurses, additional training) in the work environment of nursing, in crises, but beyond, should be encouraged to reduce the burden on nursing staff in care homes.
    Type of Medium: Online Resource
    ISSN: 1472-6955
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2091496-9
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  • 3
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-05-26)
    Abstract: Hospital admissions due to acute cardiovascular events dropped during the COVID-19 pandemic in the general population; however, evidence for residents of long-term care facilities (LTCF) is sparse. We investigated rates of hospital admissions and deaths due to myocardial infarction (MI) and stroke in LTCF residents during the pandemic. Our nationwide cohort study used claims data. The sample comprised 1,140,139 AOK-ensured LTCF residents over 60 years of age (68.6% women; age 85.3 ± 8.5 years) from the largest statutory health insurance in Germany (AOK), which is not representative for all LTCF residents. We included MI and stroke admission and compared numbers of in-hospital deaths from January 2020 to end of April 2021 (i.e., during the first three waves of the pandemic) with the number of incidences in 2015–2019. To estimate incidence risk ratios (IRR), adjusted Poisson regression analyses were applied. During the observation period (2015–2021), there were 19,196 MI and 73,953 stroke admissions. MI admissions declined in the pandemic phase by 22.5% (IRR = 0.68 [CI 0.65–0.72]) compared to previous years. This decline was slightly more pronounced for NSTEMI than for STEMI. MI fatality risks remained comparable across years (IRR = 0.97 [CI95% 0.92–1.02] ). Stroke admissions dropped by 15.1% (IRR = 0.75 [CI95% 0.72–0.78]) in the pandemic. There was an elevated case fatality risk for haemorrhagic stroke (IRR = 1.09 [CI95% 1.03–1.15] ) but not for other stroke subtypes compared to previous years. This study provides first evidence of declines in MI and stroke admissions and in-hospital deaths among LTCF residents during the pandemic. The figures are alarming given the acute nature of the conditions and the vulnerability of the residents.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 4
    Online Resource
    Online Resource
    Elsevier BV ; 2022
    In:  Journal of the American Medical Directors Association Vol. 23, No. 7 ( 2022-07), p. 1117-1118
    In: Journal of the American Medical Directors Association, Elsevier BV, Vol. 23, No. 7 ( 2022-07), p. 1117-1118
    Type of Medium: Online Resource
    ISSN: 1525-8610
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 5
    In: Pflege, Hogrefe Publishing Group, Vol. 35, No. 3 ( 2022-06-01), p. 133-142
    Abstract: Zusammenfassung. Hintergrund: Das Spannungsfeld zwischen Gesundheitsschutz und Einschränkungen des sozialen Lebens in den Pflegeheimen während der Pandemie ist unzureichend aufgearbeitet. Ziel: Ziel war es, bundesländerspezifische Verordnungen zu systematisieren und die Umsetzungen dieser in einen Zusammenhang mit Einschränkungen sozialer Angebote für die Bewohner_innen zu bringen. Methoden: In einem Mixed-Methods-Design wurden Schutzmaßnahmen für Pflegeheime in der ersten Pandemiewelle aus 450 Verordnungen kategorisiert, in ein theoretisches Maßnahmenmodell eingespeist und in einem Survey unter Heimleitungen (n = 1260) zur Handhabung der Maßnahmen sowie zum Wegfall sozialer Angebote verwendet. Der Zusammenhang von Schutzmaßnahmen und Einschränkungen sozialer Angebote wurde mit binärlogistischen verallgemeinerten Schätzgleichungen analysiert. Ergebnisse: Die Verordnungen konnten in fünf Themen kategorisiert werden. Die Daten zeigen, dass „Besuchsverbote“ (98,3 %) und „Körperkontaktreduzierung“ (90,5 %) den größten Teil der Einschränkungen darstellen. Über alle Angebote hinweg waren „Verbotsmaßnahmen“ und für viele Angebote „Kontaktreduzierungen“ bedeutsam assoziiert, während etwa der Wegfall von „Gruppenangeboten“ zweimal so hoch war, wenn die Schutzmaßnahme „Reduzierung des Körperkontaktes“ umgesetzt wurde. „Besuchseinschränkungen“ zeigten kaum signifikante Assoziationen. Schlussfolgerungen: Die Ergebnisse belegen einen Zusammenhang von Schutzmaßnahmen und Wegfall sozialer Angebote. Maßnahmen, die den Gesundheitsschutz mit dem Erhalt von sozialen Angeboten und Versorgung kombinieren, sollten priorisiert werden.
    Type of Medium: Online Resource
    ISSN: 1012-5302 , 1664-283X
    RVK:
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2022
    detail.hit.zdb_id: 2077531-3
    detail.hit.zdb_id: 645005-2
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  • 6
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: While the relation between care involvement of informal caregivers and caregiver burden is well-known, the additional psychosocial burden related to care involvement during the COVID-19 pandemic has not yet been investigated. Methods A total of 1000 informal caregivers, recruited offline, participated in a cross-sectional online survey from April 21 to May 2, 2020. Questionnaires were used to assess COVID-19-specific changes in the care situation, negative feelings in the care situation, problems with implementation of COVID-19 measures, concerns/excessive demands, loss of support, change in informal caregivers’ own involvement in care and problems with provision, comprehension & practicability of COVID-19 information, and to relate these issues to five indicators of care involvement (i.e., being the main caregiver, high expenditure of time, high level of care, dementia, no professional help). Binomial and multiple regression analyses were applied. Results Across indicators of care involvement, 25.5–39.7% reported that the care situation rather or greatly worsened during the COVID-19 pandemic, especially for those caring for someone with dementia or those usually relying on professional help. In a multiple regression model, the mean number of involvement indicators met was associated with age (β = .18; CI .10–.25), excessive demands (β = .10, CI .00–.19), problems with implementation of COVID-19 measures (β = .11, CI .04–.19), an increase in caregiving by the informal caregivers themselves (β = .14, CI .03–.24) as well as with no change in the amount of caregiving (β = .18, CI .07–.29) and loss of support (β = −.08, CI −.16–.00). No significant associations with the mean number of involvement indicators met were found for gender, educational level, change in the care situation, negative feelings, and provision, comprehension & practicability of COVID-19 information. Conclusion Those caregivers who perceived extensive care burden were those who suffered most during the pandemic, calling for structural support by the healthcare system now and in the future. Trial registration This article does not report the results of a health care intervention on human participants.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 7
    In: Deutsches Ärzteblatt international, Deutscher Arzte-Verlag GmbH, ( 2022-04-22)
    Type of Medium: Online Resource
    ISSN: 1866-0452
    Language: German
    Publisher: Deutscher Arzte-Verlag GmbH
    Publication Date: 2022
    detail.hit.zdb_id: 2406159-1
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  • 8
    In: BMC Primary Care, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-12-22)
    Abstract: Though evidence on the detrimental impact of the COVID-19 pandemic in nursing homes is vast, research focusing on general practitioners’ (GP) care during the pandemic in nursing homes is still scarce. Methods A retrospective online survey among 1,010 nursing home managers in Germany was conducted during the first wave of the COVID-19 pandemic between November 2020 and February 2021. Associations between perceived deficits in GP care (routine and acute visits) and both general and COVID-19-related characteristics of nursing homes were analysed using multiple logistic regression analyses. Results The majority of nursing home managers reported no deficits in GP care (routine visits, 84.3%; acute visits, 92.9%). Logistic regression analyses revealed that deficits in GP care (routine visits) were significantly associated with visiting restrictions for GPs and nursing home size. Small nursing homes (1–50 residents) were significantly more likely to report deficits in GP care (routine visits) compared to medium (51–100 residents) and large nursing homes ( 〉  100 residents). Further, deficits in GP care (acute visits) were significantly associated with dementia as a focus of care and the burden of insufficient testing for SARS-CoV-2 among residents. Moreover, visiting restrictions for GPs were significantly associated with dementia as the focus of care and the COVID-19 incidence at the federal state level. Finally, COVID-19 cases in nursing homes were significantly associated with size of nursing homes, COVID-19-incidence on the federal state level and the burden of insufficient testing capacities for SARS-CoV-2 among residents. Conclusion We found structural factors associated with GP care deficits during the pandemic. New concepts for GP care should be implemented in pandemic preparedness plans to ensure high quality, consistent, and reliable GP care as well as effective infection prevention measures in nursing homes.
    Type of Medium: Online Resource
    ISSN: 2731-4553
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 3107315-3
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  • 9
    In: Zeitschrift für Gerontologie und Geriatrie, Springer Science and Business Media LLC
    Abstract: Nurses working in long-term care facilities were vaccinated first before residents as a matter of priority to protect the latter. Although the vaccination rate of nursing staff eventually rose due to a facility-based vaccination requirement, studies on associated factors of vaccination status are currently not available for the long-term care setting in Germany. Objective Associated factors of COVID-19 vaccination status among nursing staff in long-term care facilities were explored. Methods An online survey was conducted between October 26th 2021 and January 31st 2022. A total of 1546 nurses working in long-term care in Germany responded to questions concerning the Covid-19 vaccination campaign. Logistic regression analyses were performed. Results In this study 8 out of 10 nurses were vaccinated against COVID-19 (80.6%). Approximately 7 out of 10 nurses thought at least a few times about quitting their job since the pandemic began (71.4%). A positive COVID-19 vaccination status was associated with older age, full-time employment, COVID-19 deaths at the facility and working in northern or western Germany. Frequent thoughts of quitting their job were associated with negative COVID-19 vaccination status. Conclusion The present findings provide evidence on factors associated with the COVID-19 vaccination status of nurses in long-term care facilities in Germany for the first time. Further quantitative as well as qualitative studies are necessary for a more comprehensive understanding of the COVID-19 vaccination decision-making among nurses in long-term care, in order to implement target-oriented future vaccination campaigns in this care setting.
    Type of Medium: Online Resource
    ISSN: 0948-6704 , 1435-1269
    RVK:
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463317-6
    detail.hit.zdb_id: 1227032-5
    SSG: 5,2
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