Search

Hintergrund: Die Diagnostik eines Delirs ist anspruchsvoll und bedarf in der klinischen Routine wie in Studien genauer Definitionen. Ziel: Es wird auf verschiedene Fallstricke in der klinischen Diagnostik des Delirs hingewiesen und Lösungen werden diskutiert. Methodik: Übersichtsarbeit Ergebnisse: Häufige Problemstellungen sind a) die klinische Einschätzung von Mitarbeitern vs. der Einsatz valider Assessmentinstrumente; b) verschiedene Kriterienkataloge für ein Delir, die die Symptome eines Delirs abweichend berücksichtigen und damit zum Ein- oder Ausschluss von Patienten führen können; c) verschiedene Assessmentinstrumente, die die Symptome eines Delirs in unterschiedlichem Umfang testen und somit eine abweichende Genauigkeit aufweisen; d) kommunikationseingeschränkte Patienten wie z. B. mit Aphasie, bei denen übliche Tests oftmals versagen und alternative Verfahren hier eher zielführend sein können; e) die Entscheidung, ob ein Delir ein-, 2‑, 3‑mal oder häufiger in 24 h untersucht wird, hat Konsequenzen über die Inzidenz und Dauer eines Delirs; f) das Ende eines Delirs, das oft retrospektiv als delirfreies Intervall oder prospektiv als Zeitpunkt der Verlegung oder Auftreten eines Ausschlusskriteriums definiert wird, kann zu erheblichen Messungenauigkeiten führen. Schlussfolgerungen: Obwohl nicht alle Problemstellungen endgültig beantwortet werden können, werden eine transparente Definition, Durchführung und Dokumentation der diagnostischen Prozeduren empfohlen.

Die Studie zur Qualitätsverbesserung des Delirmanagements auf sechs deutschen Stroke Units mit knapp 500 Patient*innen zeigte, dass ein interprofessionelles Delirmanagement machbar und bei den meisten Patient*innen trotz ihrer neurologischen Erkrankung umsetzbar ist. Das Delirmanagement führte wie erwartet zwar nicht zu weniger Delirien, kann aber deren Schwere lindern. Eine interprofessionelle Zusammenarbeit mit Anpassung der Strukturen und Prozesse und regelmäßiger Evaluation ist hierfür die Voraussetzung.

Background:No qualitative studies have so far been conducted about patients' attitudes and perceptions toward their own health literacy and the use of digital apps in health and disease management based in Austria.Aim:In the context of digital apps, what are patients' attitudes and perceptions with regard to their own health literacy?Method:Guided interviews were conducted with patients in an Austrian hospital to obtain qualitative data. Qualitative content analysis was used to analyse the data.Findings:Responses to the research questions fell into three main categories: ‘health’, ‘health literacy’ and ‘digital applications in health and disease management’, with each having its own set of subcategories. Digital apps appear to be an important strategy for helping patients optimise their own health literacy, as well as their health or disease management. Challenges referred to the handling of sensitive data or the possibility of publishing unfiltered information.Conclusion:Further studies need to be carried out to gain a more detailed understanding of the findings. Personal experience plays an important role in supporting quantitative findings.

We aimed to explore the association of national COVID-19 data with the objective and subjective mental health proxies (i.e. location variance, self-reported sleep quality, level of recovery, perceived risk of infection) in team and staff members of five professional Austrian Football clubs. Data were conveniently collected during the implementation of a novel monitoring concept. The concept was designed to enable safe continuation of professional Football during the COVID-19 pandemic. These data were matched with Austrian COVID-19 data and smartphone collected location data. Multivariable linear regression models explored the association of COVID-19, defined as daily novel or active Austrian cases of COVID-19, with the mental health proxies. An increasing number of novel Austrian COVID-19 cases was significantly associated with deteriorating sleep quality (B 0.48, 95% CI 0.05; 1.00). An increasing number of active Austrian COVID-19 cases was significantly associated with an increase in perceived infection risk (B 0.04, 95% CI 0.00; 0.07) and location variance (B 0.28, 95% CI 0.06; 0.49). An increasing Austrian COVID-19 incidence is adversely associated with mental health in professional Footballers and staff members. During the ongoing pandemic, targeted mental care should be included in the daily routines of this population.

Der Expertenstandard wird aktualisiert - Seit fünf Jahren gilt der Expertenstandard Schmerzmanagement in der Pflege. Damit wird es Zeit für eine Aktualisierung. Doch inwieweit haben sich die Rahmenbedingungen für das pflegerische Schmerzmanagement, die der Standard vorgibt, in der Praxis durchgesetzt?

Prof. dr. Jürgen Osterbrink (50) spreekt op 24 mei aanstaande in Amsterdam de 14e Anna Reynvaan Lezing uit. Hij staat bekend om zijn bijzondere visie op pijnmanagement. De Duitser Osterbrink werd in Münster geboren, studeerde filosofie en verpleegkunde en heeft internationaal carrière gemaakt. Zo werkte hij onder meer in Luxemburg, Ethiopië, België, Schotland, Miami, Jacksonville, Nürnberg en nu in het Oostenrijkse Salzburg.

BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.OBJECTIVES: To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city.METHODS: In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011.RESULTS: Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent.CONCLUSIONS: Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain.