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Background 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.

OBJECTIVES There is a lack of knowledge on coping with pain and sub-group specific pain-coping profiles among older home care receivers with chronic pain. To describe pain-coping strategies, identify subgroups based on cognitive and behavioral pain-coping strategies and pain-related psychological impairment and to compare these groups with regard to socio-demographic, medical, pharmacological and psychological characteristics. METHOD Data of 212 care receivers were examined using the German pain-coping questionnaire (FESV) to determine how they cope with pain. Subgroups were identified using hierarchic agglomerative cluster analysis, using Ward's algorithm and squared Euclidean distance, and characterized using socio-demographic, medical, pharmacological and psychological parameters. Multinomial logistic regression was used to identify variables associated with the subgroups. RESULTS Older care receivers apply cognitive and behavioral strategies to manage pain. Three subgroups were identified: Cluster 1 (25.9%) with good coping competences and little psychological impairment, Cluster 2 (40.1%) with poor coping competences and high psychological impairment, and Cluster 3 (34%) with good coping competences and high psychological impairment. Significant differences between the clusters were observed for age, pain intensity, pain-related interference, daily activities, depression and resilience. Logistic regression demonstrated that belonging to Cluster 2 was associated with the number of pain-reducing medications, depression and resilience. Belonging to Cluster 3 was significantly linked to daily activities, the number of pain medications, depression and the level of care required. CONCLUSION Differentiating between pain-coping profiles in the group of older care receivers with chronic pain necessitates target group-specific pain-oriented psychotherapeutic interventions, which can result in improved pain management.

Fur ambulant versorgte Altere (≥60 Jahre) finden sich Schmerzpravalenzraten bis zu 53 %. Pflegebedurftige in Deutschland stellen unter den Schmerzbetroffenen mit Pravalenzen um 70 % eine relevante Gruppe dar. Zur Geschlechtsspezifik liegen differierende Aussagen vor. Ziel war die Ermittlung von Schmerzparametern auskunftsfahiger alterer Pflegebedurftiger im grosstadtischen Raum unter Berucksichtigung von Geschlechtsunterschieden sowie relevanter medizinischer und medikamentoser Versorgungsaspekte. Durchgefuhrt wurde eine Querschnittsuntersuchung (strukturierte Interviews) bei ≥ 65-jahrigen auskunftsfahigen (MMST ≥ 18) Pflegebedurftigen (SGB XI) mit chronischen Schmerzen (n = 225) in der eigenen Hauslichkeit. Schmerzparameter wurden mit der deutschen Version des Brief Pain Inventory (BPI-NHR) erfasst. Die Prufung des erklarenden Einflusses soziodemografischer und medizinischer Parameter, psychischer und physischer Beeintrachtigungen sowie der Analgetikaversorgung auf den starksten Schmerz erfolgte mittels multipler Regressionsanalyse. Analysen zeigen eine durchschnittliche Schmerzintensitat von 5,3 (SD ± 2,0). Der starkste Schmerz erreicht im Mittel einen Wert von 7,0 (SD ± 2,2). Signifikante Geschlechtsunterschiede waren geringfugig vorhanden (z. B. Schmerzorte, Medikamentenanzahl). Anzahl der Schmerzorte (≥14), Alltagsfahigkeiten und Schmerzmedikation (bei Bedarf, keine) waren im finalen Modell mit dem starksten Schmerz assoziiert. Lediglich bei 24,6 % der Schmerzbetroffenen wird eine mehr als 70 %ige Schmerzlinderung unter Behandlung erreicht. Die Ergebnisse verweisen auf ausgepragte Schmerzleiden bei alteren ambulant versorgten Pflegebedurftigen. Es besteht dringender Bedarf fur interdisziplinare Versorgungskonzepte.

Zusammenfassung Ziel der Studie Schizophrenie zählt zu den schwersten psychiatrischen Erkrankungen. Das deutsche Versorgungssystem weist jedoch für diese und andere chronisch psychisch Erkrankte mit einem intensiven Behandlungsbedarf nach wie vor Lücken auf. Der vorliegende Beitrag fokussiert die Veränderung der Versorgung von initial vollstationär behandelten Patienten mit Schizophrenie, die an den St. Hedwig Kliniken in Berlin in einem Modellprojekt nach § 64b SGB V versorgt werden, im Vergleich zu Patienten in der Regelversorgung. Methodik Die Zielgrößen wurden mittels Routinedaten erfasst. Dabei wurden 3 Patientenkohorten analysiert. Mittels Propensity Score Matching wurde je Kohorte eine Vergleichsgruppe gebildet. Ergebnisse Es zeigt sich, dass im Modellprojekt die Anzahl der Krankenhausaufenthalte reduziert wurde, die Gesamtverweildauer gesenkt und Gesamtkosten teilweise gesenkt wurden. Zudem verlängerte sich die Dauer bis zur nächsten Rehospitalisierung, während sich die Gesamtzahl der Kontakte zum ambulanten Sektor erhöhte. Schlussfolgerung Die angestrebte Verlagerung der Versorgung in den ambulanten Bereich wurde für Patienten mit Schizophrenie in diesem Modellprojekt erreicht.

Was ist neu? Schmerz und Schmerzfolgen Chronische Schmerzen bei älteren Pflegebedürftigen, die in der eigenen Häuslichkeit leben, sind aufgrund ihrer Häufigkeit und Intensität von hoher Relevanz. Schmerzfolgen werden in dieser vulnerablen Gruppe insbesondere in Form von ausgeprägten Beeinträchtigungen der Mobilität und Aktivität deutlich. Schmerzkommunikation in der ambulanten Versorgung Sowohl die versorgenden Ärztinnen und Ärzte als auch das Pflegepersonal ambulanter Pflegedienste kommunizieren zu selten mit den schmerzbetroffenen Pflegebedürftigen über Schmerzen, ihre Intensität und Dauer sowie über das Schmerzmanagement. Medikamentöse Schmerztherapie Die in der ambulanten Versorgung schmerzbetroffener Pflegebedürftiger defizitäre Schmerztherapie bedarf einer Überprüfung der Angemessenheit schmerzreduzierender Arzneistoffe, der gleichzeitigen Verordnung von Dauer- und Bedarfsmedikation sowie klarer Angaben zu Dosis und Dosisintervallen auf verbindlichen Medikationsplänen. Interdisziplinäre Ressourcen Den Herausforderungen einer interdisziplinären Versorgung älterer Pflegebedürftiger im ambulanten Setting wurde bisher zu wenig Beachtung geschenkt, obwohl die Interdisziplinarität im Schmerzmanagement schon lange gefordert wird. Multidisziplinäres Handeln, basierend auf abgestimmten Leitlinien und Standards, stellt den Schlüssel für ein angemessenes Schmerzmanagement dar. Die Schnittstellenkommunikation zwischen den Berufsgruppen ist optimierungsbedürftig.

Context. There are no available data regarding pain-associated clusters among nursing home residents and older adults receiving home care with chronic pain. Objectives To identify and describe pain-associated clusters in nursing home residents and older adults receiving home care with chronic pain, and to explore associations with clusters in both settings. Methods We surveyed 137 nursing home residents and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, utilizing Ward’s method with Squared Euclidean Distances in the proximities matrix. The clusters were characterized based on socio-demographic and clinical characteristics. Multinomial logistic regression was used to identify variables associated with different clusters. Results In each setting, we identified three clusters: pain-relieved, pain-impaired, and suffering severe pain. In the nursing home study and the home care study, respectively, the participant distributions were 46.72% and 11.71% in the pain-relieved cluster, 22.63% and 33.66% in the pain-impaired cluster, and 30.66% and 54.63% in the severe-pain cluster. Appropriate pain medication was only detected among pain-relieved nursing home residents. Conclusion Overall, differences in pain management exist within the two care settings presented here. There is potential for improvement in both settings. Moreover, there exists a need for clinical interventions aiming at shifting from pain-affected clusters to pain-relieved status.

Zusammenfassung. Hintergrund: Die Prävalenzraten von chronischem Schmerz liegen international bei ambulant versorgten älteren Menschen (> 65-Jährigen) bei bis zu 50 %. Eine erste nationale Studie mit auskunftsfähigen Pflegebedürftigen (≥ 18 Jahre) ermittelte für den ambulanten Bereich eine Prävalenzrate von 68,5 %. Eine bedeutende Rolle beim Schmerzmanagement kommt der pflegerischen Versorgung zu. Der bisherige Forschungsstand zur Qualität des pflegerischen Schmerzmanagements ist jedoch unzureichend. Ziel: Somit ist das Ziel der vorliegenden Untersuchung, die Angemessenheit des pflegerischen Schmerzmanagements bei älteren Pflegebedürftigen mit und ohne kognitive Einschränkungen für den ambulanten Bereich zu prüfen. Methode: Die vorliegende Querschnittstudie basiert auf den Daten des Projektes ACHE. In die Untersuchung wurden 219 Pflegebedürftige einbezogen. Mittels persönlich-mündlicher Interviews sowie einer Analyse der Pflegedokumentation wurden Informationen zum subjektiven Schmerzerleben sowie dem Schmerzmanagement eingeholt. Ergebnisse: Die Befragung der Pflegebedürftigen und die Analyse der Pflegedokumentation weisen auf deutliche Defizite hinsichtlich des pflegerischen Schmerzmanagements hin. Defizite zeigten sich vor allem in einer fehlenden systematischen Schmerzerfassung sowie fehlenden Dokumentation von Therapiezielen und der Dokumentation durchgeführter schmerztherapeutischer Maßnahmen. Schlussfolgerungen: Eine mögliche Ursache für die identifizierten Defizite eröffnet sich über derzeitige Rahmenbedingungen, welche das pflegerische Handeln in SGB V und SGB XI Leistungen trennt. Ein angemessenes pflegerisches Schmerzmanagement kann nur gewährleistet werden, wenn Rahmenbedingungen optimiert werden.

The aim of this study was to analyze the impact of being pain-affected and fear of falling on functional performance among nursing home residents, longitudinally. We used 6-month follow-up data from a cluster-randomized trial of 12 nursing homes (cluster level) with 239 nursing home residents at baseline (mean age, 95% confidence interval [CI] = 83.04 [81.40, 84.69], 70% women). The longitudinal analysis provided data on pain, fear of falling, functional mobility, and activities of daily living (individual level). The data revealed a trend indicating that pain-relieved nursing home residents showed better functional mobility over time. The results on fear of falling demonstrate obvious differences in the functional performance of nursing home residents cross-sectionally but not longitudinally. Nevertheless, the results underline the importance of an effective pain treatment to prevent decline in functional mobility among nursing home residents. Further longitudinal surveys are needed to verify the findings on functional performance.

Chronic pain is common in older adults, particularly among nursing home residents (NHR). Internationally, the reported pain prevalence among NHR ranges from 3.7% to 79.5%. At least one in two German NHR are diagnosed with pain. Unrelieved chronic pain is associated with reduced physical functioning and psychological parameters. Given the high prevalence of pain among NHR, we hypothesized that there were likely pain-associated clusters in our target group. Clustering is an opportunity to identify differences in pain management and may enable better targeted health-service delivery for professionals. There are no available data regarding pain-associated clusters (sub-groups of NHR) based on different items measuring pain. This study was performed using baseline data, and was part of a cluster-randomized controlled trial conducted in 12 nursing homes in Berlin. We assessed pain using the German Brief Pain Inventory (BPI-NHR) among 137 NHR (mean age, 83.33 years) capable of self-report. We performed hierarchical agglomerative cluster analysis to generate three clusters (naming is based on the mean value of each BPI-NHR item in each cluster): pain-relieved (46.72 %), pain-restricted (22.63 %), and severe pain (30.66 %). Body-Mass-Index (F(2,129) = 4.274, P = 0.016), Barthel-Index (F(2,133) = 3.246, P = 0.042), and appropriateness of pain medication (F(2,119) = 12.007, P = 0.000) differed between clusters. Parameters associated with an increased or decreased risk of being in a pain-diagnosed cluster will be discussed. The observed need for clinical interventions aiming at shifting from pain-diagnosed clusters to pain-relieved status will be reflected.

Die Schmerzversorgung von Pflegeheimbewohnerinnen ist nachweislich inadaquat. Um diesem Defizit zu begegnen, wurden im Projekt PAIN-Intervention eine Handlungsempfehlung zum angemessenen Schmerzmanagement entwickelt und auf dieser Basis Fortbildungen fur Pflegende angeboten. Nach Durchfuhrung der Ganztagsworkshops in der Interventionsgruppe bzw. der Basisinformation in der Kontrollgruppe zum Schmerzmanagement in Pflegeheimen schloss sich die anonyme, freiwillige Evaluation mit einem standardisierten Fragebogen an. Der Ganztagsworkshop zur Optimierung des Schmerzmanagements wurde besser bewertet als die Basisinformation. Signifikante Unterschiede zugunsten der Interventionsgruppe zeigten sich bei der Bewertung der Austauschmoglichkeiten, der erlebten Sicherheit im Umgang mit den Schmerzen der Bewohnerinnen und bezuglich der Informationen uber nichtmedikamentose Masnahmen. Trotz positiver Bewertung wird vielfach der Veranderungsbedarf im Schmerzmanagement als nichtnotwendig erachtet. Vorkenntnisse der Pflegenden zum Thema Schmerz fuhrten in der Kontrollgruppe zu einer geringeren Erweiterung der Kenntnisse. Unterschiede in der Methodik und des Zeitrahmens sowie der damit verbundene Umfang der Inhalte nehmen Einfluss auf die Bewertung. Eine multiperspektivische und interaktive Herangehensweise ermoglicht auch bei heterogenen Gruppen bessere Evaluationsergebnisse.

The reported prevalence of pain among nursing home residents (NHRs) is high. Insufficient use of analgesics, the conventional pain management strategy, is often reported. Whether and to what extent nonpharmacologic therapies (NPTs) are used to manage the pain of NHRs in Germany is largely unknown. The aim of this cluster-randomized trial was to assess the NPTs provided and to enhance the application and prescription of NPTs in NHRs on an individual level. There were six nursing homes in the intervention group and six in the control group. There were 239 NHRs, aged ≥65 years, with an average Mini-Mental State Examination score of at least 18 at baseline. Pain management interventions (cluster level) included an online course for physicians and 1-day seminar for nurses. Data on NPT applied by nurses and therapeutic NPT prescribed by physicians were obtained from residents' nursing documentation. Face-to-face interviews with NHRs assessed the NPT received. At baseline, 82.6% of NHR (mean age 83 years) were affected by pain, but less than 1 in 10 received NPT. The intervention did not result in a significant increase in the NPT applied by nurses, but did significantly increase the therapeutic NPT prescribed by physicians. Residents were active in using NPT to self-manage their pain. Given the prevalence of pain in NHRs, there is a clear need to improve pain management in this population. Extended use of NPT offers a promising approach. We recommend that nurses provide residents with education on pain-management techniques to support them in taking a proactive role in managing their pain.

Hintergrund: Nonresponse verursacht zweifelsohne ein Bias in Studienergebnissen. Ausfallursachen in Studien mit Pflegeheimbewohner(inne)n sind bisher unzureichend untersucht. Ziel und Methode: Ziel dieser Studie war es, nach dem Prozessmodell induktiver Kategorienbildung nach Mayring (2010) reliable und valide Kategorien zu entwickeln, welche detailliert Ausfallgründe von Pflegeheimbewohner(inne)n abbilden. Zudem wurden Charakteristika der Unit-Nonresponder und der Responder verglichen. Ergebnisse: Die Kategorisierung der Ausfallgründe erfolgte im Längsschnitt mit insgesamt 522 Pflegeheimbewohner(inne)n. Identifiziert wurden vier Oberkategorien («generelle Ablehnung», «gesundheitliche Aspekte», «Erreichbarkeit», «Überforderung») sowie 17 Subkategorien. Unit-Nonresponder und Responder unterscheiden sich hinsichtlich Alter und Geschlecht nicht; jedoch zeigten sich Unterschiede im Follow-up bei Familienstand, Berufsabschluss und kognitivem Status. Schlussfolgerungen: Das vorgelegte Kategorienschema kann zukünftig zur Erfassung von Ausfallgründen im Setting Pflegeheim verwendet werden. Die detaillierte Erfassung der Ausfallursachen kann zur Optimierung der Responserate beitragen.

BACKGROUND AND AIM Arterial hypertension is a common health problem in older nursing home residents (NHR). The aim of this study was to prospectively analyze blood pressure (BP) patterns, antihypertensive therapy, and visit-to-visit BP variability in NHR. METHODS BP, visit-to-visit variability (estimated by standard deviation of means) of systolic BP (SBP) were analyzed in 12 nursing homes in Germany. NHR who were at least 65 years old and had no moderate or severe dementia were studied at baseline (T0), after 3 and 6 months, respectively. RESULTS BP data were available for 177 NHR (mean age 83.8, 69.5% female) at T0. A total of 90.4% NHR was affected by hypertension. Mean systolic/diastolic blood pressure was 130,1/75,5 mmHg. BP values of ≥ 140/90 mmHg were found in 29.9%, while 33.9% of NHR exhibited SBP values

Pain management for nursing home residents (NHR) is important and needs more than a mono-disciplinary perspective. At least one in two German NHR suffer from pain. The extent of non-pharmacological therapies (NPT) used for pain management in NHR is rather low. Moreover, pharmacological pain management is often inappropriate. Scientists from six disciplines developed an intervention aiming to improve pain management skills in nursing staff and physicians. We performed a cluster-randomized controlled trial in twelve nursing homes. Pain management was analyzed before (T0, n=239) and after the intervention (T1, n=206; T2, n=177) in NHR aged ≥65 years. At baseline, 82.6% of NHR (mean age 82.9 ± 8.1 years) were affected by pain. At follow-up, the intervention resulted in an increase in prescribed NPT and a decrease (p=0.03) in the proportion of NHR without pain medication. The observed benefits of and methodological challenges in this interdisciplinary trial will be critically discussed.

Pain is common among university students. Unrelieved pain has adverse impacts on their quality of life. In this study, a pain management Web site was developed to distribute an online survey and provide Web-based pain education to university students. Participants were recruited from eight universities in Hong Kong using snowball sampling. The online survey included 37 items examining pain situations, pain management strategies, knowledge about self-medication, and demographic data of the participants. A total of 387 students participated and over 90 percent of them reported pain in the past 6 months. Around one-third of participants did not take any action to manage their pain. Pharmacological method was the most common strategy for students to relieve pain (37.2 percent). The use of over-the-counter (OTC) drug for pain relief was high (n = 214). However, OTC drug knowledge score was significantly higher among health-related group than nonhealth-related group (p 0.001). There were 188 students who also read the Web-based pain education and completed the evaluation on its usefulness. Nonhealth-related students reported significantly higher scores of self-perceived usefulness for the online education than the health-related students (p 0.001). Findings suggested the need to consider the service users' background when developing online education program in the future.

Objectives This study assessed the frequency of physician contacts for individual nursing home residents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs. Design Observational cross-sectional study conducted between March 2009 and April 2010. Setting Forty nursing homes in Berlin and Brandenburg, Germany. Participants A total of 560 NHRs. Measurements The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model. Results The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056). Conclusions Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use.

Pain management in nursing home residents (NHR) is insufficient. Hence, this guidance summarizes latest research results and guidelines of particular requirements on treatment of pain in the elderly. The purpose is to improve health care processes and outcomes on individual and institutional level. To reach this aim a multidisciplinary collaboration is essential. The prerequisite for adequate pain treatment is to conduct a standardized pain assessment. Likewise, the application of all opportunities of non-medical pain treatment strategies contributes to the reduction of occurrence of pain and therefore to the preservation of quality of life in NHR. Age-related changes in physiology may affect tolerance and effects of analgesics. Besides, drug interactions need to be considered. After all, education of NHR and involvement of their relatives in pain management foster successful management and treatment of pain.

The Brief Pain Inventory (BPI) has been psychometrically evaluated worldwide in adult patients with cancer-related and chronic pain in several languages, but never in nursing home residents with chronic pain. To address this gap, we evaluated the validity of a modified version of the BPI, the BPI for nursing home residents (BPI-NHR) in individuals who resided in German nursing homes. One analytic sample included 137 nursing home residents (mean age, 83.3 years; SD, 8.0 years) without any missing values. An extended sample also included individuals with previous missing values that were substituted with the personal mean (n = 163; mean age, 83.3 years; SD, 8.3 years). Principal axis factoring with oblimin rotation was used to compute the final 2-factor solution for the substituted sample. These factors explained 71.7% of the variance. Internal consistency was calculated using Cronbach α, and showed excellent results. Concurrent validity was tested using nonparametric correlation analyses of the BPI-NHR with the pain medication scale. The present findings support the reliability and validity of the BPI-NHR for very old nursing home residents. Further evaluation of this measure is needed to examine face validity and the effect of multimorbidity on pain interference with function. Perspective In this article we present psychometric properties of the BPI originally developed to assess cancer pain, extended to measure chronic nonmalignant pain in younger and middle-aged patients, and now further developed to measure pain intensity and interference with function among very old nursing home residents. Thus, the BPI-NHR might assist clinicians and researchers interested in assessment of pain intensity and interference in elderly individuals who reside in nursing homes.

Approximately one in every two German nursing home residents falls at least once in a 1-year period and just as many report a fear of falling. It has been hypothesized that falls self-efficacy mediates the relationship between fear of falling and functional ability. The aim of the current study was to develop the German Nursing Home Falls Self-Efficacy Scale, examine its validity, and estimate a cutoff point to differentiate nursing home residents with low or high falls self-efficacy. Nursing home residents were assessed at baseline ( n = 178, mean age = 83.7 years) and 6-month follow up ( n = 115, mean age = 83.9 years). Factorial and construct validity analyses provided preliminary support for the validity of the scale. A cutoff point of 11.5 was generated by receiver operating characteristic curve analysis. This scale may assist health care professionals in differentiating between nursing home residents with low and high falls self-efficacy and supporting residents in providing appropriate interventions. [Res Gerontol Nurs. 2016; 9(3):134–144.]

Background To evaluate the effect of interventions for general practitioners and nursing home staff to improve pain severity and appropriateness of pain medication in nursing home residents (NHR). Methods This cluster-randomized controlled trial was conducted in six nursing homes in the intervention and control group, respectively. Pain management was analysed before (T0) and after (T1, T2) an educational intervention in 239 NHR, aged ≥65 years, without moderate or severe cognitive impairment. Primary and secondary outcomes were average pain severity and appropriateness of pain medication as determined with the Numeric Rating Scale and Pain Medication Appropriateness Scale (PMASD), respectively. Results At T0, 72.2% and 73.7% of NHR (mean age 83 years) reported pain (average pain severity 2.4) in the intervention and control group, respectively. The PMASD at T0 was 53.9 in the intervention group and 60.8 in the control group (p = 0.12), while 20.6% compared to 6.9% (p = 0.009) received no pain medication in the two groups. At T2, non-significant improvements in the average pain severity (1.59) and PMASD (61.07) were observed in the intervention group. Moreover, the mean individual PMASD increased by 8.09 (p = 0.03) and the proportion of NHR without pain medication decreased by 50% (p = 0.03) in the intervention group. No appreciable changes were found in the control group at T2. Conclusions NHR exhibited a high prevalence of pain with overall low severity, while a high proportion of individuals received inappropriate pain medications. Both findings were not significantly improved by the intervention, although some aspects of drug treatment were meaningful improved.

Einleitung Im Projekt „Gesundheitsförderung für ältere pflegende Angehörige“ wurde ein standardisiertes Assessment zur Ermittlung von individuellen gesundheitsbezogenen physischen und psychischen Ressourcen und Risiken für pflegende Angehörige entwickelt. Es differenziert neun Typen und ordnet Angebote der Gesundheitsförderung zu. Das Assessment wurde mit 202 pflegenden Angehörigen (Versicherte Deutsche BKK) durchgeführt, ca. 80% wiesen einen hohen Bedarf an Gesundheitsförderung auf. Die Inanspruchnahme entsprach trotz großen Interesses an den Angeboten nicht den Erwartungen.

Pflegende Angehorige stellen aufgrund vielfaltiger Belastungen eine Zielgruppe fur Gesundheitsforderung dar. Vor diesem Hintergrund wurde im Projekt „Gesundheitsforderung fur altere pflegende Angehorige“ ein Assessment (ARR) entwickelt, implementiert und validiert. Auf der Basis des ARR wurden den Pflegenden individuelle, bedarfsgerechte und zielgruppenspezifische Angebote zur Gesundheitsforderung unterbreitet. Der Zugang erfolgte uber eine gesetzliche Krankenkasse, um die Zielgruppe optimal zu erreichen.