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4. Educational interventions to empower nursing home residents: a systematic literature review

Author

Schoberer D, Leino-Kilpi H, Breimaier HE, Halfens RJ, and Lohrmann C

Subjects
Health education, Older people, Empowerment, Self-efficacy, Self-care activities, Self-determination, Geriatrics, RC952-954.6
Abstract

Daniela Schoberer,1 Helena Leino-Kilpi,2 Helga E Breimaier,1 Ruud JG Halfens,3 Christa Lohrmann1 1Institute of Nursing Science, Medical University of Graz, Graz, Austria; 2Turku University Hospital, University of Turku, Turku, Finland; 3Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands Purpose of the study: Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents.Methods: A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively.Results: Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents.Conclusion: Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more empowered. Empowering strategies used by nurses can support residents in their growth and facilitate their self-determination. Further research on the empowerment of residents using empowerment scales is needed. Keywords: health education, older people, empowerment, self-efficacy, self-care activities, self-determination

Published
2016

6. Improving health and social care services for slum-dwelling older adults: Perspectives of health professionals

Author

Attafuah, P.Y.A., Everink, I.H.J., Lohrmann, C., Abuosi, A.A., Schols, J.M.G.A., RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, and Family Medicine

Subjects
Social Work, STRATEGIES, slum dwellers, Health Personnel, social care services, LITERACY, Public Health, Environmental and Occupational Health, Social Support, health care service, COVERAGE, Poverty Areas, health professionals, Quality of Life, Humans, older adults, Aged
Abstract

BackgroundBesides confronting the challenges of a growing older population, developing countries are dealing with limited resources and infrastructure, to ensure good health and social care services. One of these developing countries facing these challenges is Ghana. The healthcare system in Ghana currently does not have specialized geriatric services and is funded through the National Health Insurance Scheme (NHIS), private insurance companies and an out-of-pocket expenditure system. Social care services are important in improving Quality of Life (QoL) as it helps in building and strengthening relationships while also keeping slum-dwelling older adults active. There are various challenges with the health and social care of older adults in slums and practical ways to improve these have not been explored among the providers of this care.AimsThis study, therefore, aimed to explore (1) the views of health professionals on older slum-dwelling adults' health and social care needs, access, and use, and (2) recommendations for improving access to health and social care services among slum-dwelling older adults.MethodA qualitative exploratory descriptive approach was used among health professionals by conducting a focus group discussion (FGD) and interviews. A semi-structured interview guide was used to collect data from each participant.ResultsA total of 27 participants took part in the study. In the analysis of transcripts, 3 themes and 14 subthemes were conceptualized. Financial difficulties, queueing issues, distance to health facilities, health illiteracy and negative attitude of health professionals were identified as some barriers to the utilization of formal healthcare services. Social care services were described as non-existent, not structured, and having limited resources to cater for attendants. The health professionals also provided recommendations for improvement.ConclusionHealth professionals in this study discussed barriers to access and use of health and social care services. Addressing these barriers is essential to improve the use of formal health and social care services and diminish health inequity among older adults.

Published
2022

8. Shared Decision Making in the Psychiatric Inpatient Setting: An Ethnographic Study about Interprofessional Psychiatric Consultations

Author

Gurtner, C., Lohrmann, C., Schols, J.M.G.A., Hahn, S., RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, and Family Medicine

Subjects
patient involvement, interprofessional psychiatric consultations, TEAMS, communication, shared decision making, SEVERE MENTAL-ILLNESS, EXTENT, INVOLVE PATIENTS, patient-centered care, SERVICES, COLLABORATION, mental illness, clinical practice, psychiatric disorder, PERSPECTIVES, PEOPLE, HEALTH-CARE, participant observation, psychiatric inpatient setting
Abstract

Shared decision making is increasingly receiving attention in health care and might improve both the quality of care and patient outcomes. Nevertheless, due to its complexity, implementation of shared decision making in clinical practice seems challenging. This ethnographic study aimed to gain a better understanding of how psychiatric inpatients and the interprofessional care team interact during regular interprofessional psychiatric consultations. Data were collected through participant observation on two different psychiatric wards in a large psychiatric hospital in Switzerland. The observation focused on the contextual aspects of interprofessional patient consultations, the communication and interaction as well as the extent to which patients were involved in decision making. Participants included patients, psychiatrists, junior physicians, nurses, psychologists, social workers and therapists. We observed 71 interprofessional psychiatric consultations and they differed substantially in both wards in terms of context (place and form) and culture (way of interacting). On the contrary, results showed that the level of patient involvement in decision making was comparable and depended on individual factors, such as the health care professionals' communication style as well as the patients' personal initiative to be engaged. The main topics discussed with the patients related to pharmacotherapy and patient reported symptoms. Health care professionals in both wards used a rather unidirectional communication style. Therefore, in order to promote patient involvement in the psychiatric inpatient setting, rather than to focus on contextual factors, consultations should follow a specific agenda and promoting a bidirectional communication style for all parties involved is strongly recommended.

Published
2022

17. Tackling the increasing problem of malnutrition in older persons: The Malnutrition in the Elderly (MaNuEL) Knowledge Hub

Author

Federal Ministry of Science, Research and Economy (BMWFW, Ecole Sup erieure d’Agricultires (ESA), Federal Ministry of Food and Agriculture (BMEL), Department of Agriculture, Food and the Marine, HRB, Instituto de Salud Carlos III, ERC, The Netherlands Organisation for Health Research and Development (ZonMw), Visser, Marjolein, Volkert, Dorothee, Corish, C., Geisler, C., de Groot, L.C., Cruz-Jentoft, A.J., Lohrmann, C., O'Connor, Eibhlís M., Schindler, K., de van der Schueren, M.A., Federal Ministry of Science, Research and Economy (BMWFW, Ecole Sup erieure d’Agricultires (ESA), Federal Ministry of Food and Agriculture (BMEL), Department of Agriculture, Food and the Marine, HRB, Instituto de Salud Carlos III, ERC, The Netherlands Organisation for Health Research and Development (ZonMw), Visser, Marjolein, Volkert, Dorothee, Corish, C., Geisler, C., de Groot, L.C., Cruz-Jentoft, A.J., Lohrmann, C., O'Connor, Eibhlís M., Schindler, K., and de van der Schueren, M.A.

Abstract

peer-reviewed, In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A Healthy Diet for a Healthy Life (HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNuEL consortium consists of 22 research groups from seven countries (Austria, France, Germany, Ireland, Spain, The Netherlands and New Zealand). The Consortium aims to extend scientific knowledge; strengthen evidence-based practice in the management of malnutrition in older persons; build a sustainable, transnational, competent network of malnutrition experts; and harmonise research and clinical practice. MaNuEL is built on five interconnected work packages that focus on (i) defining treatable malnutrition; (ii) screening of malnutrition in different settings; (iii) determinants of malnutrition; (iv) prevention and treatment of malnutrition; and (v) policies and education regarding malnutrition screening and treatment in older persons across Europe. Systematic literature reviews will be performed to assess current research on malnutrition and identify potential knowledge gaps. Secondary data analyses of nutritional intervention trials and observational studies will also be conducted. Using Web-based questionnaires, MaNuEL will provide insight into current clinical practice, policies and health professionals' education on malnutrition and will make recommendations for improvement. MaNuEL is being advised by a stakeholder board of five experts in geriatric nutrition who represent relevant European professional societies., PUBLISHED, peer-reviewed

Published
2018

18. Joint action malnutrition in the elderly (MaNuEL) knowledge hub: summary of project findings.

Author

Volkert, D., Visser, M., Corish, C. A., Geisler, C., de Groot, L., Cruz-Jentoft, A. J., Lohrmann, C., O'Connor, E. M., Schindler, K., and de van der Schueren, M. A. E.

Abstract

Key summary points: Aim: To summarize the main scientific results achieved during the 2-year Joint Action Malnutrition in the Elderly (MaNuEL) project and to outline the recommendations derived. Findings: Four systematic reviews, six secondary data analyses of existing cohort and intervention studies, two web-based surveys and one Delphi study were performed. In addition, a scoring system to rate malnutrition screening tools and a theoretical framework (DoMAP) on the aetiology of malnutrition in older persons were developed. Message: The MaNuEL Toolbox was made available to effectively distribute and disseminate the MaNuEL results and recommendations, which will support researchers, healthcare professionals, policy-makers as well as educational institutes to advance their efforts in tackling the increasing problem of protein–energy malnutrition in the older population. Purpose: The Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub was established to extend scientific knowledge, strengthen evidence-based practice, build a sustainable, transnational network of experts and harmonize research and clinical practice in the field of protein–energy malnutrition in older persons. This paper aims to summarize the main scientific results achieved during the 2-year project and to outline the recommendations derived. Methods: 22 research groups from seven countries (Austria, France, Germany, Ireland, Spain, The Netherlands and New Zealand) worked together on 6 relevant domains of malnutrition—i.e. prevalence, screening, determinants, treatment, policy measures and education for health care professionals—making use of existing datasets, evidence and expert knowledge. Results: Four systematic reviews, six secondary data analyses of existing cohort and intervention studies, two web-based surveys and one Delphi study were performed. In addition, a scoring system to rate malnutrition screening tools and a theoretical framework on the aetiology of malnutrition in older persons were developed. Based on these activities and taking existing evidence into consideration, 13 clinical practice, 9 research and 4 policy recommendations were developed. The MaNuEL Toolbox was created and made available to effectively distribute and disseminate the MaNuEL results and recommendations. Conclusions: The MaNuEL Knowledge Hub successfully achieved its aims. Results and recommendations will support researchers, healthcare professionals, policy-makers as well as educational institutes to advance their efforts in tackling the increasing problem of protein–energy malnutrition in the older population. [ABSTRACT FROM AUTHOR]

Published
2020
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21. Tackling the increasing problem of malnutrition in older persons : The Malnutrition in the Elderly (MaNuEL) Knowledge Hub

Author

Visser, Marjolein, Volkert, D., Corish, C., Geisler, C., de Groot, C.P.G.M., Cruz-Jentoft, A.J., Lohrmann, C., O'Connor, E.M., Schindler, K., van der Schueren, D.E., Visser, Marjolein, Volkert, D., Corish, C., Geisler, C., de Groot, C.P.G.M., Cruz-Jentoft, A.J., Lohrmann, C., O'Connor, E.M., Schindler, K., and van der Schueren, D.E.

Abstract

In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A Healthy Diet for a Healthy Life (HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNuEL consortium consists of 22 research groups from seven countries (Austria, France, Germany, Ireland, Spain, The Netherlands and New Zealand). The Consortium aims to extend scientific knowledge; strengthen evidence-based practice in the management of malnutrition in older persons; build a sustainable, transnational, competent network of malnutrition experts; and harmonise research and clinical practice. MaNuEL is built on five interconnected work packages that focus on (i) defining treatable malnutrition; (ii) screening of malnutrition in different settings; (iii) determinants of malnutrition; (iv) prevention and treatment of malnutrition; and (v) policies and education regarding malnutrition screening and treatment in older persons across Europe. Systematic literature reviews will be performed to assess current research on malnutrition and identify potential knowledge gaps. Secondary data analyses of nutritional intervention trials and observational studies will also be conducted. Using Web-based questionnaires, MaNuEL will provide insight into current clinical practice, policies and health professionals’ education on malnutrition and will make recommendations for improvement. MaNuEL is being advised by a stakeholder board of five experts in geriatric nutrition who represent relevant European professional societies.

Published
2017

25. What is the clinical value of PET/CT in the diagnosis of pulmonary nodules?

Author

Lohrmann C and Weber Wa

Subjects
medicine.medical_specialty, Lung Neoplasms, Biopsy, Multimodal Imaging, Sensitivity and Specificity, Diagnosis, Differential, Fluorodeoxyglucose F18, Image Interpretation, Computer-Assisted, medicine, Humans, Anatomic Location, Lung, PET-CT, medicine.diagnostic_test, business.industry, Solitary Pulmonary Nodule, Image enhancement, Image Enhancement, Positron emission tomography, Positron-Emission Tomography, Clinical value, Surgery, Tomography, Radiology, Ct imaging, Nuclear medicine, business, Tomography, X-Ray Computed
Abstract

The noninvasive diagnostic workup of solitary pulmonary nodules (SPNs) continues to be a challenge for radiologists and nuclear medicine physicians. Morphological evaluation is useful to differentiate between benign and malignant SPNs, but there is a considerable overlap between the benign and the malignant features, resulting in a large fraction of morphologically indeterminate SPNs. Integrated PET/CT with the glucose analogue 18F-fluorodeoxyglucose (FDG PET/CT) can simultaneously evaluate morphological characteristics, anatomic location and metabolic status of SPNs. FDG PET/CT has been shown to result in an overall improved accuracy for the detection of malignant SPNs. In addition, it is the most accurate technique for the staging of malignant SPNs. On the other hand, there are many causes for false positive or false negative FDG PET/CTs. Therefore, FDG PET/CT cannot replace histological evaluation of SPNs, but can be clinically helpful in specific subgroups of patients with SPNs. The goal of this review is to provide an overview of the literature on PET/CT imaging in SPNs and to describe several clinical scenarios for the use of FDG PET/CT in SPNs.

Published
2014

29. Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference

Author

Rolland, Y., Resnick, B., Katz, P.R., Little, M.O., Ouslander, J.G., Bonner, A., Geary, C.R., Schumacher, K.L., Thompson, S., Martin, F.C., Wilbers, J., Zuniga, F., Ausserhofer, D., Schwendimann, R., Schussler, S., Dassen, T., Lohrmann, C., Levy, C., Whitfield, E., Souto Barreto, P. de, Etherton-Beer, C., Dilles, T., Azermai, M., Bourgeois, J., Orrell, M., Grossberg, G.T., Kergoat, H., Thomas, D.R., Visschedijk, J., Taylor, S.J., Team, O.S., Handajani, Y.S., Widjaja, N.T., Turana, Y., Rantz, M.J., Skubic, M., Morley, J.E., Rolland, Y., Resnick, B., Katz, P.R., Little, M.O., Ouslander, J.G., Bonner, A., Geary, C.R., Schumacher, K.L., Thompson, S., Martin, F.C., Wilbers, J., Zuniga, F., Ausserhofer, D., Schwendimann, R., Schussler, S., Dassen, T., Lohrmann, C., Levy, C., Whitfield, E., Souto Barreto, P. de, Etherton-Beer, C., Dilles, T., Azermai, M., Bourgeois, J., Orrell, M., Grossberg, G.T., Kergoat, H., Thomas, D.R., Visschedijk, J., Taylor, S.J., Team, O.S., Handajani, Y.S., Widjaja, N.T., Turana, Y., Rantz, M.J., Skubic, M., and Morley, J.E.

Abstract

Item does not contain fulltext, The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations.

Published
2014

30. Spanfrakturen der dorso-ventralen lumbalen Spondylodese: ein Problem der Spangröße?

Author

Kubosch, D, Konstantinidis, L, Lohrmann, C, Milz, S, Südkamp, NP, and Strohm, PC

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Fragestellung: Die dorso-ventrale Spondylodese im thorako-lumbalen Bereich der Wirbelsäule ist ein in der orthopädischen Chirurgie häufig durchgeführtes Verfahren. Bei dieser Operation gewinnt der Einsatz von alternativen Materialien, wie zum Beispiel Titan-Cages, weiterhin an Bedeutung.[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie; 73. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 95. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 50. Tagung des Berufsverbandes der Fachärzte für Orthopädie

Published
2009
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32. Tackling the increasing problem of malnutrition in older persons: The Malnutrition in the Elderly (MaNu EL) Knowledge Hub.

Author

Visser, M., Volkert, D., Corish, C., Geisler, C., Groot, L. C., Cruz‐Jentoft, A. J., Lohrmann, C., O'Connor, E. M., Schindler, K., and Schueren, M. A.

Subjects
HEALTH policy, GERIATRIC nutrition, DIETETICS research, DIFFUSION of innovations, EXPERTISE, INTERPROFESSIONAL relations, MEDICAL personnel, OLD age, PROTEIN-energy malnutrition, PREVENTION, DIAGNOSIS
Abstract

In order to tackle the increasing problem of malnutrition ( i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly ( MaNu EL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative ( JPI) A Healthy Diet for a Healthy Life ( HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNu EL consortium consists of 22 research groups from seven countries (Austria, France, Germany, Ireland, Spain, The Netherlands and New Zealand). The Consortium aims to extend scientific knowledge; strengthen evidence-based practice in the management of malnutrition in older persons; build a sustainable, transnational, competent network of malnutrition experts; and harmonise research and clinical practice. MaNu EL is built on five interconnected work packages that focus on (i) defining treatable malnutrition; (ii) screening of malnutrition in different settings; (iii) determinants of malnutrition; (iv) prevention and treatment of malnutrition; and (v) policies and education regarding malnutrition screening and treatment in older persons across Europe. Systematic literature reviews will be performed to assess current research on malnutrition and identify potential knowledge gaps. Secondary data analyses of nutritional intervention trials and observational studies will also be conducted. Using Web-based questionnaires, MaNu EL will provide insight into current clinical practice, policies and health professionals' education on malnutrition and will make recommendations for improvement. MaNu EL is being advised by a stakeholder board of five experts in geriatric nutrition who represent relevant European professional societies. [ABSTRACT FROM AUTHOR]

Published
2017
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33. Care dependency in nursing home: a psychometric study

Author

Lohrmann, C, Balzer, K, Dijkstra, Ate, and Dassen, T

Subjects
nursing home, validity, reliability, SETTINGS, care dependency, SCALE
Abstract

The Dutch Care Dependency Scale, an instrument for the assessment of a patient's care dependency, has been translated into German. The purpose of this study was to examine the reliability and validity of the German version of the scale. The 15-item scale has been developed for the use in nursing homes. Data were collected from 81 people living in nursing homes in Berlin, Germany. The sample was measured three times. Cronbach's alpha was 0.94. Interrater and intrarater reliability revealed moderate to substantial Kappa statistics. As the results of this study were satisfying, positive recommendations regarding the suitability of the German version of the Care Dependency Scale for use in nursing homes could be made. However, further psychometric testing of the scale is recommended.

Published
2003

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