Search

Epilepsie ist eine chronische neurologische Krankheit, von der geschätzte 50 Millionen Menschen weltweit betroffen sind. Die Gesundheitsversorgung von Menschen mit Epilepsie hat zum Ziel, die allgemeine Morbidität zu senken und psychosoziale Outcomes zu verbessern. Hinsichtlich der Begleitung von Menschen mit chronischen Erkrankungen gewinnt der Pflegeberuf zunehmend an Bedeutung. Pflegefachpersonen betrachten die Edukation von Epilepsie-Betroffenen im Sinne des Empowerment Ansatzes als einen Kernaspekt ihrer Aufgaben. Über Konzepte zur Patient*innenedukation bei Epilepsie, die auf Grundlage von tatsächlich geäußerten Bedürfnissen der Betroffenen erstellt worden sind, gibt es allerdings wenige empirische Arbeiten. Ziel dieser Arbeit ist es, die Informations- und Edukationsbedürfnisse von erwachsenen Patient*innen mit Epilepsie zu erforschen, um einen für sie relevanten Themenpool zu erstellen. Diese Themen sollen als Richtschnur für die Praxis dienen, damit entsprechende zielgruppenorientierte und individualisierte Patientenedukationsmaßnahmen geplant, gestaltet und/ oder angepasst werden können. Methode: Zur Beantwortung der Forschungsfragen wurden leitfadenorientierte Interviews mit sechs Menschen mit Epilepsie durchgeführt. Die Teilnehmer*inne wurden mit Unterstützung des „Epilepsie Dachverband Österreich“ und der „Epilepsie Interessensgemeinschaft Österreich“ rekrutiert. Die Interviews wurden auf Tonband aufgezeichnet und transkribiert. Die Analyse erfolgte nach der inhaltlich strukturierenden qualitativen Inhaltsanalyse nach Kukartz & Rädiker (2022). Ergebnisse: Diese Arbeit zeigt, dass Menschen mit Epilepsie allgemeine Informationen über ihre Krankheit, wie z.B. mögliche Ursachen, die Behandlung und der Umgang mit den epileptischen Anfällen benötigen und einfordern. Generell lässt sich aber aus dieser Arbeit ableiten, dass die Beratung von Menschen mit Epilepsie stärker auf die jeweiligen Lebensphasen und Lebensabschnitte angepasst werden müssen und dass die Erwartungen der Betroffenen weit über die Informations- oder Edukationsmaßnahmen hinausgehen. Den psychosozialen Aspekten der Krankheit und der Bewältigung des Alltags muss in der Beratungstätigkeit mehr Aufmerksamkeit geschenkt werden. Schlussfolgerung: Da die behandelnden Mediziner*innen nicht alle Aspekte der Betreuung, Begleitung und Beratung von Menschen mit Epilepsie abdecken können, wäre der Einsatz von Epilepsy Specialist Nurses (ESN) eine gute Möglichkeit, um den Bedarf an Beratung hinsichtlich des psychosozialen Bereichs und des Alltags abzudecken. Voraussetzung dabei ist, dass facheinschlägigen Erfahrung und Weiterbildungen in der Epilepsiepflege vorhanden sind und eine enge Zusammenarbeit mit Selbsthilfe-, und Betroffenengruppen erfolgt. Epilepsy is a chronic neurological disease that affects an estimated 50 million people worldwide. Health care for people with epilepsy aims to reduce general morbidity and improve psychosocial outcomes. With regard to the support of people with chronic diseases, the nursing profession is becoming increasingly important. Nursing professionals regard the education of people affected by epilepsy in terms of the empowerment approach, as a core aspect of their tasks. However, there is little empirical work on concepts for patient education in epilepsy that have been created on the basis of the needs actually expressed by those affected. Aim: The aim of this work is to research the information and education needs of adult patients with epilepsy in order to create a topic pool that is relevant to them. These topics should serve as guidelines for practice so that appropriate target group-oriented and individualized patient education measures can be planned, designed and/or adapted. Method: To answer the research questions, guideline oriented interviews were conducted with six people with epilepsy. The participants were recruited with the support of the „Epilepsie Dachverband Österreich“ and the „Epilepsie Interessensgemeinschaft Österreich“. The interviews were tape-recorded and transcribed. The analysis was performed using the qualitative content analysis according to Kukartz & Rädiker (2022). Results: This thesis shows that people with epilepsy need and demand general information about their illness, such as possible causes, treatment and how to deal with the epileptic seizures in everyday-life. In general, it suggests that the counseling of people with epilepsy must be more closely adapted to the respective stages and periods of life and that the expectations of those affected go far beyond the information and educational measures, respectively. More attention needs to be paid in addressing the psychosocial aspects of the disease and the coping strategies with everyday life. Conclusion: Since the attending physicians cannot cover all aspects of the care, support and counseling needs of people with epilepsy, the deployment of Epilepsy Specialist Nurses (ESN) would be an adequate way to cover the counseling demands with regard to the psychosocial support and everyday life. This requires specialist experience and further training in epilepsy care and indicates a greater cooperation with support groups and affected communities. Abweichender Titel laut Übersetzung der Verfasserin/des Verfassers Masterarbeit Wien, FH Campus Wien 2023

Aufgrund der Komplexität von chronisch entzündlichen Darmerkrankungen (CED) empfehlen internationale Standards Pflege und Beratung durch IBD Nurses, Pflegefachkräfte mit spezifischer CED Ausbildung. In Österreich obliegt diese Aufgabe jedoch meist allgemein ausgebildeten DGKP. Die Betreuung von CED Patient*innen mit schweren Krankheitsverläufen stellt allgemein ausgebildete DGKP im stationären Bereich vor besondere Herausforderungen. Wahrnehmung und Erfüllung des Beratungsbedarfes dieser Patient*innen durch den gDfGuK werden in dieser Masterarbeit in leitfadengestützten qualitativen Interviews erhoben. Beratungsbedarf bei CED Patient*innen wird zwar wahrgenommen, aber nur teilweise erfüllt. Die Interviewpartner*innen halten grundlegendes Fachwissen, Integration der pflegerischen Beratungsleitsung in ein multidisziplinäres Team (MDT) in Form von multidiziplinären Teambesprechungen sowie verlässliche aktuelle Informationsquellen für wichtige Voraussetzungen zur Qualitätssicherung bezüglich pflegerischer CED Beratung. Unsicherheit über den Auftrag, ambivalente Stellung im multidisziplinären Team sowie niedrige Priorität von Beratungsaufgaben im Pflegealltag können als Hinweise für mangelnde Integration von Beratung in das Berufsverständnis von professioneller Pflege und mangelnde Implementation in die Aufbau- und Ablauforganisation gewertet werden. Somit wurde die organisatorische und konzeptionelle Verankerung von Beratung bei CED als strukturelle Voraussetzung für adäquate Beratungsqualität bei CED wurden identifiziert. Aufgrund der vielfältigen Anpassungserfordernisse sind weitere Erhebungen notwenig, um eine adäquate Planungsqualität der notwenigen Veränderungen zu gewährleisten. Due to the complexity of IBD, international guildelines recommend care and counseling by IBD nurses, nursing professionals with specific IBD training. In Austria, generally trained registered nurses (RNs) are responsible these tasks. In inpatient settings, these nurses care for IBD patients with severe disease progression and complications. Qualitative interviews based on a self-developed interview-guide are used to explore their perception and fulfillment of counseling needs of IBD patients. Perceiving counseling needs of IBD patients, these RNs are still unable to meet these needs sufficiently. In order to assure adequate quality of Nursing counseling in IBD, the interviewees express the need of basic specialist knowledge, integration of nursing counseling in a multidisciplinary team (MDT) by multidisciplinary team meetings and reliable sources of information Uncertainty about the task, ambivalent position in the MDT and low priority of counseling tasks in everyday care indicate of a lack of integration of counseling in the professional understanding of nursing care and a lack of implementation in the structural and process organization. Due to the diverse adjustment requirements, further surveys are necessary in order to guarantee an adequate planning quality of the necessary changes. Abweichender Titel laut Übersetzung der Verfasserin/des Verfassers Masterarbeit Wien, FH Campus Wien 2022

Amaç: Bu araştırmanın amacı, hemşire tarafından sunulan “Akıllı Diyabetim” mobil sağlık uygulaması destekli diyabet danışmalığının tip 2 diyabetli bireylerin öz bakım ölçeği puanları üzerine etkisini araştırmaktadır. Yöntem: Bu çalışma, ön test- son test kontrol gruplu yarı deneysel tasarımda yapılmıştır. Araştırmanın evrenini, Şubat-Haziran 2021 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Hastanesi Endokrinoloji ve Metabolizma Polikliniği’nde izlenen tip 2 diyabet tanısı almış bireyler oluşturmuştur. Örneklem büyüklüğünü belirlemek için güç analizi yapılmıştır. Etki büyüklüğü, orta etki büyüklüğü alınarak (d=0.50), %80 güç ve %95 güven düzeyinde en az örnek büyüklüğü kontrol grubu için 34 kişi, girişim grubu için 34 kişi olmak üzere toplam 68 kişi olarak belirlenmiştir. Araştırma süreci içerisinde örneklem kayıpları yaşanabileceği için hesaplanan kişi sayısının %10 fazlasının uygun olacağı düşünülmüştür. Sonuç olarak her bir grup için 37 kişinin alınmasına karar verilmiştir. Girişim grubuna araştırmacı tarafından “Akıllı Diyabetim” mobil sağlık uygulaması destekli diyabet danışmanlığı uygulanmıştır. Kontrol grubuna ise endokrinoloji ve metabolizma polikliniği tarafından verilen standart hemşirelik danışmanlığı sunulmuştur. Araştırma verilerinin toplanmasında “Birey Tanıtım Formu” ve “Diyabet Öz Bakım Ölçeği” kullanılmıştır. Araştırma verileri, araştırmacı tarafından yüz yüze görüşülerek ve akıllı telefon uygulaması üzerinden toplanmıştır. Araştırmanın yapılabilmesi için Ege Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu onayı ve Ege Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları Anabilim Dalı’ndan yazılı izin alınmıştır. Veriler SPSS 22.0 paket programı ile analiz edilmiştir. Bulgular: Girişim grubu bireylerin yaş ortalaması 39.66±0.61 olup %50’si kadındır. Kontrol grubunun yaş ortalaması 39.36±0.54 olup %58,8’i kadındır. Bağımsız gruplar için t testi sonrasında girişim ve müdahale grubu ön test puanları arasında anlamlı bir fark bulunmamıştır. Son test puanları için uygulanan test sonrası 0.05 anlamlılık düzeyinde fark bulunmuştur. (p, Objective: The aim of this study is to investigate the effect of diabetes counseling supported by the “My Smart Diabetes” mobile health application, offered by the nurse, on the self-care scale scores of individuals with type 2 diabetes. Method: This study was carried out in a quasi-experimental design with pretest posttest control group. The population of the study consisted of individuals diagnosed in Faculty with type 2 diabetes who were followed up in the Ege University Medical Hospital Endocrinology and Metabolism Polyclinic between February and June 2021. The power analysis method was used to calculate the sample size of the study. The effect size was determined as 68 persons, with a median effect size (d = 0.50), at least 34 sample size for the control group at the 80% power and 95% confidence level, and 37 for the enterprise group. It is considered that 10% of the calculated number of people would be suitable because there may be loss of sampling within the research process. As a result, it was decided to take 37 people for each group. Diabetes counseling supported by the “My Smart Diabetes” mobile health application was applied to the intervention group by the researcher. The control group will be provided with standard nursing counseling given by the endocrinology and metabolism polyclinic. Person identification form and Diabetes Self-Care Scale were used in the collection of research data. The research data were collected between February and June 2021 and the researcher interviewed face to face. The data were analyzed with the ,SPSS, 22.0 package program. Result: The mean age of the individuals in the intervention group was 39.66±0.61 and 50% of them were women. The mean age of the control group was 39.36±0.54 years and 58.8% were women. After the t test for independent groups, there was no significant difference between the intervention and intervention group pre-test scores. There was a difference of 0.05 significance level after the test applied for the post-test scores (p

本研究の目的は,社会復帰援助プログラム(キングの目標達成理論とオレム・アンダーウッドのセルフケア理論に基づき,筆者が作成したプログラム)を通して看護面談を実施した2事例について,社会生活を維持したケースと再入院に至ったケースにおける看護介入とその介入による患者の回復過程の変化を比較し,社会復帰支援にとっての本プログラムの有効性や無効性の観点から,今後のプログラムの在り方を検討することである.面談中の会話の内容,自我得点,ラザルス式SCIの結果をデータとし,分析した結果,「自己洞察力の有無」と「現実直面の機会の有無」が患者の社会生活維持に影響をおよぼしていたことが明らかになった.したがって,自己洞察力を深める「語りの場」の提供をすること,そして重要他者も含めた包括的かかわりの実践により,患者の現実直面の機会を提供することが本プログラムの有効性を高めるという示唆が得られた., The purpose of this study is to examine the effectiveness of the rehabilitation care program (made by the researcher by modifying King's theory of goal attainment and Orem-Underwood's theory of self care), by comparing two cases who were given nursing counseling throughout this program. Nursing counseling was provided to two schizophrenia patients who were determined to be discharged from a hospital after a relapse. Data was collected from conversation during nursing counseling sessions, ego strength scores and Lazarus stress coping inventory scores. As a result of analyzing data, it was identified that "deepening insight" and "an opportunity of facing reality" exerted an influence on their ability to continue living in a community. Therefore, the above result indicated that the effectiveness of this program would be increased by providing 'narrative occasion' in order to deepen insight and opportunity of facing reality through assertive care including a patients' key person.

本研究の代表者らは、《まちの保健室》事業の趣旨に基づき看護系大学で展開される「専門相談」の一環として、精神看護学担当教員による『こころの健康相談』を立ち上げ、平成15年度より実践している。これまでの活動実績と、来談者のニーズおよび相談の成果に関する調査結果から、当活動は地域の関連専門機関との補完的な役割を担い得るという実践的意義が示唆された。そこで、今回は、当活動独自のアプローチと役割の探求を目的として、相談記録の質的帰納的分析ならびに地域の関連機関の専門職への面接調査を実施した。平成17・18年度の全相談件数65件に関する相談記録を分析した結果、、、、、、、、などのアプローチの要素が抽出され、来談者のニーズに応じて組み合わされていることが明らかになった。また、地域の関連機関に所属する専門職のうち研究協力に同意の得られた10名(医師5名、精神保健福祉士2名、臨床心理士2名、保健師1名)に対する面接調査の結果、、、といった当活動への認識、、、などの役割期待が語られるとともに、活動頻度を増やすことや連携体制についての提案が得られた。以上の結果および考察を踏まえて、大学を拠点とした看護師による『こころの健康相談』の実践活動について、概念モデルの試案を作成した。今後は妥当性の検討および精錬を重ね、活動の普及と人材育成に貢献し得る実践モデルを開発することが課題である。, As a part of the specialized consultations developed at a nursing-affiliated university based on the concepts of the Town Healthcare Room project, the researchers in this study have been undertaking mental health nursing consultations since 2003. The needs and the benefits of the consultees were examined by ongoing interview surveys and the written questionnaire surveys of the consulties. As a result, it is suggested that these activities can cover complementary roles with related specialized organizations. Then with the goal of finding an original approach to these activities, we undertook a qualitative analysis of the approach offered by the consultation process and conducted studies via related regional organizations on the awareness of and role expectations toward the activities. The following findings were obtained. A qualitative analysis of the records of 65 consultations in 2005 and 2006 revealed the elements of the approach, including the recipience of worries, the recognition of one's own strengths, a review of the stress situation, an increase in coping competence, advice on psycho-education, the provision of specialized knowledge regarding illness and treatment, an assessment of mental state, and the provision of information on social resources, as well as a variety of techniques combined to address the needs of the consultees. Of specialists who belonged to regional organizations, ten persons agreed to cooperate in the research (five physicians, two mental health welfare workers, two clinical psychologists, and one public health nurse). As a result of the interview surveys, we heard about awareness of the activities, including their "ease of use," "feeling safe to talk about issues," and "nurse's own role," as well as their coverage of areas that specialized organizations can not cover, regional contributions that can only be made by a university, the specialized nature of nursing, and other role expectations, and at the same time we received suggestions to step up the frequency of the activities and proposals regarding the liaison system. In view of the above findings and considerations, we prepared a proposal for a concept model of mental health nursing consultation activities based at a university.

本研究の代表者らは、《まちの保健室》事業の趣旨に基づき看護大学教員が展開する『専門相談』の一環として、精神看護学担当教員による『こころの健康相談』を立ち上げ、平成15年度より実践している。1年間の活動実績から、来談者にとっての、精神神経科や心療内科に求めるものとは異なるニーズが示唆された。そこで、2年目の活動実績の検討ならびに継続来談者への面接調査を行い、来談者のニーズおよび相談の効果について検討した。その結果、相談件数は1年目の約1.8倍に増加しており、来談理由については、精神的問題をもつ子どもの親としての悩みや家族関係のストレスが過半数を占めていた。自分自身の健康問題では抑うつ状態が最も多く、その半数は神経科に通院服薬中であり、その他に通院中の心療内科から紹介された人もいた。これらのことから、来談者の多くは精神科・神経科、心療内科などの医療機関の活用もしくは補完的な機能に関するニーズを有しているものと考えられた。継続来談者への面接調査の結果をも含めて検討した結果、(1)専門的な判断や助言、(2)じっくりと話を聴いてもらうこと、(3)適切な社会資源の情報、などに関するニーズが明らかになった。相談による効果については、継続来談者には、(1)心理的な安定が得られた、(2)問題解決への動機づけが高まった、(3)専門的な情報や助言を主体的に活用するようになった、(4)状況の改善や自己効力感の高まりが得られた、(5)悩みはありながらも安定した生活を営めるようになった、などの前向きな変化がみられた。, In accordance with the purpose of the "Community Healthcare Room" project, in 2003 the representatives of this research set up the Mental Health Consultation Room with a base at the College of Nursing Art and Science, University of Hyogo. Since then, mental health nursing consultation has been provided by faculty members teaching mental health and psychiatric nursing. This paper reports the results of a study that examined the needs of clients and effects of the consultations, through a review of activities during the second year of the project's operation and interviews with those who continue to visit the consultation office. The number of consultation cases in the second year increased to 1. 8 times the number seen in the first year. As for the reasons for visiting the mental health consultation room, the majority of reasons cited were worries as a parent who has a child with mental health problems or stress from family relationships. Among visitors who had their own health problems, the largest number of people complained about depressive moods, half of whom see a psychiatric doctor regularly and take medication. There were some people who visited the consultation room on the recommendation of their psychiatric doctors. From these findings, it is suggested that many visitors expect the consultation room to perform complementary functions with a medical institution such as a psychiatric clinic and psychosomatic medicine clinic. As a result of examining the results of interviews with those continuing to go to the consultation room, in addition to findings from past activities, the following needs of visitors have been identified : (1) professional judgment and advice ; (2) active listening ; and (3) information on and referral to appropriate social resources. Regarding the effects of consultation, the following positive changes were seen in visitors (1) increased mental stability ; (2) increased motivation for solving problems ; (3) more proactivity in seeking professional information and advice ; (4) improved conditions and increased selfefficacy ; and (5) becoming able to have a stable life despite someworries.