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Self-efficacy expectancy in adolescents with anorexia nervosa in the outpatient setting: A cross-sectional study Abstract: Introduction: The population involved in this study are individuals with anorexia nervosa (AN). AN is a disease with sometimes life-threatening underweight. Self-esteem problems, anxiety and social problems accompany those affected. AN is often chronic. Hospitalized patients quickly gain weight, but often the underlying eating problem persists, which leads to rehospitalization. Studies on the self-efficacy expectation (SWE) of those affected are largely lacking. Aim: The aim of this study is to examine the SWE in those affected in the post-hospital setting with reference to the age of the affected persons, the number of hospitalizations and the course of the disease. Method: As part of this cross-sectional study, those affected were interviewed in the post-hospital, psychosomatic setting using a standardized questionnaire "General SWE". The data were evaluated descriptively and by means of inferential statistics. Result: 85 young people were interviewed. In the sample, the SWE score averaged = 28.53 with up to and including three hospitalizations and = 24.68 with four or more hospitalizations. If the inpatient stay was only recently, the SWE score shows a lower value (= 26.08) than for those with a longer stay (= 29.00). Conclusion: The results indicate that SWE can influence the course of the disease in those affected. People with higher SWE values show a more favorable course of the disease with fewer rehospitalizations. The strengthening of the SWE is therefore of great importance in the inpatient and outpatient setting through targeted interventions by specialists.

Introduction: Successful home care for people living with dementia (PLwD) allows them to live in their own home environment for as long as possible. Current findings indicate a need for further development of medical and nursing knowledge and skills in evidence-based collaborative care for these patients. Aim: To identify specifics of inter-professional care for PLwD and training needs of home care nurses and general practitioners involved in care. Method: A multi-perspective qualitative study was conducted, comprising focus groups as well as individual interviews. Focus groups and interviews followed a semi-structured topic guide. Interview data was digitally recorded and transcribed verbatim, followed by a thematic framework analysis. Results: The sample consisted of nine nurses, one medical assistant, three general practitioners and nine family caregivers of PLwD. Five themes related to inter-professional home care were inductively developed: challenges in outpatient dementia care, challenges in collaboration, insufficient healthcare infrastructure, competencies needed in dementia care, and training requirements. Challenges were a lacking flow of information as well as continuity and organization of care. Home care nurses and family caregivers complained about missing communication skills in health professionals involved in the care of PLwD. Conclusions: The interviews revealed heterogeneous training needs of home care nursing staff and general practitioners that can be addressed by an inter-professional training course.

Patient handover from anaesthesia to postanaesthesia unit: An analysis of the current situation in three Swiss hospitals Abstract: Background: Patient handovers carry a risk of inadequate or missing communication of important information that can jeopardize patient safety. To increase patient safety, protocols for processes and contents of a structured patient handover were created. Aim: To assess the current status of patient handovers from anaesthesia staff to recovery room nurses. Method: After a literature search an observation protocol for patient handovers according to the SBAR concept (von Dossow & Zwißler, 2016) was developed. Using this checklist, non-participant observations were conducted in three Swiss hospitals and evaluated with statistical analysis. Results: A total of 98 observations were made. The report receiving person felt integrated into the handover and received the necessary information. Deficiencies in patient identification and a joint control of lines after surgical interventions could be identified. The subjectively rated quality of patient handover did not differ between the three hospitals (X²(2)=,927, p=,629) and also not according to the time of day (X²(2)=3,604, p=,216). There was also no difference between the subjective quality of the handover and the delivering professional group (X²(3)=4,507, p=,212). Conclusions: The subjective quality of patient handover did not differ between the three hospitals. However, the patient handover protocols need to be adapted to ensure that patient identification and a joint assessment including control of lines and drains are performed.

Support needs of caregivers of people with dementia: An integrative literature review Abstract: Background: Family caregivers are of great importance in the home care for people with dementia. The care and related stress can have a negative impact on their health. The CSNAT (German: KOMMA) is an approach to support family caregivers in palliative home care that could be used for this group of people. Aim: The aim was to identify support needs for caregivers of people with dementia in the literature and compare these with those that formed the basis for the development of the KOMMA approach. Method: We performed an integrative review. Literature research was conducted in February and March 2021 in the MEDLINE, CINAHL and PsycInfo databases. Relevant studies were identified and assessed using inclusion and exclusion criteria. Using MAXQDA, the data were assigned to categories with a content analytic procedure. Results: 23 studies were included that had been published with peer review procedure. Compared to the KOMMA approach, family caregivers show divergent support needs in the areas of (in)formal assistance, access to knowledge, managing physical and mental health conditions, maintaining the relationship, (temporarily) relinquishing the caregiving role and social integration. Conclusion: The KOMMA tool for identifying support needs cannot be directly adopted for this group of caregivers in its present form. However, given the richness of identified support needs, the development of a person-centered and needs-oriented assessment seems important.

How do nurses describe timeliness in the delivery of nursing interventions? A qualitative study Abstract: Background: Timeliness of nursing interventions is fundamental to professional medical care. Although nurses have developed strategies to manage time resources, nursing interventions are often carried out too early or too late. Both can have a negative impact on the quality of care and safety. However, no publications are available describing nurses' views on the appropriateness of time to perform nursing interventions. Aim: The aim was to describe what registered nurses in the hospital understand by the timeliness to deliver care. Methods: For this qualitative study, eight registered nurses were interviewed individually. Data analysis was performed using content analysis according to Mayring. Results: For the participants, timeliness in performing care interventions can be described as relational and dynamically changing over time. For them it is not limited to a defined point in time and they explain it as a time frame. From their point of view, timely action can prevent harm and suffering and ensure patients safety and well-being. Environmental factors, nursing goals and the urgency of actions influence them whether they act in a timely manner. Conclusion: Among the participating nurses, there exists a shared, often implicit, understanding of timeliness. Results of this study may help to understand the implicit understanding and the related processes and contribute to quality assurance in nursing.

Stress experience of teachers in nursing education: A qualitative survey Abstract: Background: Teachers in nursing operate in a special area of tension. In addition to the demands of teaching, stress factors arise out of the nature of nursing. Aims: The main question is how teachers in health care and nursing describe their professional stress experience. Supportive and stressful factors as well as coping strategies of the teachers should be identified and described. Methods: This is descriptive qualitative research. Twenty-six guideline-based telephone interviews were conducted with nursing teachers in northern Germany. After transcription these were subjected to qualitative content analysis according to 21-2Mayring (2015). Results: The teachers in nursing indicate varying degrees of professional stress. Main aspects are general conditions, high workload, misconduct and problems of students and cooperation with the collegial team and school management. The proximity to the professional field of nursing has both mitigating and reinforcing factors on the experience of stress. Conclusions: Stress experience is described by the teachers in the context of a lack of support and appreciation of professional performance. In order to maintain the high level of motivation and identification with nursing and the professionalization of nursing, and to ensure high-quality education, teachers need support in the form of solid personnel, material and space resources, as well as more visible recognition of their work.

Physical restraints in acute hospitals: A quantitative observational study as a starting point for the further development of quality management Abstract: Background: Despite the known associated risks and adverse events, physical restraints are mostly observed in daily care practice of long-term care. Comparatively few studies are available for normal wards. Research question/aim: The explorative cross-sectional study investigated prevalences, types and reasons of physical restraints in nine selected normal wards of a maximum care hospital. Methods: The prevalences and types of physical restraints were collected in the early and late shift in summer 2020 via direct observation using standardised observation forms. The reasons for the use were recorded via a standardised survey of the nursing staff. Results: In the early shift, 15 out of 167 patients had physical restraints (9%), in the late shift 23 out of 191 (12%). People over 80 years were most affected (n = 8; 23.5% and n = 14, 25.9%). The highest prevalence was found in the clinic for neurogeriatrics with 21.4% (n = 3) and 37.5% (n = 6). Bedside restraints were used particularly frequently (n = 14; 93.3% and n = 22, 95.7%, resp.). The physical restraints were predominantly justified with the protection against fall injuries (n = 8, 53.3% and n = 15, 65.2%). Conclusions: Raising awareness among nursing staff through training and other accompanying measures are starting points for reducing physical restraints. In order to achieve sustainable changes, the management level should initiate appropriate measures and consistently accompany their implementation.

Role understanding of expert nurses in primary and acute care in Germany: A descriptive cross-sectional study Abstract. Background: Innovative care concepts are necessary to cope with the increase in complex care situations due to a rising number of older people with chronic diseases and a simultaneous shortage of nursing and medical staff. In the context of the implementation and development of new, innovative nursing roles, an unclear role understanding is considered a barrier. Aim: Description of expert nurses' (EN) role understanding in primary and acute care in Germany. Method: Using questionnaires, EN are asked cross-sectionally about role clarity, competencies and performance as well as perceived autonomy and interprofessional collaboration. Results are analysed descriptively. Results: A total of eight (primary care) and 14 (acute care) EN completed the questionnaires. The majority of EN often/very often perform both the clinical (77.5% and 85.7%, respectively) and the expert role (75% and 78.6%, respectively) and indicate that they can explain their role to patients (75% and 92.9%, respectively) and physicians (87.5% and 90.9%, respectively). Having a high degree of autonomy is more likely to be perceived by EN working in acute care. Conclusion: Although there are similarities in terms of role understanding, EN working in acute care can apparently benefit from already established structures, which is reflected, among other things, in their perceived autonomy.