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On the effectiveness of a new advisory service for parents of children in need of care: a controlled study Abstract: Background: Families with children in need of care are exposed to great stress. This results in risks that often lead to a poor living and care situation for families. To support them, an innovative regionally anchored support service is being developed by so-called Family Health Partners (FGP) as part of the NEST research project. Aim/Objective: The primary endpoint of the study is the quality of life of the families. Secondary outcomes are resilience factors and associated measures as well as access to care services. Methods: The effectiveness of the FGP will be tested in a controlled study with four measurement times (baseline, after 6, 12 and 18 months) between January 2022 and April 2024. A total of 204 families with children in need of care were recruited for an intervention and control group. Multilevel models are used to analyze the longitudinal data. Results: Between T0 and T1 there are statistically significant improvements in the intervention group, especially in daily and social stress in the family, in mental health and resilience. In addition, knowledge about general benefit rights as well as specific support and relief offers for caring parents has increased. Conclusions: The results of the first two measurement times indicate that a positive change in quality of life, resilience and health literacy can be achieved through the FGP.

Use of support and relief services for parents of children in need of care: Results of the FamBer observational study Abstract: Background: Parents of children in need of care in Germany can fall back on a variety of relief and support services. So far, however, there has been a lack of systematic studies and quantitative data on the use of such offers at the individual level of parents and other legal guardians. Aim: The study on the compatibility of care and work for parents with a child in need of care (FamBer; funding: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, Germany) examines the knowledge of relief and support services, their use and the perceived benefits of these offers. Methods: 1070 parents answered a multidimensional online questionnaire in the cross-sectional study that was developed based on the Kindernetzwerk Study 2 from 2013 and the German socio-economic panel (SOEP). In addition to descriptive analyses, group comparisons were carried out using Chi², Mann-Whitney U or Kruskal-Wallis H tests. Results: 43 to 58% of parents are aware of the respective legal options for taking time off work, but only very few families make use of them. The other support offers differ significantly in terms of the level of knowledge and utilization; these vary primarily with the education of the parents and the care needs of the child. They assessed the used services for consultation and advice as only little helpful. Conclusions: Due to the study design, we cannot rule out that the findings are also based on personal characteristics of the parents and their living conditions. Nevertheless, a large number of problems (e.g. a lack of information, low using, ineffectiveness of support services) can be identified that need to be overcome.

Implementation of the German CSNAT-I to support family caregivers in palliative home care: Evaluation results Abstract. Background: Supporting family carers in palliative home care mostly lacks a systematic approach. In a three-year model project, the Carer Support Needs Assessment Tool Intervention (CSNAT-I), an evidence-based person-centred approach for family caregiver support, was implemented and evaluated in three project regions in North Rhine-Westphalia. Aim: To present the implementation process and factors that impacted on it. Methods: The German CSNAT-I was adapted and subsequently implemented by six hospice services and specialised home palliative care teams with the assistance of champions. The evaluation was based on Normalization Process Theory (NPT) using a mixed methods evaluation design. Results: The German CSNAT-I was used across service boundaries, but routine implementation could not be fully achieved within the relatively short implementation timeframe. Staff members were convinced of the approach's significance, and feedback from family caregivers was generally positive or non-specific. The practice of caregiver support evolved, and the importance of family caregivers received increased attention. Barriers emerged in person-centred communication with family caregivers and within organizational routines. Conclusion: The implementation showed that the person-centred intervention has the potential to enhance caregiver support in the German palliative home care setting. Implementing the CSNAT-I requires a cultural shift within the services.

Community Nursing for people with a migration biography: a qualitative study Abstract: Background: People with a migration background or with special socio-cultural needs have difficult access to health services or are affected by overuse, underuse or misuse. Community Nursing (CN), which was implemented in March 2022 in a district in Austria, can strengthen health literacy and promote individual well-being. Aim: The aim was to obtain information about perception and use of CN services by people with a migration biography and to identify adequate measures to promote increased use. Methods: In March 2023, two focus group interviews with stakeholders and people with a migration biography regarding the use of the CN service were conducted, analyzed and validated in workshops in a municipality in Vorarlberg. Results: Diverse barriers (lack of language skills, lack of knowledge about own insurance coverage, lack of information, emotional inhibiting factors such as fear, shame and reservations about care services) were identified. The jointly developed solutions for a low-threshold offer range from the use of key persons, and health counseling in meeting cafés, to a targeted information strategy. Conclusions: A successful CN service requires a comprehensive implementation strategy and needs-based measures. The identified barriers, fears, and reservations should be considered to facilitate access to CN for people with a migration background.

"Take a break - Time-out for me": A practice project to promote a healthy rest break Abstract. Background: Breaks are essential for physical and mental health. In health care professions breaks are often cancelled or interrupted. Nursing staff should be enabled to take breaks regularly and without any interruptions. They should be given alternative options to organize their breaks. Methods: A pre-post survey was carried out with one group by means of questionnaires. The two break models "Feel good manager" and "I'm away" were tested by the nursing staff, followed by a debriefing meeting. Results: Before this project none of the nurses had rated his/her satisfaction regarding the breaks as "very good" or "good". This changed during the project to 45,5% (t₁) and 22,2% (t₂). None of the nurses felt "very well" or "well" recovered before the project. An increase to 54,6% (t₁) respectively 33,3% could be asserted. Only 7,1% (t₀) indicated to take their breaks "always" or "usually" in "full-length". With the break model "Feel good manager" it changed to 100% and with the model "I am away" to 33,3%. The amount of interruptions could be reduced from 4 (t₀) to 2 (t₁) and 0 (t₂). Discussion: These break models are not applicable arbitrarily by other wards at will. Instead, individual situation analysis should be carried out with according adjustments. These models cannot be tested in case of lack of break areas or absence of personnel. Conclusion: The described project procedure can be transferred to other wards.

Care-related Case Management and the experienced burden of informal caregivers: empirical study Abstract. Background: Informal caregivers are responsible for the majority of home care in Germany. Their experience of stress is becoming more and more relevant given the tense staffing situation in outpatient professional care in rural areas. Case management as an innovative approach to caring in peripheral areas also focuses on the burden experienced by informal caregivers. Aim: The question arises as to whether care-related case management can have a positive influence on the burden experienced by informal caregivers. Methods: In a mixed-method approach, the influence of case management on the experience of stress is analyzed quantitatively (N = 251) and qualitatively (N = 40) using a pre-post design with a control group. Group difference tests based on the HPS-scale and content analysis of the interviews are conducted. Results: The analyses suggest that case management can have a positive influence on the experience of burden. From a quantitative perspective, there was a stabilizing influence on the experience of burden in the intervention group, while burden increased in the control group. Qualitatively, there was an influence on subjective burden. In particular, the role of the case manager as a central contact person in matters regarding the care situation is relevant. Conclusions: By providing new resources and coping strategies, case management can effectively alleviate the burden experienced by informal caregivers.

The implementation of clinical assessment by nurses in Switzerland: A cross-sectional study from the nursing perspective Abstract: Background: Clinical assessment is a core competency of BSc and MSc prepared nurses in Switzerland. However, influencing factors of its implementation and the experience in the interprofessional team has been studied little so far. Objective: The aim of this study was to explore how often clinical assessment skills are used by BSc and MSc graduated nurses in Switzerland, to identify facilitating and hindering factors for implementation and to investigate the nurses experience of the implementation in the interprofessional team. Method: We used an exploratory, descriptive research design employing a cross-sectional study of the convenience sample of BScN and MScN graduates in Switzerland. 264 questionnaires were analysed quantitatively and 149 written statements as part of the survey qualitatively. Results: Respondents indicated that they routinely only use 18.9% of the 53 assessment skills they were trained in. The "respiratory system", "abdomen", "skin" and "mental status" were used most frequently. MScN graduates use respiratory assessments and BScN graduates use abdominal assessments more frequently. Lack of time and interruptions, lack of influence on patient care and specialty specific skills are hindering factors for the implementation. Better conditions at the institutional level and appreciation within the interprofessional team can make an encouraging contribution in future. Conclusion: This study illustrates, that the theory-practice transfer of clinical assessment in Switzerland needs to be further promoted.

The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design Abstract: Background: Most patients in acute care hospitals experience movement limitations due to surgery or a general deterioration of their condition. Therefore, nurses need a high level of competence in movement promotion. Aim: The aim of this study was to evaluate the feasibility of a three-day advanced kinaesthetics training course followed by six months of practical support to promote kinaesthetic competence in inpatient acute care and the competence development achieved as a result. Methods: The evaluation of the nurses' effectiveness was conducted using a pre- and post-measurement of kinaesthetic competence through a self-assessment questionnaire and an observation protocol. The evaluation of feasibility was done through a semi-structured questionnaire. Results: Eight nurses rated their kinaesthetics competence as good before (mean: 10,8 on a scale of 4-16) and very good after the intervention (mean: 13,2). The kinaesthetics trainer assessed the competence before as sufficient (mean: 9,4 on a scale of 4-16) and very good (mean: 14,5) after the practical support. The need to make practical support more flexible is highlighted in the qualitative data. Conclusion: The results demonstrate that a three-day training followed by six months of practical support has a positive impact on nurses' kinaesthetic competence.