HeilberufeSCIENCE最新文献

Background: In response to the COVID-19 pandemic, the German legislator has changed the framework conditions for care counselling (provided mainly by outpatient care services) in the German long-term care insurance (§ 37 (3) SGB XI). The care counselling no longer has to be provided in the home of the patients but is also possible by telephone or online. In 2020, the existing obligation for family members and other informal caregivers to make use of a care counselling service was suspended for a few months.

Aim: The aim of this study was first of all to describe the influence of the COVID-19 pandemic on the number and duration of care counselling by outpatient care services in Bavaria, Germany. Particular attention was paid to the following question: what impact did the suspension of the obligation to make use of care counselling have on the utilization of care counselling?

Method: Secondary analysis of more than 43,000 data sets of the BARMER Nursing Insurance in Bavaria. Evaluation primarily by means of time series analyses and other descriptive statistics. In addition, the correlation between the weekly number of care counselling consultations and the cases of COVID-19 in Bavaria was calculated.

Results: At the end of March and in April 2020 the number of consultations decreased by nearly 80% compared to February 2020. The concern about contagion with SARS-CoV-2 was crucial to this slump in the number of counselling visits; however, the reduction was also made possible by the suspension of the obligation to provide care counselling, which was decided on 27 March 2020. The suspension of the obligation to provide advice alone led to a decrease of between 44% and 49% in Bavaria. The available data also indicate that telephone consultations are shorter than face-to-face consultations.

Conclusion: The available data suggest that only about half of the care consultations would be used by users if the obligation to make use of care counselling-as laid down in § 37 (3) SGB XI-were permanently eliminated. In addition, they contain clear indications that remuneration after time (as practised in Bavaria) has led to an extension of the consultation times.

Background: Due to the COVID-19 pandemic, universities had to switch to online teaching as quickly as possible. Part-time students who work in the healthcare sector have to manage the balancing act between an invariably online education and a mandatory physical attendance in a profession that maintains the system.

Aim: The aim of the study was to explore the challenges faced by part-time students working in the healthcare sector, to identify the need for change and to derive recommendations for action for the university.

Methods: The data were collected using an open response online questionnaire. The obtained data were evaluated according to the qualitative content analysis of Mayring.

Results: Probably the greatest challenges that part-time students have to deal with, are the self-organized learning or the (on time) accomplishment of work assignments, which are often perceived as too extensive, and the independent development of teaching content. Furthermore, part-time students reported about the difficultness to reconcile e‑learning and work and/or family.

Conclusion: These perceived challenges are not new but since additional family commitments and uncertainty of daily work routine are added, these challenges are gaining in importance during COVID-19. Therefore, learning environments, which are currently offered to part-time students, must be understood as caring spaces. In addition to new didactic concepts, universities should invest in the promotion of students' personal and social competencies.

Background: Malnutrition remains a challenging problem in hospitals, especially among geriatric patients. The background and causes are actually well known but still underestimated in clinical practice.

Aim and methods: This study evaluated possible differences in rates of malnutrition risk and malnutrition in geriatric patients living at home and geriatric patients living in residential nursing homes. For this purpose, data from a total of 4 surveys (3 times nutritionDay plus 1 additional survey) were combined and evaluated. In this secondary analysis, 258 patients 65 years and older are included. Malnutrition risk is determined by the malnutrition universal screening tool (MUST) and malnutrition by the ESPEN criteria.

Results: Of the patients 86.0% (n = 222) live at home and 14.0% (n = 36) in residential nursing homes. The patients living in nursing homes have a higher morbidity and need of care. Indicators for the increased morbidity are a larger number of nights spent in the clinic in the last 12 months (mdn 10.0 vs. 5; p 0.007), higher number of daily drug intake (mdn 9.0 vs. 7.0; p 0.002) and greater limitations in walking abilities (mdn 3.0 vs. 1.0; p < 0.001). They are significant older (median 86.0 vs. 78.0; p < 0.001) and show a higher percentage of manifest malnutrition (35.7%; n = 10 vs. 20.1%; n = 40; p 0.062).

Conclusion: Geriatric patients living at home and in residential nursing homes show high rates of malnutrition. A malnutrition screening at the beginning and during hospital stay is urgently required in every case as this is the only way to identify those affected. In addition, regular screening in outpatient departments as well as in nursing homes is also necessary.