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1.
Z Kinder Jugendpsychiatr Psychother ; 50(1): 9-15, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34110245

RESUMO

Objective: The problematic use of computer games was included in the DSM-5 and in the ICD-11. Initial research revealed associations between problematic gaming (PG) and quality of life (QoL). However, clarification is needed concerning which dimensions of the multidimensional construct QoL are particularly relevant for PG. Method: To answer this question empirically, we asked 503 parents (mean age: 47.63 years) to rate their 503 children (average age: 14.60 years) regarding QoL and PG, using validated questionnaires on parental assessments of adolescent PG and health-related QoL to collect the data. Correlation analyses were calculated to determine bivariate relations, and a multiple linear regression was used to conduct a multivariable analysis. Results: In the bivariate analyses, a higher severity of PG was associated with a lower health-related QoL in all five surveyed dimensions. In the multivariable model (corrected R2 = 0.35), we observed statistically significant associations between higher severity of PG and male sex and lower age of the adolescent as well as lower QoL in the dimensions of physical well-being and school environment. Conclusions: According to the findings of the present study, physical well-being and school environment should be especially focused on in preventive approaches against the development of PG in youth.


Assuntos
Comportamento Aditivo , Jogos de Vídeo , Adolescente , Comportamento Aditivo/epidemiologia , Criança , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Pais , Qualidade de Vida , Inquéritos e Questionários
2.
Prax Kinderpsychol Kinderpsychiatr ; 69(6): 570-589, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32988309

RESUMO

The Zurich Specialist Clinic for Adolescent with Gender Dysphoria - Preliminary Follow-up Results The specialist clinic for children and adolescents with gender dysphoria (GD) of the Psychiatric University Hospital of Zurich shows an increasing number of referrals since its foundation in 2009. Since 2014 we started an observational study including adolescents aged 13 years and older. At the time of the first appointment (T0) N = 77 participants completed a battery of questionnaires assessing demographic factors, general psychopathology, quality of life as well as gender identity, social transitioning and GD treatment modalities. Few of the adolescents were socially transitioned and had hormone therapy but 77.9 % wished to get hormone therapy. Follow up assessment T1 was performed after at least one year of treatment in our specialist clinic. 51 adolescents completed an online follow-up examination including the same questionnaires and baseline parameters as well as a scale measuring treatment satisfaction. At T0, 77.3 % of the adolescents scored in the clinical range of the Youth Self Report (YSR) total score, which did not decrease significantly until T1 in our preliminary follow up sample. Puberty blocking before T0 correlated negatively with the YSR score, indicating less psychopathology in treated patients. Preliminary longitudinal analysis suggests that social transitioning influences quality of life (Kidscreen subscale autonomy and parental relationship). At T1, 52 % of the adolescents were socially transitioned in all contexts and 70 % received gender affirming hormonal treatment. Gender identity changed between T0 and T1 in about 18 % of the cases. Treatment satisfaction in most cases was high.


Assuntos
Disforia de Gênero/terapia , Adolescente , Instituições de Assistência Ambulatorial , Feminino , Seguimentos , Disforia de Gênero/psicologia , Identidade de Gênero , Humanos , Masculino , Qualidade de Vida
3.
Prax Kinderpsychol Kinderpsychiatr ; 69(6): 554-569, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32988300

RESUMO

Mental Stress and Health-Related Quality of Life in Adolescents with Gender Dysphoria Although the level of mental stress in adolescents with gender dysphoria is found to be generally high in many studies, differences have been shown between samples of gender dysphoria clinics for adolescents in different countries. However, a comparison within the German speaking area is lacking. In this article we compared samples of gender dysphoria clinics from Munster (Germany) and Zurich (Switzerland) and tested potential correlates of mental stress using quantitative methods. Subsequently, we interviewed clients from both clinics regarding mental stressors and protective factors. There were no quantitative differences in the level of mental stress of clients between Munster and Zurich, whereas health-related quality of life was significantly higher in Munster. Problems in physical well-being and school environment were the strongest correlates of mental stress. This reflects in the interviews, too, in addition to further related factors reported. We conclude that physical well-being and inclusion at school should be addressed with special emphasis in counseling or treatment of adolescents with gender dysphoria to counter the in average high levels of mental stress.


Assuntos
Disforia de Gênero/psicologia , Qualidade de Vida , Estresse Psicológico , Adolescente , Alemanha , Humanos , Suíça
4.
Prax Kinderpsychol Kinderpsychiatr ; 69(3): 218-235, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32394820

RESUMO

Do Children and Adolescents with Different Reasons for Admission Equally Benefit from Institutional Care? Currently, almost 150.000 children and adolescents are placed in institutional care in Germany with the aim to improve their living conditions. Various studies showed positive effects concerning the development of those institutionalized children and adolescents. Within the present study, 500 children and adolescents in institutional care were examined regarding the improvement of quality of life and social competencies during their care placement depending on the respective reason for admission (group A: admission due to mental health and behavior problems; group S: problems in the context of the school; group O: no mental health problems, but other reasons). Furthermore, differences in the development of children and adolescents who initiated the placement by themselves and those who did not were examined. Results show that over a period of 18-24 months, all three groups developed effectively equally. Group A had a lower initial level regarding quality of life and social competencies compared to group S and group O and therefore reached lower outcomes within the investigation period. Development was irrespective of whether or not children and adolescents initiated the institutional placement by themselves. The results demonstrate that all three groups were able to benefit from institutional care, although children and adolescents with mental health problems had a notable potential for further development.


Assuntos
Criança Institucionalizada/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Comportamento Problema/psicologia , Qualidade de Vida , Habilidades Sociais , Adolescente , Criança , Alemanha , Humanos , Saúde Mental
5.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 525-539, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480945

RESUMO

Quality of Life in Children with Down Syndrome from Parental Point of View Parents of 42 children with Down syndrome (mean age 9 years) report on their child's quality of life (physical, emotional and social domain). The KINDL-R was used as a proxy-report measure. Quality of life correlated negatively with behavioral symptoms (SDQ), but did not vary between children in mainstreamed or special schools. Regression analysis identified the child's behavioral symptoms and parental stress - assessed when the children had reached the age of five - as significant predictors of quality of life assessed four years later.


Assuntos
Síndrome de Down/psicologia , Pais/psicologia , Qualidade de Vida , Inquéritos e Questionários , Criança , Pré-Escolar , Humanos , Procurador , Estresse Psicológico
6.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 488-502, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480942

RESUMO

Quality of Life and Behavioral Problems of Unaccompanied Minor Refugees in Child Care Facilities Unaccompanied minor refugees (UMR) who arrive in Germany are generally placed in institutional child care facilities. UMR are a very burdened group, however other children and adolescents in institutional care are burdened as well, and their quality of life is often reduced. The aim of the current study was thus to compare quality of life and behavioral problems of UMR in child care facilities with those of other resident adolescents. For a total of 50 UMR, data regarding behavioral problems was available, for 41 UMR ratings on quality of life, both from external assessments. Two parallel comparison samples of other adolescents in the same institutional care facilities were drawn with adolescents with and without a migration background. Results show that in general, UMR show fewer behavioral problems than the other two groups, especially in externalizing behavior. For internalizing behavior, no differences were evident. For quality of life, no differences could be found between the three groups of inhabitants in institutional care. This indicates that the same factors determining quality of life are present in all three groups, but that the underlying mental problems are different in UMR than in other adolescents. Thus, staff in institutional care should possibly work differently with these group of adolescents than with other inhabitants and should be educated respectively.


Assuntos
Cuidado da Criança , Menores de Idade/psicologia , Comportamento Problema , Qualidade de Vida , Refugiados/psicologia , Adolescente , Criança , Cuidado da Criança/organização & administração , Alemanha , Instalações de Saúde , Humanos
7.
Pflege ; 32(5): 235-248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31429372

RESUMO

Internal consistency and construct validity of the Quality of Life measurement in dementia QUALIDEM - a secondary data analysis of cross-sectional data Abstract. Background: Maintaining and improving the Quality of Life (QoL) of people with dementia is the principal aim of nursing and medical care. The QUALIDEM is a theory-based, dementia-specific QoL instrument in the German language. Until now, however, there are hardly any findings on the construct validity. OBJECTIVE: Evaluation of the item difficulty, internal consistency, discriminant and convergent validity of the German QUALIDEM. METHOD: The evaluation of the construct validity is based on a Multi-Trait-One-Method approach, using a sample of 167 people with mild to severe dementia and 71 people with very severe dementia. RESULTS: The correlation between the QUALIDEM subscales and the comparative constructs agitation, depression, anxiety, aberrant motoric behavior, apathy, pain and QoL, measured with the Alzheimer's Disease Related Quality of Life instrument, was confirmed in the expected direction in 82 % of the predefined hypotheses. The correlation coefficients range between 0.04 and -0.60 (discriminant validity) and -0.21 and 0.71 (convergent validity). For the majority of QUALIDEM subscales a good internal consistency could be demonstrated. CONCLUSION: The results indicate first indications for the construct validity of the QUALIDEM subscales and for the further development of the instrument. In future studies, the validity of the German QUALIDEM should be further investigated.


Assuntos
Demência , Qualidade de Vida , Inquéritos e Questionários , Estudos Transversais , Humanos , Reprodutibilidade dos Testes
9.
Prax Kinderpsychol Kinderpsychiatr ; 66(3): 179-193, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-28266257

RESUMO

Burden of Parents of Pediatric Cancer Patients in Pediatric-oncological Rehabilitation All family members experience high burden in case of paediatric cancer. Family-oriented rehabilitation (FOR) aims to improve the physical and mental situation of the families. We investigated anxiety and depression (HADS) and cancer-related burden of parents (n = 69) before and after FOR and analysed its association with quality of life of the ill children. At beginning of FOR 70 % of the parents showed moderate to high anxiety scores and 47 % moderate to high depression scores. They reported cancer-related burden such as exhaustion, cancer-related fears and a burden of family's daily life due to the cancer disease. At the end of FOR 40 % of the parents showed moderate to high anxiety scores and 30 % moderate to high depression. Cancer-related burden measured with self-developed items also decreased after FOR. Compared to age- and gender-adapted norm values, mothers show significantly higher anxiety and depression scores, whereas fathers show no differences in depression scores compared to norm values at the end of FOR. Quality of life of ill children and anxiety and depression scores in the parents are significantly associated with each other. Results of the study show that parents stabilise after FOR and improve their mental situation. However, the results also underline the need for long-term psychosocial support for all family members.


Assuntos
Efeitos Psicossociais da Doença , Terapia Familiar/métodos , Pai/psicologia , Mães/psicologia , Neoplasias/psicologia , Neoplasias/reabilitação , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Adaptação Psicológica , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Criança , Pré-Escolar , Terapia Combinada , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Projetos Piloto , Qualidade de Vida/psicologia , Centros de Reabilitação , Inquéritos e Questionários
10.
Prax Kinderpsychol Kinderpsychiatr ; 66(9): 702-718, 2017 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-29111894

RESUMO

Healthy Siblings of Children with Autism Spectrum Disorders. A Mixed-methods Pilot Study Healthy siblings of chronically ill and/or disabled children may have an increased risk of developing behavioral problems; this is particularly given for siblings of children with Autism Spectrum Disorders (ASD). Quality of life and distress of five siblings (12-15 years) of children with ASD were examined using self- and parent-proxy-reports. Guideline-based interviews were conducted with the siblings and their parents and analyzed according to Mayring. Quality of life described by the children resembled the KINDLR´s standardized range of scores, but parents described a decreased quality of life. Both siblings and parents reported low to medium distress. Interviews revealed healthy children are asked by their parents to take responsibility for their siblings with ASD. Parents assumed their healthy children are less affected by the ASD of the sibling. The healthy siblings described being "annoyed" by ASD-associated behavior and partly feeling "treated unfairly". They wished their sibling no longer "suffered" from ASD or behaved "normally". The results of this pilot study, albeit with a small sample, show siblings do experience low to medium burden. This burden is often caused by the sibling relationship or the ASD-associated behavior. Suggestions for supporting the healthy siblings are given.


Assuntos
Transtorno do Espectro Autista , Irmãos , Criança , Saúde da Família , Humanos , Projetos Piloto , Qualidade de Vida , Relações entre Irmãos
11.
J Dtsch Dermatol Ges ; 14(12): 1249-1260, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27992138

RESUMO

HINTERGRUND: Zur Wirksamkeit von Aknetherapien und deren Auswirkungen auf die Lebensqualität erwachsener Patienten liegen kaum Daten vor. ZIEL: Erhebung der Wirkung von Azelainsäure 20 % Creme (Skinoren® ) auf Akne-Schweregrad und krankheitsbedingte Lebensqualität. PATIENTEN UND METHODIK: Nichtinterventionelle Studie bei erwachsenen Patientinnen mit leichter bis mittelschwerer Akne. Wirksamkeitsparameter waren DLQI sowie Akne-Schweregrad im Gesicht, am Dekolleté sowie am Rücken im Gesamturteil des Prüfarztes (IGA-Skala: Grad 1 = annähernd reine Haut; 2 = leichte Akne; 3 = mittelschwere Akne). Visiten waren zu Studienbeginn sowie nach 4-8 und zwölf Wochen geplant. ERGEBNISSE: Von den 251 eingeschlossenen Patientinnen lag zu Studienbeginn bei 59 %, 31 % bzw. 10 % ein IGA-Grad von 1, 2 bzw. 3 vor; die am häufigsten betroffene Hautpartie war das Gesicht (IGA-Grad 2 oder 3: 79 %). Nach zwölf Behandlungswochen war eine signifikante Besserung der Acne vulgaris im Gesicht (IGA-Grad 0 oder 1: 82 %) sowie auf Dekolleté und Rücken feststellbar. Der mediane DLQI-Wert sank von neun zu Studienbeginn auf fünf nach zwölf Behandlungswochen. Neunzig Prozent der behandelnden Ärzte und Patientinnen beurteilten die Verträglichkeit der Behandlung als sehr gut oder gut. SCHLUSSFOLGERUNGEN: Die Anwendung von 20%iger Azelainsäure-Creme führt bei erwachsenen Frauen zu einer signifikanten Besserung der Acne vulgaris und der krankheitsbedingten Lebensqualität.

12.
Artigo em Alemão | MEDLINE | ID: mdl-27027217

RESUMO

Do Attachment Styles of Mentally Ill Parents Impact on the Health-related Quality of Life of their Children? Parents with a mental disorder often display a problematic attachment style which may impact on their children's health related quality of life (HrQoL). The current study cross-sectionally examines attachment styles (BEPE) in mentally ill parents with underage children (n = 62) and the effect of attachment on their children's HrQoL (KINDL-R). Results show that secure attachment is less represented in parents with a mental health condition than in a healthy reference group. Within the clinical sample, children of mentally ill parents with a secure attachment style exhibit a higher HrQoL than children of mentally ill parents with ambivalent or avoidant attachment styles. These findings indicate not only that problematic attachment styles frequently occur in families with a mentally ill parent, but also suggest that this negatively affects the children's HrQoL. Appropriate interventions should include attachment oriented concepts.


Assuntos
Filho de Pais com Deficiência/psicologia , Transtornos Mentais/psicologia , Apego ao Objeto , Relações Pais-Filho , Qualidade de Vida/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Reativo de Vinculação na Infância/diagnóstico , Transtorno Reativo de Vinculação na Infância/psicologia
13.
Pflege ; 29(2): 93-101, 2016.
Artigo em Alemão | MEDLINE | ID: mdl-26974281

RESUMO

BACKGROUND: Regional dementia care networks become more and more important in the care for community-dwelling persons with dementia (PwD). However, the quality of life of PwD, served by dementia care networks, has not been investigated yet. It also remains unclear if there are differences between urban and rural dementia care networks. This study therefore aims at investigating the quality of life of PwD using this care model, also regarding possible regional differences. METHODS: Within the DemNet-D-Study, PwD and their primary caregivers were interviewed using typical outcome parameters (quality of life: QoL-AD, depression: GDS, challenging behaviour: CMAI, capacities of daily living: IADL, caregiver burden: BIZA-D). In addition to these parameters, regional differences were analysed using multi-level-analysis. RESULTS: In total, 560 PwD (79.7 years; 57.0 % female) and their caregivers participated in the study. Both self- and proxy-rated quality of life is on a moderate level. The analysis shows a sufficient explanation of the quality of life. (self: p<0.001, R2=0.493; proxy: p<0.001, R2=0.406). Higher quality of life was found for PwD living together with their care givers and for those PwD with higher capacities of daily living. Regional (urban vs. rural) differences could not be found. CONCLUSION: The quality of life of community-dwelling PwD using regional dementia care networks is comparable to those in other studies of outpatient dementia care. Further investigation should be carried out regarding different types of dementia care networks.


Assuntos
Doença de Alzheimer/enfermagem , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Redes Comunitárias , Equipe de Assistência ao Paciente/organização & administração , Qualidade de Vida/psicologia , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Assistência Ambulatorial , Efeitos Psicossociais da Doença , Transtorno Depressivo/enfermagem , Transtorno Depressivo/psicologia , Avaliação da Deficiência , Feminino , Humanos , Vida Independente , Masculino , Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , População Rural , População Urbana
14.
Pflege ; 29(4): 183-91, 2016 07.
Artigo em Alemão | MEDLINE | ID: mdl-27239744

RESUMO

Background: The maintenance and promotion of Quality of Life (QoL) of people with dementia is a major outcome in intervention studies and health care. The Quality of Life Alzheimer's Disease (QoL-AD) is an internationally recommended QoL measurement also available in German language. Until now, only a few results on the psychometric properties of the German QoL-AD were available. Objective: Evaluation of internal consistency and construct validity of the QoL-AD proxy. Method: A principal component analysis (secondary data analysis) of the 13 QoL-AD items was carried out based on the total sample of 234 people with dementia from nine nursing homes in Germany. Subsequently, the internal consistency of the identified factors was examined using Cronbach's alpha. Results: Two factors physical and mental health and social network were determined. Both factors explain 53 % of the total variance. The stability of both factors was validated in two sensitivity analyses. The internal consistency is good for both factors with a Cronbach's alpha of 0.88 (physical and mental health) and 0.75 (social network). Conclusion: The QoL-AD proxy allows the assessment of two relevant health-related QoL domains of people with dementia. However, in future studies especially the inter-rater reliability of the QoL-AD proxy has to be examined.


Assuntos
Doença de Alzheimer/enfermagem , Doença de Alzheimer/psicologia , Avaliação em Enfermagem/estatística & dados numéricos , Procurador , Psicometria/estatística & dados numéricos , Qualidade de Vida/psicologia , Inquéritos e Questionários , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Masculino , Reprodutibilidade dos Testes , Autocuidado/classificação , Autocuidado/psicologia
15.
Z Kinder Jugendpsychiatr Psychother ; 43(6): 433-41, 2015 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-26602047

RESUMO

OBJECTIVE: Presently, little is known aqout the quality of life (QoL) as well as the strengths and difficulties of young people with achondroplasia. This study describes these patient-reported indicators and identifies possible correlates. METHOD: At the invitation of a patient organization, a total of 89 short-statured patients aged 8 to 28 years and their parents participated in this study. QoL was assessed cross-sectionally with both generic and disease-specific instruments and the Strengths and Difficulties Questionnaire (SDQ) as a brief behavioral screening. In addition to descriptive analyses, patient data were compared with a reference population. Hierarchical regression analyses reflecting sociodemographic, clinical, and psychological variables were conducted to identify correlates of QoL. RESULTS: QoL and the strengths and difficulties of young patients with achondroplasia did not differ substantially from a healthy norm sample. However, the participants reported more behavioral problems and limitations in their physical and social QoL compared to patients with another short stature diagnosis. Strengths and difficulties, height-related beliefs, and social support correlated significantly with QoL. Adding psychological variables to the regression model increased the proportion of variance explained in QoL. CONCLUSIONS: Young persons with achondroplasia did not differ in their QoL and strengths and difficulties from healthy controls. Characteristics such as height appear less important for the self-perceived QoL than are strengths and difficulties and protective psychosocia~factors.


Assuntos
Acondroplasia/psicologia , Nanismo/psicologia , Qualidade de Vida/psicologia , Papel do Doente , Acondroplasia/diagnóstico , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Psicometria/estatística & dados numéricos , Valores de Referência , Autoavaliação (Psicologia) , Inquéritos e Questionários , Adulto Jovem
16.
Artigo em Alemão | MEDLINE | ID: mdl-25968412

RESUMO

Psychological Symptom Burden in Children and Adolescents After Leukemia or Lymphoma Diseases. A cancer diagnosis represents a major challenge for children and young people at an early stage in life. Objective of the present study is the investigation of mental health and psychosocial burden in children and young adolescents two or more years after the treatment of leukemia (ALL, AML) or lymphoma disease (NHL) compared to peers not suffering from cancer as well as available standard values. 42 former patients and 23 healthy peers were included in the comparative analysis. In addition to socio-demographic and medical information the following validated questionnaires were used: the General Depression Scale (ADS), the Strength and Difficulties Questionnaire (SDQ) for the detection of behavioral difficulties and strengths, the KINDL-R questionnaire for assessing quality of life in children and adolescents, the Herth Hope Index (HHI), the Social Questionnaire (SFS 4-6) for assessing the educational integration and the General Self-Efficacy Scale (GSE) to measure self-efficacy. Children and young adolescent survivors of leukemia or lymphoma report significantly less depressive symptoms and significantly higher quality of life compared to a healthy age-matched comparison sample and representative standard values. Beyond, former patients do not differ significantly in psychological and psychosocial aspects compared to a healthy age-matched comparison sample and available standard values.


Assuntos
Efeitos Psicossociais da Doença , Leucemia Mieloide Aguda/psicologia , Linfoma não Hodgkin/psicologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/psicologia , Sobreviventes/psicologia , Adolescente , Criança , Feminino , Seguimentos , Humanos , Leucemia Mieloide Aguda/terapia , Linfoma não Hodgkin/terapia , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Psicometria/estatística & dados numéricos , Qualidade de Vida , Valores de Referência , Autoeficácia , Inquéritos e Questionários
17.
Pflege ; 27(6): 369-80, 2014 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-25416484

RESUMO

BACKGROUND: A fundamental aim of social science and for practitioners is the improvement of the quality of life of inpatients residing in long term care homes. Health, as a vital part of quality of life, gains in subjective importance with rising age. AIM: This paper aims to analyse the aspects of «Intact mental abilities¼ and "Mobility" thorough in terms of the subjective quality of life of nursing home residents. MATERIALS AND METHOD: nine male and 33 female inpatients of eight independent nursing homes within Berlin and surrounding regions have been interviewed using narrative guidance questions. The interviewees were selected by the interviewer participating in their day to day life and through the means of direct conversations with the respective persons. The following analysis is based on Bohnsack's documentary method. RESULTS: Findings suggest that it is important for the interviewees to retain their mental abilities up until old age to be capable of acting autonomously and independently controlling their own life. The respondents not only perceive the loss of their own cognitive abilities as problematic, but also that of their cohabitants, as such impedes social contacts. Another key component of well-being deems to be the ability "to walk", in other words, mobility is basis for retaining self-determination and facilitates to participate in activities within the nursing homes. CONCLUSION: Nursing home residents should receive tailored support in cognitive abilities. In addition, interested residents should receive enhanced information about the disease of dementia. The mobility should be largely preserved more close to everyday life movement offers available towards the residents.


Assuntos
Idoso Fragilizado/psicologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Cognição , Feminino , Alemanha , Humanos , Entrevista Psicológica , Masculino , Limitação da Mobilidade , Autonomia Pessoal , Pesquisa Qualitativa
18.
Pflege ; 27(2): 69-80, 2014 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-24670540

RESUMO

A nursing oasis (NO) can be understood as a version of special care units. The focus is on a constantly living arrangement for people with severe dementia in nursing homes (multiple person room). Nurses are permanently present during the day shift. The question has to be raised which characteristics of quality of life (QoL) are mentioned and how nurses and relatives do assess this concept. Qualitative Results of a two-year evaluation study of 15 people living in NOs are presented. Data were collected during four (five) group discussions with 8 nurses (15 relatives). Additionally problem-based interviews were realized. Data evaluation was oriented to the grounded theory. The findings show that primarily the focus of QoL in NOs was on psychophysical well-being. Assessments of relatives and nurses were prevailing positive and could be interpreted in the light of the Festingers' social-psychological "Theory of Cognitive Dissonance". Comparisons between the situation before and after the implementation of the NOs were shown to be relevant for the overall assessments. All in all we have to deal with the construction of "care worlds of everyday life" in long term care institutions.


Assuntos
Doença de Alzheimer/enfermagem , Atitude do Pessoal de Saúde , Cuidadores/psicologia , Comportamento do Consumidor , Instituição de Longa Permanência para Idosos , Casas de Saúde , Qualidade de Vida/psicologia , Atividades Cotidianas/classificação , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Avaliação da Deficiência , Arquitetura de Instituições de Saúde , Feminino , Alemanha , Humanos , Masculino , Teoria de Enfermagem , Pesquisa Qualitativa
19.
Z Evid Fortbild Qual Gesundhwes ; 186: 1-9, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38580503

RESUMO

INTRODUCTION: Health-Related Quality of Life (HRQoL) data is frequently requested in early benefit assessment in Germany. To test the hypothesis that the importance of HRQoL in general and the significance of disease-specific instruments in particular has increased since the introduction of AMNOG in Germany, we analysed all early benefit assessments between 2011 and 2022. METHODS: All 793 early benefit assessments completed between 01/01/2011 and 03/11/2022 were systematically analysed. The HRQoL instruments featured in the dossier submissions were extracted for all assessments and categorized into generic and specific instruments. All G-BA resolutions were likewise assessed for consideration and acceptance of generic and specific HRQoL instruments. In addition, it was examined whether there was an association between HRQoL data and the extent of additional benefit. RESULTS: Since 2014 HRQoL data have continuously been submitted in 70% to 80% of assessments per year with the exception of 2022 (63%). Generally, disease-specific instruments are favoured, regarding submissions by industry but especially with higher acceptance by the G-BA in the resolution. Subgroup analyses revealed oncology as a major contributor to the submission and acceptance rates of disease-specific instruments. Disease-specific instruments were submitted in 81% of all oncology assessments and accepted in 53% of assessments. Overall, assessments with accepted HRQoL data tend to reach a higher overall benefit. Procedures with accepted HRQoL were most likely to receive a considerable benefit (31%), while for procedures in which HRQoL data were not accepted, a benefit was most often (65%) not proven. DISCUSSION: Industry has followed the request for submission of specific HRQoL instruments early on. Higher submission rates of specific instruments over time which at the same time meet the methodological requirements indicate that industry has learned from early assessments. A potential reason for the high submission- and acceptance rates of specific HRQoL instruments in oncology might be the particularly high relevance of HRQoL in this indication. Possible effects of changes in legislature on the future development of submission and acceptance of HRQoL data need to be monitored. CONCLUSION: In Germany, HRQoL has gained a relevant position in early benefit assessment over time. Overall specific instruments are favoured, regarding submissions by industry but especially through consideration by the G-BA in the resolution. Furthermore, HRQoL data can be supportive for benefit assessments, in particular to show that advantages in morbidity and/or mortality are reflected in HRQoL and not at the expense of HRQoL.


Assuntos
Qualidade de Vida , Alemanha , Humanos , Programas Nacionais de Saúde , Inquéritos e Questionários
20.
Z Evid Fortbild Qual Gesundhwes ; 169: 28-38, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35288063

RESUMO

INTRODUCTION: Delirium is a common condition of a global disturbance of cognition, triggered by underlying diseases. The objective of this study is to review the current evidence in the literature on direct healthcare costs and health-related quality of life (HRQOL) associated with delirium. METHODS: A systematic search was conducted in PubMed and Embase for relevant studies published between January 1, 2010 and November 4, 2021. Studies for inclusion reported estimates on healthcare costs or HRQOL, adjusted for relevant confounding factors. RESULTS: Fourteen studies on healthcare costs and eleven studies on HRQOL were included. Delirium resulted in (adjusted) increased costs ranging from $1,532 to $22,269 depending on included cost categories, the country and the type of hospital department. Increased length of stay for delirious patients ranged from 2.5 days to 10.4 days and had the largest contribution to overall, direct incremental costs. Heterogeneity was observed in HRQOL outcomes. CONCLUSION: The analysis indicates that the presence of a delirium episode may lead to increased costs of hospitalisation. Changes in HRQOL due to delirium are not well demonstrated and more research is needed to determine the effect of delirium on HRQOL.


Assuntos
Delírio , Qualidade de Vida , Delírio/terapia , Alemanha , Custos de Cuidados de Saúde , Hospitalização , Humanos
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