Gesundheitsverhalten und Bedürfnisse von Menschen mit COPD während der COVID-19-Pandemie - Eine Dokumentenanalyse.

Health behaviours and needs of people with COPD during COVID-19 pandemic: a document analysis Abstract. Background: The government's guidelines affected people with COPD on different levels during the COVID-19 pandemic. In addition to belonging to a group of particularly vulnerable persons, they had to adapt their health behaviours, in particular physical activity, to recommendations provided in order to prevent negative effects on disease progression. There is little knowledge regarding how this group of patients coped with these challenges during the COVID-19 pandemic. OBJECTIVE: To describe the health behaviours and needs people with COPD convey during nursing phone consultations and which nursing interventions have been carried out. METHODS: A document analysis of 50 nursing phone consultations was performed. The data were summarised descriptively and analysed thematically. RESULTS: The main topics were the adaptation of physical activity, the implementation of the recommendations to the individual life situation, the detection of a COVID-19 infection and questions concerning the planning of medical appointments. CONCLUSION: The COVID-19 pandemic poses additional challenges to the disease management of people with COPD. The increased need for care brought on by the pandemic was able to be met by the knowledge provided in the nursing phone consultations. What remains to be established is what role the consultations play in a sustainable change in behaviour and in dealing with negative emotions.

The German version of the Assessment of Chronic Illness Care: instrument translation and cultural adaptation.

BACKGROUND: In Switzerland, there is a dearth of information on the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM). To drive quality improvement programmes, it is necessary to have practical assessment tools in the country's own language to evaluate the delivery of CCM activities. METHODS: German translation and adaptation of the original Assessment of Chronic Illness Care (ACIC). We followed a sequential forward and backward translation approach. In a multidisciplinary committee review the original English version and the translations were compared, instructions and formats modified and cross-cultural equivalences verified. The second version was pre-tested and multidisciplinary group discussion led to the final version which aimed to create a comprehensive culturally adapted translation capturing the original idea of the items rather than a direct one to one translation. RESULTS: Difficulties encountered during the translation process consisted in the difference of health care settings and health care organization in Switzerland and USA.The adapted German version was delivered to a managed care organization in the city of Zurich to test the initial use for diabetes care. The average ACIC subscale scores were: organization of the health care delivery system: mean (m) = 7.31 (SD = 0.79), community linkages: m = 3.78 (SD = 1.09), self-management support: m = 4.88 (SD = 1.21), decision support: m = 4.79 (SD = 1.16), delivery system design: m = 5.56 (SD = 1.28) and clinical information systems: m = 4.50 (SD = 2.69). Overall, the ACIC subscale scores were comparable with the scores of the original testing. CONCLUSION: After cultural adaptations the German version of the ACIC is applicable as a tool to guide quality improvement in chronic illness care in German speaking countries in Europe.

Assessment of Chronic Illness Care with the German version of the ACIC in different primary care settings in Switzerland.

BACKGROUND: In Switzerland the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM) is unknown. METHODS: According to guidelines we translated the Assessment of Chronic Illness Care (ACIC) into German (G-ACIC). We tested the instrument in different primary care settings and compared subscales with the original testing. RESULTS: Difficulties encountered during the translation process consisted in the difference of health care settings in Switzerland and USA. However initial testing showed the G-ACIC to be a suitable instrument. The average ACIC subscale scores in Swiss managed care (MC)-, group (GP)- and single handed practices (SP) were higher for MC practices than for group- and single handed practices: Organization of the healthcare delivery system: MC mean (m) = 6.80 (SD 1.55), GP m = 5.42 (SD 0.99), SP m = 4.60 (SD 2.07); community linkages: MC m = 4.19 (SD 1.47), GP m = 4.83 (SD 1.81), SP m = 3.10 (SD 2.12); self-management support: MC m = 4.96 (SD 1.13), GP m = 4.73 (SD 1.40), SP m = 4.43 (SD 1.34); decision support: MC m = 4.75 (SD 1.06); GP m = 4.20 (SD 0.87), SP m = 3.25 (SD 1.59); delivery system design: MC m = 5.98 (SD 1.61), GP m = 5.05 (SD 2.05), SP m = 3.86 (SD 1.51) and clinical information systems: MC m = 4.34 (SD = 2.49), GP m = 2.06 (SD 1.35), SP m = 3.20 (SD 1.57). CONCLUSIONS: The G-ACIC is applicable and useful for comparing different health care settings in German speaking countries. Managed care organizations seem to implement the different components of the CCM in a greater extend than group and single handed practices. However, much room exists for further improvement.