RESUMEN
The Prevention Act has greatly promoted the implementation of interventions focusing on the physical activity of nursing home residents. However the goal-compliant implementation and long-term sustainability of such offers is often associated with major challenges.Over a period of 2.5 years, the program "Lübeck Worlds of Movement Model" was evaluated during its implementation in nursing homes in the city of Lübeck. The main objective was to discover promoting or inhibiting factors of the implementation process. Alongside other data collection, 52 partially structured, problem-oriented interviews were conducted with participating professionals (e.g., employees of the nursing homes, trainers). They were analyzed and structured in a topic-based manner.A number of promoting and inhibiting factors were identified. The structure of the program supports the participants' and trainers' motivation to stick to the program. However, it was not well received nor permanently adopted in all areas of the nursing homes. The lack of involvement of nursing staff and of anchoring the program in the organizational structure and culture of the facilities were two of the most important inhibiting factors. Furthermore the model is suitable only for a limited number of residents. Further adaptations and developments have to be tackled to meet the target group's needs and achieve the successful implementation and long-term sustainability of the program.
Asunto(s)
Pacientes Internos , Casas de Salud , Atención a la Salud , Alemania , Hospitalización , HumanosRESUMEN
The concept of "health literacy", which has gained attention in English-speaking countries during the last decade, is becoming increasingly popular in Germany. While studies on an international level indicate that people with migration background are often limited in their health literacy, there is a lack of empirical data on that topic in Germany. However, it is well known that they are exposed to health-related risks and problems comparatively often whereas they use health care services less frequently. This article focuses on the native speaking counseling services of the Independent Patient Counseling Germany (UPD gGmbH) as an example of good practice and introduces the results of the evaluation of this counseling service. Qualitative interviews were conducted with UPD-consultants as well as with users of the services. It became apparent that Turkish and Russian-speaking immigrants often have limited health-related literacy. Therefore, support and counseling services should focus not only on issues concerning language and cultural aspects. Furthermore, strategies strengthening the health literacy of persons with migration background are required. Therefore, instruments and strategies will be developed in cooperation with the UPD which aim to improve such skills of the UPD-consultants.
Asunto(s)
Información de Salud al Consumidor/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Promoción de la Salud/organización & administración , Migrantes/educación , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Alemania/epidemiología , Alfabetización en Salud/métodos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Adulto JovenRESUMEN
Background: Because of the constantly aging population and the number of people suffering from chronic illnesses in old age, the number of family caregivers and their role in care provision is increasing. Most of these people are acting without any prior experience in the care sector, have a limited understanding of the healthcare system and carry out the tasks alongside the demands of their own day to day lives. Technical support solutions such as the Liv app (developed in the project münster.land.leben) are therefore gaining traction.The objective of the Liv app is to improve the digital healthcare expertise of the vulnerable group of family caregivers in Germany. Objective of the paper research question: The goal of this study was to test the prototype of the Liv app and refine the concept with the participation of family caregivers. Material and methods: Qualitative online interviews were conducted with 10 family caregivers with the aid of a prototype of the app and evaluated using a structured, qualitative content analysis. Results: The family caregivers rated the layout and the simplicity of the features as positive overall. As a condition for them to use the app, the interviewees stressed its ease of use and the quantity of documentation provided. Suggestions for enhancements were related to specifying activities, including additional forms of communication, reminders and confirmation, providing links to more information, integrating the app into other digital systems and enabling important documents to be saved. Discussion: From the perspective of those affected, the app meets a huge unserved need. Based on the interviewees' suggestions six enhancements to the app are under discussion. To avoid cluttering up the app, their usefulness needs to be tested in another study.
RESUMEN
Population and individual deficits in health literacy, and their associated negative health outcomes, have received growing attention in the political arena in recent years. In order to respond to the problem, several governments have adopted national action plans, which outline strategies to improve health literacy. Drawing on the action plans of the USA, Australia, Scotland, and Wales and applying Entman's concept of framing, this paper analyses how health literacy debates are framed within the political arena as well as the factors that influence framing. Analysing data from policy documents and in-depth expert interviews, this paper identifies relevant frames developed to (i) define the problem of limited health literacy, (ii) provide causal explanations, (iii) rationalise why health literacy requires political action, and (iv) present solutions. The findings indicate that the malleability of the concept allows that a diversity of frames and solutions are promoted, yet risks that debates remain vague. Health literacy seems to have been successfully used to instigate political debates about health system reforms, patient empowerment, and shared decision making. The analysis suggests that health literacy might, if applied strategically, help to focus policy debates on key public health problems and the development of systemic solutions.