[Development of an app to support in-home care consultation visits]. / Entwicklung einer App zur Unterstützung häuslicher Pflegeberatungsbesuche.

BACKGROUND: The in-home care consultation visits according to § 37.3 of the Social Security Statute Book XI have been carried out inconsistently so far and with a lack of structured care documentation. In the INGE-integrate4care project, an app was developed to support the quality assurance of visits. METHOD: Based on a user-centered design approach, 10 semistructured expert interviews were conducted and analyzed using qualitative content analysis according to Mayring. In group-based expert walkthroughs with 7 participants, the design, contents and functions of the app were discussed, requirements were collected in feedback lists and digitally implemented by developers. RESULTS: Interviewees reported that visits are heterogeneous, that there are individual approaches and that this should be reflected in the design of the app. Important topics for the app were, e.g. contents of the NBA and the burden on caregivers. Functions such as the recommendation of measures on the basis of documented information are desirable. On the other hand, too stringent guidelines of the app would be an obstacle, as these would limit the conversational character of the visit. The NBA and BIZA­D were chosen by the experts in the project as suitable basic assessments and adapted to the visits. Flexible access to items, visualization of care status per category, and the ability to select and track measures were specified to support workflow. DISCUSSION: The user-centered design approach enabled the development of an app that is characterized by both flexibility and structure. The tool will be further optimized with the help of usability evaluations and focus groups.

Screening for Depression in Old Age With Very Short Instruments: The DIA-S4 Compared to the GDS5 and GDS4.

Purpose of the Study: This article presents a short form of the Depression in old Age Scale with four items (DIA-S4). The diagnostic accuracy of the DIA-S4 was tested and compared to short forms of the Geriatric Depression Scale (GDS5, GDS4). Methods: Using the Montgomery and Asberg Depression Rating Scale (MADRS) as gold standard, the scales were validated with a sample of N = 331 geriatric inpatients. Results: The DIA-S4 had an internal consistency of .70, the GDS5 of .55, and the GDS4 of .58. The test efficiency considering ROC analyses for the DIAS-4 was AUC = .86, for the GDS5 AUC = .78, and for the GDS4 AUC = .74. The best cut-off score for the DIA-S4 was 1.5 with a sensitivity of 87% and a specificity of 68%, for the GDS4 1.5 with a sensitivity of 58% and a specificity of 81%, and for the GDS5 1.5 with a sensitivity of 88% and a specificity of 49%. Conclusion: Based on the data of this study, the DIA-S4 shows better psychometrical qualities than the GDS5 and the GDS4. It can be used as a very short screening scale for depression in old age in research and clinical practice.