[Dementia in Germany: results of an interdisciplinary expert workshop]. / Demenz in Deutschland--Ergebnisse eines interdisziplinären Expertenworkshops.

In the aging population of Germany the consequences of Dementia for the society and the health care sector are complex and solutions require a multidisciplinary approach. The aim of the two-day interdisciplinary expert conference was to consider dementia from different perspectives, to identify dementia-related problems and to discuss integrative solutions under consideration of complementary therapies. In different working groups the experts developed solutions and recommendations with regards to political need, health care and future research priorities. The present recommendations profited very much from the interdisciplinary participants of the conference and brought together the expertise of different fields resulting in a comprehensive picture about dementia in Germany.

The effects of dementia care mapping on nursing home residents' quality of life and staff attitudes: design of the quasi-experimental study Leben-QD II.

BACKGROUND: The main objective of care for people with dementia is the maintenance and promotion of quality of life (Qol). Most of the residents in nursing homes have challenging behaviors that strongly affect their Qol. Person-centered care (PCC) is an approach that aims to achieve the best possible Qol and to reduce challenging behaviors. Dementia Care Mapping (DCM) is a method of implementing PCC that has been used in Germany for several years. However, there are no data on the effectiveness of DCM or the challenges of implementation of DCM in German nursing homes. METHODS/DESIGN: In this quasi-experimental non-randomized cluster-controlled study, the effects of DCM will be compared to 2 comparison groups. 9 nursing homes will take part: 3 will implement DCM, 3 will implement a comparison intervention using an alternative Qol assessment, and 3 have already implemented DCM. The main effect outcomes are Qol, challenging behaviors, staff attitudes toward dementia, job satisfaction and burnout of caregivers. These outcomes will be measured on 3 data points. Different quantitative and qualitative data sources will be collected through the course of the study to investigate the degree of implementation as well as facilitators of and barriers to the implementation process. DISCUSSION: This study will provide new information about the effectiveness of DCM and the implementation process of DCM in German nursing homes. The study results will provide important information to guide the national discussion about the improvement of dementia-specific Qol, quality of care in nursing homes and allocation of resources. In addition, the study results will provide information for decision-making and implementation of complex psychosocial interventions such as DCM. The findings will also be important for the design of a subsequent randomized controlled trial (e.g. appropriateness of outcomes and measurements, inclusion criteria for participating nursing homes) and the development of a successful implementation strategy. TRIAL REGISTRATION: Current Controlled Trials ISRCTN43916381.

[Comment about the policy statement of the MDS. A position statement of the assessment group of the University Witten/Herdecke with regard to nursing documentation]. / Kommentar zur Grundsatzstellungnahme "Pflegeprozess und Dokumentation" des MDS. Positionspapier der Assessmentgruppe, Universität Witten/Herdecke, zur Pflegedokumentation.

In 2005 the Medical Advisory Service of Social Health Insurance (MDS) in Germany published a policy statement with regard to the nursing process and documentation. According to the intention of the association, this statement should be considered as recommendations which are able to improve nursing practice and to contribute to streamlining of bureaucracy in nursing care. Recognising the broad impact of this publication on nursing institutions, a working group on nursing assessment of the University Witten/Herdecke conducted a critical review of the statement. Significant criteria for evaluation were the primary role of nursing documentation, quality requirements for the documentation as well as recent scientific results concerning the implementation of nursing process and assessment-based nursing diagnoses. The review revealed that the statement lacks of a clear rationale and its content appears to be merely research-based. Therefore it has to be questioned if the publication will accomplish the claimed effects. In fact, future quality criteria for health care are to be developed independently on the basis of scientific results and in consideration of the experiences of all concerned social groups.

[Abdominal massage as intervention for patients with paraplegia caused by spinal cord injury--a pilot study]. / Bauchmassage als Intervention bei Menschen mit Querschnittlähmung--eine Pilotstudie.

UNLABELLED: Patients with paraplegia caused by spinal cord injuries have to deal with the loss of the central nervous regulation of the bowel functions. The management of defaecation can take a lot of their daily time. To support the colon motility, different methods of abdominal massage are used in nursing practice. But a review of current international literature reveals, that there is still a lack of evidence for the effect of abdominal massage on defaecation. In order to prove this effect, a pilot study was conducted using a quasi-experimental design with time series and including seven patients with paraplegia caused by spinal cord injury. Data were collected over three weeks: one week before intervention, during the intervention week and one week after intervention. In the intervention week, the patients received a specific abdominal massage each morning before breakfast. Following outcome-criteria have been considered: frequency and duration of defaecation, amount and consistency of faeces as well as subjective perception of the massage and its effects. RESULTS: Some distinctive changes in the frequency and duration of defaecation could be registered over time. Most patients regarded the massage as a comfortable intervention that may have positive effects of the defaecation. Due to the pilot character of the study further research is necessary in order to validate these effects.

[The amount of nursing care for patients with myocardial infarction--a descriptive study]. / Die Erfassung des Pflegeaufwands bei Patienten mit der medizinischen Diagnose Myokardinfarkt. Eine deskriptive Studie.

In Germany nurses have no evidence-based data about the amount of nursing care for patients with specific medical diagnosis. These data are necessary for the demanded appropriate consideration of criteria of nursing care in a German-DRG. The pilot study "The amount of nursing care for patients with myocardial infarction", which was part of a students research project at the University of Witten/Herdecke, can provide a basis for this consideration. The amount of nursing care for a convenience sample of 26 patients during their stay at a university hospital in Munich is the focus of a cross-sectional descriptive study. A standardized instrument measuring the amount of care was developed by the project group. The nursing intervention system LEP was used to determine the nursing care hours. The patients' average length of stay is 9.5 days. 73 percent spent 2.4 days in the intensive care unit. The average amount of nursing care is 32.2 hours per patient or 3.4 hours per patient and day, respectively. Typical nursing activities as well as an amount of nursing care pattern in the course of the stay can be seen. Variations of nursing care and length of stay show the inhomogeneity of the investigated group. Older patients and patients with associated diagnoses show an increase of the amount of nursing care and length of stay. The amount of nursing care of old patients in the category "motion and transfer" increases drastically compared to younger ones. The results of this pilot study confirm the assumption that just the diagnosis myocardial infarction is not sufficient to predict and describe the amount of nursing care. Based on this study, further research with larger samples and a longer investigation time is necessary.