Needs- and user-oriented development of contactless camera-based telemonitoring in heart disease-Results of an acceptance survey from the Home-based Healthcare Project (feasibility project).

Home-based telemonitoring in heart failure patients can reduce all-cause mortality and the relative risk of heart failure-related hospitalization compared to standard care. However, technology use depends, among other things, on user acceptance, making it important to include potential users early in development. In a home-based healthcare project (a feasibility project) a participatory approach was chosen in preparation for future development of contactless camera-based telemonitoring in heart disease patients. The project study patients (n = 18) were surveyed regarding acceptance and design expectations, and acceptance-enhancing measures and design suggestions were then drawn from the results. The study patients corresponded to the target group of potential future users. 83% of respondents showed high acceptance. 17% of those surveyed were more skeptical with moderate or low acceptance. The latter were female, mostly living alone, and without technical expertise. Low acceptance was associated with a higher expectation of effort and lower perception of self-efficacy and lower integratability into daily rhythms. For the design, the respondents found independent operation of the technology very important. Furthermore, concerns were expressed about the new measuring technology, e.g., anxiety about constant surveillance. The acceptance of a new generation of medical technology (contactless camera-based measuring technology) for telemonitoring is already quite high in the surveyed group of older users (60+). Specific user expectations concerning design should be considered during development to increase acceptance by potential users even more.

A mixed-methods evaluation of interprofessional education in palliative care: changes in student attitudes towards health professions.

Background: Future health care increasingly requires interprofessional thinking and decision-making which should be taught during medical study and vocational training. Against this backdrop, the Medical Faculty at TU Dresden developed an elective course on "Interprofessional Palliative Medicine" in which medical students and trainees in different health professions have been taught together since the 2017 summer semester. An extensive and simultaneous course evaluation conducted in the 2019 summer semester and 2019/20 winter semester investigated if and how strongly attendees' perceptions of interprofessional collaboration had changed as a result of the elective course. Method: The course evaluations included quantitative pre- and post-questions on a questionnaire (n=50) covering, among other things, the perception of roles, according to the Role Perception Questionnaire, and qualitative interviews (n=20). The pre- and post-questions were compared using the Wilcoxon test for related samples and the effect sizes were calculated according to Cohen. The qualitative interviews were analyzed for content using a combined deductive-inductive approach. Results: It was seen that the perceptions and attitudes of each professional group were mutually influenced as a result of the elective course. The quantitative analysis showed the largest effects regarding gains in understanding the roles and competencies of one's own and the other professions (d=0.975) and a reciprocal feeling of "being dependent on each other" (d=0.845). In the interviews, it was seen that medical students developed a greater appreciation for the subject matter and tasks associated with nursing. A strengthening of self-perception was primarily found in the trainees. Conclusion: The elective course on "Interprofessional Palliative Medicine" contributed to the changes in attitude not only with an increased self-awareness of one's own professional group, but also a greater understanding of the roles and expertise of the other health professions. The results speak for the benefit of expanding the interprofessional courses offered.

Need-based care of multi-morbid patients - supporting general practitioners with algorithm-generated recommendations of healthcare services (telemedicine-project ATMoSPHÄRE).

BACKGROUND: The patient-oriented and need-based care of multi-morbid patients with healthcare services and assistive products can be a highly complex task for the general practitioners (GPs). An algorithm-based digital recommendation system (DRS) for healthcare services was developed within the context of the telemedicine research project ATMoSPHÄRE. The plausibility of the DRS was tested and the results used to examine if, and to what degree, the DRS provides useful assistance to GPs. METHODS: The plausibility of the recommendations of the DRS were tested with the Delphi procedure (n = 8) and Interviews (n = 4) in collaboration with the GPs. They proposed services and assistive products they considered appropriate for two multi-morbid patients. Furthermore, GPs had to report whether, and to what degree they deemed the algorithm-generated recommendations appropriate. Significant quantitative differences between the GPs', and the algorithm-generated, recommendations were evaluated with paired-samples-Wilcoxon-test. RESULTS: The first Delphi round revealed a high variability regarding the amount and character of services recommended by the physicians (1 to 10 recommendations, mean = 5.6, sd = 2.8). These professional recommendations converged after consideration of the algorithm-generated recommendations. The number of algorithm-generated recommendations which were judged as appropriate ranged between 7 and 17 of a total of 20 (mean = 11.9, sd = 2.5). The interviews revealed that the additional algorithm-generated recommendations which were judged appropriate contained mainly social care services. CONLUSION: The DRS provides GPs with additional appropriate recommendations for the need-based care of patients, which may not have been previously considered. It can therefore be assessed as a helpful complement in the primary care of multi-morbid patients.

[Environmental Justice: Subjective Heat Exposure as a Result of Climate Change in Contrasting Urban Neighborhoods]. / Umweltgerechtigkeit: Subjektive Hitzebelastung als Folge des Klimawandels in konträren Stadtquartieren.

BACKGROUND: The City of Dresden has no data on the perception of climate change and the associated increase in the average temperature during summer times yet. The data are needed to develop targeted action for vulnerable groups. METHOD: To close this gap, a representative survey of the population was carried out in Dresden in 2017. Two urban districts, which differ from one another both in terms of urban planning and social structure, were compared, in particular, regarding the question of whether there was a fair distribution or procedural justice concerning the effects of subjective heat burden and influencing factors. RESULTS: The results showed that especially inhabitants of the urban area with predominantly prefabricated buildings, less green space and an increased proportion of socially disadvantaged felt more exposed to the summer heat and had fewer opportunities to adapt to the high temperature. CONCLUSION: In addition to urban development measures, the results can be used to derive measures for the prevention of heat-related illnesses. These require, for example, increased advice and health education locally to reach people.