Digital Health for Migrants, Ethnic and Cultural Minorities and the Role of Participatory Development: A Scoping Review.

Digital health interventions (DHIs) are increasingly used to address the health of migrants and ethnic minorities, some of whom have reduced access to health services and worse health outcomes than majority populations. This study aims to give an overview of digital health interventions developed for ethnic or cultural minority and migrant populations, the health problems they address, their effectiveness at the individual level and the degree of participation of target populations during development. We used the methodological approach of the scoping review outlined by Tricco. We found a total of 2248 studies, of which 57 were included, mostly using mobile health technologies, followed by websites, informational videos, text messages and telehealth. Most interventions focused on illness self-management, mental health and wellbeing, followed by pregnancy and overall lifestyle habits. About half did not involve the target population in development and only a minority involved them consistently. The studies we found indicate that the increased involvement of the target population in the development of digital health tools leads to a greater acceptance of their use.

Intercultural communication in long-term care: The perspective of relatives from Switzerland.

INTRODUCTION: Due to globalization and the resulting diversity intercultural communication is increasingly coming to the fore. In addition, long-term care is mainly staffed with caregivers who have a migration background, which makes successful intercultural communication all the more important. Therefore, the aim of the present study was to define recommendations by interviewing relatives which can be used to promote intercultural communication in long-term care with regard to relationship building. METHOD: A qualitative explorative content analysis, which follows the content-structuring method with an inductive approach. The semi-structured guided individual interviews were conducted with relatives (n = 14) of residents from two retirement centers in Switzerland. RESULTS: Four categories were defined: "Perceive communication as a need", "Consider the desire for recognition of relatives", "Promote readiness of caregivers", and "Know opportunities and challenges in intercultural communication". CONCLUSION: Intercultural communication means being aware of the significance of culture and one's own origins in order to recognize the peculiarities of the counterpart and to interact sensitively with them. Relatives want to be actively involved when nurses reach their limits in communication and interaction. Relatives want safe care that is based on empathy. When nurses show concern towards others in a person-centered way and are aware of where they come from, this can promote trust and contribute significantly to supporting communication and interaction between cultures.

A qualitative study of the sources of chronic obstructive pulmonary disease-related emotional distress.

OBJECTIVE: The aim of this study is to identify the sources of illness-related emotional distress from the perspective of individuals living with mild to severe chronic obstructive pulmonary disease (COPD). METHODS: A qualitative study design with purposive sampling was applied at a Swiss University Hospital. Eleven interviews were conducted with individuals who suffered from COPD. To analyze data, framework analysis was used, guided by the recently presented model of illness-related emotional distress. RESULTS: Six main sources for COPD-related emotional distress were identified: physical symptoms, treatment, restricted mobility, restricted social participation, unpredictability of disease course and COPD as stigmatizing disease. Additionally, life events, multimorbidity and living situation were found to be sources of non-COPD-related distress. Negative emotions ranged from anger, sadness, and frustration to desperation giving rise to the desire to die. Although most patients experience emotional distress regardless of the severity of COPD, the sources of distress appear to have an individual manifestation. DISCUSSION: There is a need for a careful assessment of emotional distress among patients with COPD at all stages of the disease to provide patient-tailored interventions.

Resources and resilience factors: How advanced practice nurses can promote resilience in hearing and visually impaired people - A grounded theory perspective from Switzerland.

BACKGROUND: There is an increase in hearing and visual impairments worldwide. Those affected have a reduced ability to participate in social contacts, mobility, and access to information. Until now, there have been no recommendations for Advanced Practice Nurses (APNs) in Switzerland to support this group of people in the autonomous organization of everyday life in their own homes. OBJECTIVE: The aim of the study was to understand how people integrate their dual hearing and visual impairments into everyday life to derive recommendations for APNs to support individuals to manage their daily lives. METHODS: Following the constructivist approach of grounded theory, guided interviews and a questionnaire survey with hearing and visually impaired persons (n = 46) over 70 years of age on independent daily living were conducted (concurrent embedded strategy). In addition, demographic data on age, gender, living situation, and use of assistive devices were analyzed. FINDINGS: Based on the results, a communication-based dynamic resilience model (CoRes) was developed. This article represents the third phase of the three-stage-model. Integration of altered hearing depends on resources and risk factors. CONCLUSIONS: Advanced practice nurses can use recommendations from this research to actively help individuals and their families build resilience.

Ableism, Human Rights, and the COVID-19 Pandemic: Healthcare-Related Barriers Experienced by Deaf People in Aotearoa New Zealand.

The COVID-19 pandemic significantly affected global healthcare access and exacerbated pre-pandemic structural barriers. Literature on disabled people's experiences accessing healthcare is limited, with even less framing healthcare access as a human rights issue. This study documents and critically analyses Deaf people's healthcare access experiences in Aotearoa New Zealand during the COVID-19 pandemic. Eleven self-identified Deaf individuals participated in semi-structured videoconferencing interviews. Discourse analysis was applied to participant narratives with discourses juxtaposed against a human rights analysis. Barriers influencing healthcare access included: (1) the inability of healthcare providers to communicate appropriately, including a rigid adherence to face mask use; (2) cultural insensitivity and limited awareness of Deaf people's unique needs; and (3) the impact of ableist assumptions and healthcare delaying care. Barriers to healthcare access represent consecutive breaches of rights guaranteed under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Such breaches delay appropriate healthcare access and risk creating future compounding effects. Action is required to address identified breaches: (1) The CRPD should also underpin all health policy and practice development, inclusive of pandemic and disaster management responsiveness. (2) Health professionals and support staff should be trained, and demonstrate competency, in Deaf cultural awareness and sensitivity.

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study.

WHAT IS KNOWN ON THE SUBJECT?: Treatment and mental health care in familiar environments are beneficial for older people experiencing mental health issues. But there are not enough qualified and specialized nurses who can meet the complex needs of nursing home residents experiencing mental health issues. The University Hospital of Psychiatry Zurich, Switzerland, established an outreach interprofessional mental health service to foster the care for residents experiencing mental health issues in nursing homes. Based on existing studies, little can be said about whether nurses in nursing homes find these types of services helpful. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Nurses in nursing homes caring for residents experiencing mental health issues felt relieved by having inclusive support from the interprofessional mental health service. Nurses appreciated the mental health team and felt accompanied and more confident in their daily work. Results showed that nurses wanted to be included in the care and treatment processes and to work as partners on an equal footing with the mental health team. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Outreach interprofessional mental health services for nursing homes should take into account nurses' views and professional experience, and value and respect their role as nurses. Outreach interprofessional mental health services for nursing homes should offer further training in psychiatric nursing, include an accessible contact person in the team, and develop clear processes and responsibilities. ABSTRACT: INTRODUCTION: Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide. AIM: To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration. METHOD: Qualitative descriptive analysis based on 13 semi-structured interviews. Framework analysis and complex adaptive systems theory were applied. RESULTS: One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership-based collaboration. DISCUSSION: Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations. IMPLICATIONS FOR PRACTICE: To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.

["It's like being inside a capsule": How people aged 70 and over recognize and reflect on hearing and visual impairment - partial results from the KoRes stage model]. / "Es ist, wie in einer Kapsel zu sein." Wie Personen über 70 Jahren eine Hör- und Sehbeeinträchtigung erkennen und reflektieren - Teilergebnisse aus dem Stufenmodell KoRes.

INTRODUCTION: Combined hearing and vision impairment, which can negatively affect the performance of activities of daily living, is particularly prevalent in those over 70 years of age. Existing studies show that this dual sensory impairment has implications for safety in the home environment. Insights into how individuals integrate hearing and vision changes into their daily lives are needed for planning care-related interventions. METHODS: A qualitative method was used supplemented with quantitative methods ("Concurrent Embedded Strategy"). Based on the grounded theory approach, we conducted guided interviews with hearing- and vision-impaired individuals aged 70 years and over (n=46) as well as a questionnaire survey on how they cope with their daily lives. RESULTS: As part of their processing, individuals with hearing and visual impairments go through three stages that are closely linked to "being able to communicate." A partial result of the KoRes model is presented. This article focuses on the first two stages of this model: "diagnosis" and "reflection". CONCLUSION: People with dual sensory impairment behave reactively on the first two of a total of three stages with regard to the processing of their impairments. They need a supportive environment to be able to clarify these changes in hearing and vision and come to grips with the underlying causes.

Exploring Health-Related Needs of Elderly People (70+) at Home: A Qualitative Study From Switzerland.

BACKGROUND: The elderly represents the fastest growing group in our population. Since there is a close relationship between the number of older people and health care expenditure, promoting healthy aging has become an important topic. However, it is essential to understand first the needs of this population in order to create suitable programs and activities. METHODS: A qualitative design was used in this study to explore the subjective views of elderly people and to learn more about their health-related needs. A total of 12 participants were recruited using a consecutive sampling strategy. The data were collected through semi-structured interviews and analyzed by employing a summarizing content analysis. RESULTS: This study has identified 4 areas of health-related needs: Independence and autonomy, social security, structure in daily life and community and belonging, where all categories are interrelated and interact with one other. CONCLUSION: Focusing more on community-based approaches would support creating a conducive environment. Also, home visits undertaken by a specialized nurse focused on health risks and disabilities could be an adequate approach to support the elderly population in an efficient way and to offer targeted programs and activities.

Patient Satisfaction With the Quality of Counseling Provided by Advanced Practice Nurses Specialized in Multiple Sclerosis: A Quantitative Analysis.

ABSTRACT: BACKGROUND: The challenges in dealing with multiple sclerosis (MS) have increased considerably in recent years. In addition to neurologists, MS nurse specialists are key to the management of MS patients, but there is a lack of evidence regarding their quality of counseling. METHODS: The data collection took place between October 2018 and March 2019 in the outpatient clinic of a university hospital. The quality of counseling was assessed using the APN-BQ, an instrument that contains 19 items that can be assigned to 4 dimensions. Participants were asked to rate their satisfaction on a scale from 0 to 3. General satisfaction was assessed on a scale from 0 to 100. RESULTS: The participants (n = 110) rated the quality of counseling and their general satisfaction high. The mean (SD) of the structure quality dimension was 2.64 (0.44), and satisfaction with length and frequency of consultations (2.53 [0.63]) scored better than outcome quality (1.99 [0.62]) and process quality (2.13 [0.60]). CONCLUSION: Overall, there was a high rate of satisfaction with the quality of counseling. In addition to the length and frequency of consultations, MS patients particularly appreciated the availability and expertise of MS nurse specialists.

[Preparedness to provide care in relation to the satisfaction with hospital discharge planning and level of knowledge of relatives to elderly patients]. / Die Zufriedenheit mit der Austrittsplanung und die Informiertheit von Angehörigen beeinflussen die Bereitschaft, Pflege zu übernehmen.

Preparedness to provide care in relation to the satisfaction with hospital discharge planning and level of knowledge of relatives to elderly patients Abstract. BACKGROUND: Relatives are a great resource for older people who are discharged after hospitalization. Studies have so far shown very little about the readiness of relatives to aid in caregiving. AIM: The study examined if relatives showed a relationship between readiness to provide care and satisfaction with hospital discharge management as well as group differences between well-informed and less informed relatives. METHOD: In addition to demographic data, the preparedness to provide care, satisfaction and extent of knowledge of relatives were surveyed using a retrospective cross-sectional study. Analyses were made of the relationship between preparedness to provide care and satisfaction with hospital discharge management, as well as group differences between informed and less informed relatives in terms of their preparedness to provide care. RESULTS: Of the 111 relatives, the majority were adult offspring (55.9 %) and partners (32.4 %) that participated in the study. A weak correlation was detected between the satisfaction with the hospital discharge planning of relatives and their willingness to provide care (rs = -0.113, p = 0.267). The group differences between well-informed and less informed relatives were significant (t(102) = 2.301, p = 0.023). CONCLUSION: Relatives that evaluated themselves as well informed are more likely to be in the position to provide informal care. Therefore, it is necessary to involve relatives more in the planning of hospital discharges and to inform them better. Experimental studies are necessary to find out if the preparedness to provide care can be increased through good discharge planning and specific information provision.

In hospital with a hearing impaired child - How parents experience communication between nurses and their child / Das Kind mit einer Hörbeeinträchtigung im Spital - Wie Eltern die Kommunikation zwischen Pflegenden und ihrem Kind erleben.

Background: In daily communication, children with hearing impairment are restricted and dependent on their parents' help. In case of a hospitalisation, the risk of insufficient information and resulting traumatisation for those children is high. The aim of this study is the investigation of the communicative needs of the children concerned in order to avoid negative consequences of a hospitalisation and of inappropriate communication by nursing staff. Aim: This study explores how parents of a child with hearing impairment experience the communication between the nursing staff and their hospitalised child. Method: The study was conducted together with an advisory centre for hearing-impaired children, where most of the parents could be recruited. Narrative, semi-structured interviews were conducted. The transcribed interviews were analysed according to the method of interpretative phenomenology. Results: The parents expressed their wish for affectionate verbal and nonverbal love and care for their child. They often experienced the nursing staff having little time, that there was no continuity and that the communicative needs of the child were not recognised. Since the parents did not think the nursing staff were capable of communicating with the child and because they wanted to protect him or her, they adopted a mediating role. Conclusions: Besides the sensitisation of the nursing staff, time resources, continuity, professional knowledge and benevolence in the nursing care of a child with hearing impairment play a fundamental role.

Being an informal caregiver for a relative with liver cirrhosis and overt hepatic encephalopathy: a phenomenological study.

AIMS AND OBJECTIVES: To explore the experiences of being an informal caregiver for a relative with liver cirrhosis and overt hepatic encephalopathy. BACKGROUND: Overt hepatic encephalopathy is a common complication in patients with liver cirrhosis. It is associated with decreased quality of life for patients, and presents a major burden for caregivers. The involvement of informal caregivers in medical care is recommended, but it has not been clearly described. An understanding of the experience of caregivers is needed to improve the support provided to them by healthcare professionals. DESIGN: A qualitative, interpretative, phenomenological approach was used. METHODS: Twelve informal caregivers participated in qualitative interviews. The analysis followed the six steps of the interpretative phenomenological approach. RESULTS: Caregivers' experiences were described using five themes: (1) feeling overwhelmed by their loved one having unexplainable symptoms and behaviours; (2) learning that this and previous experiences were complications of liver disease; (3) becoming aware of the symptoms of hepatic encephalopathy; (4) having feelings of being tied down and (5) experiencing and overcoming obstacles in working with healthcare professionals. CONCLUSIONS: This study provides insight into caregivers' experiences and the consequences for their lives. The first occurrence of symptoms was a shock, but receiving the diagnosis was seen as an important step in understanding and learning. Caregivers provide daily assessments of their relatives' conditions, and they feel responsible for medication management. Over time, the caregivers impressively showed how they were able to incorporate their personal experiences into caregiving and to accept more accountability in managing the disease. RELEVANCE TO CLINICAL PRACTICE: Nurses should acknowledge caregivers as experts in caring for their loved ones. Nurses can assist caregivers in managing an episode of hepatic encephalopathy and can provide individualised interventions to ease the future burden.

[Being cared for and caring: living with multiple chronic diseases (Leila)-a qualitative study about APN contributions to integrated care]. / Umsorgt werden und umsorgen: Leben mit mehreren Langzeiterkrankungen (Leila) - Eine qualitative Studie zum Beitrag von APN in integrierter Versorgung.

BACKGROUND: Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called "Living with chronic disease" (Leila) was initiated. AIM: The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development? METHODS: A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians. RESULTS: The findings revealed "Being cared for and caring" as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category "organizing everyday life" describes how patients learned to cope with the consequences of living with multiple chronic diseases. "Using all resources" as another category demonstrates how capabilities and strengths were adopted. CONCLUSIONS: The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing.

["My reward is being able to serve". Housemother's retrospective memories of the loss of power in their position in houses "for the sick and needy" between 1945 and 1995]. / «Mein Lohn ist, dass ich darf¼.Wie Hausmütter den Machtverlust ihrer Position in Häusern für «Kranke und Pflegebedürftige¼ zwischen 1945 und 1995 im Rückblick erinnerten.

Institutional families were widespread in the 20th century. As there is very little empirical material on the function of the housemother, a qualitative study was launched to explore members' memories of the function of the housemother between 1945 and 1995 and how communal life in the institutional families of the period was possible. The study was methodologically oriented towards oral history techniques and the principles of Grounded Theory as well as towards sequential line by line analysis. For the purposes of this article, the interviews with nine housemothers were selected from the interviews conducted for the wider study (n=42). The central question concerned how housemothers experienced professional developments in retrospect and the influence these had on the function of the housemother. The interviews resulted in the definition of three phases which the housemothers passed through during their role as housemother. This article describes the third phase: "Leaving the function of the housemother - lost and frustrated power and dominance". Housemothers were not only housekeepers but also carers. Together with the husbands, they represented the heads of their institutional families. Housemothers found living in one house with the other members of the "family" a burden, but at the same time they benefitted from the great freedom they had. This aspect is described using the core categories of power and dominance.

[How do users experience the handling of the Observed Emotional Rating Scale?]. / Wie erleben Erfasserinnen den Umgang mit der Observed Emotional Rating Scale?

As barely any empirical data on the application of the Observed Emotion Rating Scale (OERS) on sufferers of dementia is available for German-speaking Europe, the pilot project titled "Agitation" aimed to see how those persons entering the data get along with the OERS instrument. For this purpose, 12 test persons were persuaded to carry out observations with the OERS instrument in three care centres located in the Swiss Canton of Zurich. The test persons were predominantly holders of nursing qualifications and/or experienced in caring for patients suffering from dementia. Data collection was undertaken on the basis of three focus group interviews which were evaluated via qualitative content analysis. The preliminary results gained in the focus group interviews were validated by the same people using a questionnaire. The categories were titled "Missing Clearness", "Missing Possibility to Encode", "Level of Dementia", "Estimation of Emotions", "Influencing Factors" and "User Training". These indicated that know-ledge of dementia is just as important as skilled use of OERS.