Gewalt und Gewaltprävention in der stationären Altenpflege während der COVID-19-Pandemie.

Violence and Violence Prevention in Nursing Homes during the COVID-19 Pandemic - A partial analysis of Interviews with Managers or Team Leaders Abstract. Background: During the first wave of the COVID-19 pandemic, strict infection control measures were in force in long-term residential care in Germany that burdened staff and isolated residents socially. Both are considered risk factors for violence in long-term residential care. Questions: How does violence develop in nursing homes under pandemic conditions from the point of view of managers and how do strategies for preventing violence change? Methods: Semi-structured telephone interviews were conducted with staff in 43 nursing homes: 25 with service managers, 15 with nurse managers, 28 with nursing team leaders and 10 with registered nurses with extended tasks. The interviews were recorded as audio, transcribed and analysed in five steps following the "Thematic Framework Analysis". Results: The infection control measures were partly perceived as deprivation of freedom. Residents, relatives and staff partly reacted most with verbal violence. Nevertheless, the issue of violence was not a major concern for management and preventive measures were not carried out. Conclusions: The results show that strategies to prevent violence might not be sufficiently established in the institutions involved and would have to be adapted to the conditions of the pandemic. Further research is needed to evaluate infection control measures in their potential to increase the incidence of violence.

[Physical activity and activities of daily living of nursing homes residents: A systematic review and meta-analysis]. / Körperliche Aktivität und Aktivitäten des täglichen Lebens bei Bewohnerinnen und Bewohnern in der stationären Pflege - eine systematische Übersicht und Metaanalyse.

BACKGROUND: Interventions to promote physical activity in nursing homes are among the priorities of German long-term care insurance funds. We summarized the evidence on the effectiveness of such interventions. METHODS: We conducted a systematic literature search in five electronic databases in November 2019, which was complemented by searching reference lists and trials registries. Eligible studies included individually (RCTs) or cluster randomized trials or non-randomized comparative studies that investigated the effectiveness of interventions to promote physical activity in nursing home residents and their impact on the ability to perform activities of daily living. Results were synthesized using random effects meta-analysis. RESULTS: Meta-analysis of 19 included studies with high risk of bias showed a small yet statistically significant effect on activities of daily living (SMD = 0.40, 95 % CI 0.08-0.72); heterogeneity was substantial (I2 = 77 %, p < 0.0001). Sensitivity analysis excluding two non-randomized comparative studies did not alter the results (SMD = 0.40, 95 % CI 0.03-0.76). The effect attenuated but was still statistically significant in a meta-analysis which excluded five studies that were largely responsible for the heterogeneity (SMD = 0.27, 95 % CI 0.12-0.43, I2=34 %, p = 0.10). Subgroup analyses did not demonstrate any statistically significant results in favour of physical activity. DISCUSSION: We found evidence for a beneficial effect on activities of daily living in favour of interventions that aim to promote physical activity. Due to the high overall risk of bias and substantial heterogeneity of the included studies the results should be interpreted with caution, though. CONCLUSION: Methodologically sound studies are needed to strengthen the evidence base on the topic.

[Violent behavior of staff towards nursing home residents: A systematic review of instruments to measure prevalence]. / Personale Gewalt in der stationären Altenpflege: Eine systematische Übersicht über Instrumente zur Erfassung der Prävalenz.

BACKGROUND: Reduction or prevention of violence is one of the fields of preventive interventions in nursing homes. To prove the effectiveness of appropriate interventions, valid instruments are crucial to measure violence. METHODS: Between November 2019 and May 2020, a systematic search for studies and instruments was conducted in relevant databases and reference directories assessing violent behaviour by employees towards residents, by residents towards employees and resident-to-resident abuse. RESULTS: 24 instruments were identified. 8 instruments capture staff-to-resident violence, 14 capture resident-to-staff violence, 3 resident-to-resident aggression, and 5 instruments are not exactly attributable to the constellation of violence. No instrument covers all three situations of violence. Four of the instruments used to capture violence by staff cover all forms of personal violence. Validity and reliability data are inadequate. DISCUSSION: At present, there is no tool that fully depicts violence in resident homes and is suitable for measuring the effectiveness of interventions. There are sufficient tools for the individual constellations of violence that represent all forms of violence. Not all instruments could be procured in their original form, and even available instruments did not always provide information on the development of the instruments and a possible review of their quality. CONCLUSION: There is a lack of an internationally comparable instrument representing elder abuse in the inpatient setting with sufficient validity and reliability.

[Health protection against heat extremes in Germany: What has been done in federal states and municipalities?] / Gesundheitsschutz bei Hitzeextremen in Deutschland: Was wird in Ländern und Kommunen bisher unternommen?

BACKGROUND: Heat extremes are one of the most perceptible health risks of climate change. In the field of prevention, Germany relies on recommendations for heat health action plans and on programs to support such measures. OBJECTIVES: To give an overview of measures and projects for the prevention of heat-related mortality and morbidity that have been established in Germany. MATERIALS AND METHODS: Activities and projects covering heat and human health since 2003 were identified by database and Internet search. Projects just indirectly related to human health were excluded. We recorded federal states and funding agencies, and which of the eight core elements of the Federal Ministry for the Environment recommendations for action are addressed by the measure. RESULTS: Of the 190 projects, 19 can be assigned the keyword "heat health action plan", although these are very heterogeneous activities. The individual measures partly covered several criteria of the recommendations for action: 70.0% concern urban planning and construction, 37.4% information and communication, 24.2% vulnerable groups, 17.9% reducing indoor heat, 15.3% the use of a heat warning system, 13.7% each for central coordination, interdisciplinary cooperation, and the preparation of health and social systems, and 5.3% refer to monitoring and evaluation of measures. DISCUSSION: The number of measures and projects in Germany is considerable. However, it remains unclear whether these actions meet the criteria for effective medium- and short-term protection.

[Forensic nursing in Germany? Nurses' perceptions of domestic violence]. / "Forensic Nursing" in Deutschland? Wahrnehmungen von Pflegekräften zu häuslicher Gewalt.

More than one of three women has been a victim of domestic violence at least once. Victims would like to have a well-informed contact person within the healthcare system who knows about support programs. In many countries that is the responsibility of the healthcare system and is called Forensic Nursing. Therefore, it is interesting to know how nurses in Germany perceive domestic violence and under what circumstances they could imagine taking on tasks in the fields of documentation and nursing. The data for this qualitative study was collected via four focus groups consisting of 38 nurses--3 men and 35 women--with work experience in a hospital. Nurses seem to have difficulties in recognising domestic violence. Whether the subject of domestic violence is addressed explicitly depends on the relationship built up between the patient and the nurses. Nurses do not necessarily take further steps. They could imagine providing help by listening actively, providing information about support programs and providing consulting services. Only occasionally nurses agree to document the case to be used as forensic evidence. Another open issue is appropriate remuneration. It is necessary to integrate that subject systematically into basic and advanced training on different levels of qualification.