Publications by authors named "Friederike Thilo"

15 Publications

  • Page 1 of 1

Facilitating the use of personal safety alerting device with older adults: The views, experiences and roles of relatives and health care professionals.

Geriatr Nurs 2021 Jul-Aug;42(4):935-942. Epub 2021 Jun 12.

School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; School CAPHRI, Department of Family Medicine, Maastricht University, Maastricht, The Netherlands. Electronic address:

To explore relatives', community nurses' and general practitioners' perspectives and experiences in promoting Personal Safety Alerting Device (PSAD) use among community-dwelling older adults, we applied a qualitative study design. Altogether 15 focus groups and 11 semi-structured interviews were conducted. Data-analysis followed the Qualitative Analysis Guide of Leuven. PSAD use was considered to be complex. Relatives and health care professionals are involved in a negotiation process comprising three phases: A) waiting for a critical event in the older adult's everyday life; B) introducing the idea of a PSAD; C) deciding on and supporting PSAD use. In conclusion, the actors involved in PSAD use should be aware of the negotiation process, which is complex, dynamic, iterative and needs time. While nurses play a crucial role, they lack sufficient knowledge for comprehensive PSAD counselling. The negotiation process could serve as an example for other technologies in the context of aging in place.
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http://dx.doi.org/10.1016/j.gerinurse.2021.05.005DOI Listing
June 2021

Deciding about the use of a Personal Safety Alerting Device-The need for a legitimation process: A qualitative study.

J Adv Nurs 2021 Jan 13;77(1):331-342. Epub 2020 Oct 13.

Applied Research & Development in Nursing, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.

Aims: To explore reasons, thoughts, motives, and influencing factors regarding the use or non-use of Personal Safety Alerting Devices (PSADs) in the daily lives of community-dwelling older persons.

Design: A qualitative descriptive study design was used.

Methods: Six focus groups were conducted with a total of 32 older persons between February-August 2016. Data analysis followed the Qualitative Analysis Guide of Leuven.

Results: The participants described the use or non-use of PSADs as a decision resulting from a "legitimation process". This process implies that a person needs to perceive the necessity for a PSAD and then determine the right moment at which to start using it. During this process, each person weighs her or his "ageing self" and "perception of technology" then decides whether to start using a device or to delay its use. "Critical events" initiate this process, compelling the person to consider their own safety and their possible need for assistance.

Conclusion: The legitimation process suggests that the initiation of PSAD use represents a turning point in life. Using a PSAD is not simply a matter of obtaining one. It is a complex decision-making process establishing legitimation for its use, which is interwoven with one's individual ageing, self-perception, and the meaning attributed to the device.

Impact: Older persons need to be supported; in particular, they require time to go through the legitimation process for PSAD use. Nurses can empower them in this process, such that they perceive using a PSAD as a means to restore their frailty balance and feel enabled to (re)gain control over their own life and thus to preserve their independence.
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http://dx.doi.org/10.1111/jan.14566DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756415PMC
January 2021

[Digital transformation in residential old age institutions].

Z Gerontol Geriatr 2020 Oct 1. Epub 2020 Oct 1.

Angewandte Forschung und Entwicklung Pflege, Departement Gesundheit, Berner Fachhochschule, Bern, Schweiz.

Background: Residential old age institutions are currently undergoing a digital transformation process, which is characterized by an orientation towards increasing digitalization of work processes as well as the institutional infrastructure. But what does the variety of technical solutions used in these old-age institutions look like and how is the digital transformation process assessed by the managers of these institutions?

Material And Methods: The survey was carried out as a standardized online survey of residential old age homes throughout Switzerland. The respective managers were interviewed. The sample was made up of 466 institutions.

Results: Established technologies, such as television, contact and fall mats as well as software solutions in the administrative area are used almost everywhere, while robots for activating the clientele, gaming consoles or telemedical technologies are rarely used. Among those interviewed there were more people who saw advantages rather than disadvantages in the use of technical tools. The greatest obstacles that were perceived when introducing a new technology were the associated costs, a lack of employee skills and a nonexistent infrastructure. Multivariate analysis showed that the degree of digitalization in a facility depends not only on its size but above all on the technological affinity and rating of the senior staff.

Conclusion: The degree of technology in old age institutions varies but overall it is rather sobering regarding the use of completely new technologies, such as robotics or telemedicine. Barriers to the increasing digital transformation were worked out from the survey and are discussed.
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http://dx.doi.org/10.1007/s00391-020-01789-0DOI Listing
October 2020

Team efficacy and leadership in managing aggressive situations in the general hospital setting: A qualitative descriptive analysis of focus groups with ward managers.

J Clin Nurs 2020 Mar 13;29(5-6):974-986. Epub 2020 Jan 13.

Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.

Aims And Objectives: To explore the perception and issues regarding the ability of nursing teams to manage patient and visitor aggression in clinical practice, from ward managers' perspectives.

Background: Patient and visitor aggression causes substantial human suffering and financial damage in healthcare organisations. Nurse managers are key persons for developing their teams' efficacy in dealing with patient and visitor aggression. However, their perception of patient and visitor aggression in clinical practice has rarely been explored, and issues relating to team management in this context are underinvestigated.

Design: A secondary, qualitative thematic analysis of focus group interviews.

Methods: Five focus groups consisting of a total of 30 ward and deputy ward managers from five Swiss hospitals were interviewed with audio recording between December 2015-January 2016. Since the recordings were rich in additional content exceeding the primary research question, a secondary analysis was conducted to answer the questions: (1) Which factors influence team efficacy in regard to patient and visitor aggression? (2) What are the implications for nurse leadership? The Consolidated Criteria for Reporting Qualitative Research was followed in the conduct and reporting of this study.

Results: Three themes emerged from our analysis: (a) contextual factors (organisational safety culture and collaboration), (b) influences from within the team (team culture, nursing aggression and general management principles) and (c) implications for nurse leadership.

Conclusions: Managing patient and visitor aggression is a challenge for nurse managers. A team's ability to prevent, de-escalate and debrief after PVA incidents is an important leadership task in which ward managers are neither supported in nor trained for within their organisations.

Relevance To Clinical Practice: Nurse managers in general hospitals require more support to enable their teams to cope effectively with patient and visitor aggression. Policy and guideline implementation need to be prioritised.
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http://dx.doi.org/10.1111/jocn.15169DOI Listing
March 2020

Professionalism in a digital and mobile world: A way forward for nursing.

J Adv Nurs 2020 Jan 21;76(1):4-6. Epub 2019 Oct 21.

School of Nursing and Data Science Institute, Columbia University, New York, NY, USA.

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http://dx.doi.org/10.1111/jan.14224DOI Listing
January 2020

Usability of a wearable fall detection prototype from the perspective of older people-A real field testing approach.

J Clin Nurs 2019 Jan 1;28(1-2):310-320. Epub 2018 Aug 1.

School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.

Aims And Objectives: Community-dwelling older people were involved in the testing of a fall detection device to improve its utilisation and acceptance in everyday life.

Background: The usability of alerting devices remains unsatisfactory, as they are scarcely utilised by older people, despite wide recognition of the importance of rapid assistance after a fall. Moreover, the time a person remains on the floor negatively impacts the severity of fall consequences. However, it is unclear how to increase alerting device utilisation in everyday life. Therefore, older people were involved in this research to consider their perspective during prototype development.

Design: A qualitative focus group study was conducted, following a real field testing approach, underpinned by the theoretical framework "Medical Device Technology Development Process."

Methods: Fifteen community-dwelling older people tested the prototype in daily living over a period of nine days. Different means of involvement were exploited such as "user seminars" or "discussion with users." On day 9, data were collected using focus groups and analysed with qualitative content analysis.

Results: The participants' perspectives yielded positive aspects of the prototype along with aspects requiring improvement. They indicated that technical requirements are essential. They also revealed that a minimal change in daily routines, support for physical activity and independent living and the inclusion of trusted contact persons could lead to wider use of the alerting device.

Conclusions: Involving users is crucial in gaining a deeper understanding of aspects influencing utilisation of an alerting device. The study revealed that usability is influenced both by technical requirements as well as habits and personal preferences. This finding is vital, as habits and personal preferences can only be identified through the involvement of target users.

Relevance To Clinical Practice: The study provides key insights for health practitioners interested in promoting the use of an alerting device in community-dwelling older people.
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http://dx.doi.org/10.1111/jocn.14599DOI Listing
January 2019

Using and choosing digital health technologies: a communications science perspective.

J Health Organ Manag 2017 Mar;31(1):28-37

Center for the Advancement of Healthcare Quality and Patient Safety (CAHQS), Faculty of Communication Sciences, Università della Svizzera italiana (USI) , Lugano, Switzerland.

Purpose The purpose of this paper is to explore a non-technical overview for leaders and researchers about how to use a communications perspective to better assess, design and use digital health technologies (DHTs) to improve healthcare performance and to encourage more research into implementation and use of these technologies. Design/methodology/approach Narrative overview, showing through examples the issues and benefits of introducing DHTs for healthcare performance and the insights that communications science brings to their design and use. Findings Communications research has revealed the many ways in which people communicate in non-verbal ways, and how this can be lost or degraded in digitally mediated forms. These losses are often not recognized, can increase risks to patients and reduce staff satisfaction. Yet digital technologies also contribute to improving healthcare performance and staff morale if skillfully designed and implemented. Research limitations/implications Researchers are provided with an introduction to the limitations of the research and to how communications science can contribute to a multidisciplinary research approach to evaluating and assisting the implementation of these technologies to improve healthcare performance. Practical implications Using this overview, managers are more able to ask questions about how the new DHTs will affect healthcare and take a stronger role in implementing these technologies to improve performance. Originality/value New insights into the use and understanding of DHTs from applying the new multidiscipline of communications science. A situated communications perspective helps to assess how a new technology can complement rather than degrade professional relationships and how safer implementation and use of these technologies can be devised.
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http://dx.doi.org/10.1108/JHOM-07-2016-0128DOI Listing
March 2017

Involvement of the end user: exploration of older people's needs and preferences for a wearable fall detection device - a qualitative descriptive study.

Patient Prefer Adherence 2017 20;11:11-22. Epub 2016 Dec 20.

Applied Research and Development in Nursing, Health Division, Bern University of Applied Sciences, Bern, Switzerland.

Purpose: To explore the needs and preferences of community-dwelling older people, by involving them in the device design and mock-up development stage of a fall detection device, consisting of a body-worn sensor linked to a smartphone application.

Patients And Methods: A total of 22 community-dwelling persons 75 years of age and older were involved in the development of a fall detection device. Three semistructured focus group interviews were conducted. The interview data were analyzed using qualitative descriptive analysis with deductive coding.

Results: The mock-up of a waterproof, body-worn, automatic and manual alerting device, which served both as a day-time wearable sensor and a night-time wearable sensor, was welcomed. Changes should be considered regarding shape, color and size along with alternate ways of integrating the sensor with items already in use in daily life, such as jewelry and personal watches. The reliability of the sensor is key for the participants. Issues important to the alerting process were discussed, for instance, who should be contacted and why. Several participants were concerned with the mandatory use of the smartphone and assumed that it would be difficult to use. They criticized the limited distance between the sensor and the smartphone for reliable fall detection, as it might restrict activity and negatively influence their degree of independence in daily life.

Conclusion: This study supports that involving end users in the design and mock-up development stage is welcomed by older people and allows their needs and preferences concerning the fall detection device to be explored. Based on these findings, the development of a "need-driven" prototype is possible. As participants are doubtful regarding smartphone usage, careful training and support of community-dwelling older people during real field testing will be crucial.
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http://dx.doi.org/10.2147/PPA.S119177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5189694PMC
December 2016

Involvement of older people in the development of fall detection systems: a scoping review.

BMC Geriatr 2016 Feb 11;16:42. Epub 2016 Feb 11.

School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.

Background: The involvement of users is recommended in the development of health related technologies, in order to address their needs and preferences and to improve the daily usage of these technologies. The objective of this literature review was to identify the nature and extent of research involving older people in the development of fall detection systems.

Methods: A scoping review according to the framework of Arksey and O'Malley was carried out. A key term search was employed in eight relevant databases. Included articles were summarized using a predetermined charting form and subsequently thematically analysed.

Results: A total of 53 articles was included. In 49 of the 53 articles, older people were involved in the design and/or testing stages, and in 4 of 53 articles, they were involved in the conceptual or market deployment stages. In 38 of the 53 articles, the main focus of the involvement of older people was technical aspects. In 15 of the 53 articles, the perspectives of the elderly related to the fall detection system under development were determined using focus groups, single interviews or questionnaires.

Conclusions: Until presently, involvement of older people in the development of fall detection systems has focused mainly on technical aspects. Little attention has been given to the specific needs and views of older people in the context of fall detection system development and usage.
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http://dx.doi.org/10.1186/s12877-016-0216-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750302PMC
February 2016

[Cooperation in practice, science and industry ].

Krankenpfl Soins Infirm 2015 ;108(9):13-5

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December 2015

[Learning research competence for general practice].

Krankenpfl Soins Infirm 2013 ;106(9):24-7

Institut für angewandte Pflegewissenschaft der Fachhochschule St. Gallen.

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November 2013
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