Publications by authors named "Maresa Buchholz"

5 Publications

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Translation and adaptation of the German version of the Veterans Rand-36/12 Item Health Survey.

Health Qual Life Outcomes 2021 May 4;19(1):137. Epub 2021 May 4.

University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.

Background: The translated and culturally adapted German version of the Veterans Rand 36 Items Health Survey (VR-36), and its short form, the VR-12 counterpart, were validated in a German sample of orthopedic (n = 399) and psychosomatic (n = 292) inpatient rehabilitation patients.

Methods: The instruments were analyzed regarding their acceptance, distributional properties, validity, responsiveness and ability to discriminate between groups by age, sex and clinically specific groups. Eligible study participants completed the VR-36 (n = 169) and the VR-12 (n = 177). They also completed validated patient-reported outcome measures (PROs) including the Euroqol-5 Dimensions 5 Level (EQ-5D-5L); Depression, Anxiety and Stress Scale (DASS); Hannover Functional Abilities Questionnaire (HFAQ); and CDC Healthy Days. The VR-12 and the VR-36 were compared to the reference instruments MOS Short Form-12 Items Health Survey (SF-12) version 1.0 and MOS Short Form-36 Items Health Survey (SF-36) version 1.0, using percent of completed items, distributional properties, correlation patterns, distribution measures of known groups validity, and effect size measures.

Results: Item non-response varied between 1.8%/1.1% (SF/RE) and 6.5%/8.6% (GH/GH). PCS was normally distributed (Kolmogorov-Smirnov tests: p > 0.05) with means, standard deviations and ranges very similar between SF-36 (37.5 ± 11.7 [13.8-66.1]) and VR-36 (38.5 ± 10.1 [11.7-67.8]), SF-12 (36.9 ± 10.9 [15.5-61.6]) and VR-12 (36.2 ± 11.5 [12.7-59.3]). MCS was not normally distributed with slightly differing means and ranges between the instruments (MCS: 36.2 ± 14.2 [12.9-66.6], MCS: 39.0 ± 15.6 [2.0-73.2], MCS: 37.2 ± 13.8 [8.4-70.2], MCS: 39.0 ± 12.3 [17.6-65.4]). Construct validity was established by comparing correlation patterns of the MCS and PCS with measures of physical and mental health. For both PCS and MCS there were moderate (≥ 0.3) to high (≥ 0.5) correlations with convergent (PCS: 0.55-0.76, MCS: 0.60-0.78) and small correlations (< 0.1) with divergent (PCS: < 0.12, MCS: < 0.16) self-report measures. Known-groups validity was demonstrated for both VR-12 and VR-36 (MCS and PCS) via comparisons of distribution parameters with significant higher mean PCS and MCS scores in both VR instruments found in younger patients with fewer sick days in the last year and a shorter duration of rehabilitation.

Conclusions: The psychometric analysis confirmed that the German VR is a valid and reliable instrument for use in orthopedic and psychosomatic rehabilitation. Yet further research is needed to evaluate its usefulness in other populations.
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http://dx.doi.org/10.1186/s12955-021-01722-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097879PMC
May 2021

Attitudes towards advanced nursing roles in primary dementia care - Results of an observational study in Germany.

J Adv Nurs 2021 Apr 10;77(4):1800-1812. Epub 2020 Dec 10.

German Center for Neurodegenerative Diseases (DZNE) e.V. Site Rostock/Greifswald, Translational Health Care Research, Greifswald, Germany.

Aims: To demonstrate the attitudes of general practitioners (GPs), nurses, persons with dementia, and caregiver towards suitable tasks and qualification needs for and the acceptance and impact of advanced nursing roles in German dementia primary care.

Design: Observational study using a questionnaire survey with 225 GPs, 232 nurses, 211 persons with dementia, and 197 caregivers, conducted between December 2017-August 2018.

Methods: A questionnaire was generated that includes specific assessment, prescription, and monitoring tasks of advanced nursing roles in dementia primary care as well as qualification requirements for and the acceptance and the impact of advanced nursing roles. Data were analysed using descriptive statistics. Group differences were assessed using the Fisher's exact test.

Results: Advanced nursing roles were highly appreciated across all groups. Assessment and monitoring tasks were rated as highly suitable, and prescription authorities as moderately suitable. Nurses felt less confident in assessment and monitoring, but more confident in prescribing as practitioners expected. Patients and caregivers would appreciate a takeover of tasks by nurses; nurses and practitioners preferred a delegation. A dementia-specific qualification was rated as best suitable for advanced nursing roles, followed by 'no specific qualification' if medical tasks that only can be carried out by practitioners were delegated and an academic degree if tasks were substituted. Advanced nursing roles were rated as beneficial, strengthening the confidence in nursing care and improving the cooperation between professionals and the treatment. Practitioners assumed that advanced nursing roles would improve job satisfaction of nurses, which was not confirmed by nurses.

Conclusion: There is an extended consensus towards the enlargement of advanced nursing roles, represented by high endorsement, acceptance, and willingness to reorganize tasks.

Impact: Results debunk the common notion that German practitioners would be reluctant towards advanced nursing roles and a takeover of current practitioner tasks, supporting the implementation of advanced nursing roles in Germany.
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http://dx.doi.org/10.1111/jan.14705DOI Listing
April 2021

Adequacy of care provision in long-term home nursing arrangements: A triangulation of three perspectives.

Nurs Open 2020 09 2;7(5):1634-1642. Epub 2020 Jul 2.

Department Methods Institute for Community Medicine University Medicine Greifswald Greifswald Germany.

Background: A growing proportion of older people in Germany receive long-term care from informal and professional caregivers at home. Their personal assessment of the individual care situation is scarcely considered.

Aim: This study aimed to explore the subjective views of care recipients, informal and professional caregivers on the adequacy of care provision in long-term home care arrangements.

Design And Methods: Qualitative semi-structured face-to-face interviews were conducted with ten care recipients, ten professional caregivers and eight informal caregivers to capture their perspectives on the adequacy of the care received and delivered. Qualitative content analysis was applied using MAXQDA software.

Results: All groups highlighted that they perceive an of care, even though their explanations differed. The underprovision was mainly described regarding the quality rather than quantity of services. It occurs especially in interpersonal relationships and social inclusion, where the gap between the self-perceived current situation and the desires of those affected is most prominent. The ambivalent impact of home care on social participation becomes apparent. Perceptions of an of care range from the view that it appears mainly with respect to informal care to the statement that it is currently non-existent or generally impossible. of care is experienced as serious whenever the interviewees face the challenge of preserving existing abilities or regaining certain skills.
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http://dx.doi.org/10.1002/nop2.548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424429PMC
September 2020

Concepts of health in long-term home care: An empirical-ethical exploration.

Nurs Ethics 2020 Aug 30;27(5):1187-1200. Epub 2019 Aug 30.

University Medicine Greifswald, Germany.

Background: Concepts of health have been widely discussed in the philosophy and ethics of medicine. Parallel to these theoretical debates, numerous empirical research projects have focused on subjective concepts of health and shown their significance for individuals and society at various levels. Only a few studies have so far investigated the concepts of health of non-professionals and professionals involved in long-term home care and discussed these empirical perspectives regarding moral responsibilities.

Objectives: To identify the subjective concepts of the health of non-professionals (care recipients, informal caregivers) and professionals (registered nurses) involved in long-term home care and to discuss them against the background of existing normative guidelines addressing non-professionals and professionals' responsibilities and rights concerning health.

Research Design: A qualitative design was chosen to explore subjective concepts of health. Data were collected by semi-structured interviews; content analysis was applied according to Mayring.

Participants And Research Context: Twenty-eight interviews were conducted with non-professionals and professionals in long-term home care arrangements in Northern Germany.

Ethical Considerations: Ethics approval was obtained from the Institutional Review Board at the University Medicine Greifswald (BB123/16).

Findings: Non-professionals and professionals consider health as a capability that enables them to participate in social activities and live their own lives according to their preferences. The former regard health particularly as a feeling and an attitude, the latter as the absence of disease with a focus on mental and emotional well-being. Both groups highlight the unsurpassable value of health and the personal responsibility for it.

Discussion: Normative guidelines applicable to practice in long-term home care discuss responsibilities and rights unevenly and raise several problems regarding non-professionals and professionals' subjective concepts of health.

Conclusion: Individuals' concepts of health are relevant for the subsequent interpretation of rights and responsibilities and should, thus, be reflected upon to address health-related needs effectively.
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http://dx.doi.org/10.1177/0969733019868277DOI Listing
August 2020

Relationships and burden: An empirical-ethical investigation of lived experience in home nursing arrangements.

Bioethics 2019 05 8;33(4):448-456. Epub 2019 Apr 8.

Institute of Ethics and History of Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany.

Quantitative research has called attention to the burden associated with informal caregiving in home nursing arrangements. Less emphasis has been placed, however, on care recipients' subjective feelings of being a burden and on caregivers' willingness to carry the burden in home care. This article uses empirical material from semi-structured interviews conducted with older people affected by multiple chronic conditions and in need of long-term home care, and with informal and professional caregivers, as two groups of relevant others. The high burden of home-care arrangements is unanimously stressed by all three groups involved in the triangle of care. An empirical-ethical investigation of what can be legitimately expected from family members and informal caregivers, informed by Frith's symbiotic empirical ethics approach, was undertaken. Key tenets from the special goods theory and nursing professionalism are used as analytical tools. The study concludes that the current situation may hinder professional development and can reinforce feelings of being a burden to relevant others.
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http://dx.doi.org/10.1111/bioe.12586DOI Listing
May 2019