Verbundprojekt im Forschungsverbund Autonomie im Alter
Selbstbestimmt und unterstützt leben im Quartier – Vernetzung, Implementierung und Evaluation von Demenzlotsen

Zeitraum

  • August 2019 – Dezember 2021

Leitung

  • Dr. Stephanie Heinrich
  • Prof. Dr. Gabriele Meyer

Mitarbeit:

  • Grünzig, Manuela
  • Klatt, Thomas
  • Geyer, Jennifer
  • Schiller, Christine

Förderung

  • Land Sachsen-Anhalt und EFRE

Zusammenfassung

Projektziel ist die Unterstützung und Begleitung von Menschen mit Demenz und ihrer Angehörigen, um ein selbstbestimmtes Leben im Quartier zu ermöglichen. Qualifizierte Demenzlotsen werden Menschen mit Demenz und ihre Angehörigen über die verschiedenen Krankheitsphasen hinweg im Sinne eines Case Managements begleiten und als eine kontinuierliche Kontaktperson Hilfestellungen geben. Beabsichtigt ist, die Bedürfnisse der Menschen mit Demenz zu erfassen, um Ressourcen verfügbar zu machen sowie eine qualitativ hochwertige Versorgung zu sichern. Ein Verbleib in der Häuslichkeit, die Optimierung der Pflegearrangements sowie eine Entlastung der pflegenden Angehörigen soll erreicht werden. Die Evaluation der aufsuchenden Hilfe wird auf der Prozess-, Ergebnis- und gesundheitsökonomischen Ebene durchgeführt.

Das Projektziel schließt im Weiteren den Aufbau und die Pflege einer möglichst barrierefreien und in verständlicher Sprache gestalteten Online-Plattform ein. Diese bietet Informationen zu regionalen Angeboten und Veranstaltungen, zu aktuellem Wissen für Menschen mit Demenz, Angehörigen, interessierten Bürgern sowie professionell Tätigen.

Short title

  • BE-UP

Period

  • October 2017 - December 2021

Project leader

Staff members

  • Dr. Sabine Striebich Med. Päd.
  • Ronja Ocker
  • Elke Mattern M.Sc.
  • Nadine Schmitt

Partners

  • Cooperation with the University for Health, Department for Applied Health Sciences, Bochum (Prof. Dr. Rainhild Schäfers, Elke Mattern M.Sc.).
  • 12 clinics with obstetrical departments in Saxony-Anhalt, Thüringen, Saxony, Berlin and North Rhine-Westphalia.  
  • The online randomization and data management for the BE-UP Study were conducted by the Coordination Center for Clinical Studies Halle/Saale (KKS Halle), a service facility of the Faculty of Medicine at the Martin Luther University Halle-Wittenberg (see www.kks-halle.de). 
  • Statistical analysis of the data was conducted by mediStatistica (Dr. Burkhard Haastert). 
  • The health-economy evaluation of the intervention was carried out by the Institute for Health Services Research and Health Economics at the Centre for Health and Society, Heinrich Heine University Düsseldorf (Prof. Dr. Dr. Andrea Icks)

Funding

  • Federal Ministry for Education and Research, Reg. No.: 01KG1715

Study registration

  • Registered in the German Register of Clinical Studies (Deutsche Register Klinischer Studien) under DRKS00012854 

Further details can be found under: https://be-up-studie.de/

Abstract

Background:

In Germany, the rate of caesarean sections connected with higher maternal and neonatal morbidity is above that recommended by the WHO. To date, there is no RCT with sufficient statistical power to examine the independent effect of the birth environment on the birth procedure. This clinical trial is conducted in accordance with the German national health goal “Health in childbirth”.      

Objective:

The RCT examines the effectiveness of an alternatively designed birthing room (intervention) on the primary outcome “vaginal birth” in 12 obstetric clinics in Saxony-Anhalt, Thüringen, Saxony, Berlin and North Rhine-Westphalia.  

Methodology: 

An actively controlled clinical trial with two parallel study arms to test the superiority of the intervention (alternatively designed birthing room: no central birthing bed, and various components that are not included in the normal (control) birthing room). The study participants (probands) are primiparous and multiparous women with a singleton pregnancy in the cephalic position at term who are planning a vaginal birth.  

The randomization is centrally controlled and conducted covertly. It is not possible to blind the participants or the staff members. Data review by external monitors, follow-up survey 3 months postpartum, and health economic evaluation are planned. 

The effect of the intervention will be shown in an increase in vaginal births from an absolute 5% (baseline rate: 72%) to 77% with a statistical power of 90%, a significance level of 5%, and allowing for a dropout rate of up to 10%.

Expected findings: 

Expected outcomes are: better client-oriented outcomes, greater self-determination during the birth, fewer medicinal interventions and fewer caesarean sections during future pregnancies as well as a reduction in intervention-related costs. If the intervention is effective and can be implemented nationwide, approx. 21,000 birthing mothers annually would be able to experience a vaginal birth.   

Allocation to the research area

Health care by midwives and family midwives.

Publications

Short title

  • BEVOR

Period

  • 1. Sept. 2019 - 28. Febr. 2023

 Consortium leader

  • Heinrich Heine University Düsseldorf, Institute for General Medicine
    Consortium leader: Prof. Dr. Jürgen in der Schmitten, Kornelia Götze

Consortium partners

  • Medical Faculty of the Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Sciences, Project leader: Prof. Dr. Gabriele Meyer
  • Medical Faculty of the Martin Luther University Halle-Wittenberg, Institute for History and Ethics in Medicine, Project leader: Prof. Dr. Jan Schildmann, MA
  • Medical University Göttingen (UMG), Institute for General Medicine, Project leader: Prof. Dr. Eva Hummers
  • Medical University Göttingen (UMG), Clinic for Palliative Medicine, Project leader: Prof. Dr. Friedemann Nauck
  • Clinic of the University Munich, Clinic for Palliative Medicine, Project leader: Prof. Dr. Dr. Berend Feddersen
  • LMU Munich, Institute for Ethics, History and Theory of Medicine, Project leader: Prof. Dr. Georg Marckmann, MPH
  • Heinrich Heine University Düsseldorf, Coordination Center for Clinical Studies (KKS), Project leader: Henrike Kolbe
  • Heinrich Heine University Düsseldorf, Institute for Health Care Research and Health Economics, Project leader: Prof. Dr. Dr. Andrea Icks MBA,
  • UKE Hamburg, Institute for Medicinal Biometry and Epidemiology, Project leader: Prof. Dr. Karl Wegscheider
  • BARMER Head Office Wuppertal, Project leader: Sonja Laag

Research assistants (study center in Halle (Saale) - IGPW)

Funding

  • Innovation Commission of the Federal Joint Committee, Berlin

Abstract

Background

To make self-determined decisions about medical treatment in the future is becoming increasingly important, particularly for elderly and chronically ill people. For situations in which people are no longer able to express their decisions and wishes themselves, it is possible to set up a patient’s directive containing these wishes. Even 11 years after the legal anchoring of patients’ directives, these are still not widely spread in Germany or frequently cannot be applied practically in their intended sense due to the lack of conclusiveness and validity. This lack of knowledge of preferences about medical treatments can lead to overuse, underuse, or misuse of care.

Advance Care Planning (ACP) – in German “Behandlung im Voraus Planen (BVP)” – is a process that uses a discussion process to assist people in setting up a conclusive, valid patient’s directive. In order to ensure the resulting directives are available at the right time and are heeded by the actors involved, efforts are also being made to implement them at different levels of the health care system. 

Aim

It is intended to use the BEVOR study to examine the effectivity of a ACP program for people in residential nursing homes. The ACP program is based on the Respecting Choices Program in the United States and has been adapted and further developed to suit conditions in Germany.

Methodology

A prospective, multi-centered cluster randomized controlled study (cRCT) will be carried out over a period of 21 months. In the intervention group, the accompanying discussion process will be implemented in residential nursing homes in the frame of a complex intervention and according to the standards of the German Interprofessional Association – Behandlung im Voraus Planen (DiV-BVP) e.V. (Advanced Care Planning). The facilities in the control group will receive standard care. At the same time, facilities and health system actors in the area will be incorporated in the program by means of a network. A total of 40 residential nursing facilities each with an average of 80 residents will be recruited and then randomly allocated to one of the two groups.

In the intervention group, discussion facilitators will be trained who are either employed in the nursing home itself or belong to a pool of external staff working in the homes. In direct conversations, they assist the residents and their relatives to reflect on their preferences regarding medical treatment and also take care of the written documentation and organization. The nursing homes support the implementation of the program, for example by holding further education sessions or by optimizing the concepts for palliative care. In doing so, they are assisted by regional coordinators, who are active on all levels of the program, networking and supporting the discussion facilitators. The coordinators promote and accompany the implementation in the nursing homes and inform and train regional actors such as hospitals, emergency services or general practitioners, strengthening the cooperation in general.

As the primary outcome measure, the rate of hospital admissions will be compared using an anonymous survey of all the inhabitants in the residential nursing homes. The secondary endpoints will be the actual conformity of the medical treatments with the preferences of those residents who had agreed to participate in the corresponding data collection.

The study will be complemented by a comprehensive evaluation in terms of health economy and a detailed evaluation of the selected processes.

Study registration

  •  Registered under ClinicalTrials.gov Identifier: NCT04333303

Short title:

  • ELISE

Period

  • 01.02.2021 - 31.01.2024

Project leader:

Staff member:

  • Manuela Grünzig

Funding:

Federal Ministry for Education and Research

Other project partners:

  • brain SCC GmbH (coordinator)
  • Chair for Business Information Systems/ Corporate Information Management at MLU
  • Halle-Neustädter Wohnungsgenossenschaft e.G.

Project content:

The ELISE project aims at developing, piloting and evaluating an IT-supported coordination system for procuring spontaneous support services. The users’ (volunteers and advice seekers) acceptance will be examined as well as the effect on actual everyday work relief. The methods include literature reviews, market analyses, focus group interviews, individual interviews, Delphi method and surveys. The aim is to create an offer that mobilizes spontaneous helpers in the neighborhood, improves participation, generates contacts and relieves the burden of everyday life, and that is rewarding for volunteers.

Short title

  • EsmAiL

Period

  • 1 May 2019 to 30 April 2022

Project leader

Staff members

Cooperating partners

  • Skin Clinic and Polyclinic of the University Medical Center of the Johannes Gutenberg University Mainz
  • German Society for Wound Healing and Wound Treatment (DGfW)
  • Techniker Krankenkasse, Rhineland-Palatinate State Representative Office
  • Barmer

Funding

  • Innovation Commission of the Federal Joint Committee Berlin – Registration No.: 01NVF18008

Abstract

Aim

Acne inversa is an inflammatory disease of the inverse skin regions from which approx. 1% of the population suffers. Abscesses and fistulas are formed mainly in the armpits and groin and cause malodorous secretion and severe pain. Acne inversa is a disease that dominates the patient’s life; it occurs mostly in young people, often has a progressive course and can lead to permanent bodily impediments, disability and social isolation. The aim is to reduce the burden of the disease, improve the patient’s quality of life and in the long-term to bring relief for the health care system. To this end, heterogeneous service providers are qualified to become acne inverse centers (AiC).

Methodology

Patients are randomized and either receive normal care or are transferred to an AiC. There the patient is integrated into a structured, interdisciplinary, cross-sectoral form of care.

Kurztitel

  • EvAb-Pilot

Förderzeitraum

  • Mai 2020 bis März 2023

Leitung des Konsortiums

  • Universität Witten/Herdecke, Fakultät für Gesundheit, Institut für Forschung in der Operativen Medizin, Projektleitung: Dr. rer. medic. Tim Mathes

Konsortialpartner/-innen

  • Martin-Luther-Universität Halle-Wittenberg, Interdisziplinäres Wissenschaftliches Zentrum Medizin - Ethik – Recht, Projektleitung: Prof. Dr. Henning Rosenau
  • Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Projektleitung: Prof. Dr. Anke Steckelberg

Mitarbeiter*innen (Studienzentrum Halle (Saale) -IGPW)

  • Dr. phil. Julia Lühnen
  • Julia Lauberger, M. Sc.
  • Sandro Zacher, M. Sc.

Förderung

  • Innovationsfonds des Gemeinsamen Bundesausschusses (Förderkennzeichen: 01VSF19025)

Zusammenfassung

Hintergrund

In Deutschland müssen alle Patient*innen vor der Einwilligung zu einem medizinischen Eingriff von ihren Ärzt*innen angemessen aufgeklärt werden. Regelhaft werden Aufklärungsbögen genutzt, um das Arzt-Patienten-Gespräch zu unterstützen und zu dokumentieren. Studien haben gezeigt, dass aufgrund der hohen Haftungsrisiken der Ärzt*innen für Behandlungsfehler oftmals eine risikozentrierte Aufklärung im Vordergrund steht. Eine informierte Entscheidung wird, wenn überhaupt, zu wenig unterstützt. Zudem kann sich die Art der Darstellung von Risiken einer Behandlung auf die Angst von Patient*innen und den Nocebo-Effekt auswirken.

Ziel

Das primäre Ziel dieser Pilot-Studie ist es zu untersuchen, ob evidenzbasierte Aufklärungsbögen für die Operation und Anästhesie am Beispiel des Kniegelenkersatzes diese Defizite ausgleichen, d.h. die Risikoeinschätzung verbessern und die Angst der Patient*innen vor Komplikationen sowie die Anzahl an tatsächlich auftretenden unerwünschten Ereignissen bzw. den Nocebo-Effekt reduzieren.

Methoden

Das Projekt folgt dem UK MRC-Framework für die Entwicklung und Evaluation komplexer Interventionen und beinhaltet die Elemente der Entwicklung und Pilotierung. Im Zeitraum von Mai 2020 bis März 2023 erfolgen 1) die Exploration von Informations- und Entscheidungsprozessen, 2) die Entwicklung und Pilotierung von Aufklärungsbögen, 3) die Durchführung einer Interrupted-Time-Series Studie und 4) die Prozessevaluation.

  1. Mithilfe von semi-strukturierten Interviews mit Patient*innen und Ärzt*innen wird der gesamte Prozess der Entscheidungsfindung und die Verwendung von Informationsmaterialien beschrieben. Ziel ist es zu verstehen, wann, wie und von wem Entscheidungen getroffen werden und welche Informationen entscheidend sind. Darüber hinaus werden schriftliche Informationen, die während des Entscheidungsprozesses genutzt werden, hinsichtlich der Kriterien evidenzbasierter Gesundheitsinformationen bewertet und deskriptiv analysiert.
  2. Die Aufklärungsbögen werden nach der Leitlinie zur Erstellung evidenzbasierter Gesundheitsinformation entwickelt. Parallel erfolgt eine umfassende Auswertung von Rechtsprechung und Literatur zu den rechtlichen Anforderungen an die Aufklärung. Die Pilotierung hinsichtlich der Machbarkeit erfolgt mittels Think-Aloud und Fokusgruppeninterviews. Die Pilotierung und Revision der Aufklärungsbögen erfolgt bis zur Datensättigung. Anschließend werden die Aufklärungsbögen durch Fachgesellschaften und klinische Experten überprüft.
  3. Zum Vergleich der evidenzbasierten Aufklärungsbögen mit den Standard-Aufklärungsbögen wird eine Interrupted-Time-Series Studie durchgeführt. Es ist geplant, 110 Proband*innen vor und 110 Proband*innen nach Einführung der Intervention im Krankenhaus einzuschließen. Darüber hinaus wird Ärzt*innen, die nach der Einführung der Intervention die informierte Einwilligung durchführen, eine Schulung in evidenzbasierter Entscheidungsfindung angeboten. Zielgrößen sind: Angst, Nocebo-Effekt, Nutzen- und Risikoeinschätzung, Zufriedenheit der Patient*innen mit dem Arzt-Patienten-Gespräch und Lebensqualität. Die Daten werden deskriptiv aufbereitet und mittels Regressionsanalysen für Zeitreihen ausgewertet.
  4. Die Beschreibung der Intervention und des Umsetzungsprozesses erfolgt in Anlehnung an den Prozessbewertungsrahmen des MRC unter Nutzung quantitativer und qualitativer Methoden. Es erfolgt die Untersuchung des Kontextes und der Bereitschaft zu Veränderungen auf der Ebene des Gesundheitspersonals. Barrieren und förderliche Faktoren bei der Umsetzung werden mittels semi-strukturierter Interviews mit Patient*innen und Ärzt*innen erhoben.

Erwartete Ergebnisse

Durch eine evidenzbasierte, verständliche und auf Vermeidung von verzerrter Risikodarstellung ausgerichtete Aufklärung in den evidenzbasierten Aufklärungsbögen könnte die Kompetenz der Patient*innen zur korrekten Einschätzung der Risiken des Eingriffs gestärkt werden. Dadurch könnten negative Erwartungshaltungen, Ängste vor unerwarteten Ereignissen und das Auftreten des Nocebo-Effekts reduziert werden. Zugleich kann die Akzeptanz einer rechtlich abgesicherten Aufklärung unter Ärzt*innen gestärkt werden.

Short title

  • GenDivInfo

Period

  • 01 March 2022 – 28 February 2025

Project leader

  • Prof. Dr. Anke Steckelberg

Staff members

  • PD Dr. Gero Langer
  • Dr. Julia Lühnen
  • Julia Lauberger, M. Sc.
  • Sarah Stanke, M. Sc.

Project partners

  • University of Bremen, FB 11, IPP, Dept. of Nursing Evaluation and Implementation Research: Prof. Dr. Birte Berger-Höger
  • University of Bremen, Faculty 9 Cultural Studies, Institute of Ethnology and Cultural Studies (IfEK): Dr. Margit E. Kaufmann

Supporting institutions

  • Arbeitsgemeinschaft der Wissenschaftlichen Medizinische Fachgesellschaften e.V. (AWMF): Dr. Monika Nothacker
  • Working Group Women's Health in Medicine, Psychotherapy and Society (AKF): Prof. Dr. Ingrid Mühlhauser
  • German Network Evidence-based Medicine e.V.: Prof. Dr. Dipl. Soz. Tanja Krones -
  • Patient representative BPS e.V.: Udo Ehrmann
  • Universitäts-Klinikum Hamburg Eppendorf: Prof. Dr. Christoph Heesen
  • Women's Health Center Graz, women's health expert: Mag.a Kerstin Pirker

Funding

  • Federal Ministry of Health (BMG):"Model projects for the development and testing of gender-specific care concepts as well as prevention and health promotion measures. Module 3 – Interventional studies."  (Grant number: 2522FSB12A)

Summary

Background

Medical guidelines can contribute to evidence-based care. However, current guidelines have so far taken little account of the needs of people of different genders and as far as patient participation is concerned, German guidelines still fall short of required international standards. Furthermore, there is a lack of methods for identifying relevant decision-making situations in order to synthesize the necessary evidence in a targeted manner. Altogether, current guidelines do not usually provide all the information necessary for developing evidence-based decision-aids accordingly.

The aim is to develop and pilot-test a concept for developing gender-specific and gender-sensitive medical guidelines, taking into consideration the diversity and vulnerability on the basis of which evidence-based decision-making tools can be provided. The knowledge transfer of the best available evidence for the different target groups in the healthcare system is to be optimized by the new procedure.

Methods

Development of a concept to extend guideline processes for the provision of evidence-based decision-aids and guidelines that are gender-diverse.  

The process for preparing evidence-based guidelines (S3 guidelines) will be extended to include in particular gender-specific needs and preferences as well as the content requirements of decision-aids throughout the entire process. Care will be taken to set up a guideline group that is gender (diversity) sensitive / and fairly composed. The preferences and values of the target group will be identified using systematic searches and, if necessary empirical methods. For the systematic searches, generic search strategies will be provided, which the guideline groups can adjust to the respective topics. In addition, a guidance for a scoping review will be established to identify the relevant decision-making situations.

On this basis, guideline groups can reach a consensus on key issues and prioritize outcome parameters. In this context, all available options should be considered in the sense of evidence-based decision-aids. Evidence synthesis will be provided (via external methodologists) using the GRADE methodology. Gender-specific and sensitive recommendations will be generated for each decision-making situation.

Pilot-testing of the concept using the example of a decision-making situation on non-hormonal contraceptives

Pilot-testing of the modified guideline process will be carried out with guideline authors on the basis of assessing decision-making situations concerning non-hormonal contraceptives. The guideline process will be fully implemented until a consensus about the key issues has been reached in order to then create exemplary evidence syntheses and generate recommendations. The feasibility of the concept will be tested with the aid of participatory observations, feedback and focus groups.

Adaptation and pilot-testing of an interactive e-learning training program

Existing curricula will be supplemented by aspects of the gender-specific and gender-sensitive development of guidelines and evidence-based health information (EBHI), then transferred in modular form to an interactive e-learning program. In particular, the requirements of patient representatives will be taken into account and their tasks, roles and strategies for the inclusion of the diverse interests and needs of the target group will be addressed. The training program will be tested with regard to possible user problems by people who fulfil the criteria for participating in the guideline group and then optimized.

Development and pilot-testing of appropriate gender-diversity decision-aids

Based on the criteria for EBHI, a template for an evidence-based decision-aid in modular form will be developed, which can be adapted to a web-based interactive format. Using the template, a module for a decision-aid regarding contraceptives will be created as an example. The overall concept will then be reviewed on the basis of the comparison of whether all the necessary information about the guideline process is provided. This will be followed by an assessment by patient representatives and experts and by testing the decision-aid in the target group.

Expected results

At the end of the project, a manual for the development of gender-specific guidelines and decision-aids will be available. The newly developed procedure for setting up patient-oriented guidelines and templates for decision-aids will be developed so generically that they can be used for other issues and diseases and can thus be implemented in the system in the long term. The modular form of the training program means that it can be adapted and extended and it is planned to consolidate it via the German Network Evidence-based Medicine. In the future, the optimization of knowledge management will play a decisive role in achieving the goals for promoting health literacy and informed decisions.

Short title

Period

  • November 2020 – October 2022

Project team leaders Halle

Staff members

  • Fabiola Böhm
  • Manuela Grünzig
  • Thomas Klatt
  • Laura Rothmann
  • Juliane Stubner

Consortium partners

  • Dublin City University, Ireland
  • University of Maastricht, The Netherlands
  • Gruppo SPES, Italy

Funding

  • Erasmus+

Abstract

The increase in dementia disease underlines the importance of understanding better the needs of people with dementia and of forming a creative environment for the best possible care. Professional dementia carers are rare. Although various dementia-related further education programs have been initiated in recent years, there are no European efforts worth mentioning. Further education and training programs often do not provide the necessary insights into the needs of people with dementia, which is why the staff requires additional training in order to be able to work successfully with people with dementia. The project “Improving dementia care Through Self-Experience (INTenSE)” trains professional carers to improve dementia-related support through innovative learning approaches and IT tools, enabling them to relate to the experiences of people with dementia. In the field of further education and training, INTenSE aims to use self-awareness methods to promote dementia-related knowledge and understanding of the experience of dementia throughout Europe. As a form of experimental learning, simulation strategies incorporate different ways of generating knowledge (e.g., thinking, feeling, and acting) that can be used to improve dementia care and support. Virtual Dementia Tours (VDT), role-playing or theater performances are examples of such methods. INTenSE intends to link these approaches innovatively to

  • improve cooperation and knowledge-sharing between the organizations active in the field of nursing and care,
  • develop a new network of professional carers,
  • support the digital competences of professional carers by means of a newly developed IT platform,
  • develop social understanding for the opportunities of self-awareness to improve dementia care and support and
  • to integrate self-awareness techniques into the daily activities of professional carers.

INTenSE intends making self-awareness techniques available for present and future generations of professional carers in the field of dementia.  The project activities are designed to achieve the following project objectives:

  1. Determining the status of international experiences relating to VDT, dementia-related role-playing and theatrical activities by means of a scoping review and a focus group study. The findings will form the basis for the INTenSE e-booklet and thus the fundament for further methodical steps.
  2. Creating an INTenSE e-booklet and an INTenSE Dementia Simulation Tool-kit (DST), with the help of which symptoms of dementia are simulated so that is will be possible to use enhanced empathy and understanding to improve nursing and healthcare.  The DST will contain various elements, such as a compilation of IT applications for simulating sensory deficits, a description of VDT interventions for simulating physical and cognitive symptoms, details about role-playing and theatrical performances to simulate psychological symptoms and include also the corresponding treatment instructions.
  3. Developing an internet platform to facilitate learning from each other and to promote the digital competencies of the professionals involved.

 

An INTenSE training course with a participative approach will help a total of 20 professional carers to learn about techniques for self-awareness. The subsequent focus group interviews are linked to the principles of active participation, which should help achieve the INTenSE goals.  

Another INTenSE training refers to using DST and the IT platform in the participating countries.  

The project aims at significantly improving the abilities and competences of professional players by using methods of active participation, innovative self-awareness techniques and by using the IT platform. Organizations involved in the project can participate in the development and application of innovative approaches in dementia care and training of professional players by strengthening cooperation and management skills.

By making use of the experiences and networks of the project partners, the path will be paved for developing innovative teaching courses for future professional players and thus advance the professionalization in the field of dementia care.  

Last but not least, the project has the potential to bring innovative approaches to care policy through increased awareness of dementia-related needs. The participative approach of the INTenSE project will promote transnational cooperation and facilitate the development of innovative tools that are based on self-awareness. The methodology can be applied throughout Europe, whereby the experiences in different socio-cultural settings can be of use.

Short title:

  • MoNoPol-Sleep

Period:

  • October 2018 – March 2022

Participating study centers:

  1. Coordinating study center: University of Lübeck, Institute for Social Medicine and Epidemiologiy, Section for Research and Teaching in Nursing
    Project leader: Prof. Dr. Sascha Köpke
  2. Faculty of Medicine at the Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science 
    Project leader: Prof. Dr. Gabriele Meyer
    Researcher: Dr. Almuth Berg
  3. German Center for Neurodegenerative Diseases (DZNE), Witten
    Project leader: Prof. Dr. Margareta Halek

Funding:

  • Federal Ministry for Education and Research – Reg. No.: 01GL1802B

Abstract Website: www.monopol-sleep.de

People with dementia frequently suffer from sleep disorders which lead to a number of other problems. Current research shows that medicinal treatment cannot be recommended as first-line therapy. Non-pharmacological interventions are in principle effective but at present there is no “gold standard” intervention for preventing sleep disorders in people with dementia. Existing interventions are characterized by the heterogeneity of the (usually complex) interventions and by the insufficient knowledge about the possibilities and challenges of the implementation.

The project aims at developing and piloting a complex, non-pharmacological intervention for preventing sleep disorders in people with dementia in nursing homes.

The main phase of the project is planned as a cluster-randomized study over a period of 12 months in three study centers. Twelve nursing homes each will be allocated to both the intervention and the control group. An extensive process evaluation will conducted in addition.  

Study registration no.: ISRCTN36015309

Short title

  • MundZaRR

Period

  • June 2019 to Febr. 2024

Project leader

Project assistant

Funding

  • Innovation Commission of the Federal Joint Committee Berlin – Registration No.:  01VSF18021

Abstract

The aim is to develop and evaluate a nurse-assisted dental support concept for the oral hygiene and care of residents in residential care facilities for the elderly (care level 3 – 5) in order to improve quality of life in relation to oral health.

The primary hypothesis: The reinstruction and remotivation of the nursing staff with the help of dental assistants following the instructions of dentists will improve the quality of life in relation to oral health of residents with care level 3 -5.

The existing dental concept for the care of older (and/or disabled) people stipulates that dentists conduct a regular 6-monthly evaluation of the oral health and hygiene status of care-dependent people. It also provides for the nursing staff to receive instruction based on a form sheet and for any necessary referral recommendations for dental therapy. The aim of this current project is the short-term development and medium-term testing of individualized assigned care reinstruction and remotivation measures for nursing staff who deal with oral hygiene and care. These measures are to be conducted with the help of dental assistants following the instructions of dentists. The long-term target is to improve the oral health related quality of life and the oral health of residents in care facilities for the elderly and to reduce dental-related emergencies and comorbidity by expanding the AuB concept as described.

Short Title

  • PartEngO

Duration

  • March 2022 - February 2025

Principal investigator

  • PD Dr. med. Heike Schmidt, Department of Radiation Oncology, University Hospital Halle (Saale), Krukenberg Cancer Center and Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale)
  • Prof. Dr. Anke Steckelberg, Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg

Ethical and legal project lead

  • Prof. Dr. Henning Rosenau, Interdisciplinary Center Medicine – Ethics – Law, Faculty of Law and Economics, Martin Luther University Halle-Wittenberg

Medical project lead

  • Prof. Dr. med. Haifa Kathrin Al-Ali, Krukenberg Cancer Center Halle

Scientific staff

Funding

  • Stiftung Deutsche Krebshilfe, Förderschwerpunktprogramm „Ethische Verantwortung in der modernen Krebsmedizin“ (FKZ: 70114359)

Registration

  • German Clinical Trials Register: DRKS00028470
  • StudyBox: ST-U140

Clinical cooperations

  • University Hospital for Internal Medicine IV, University Hospital Halle (Saale), Krukenberg Cancer Center, Halle (Saale)
  • University Hospital for Internal Medicine I, University Hospital Halle (Saale), Krukenberg Cancer Center, Halle (Saale)
  • University Clinic and Polyclinic for Radiation Therapy, University Hospital Halle (Saale), Krukenberg Cancer Center, Halle (Saale)
  • Krukenberg Cancer Center, Medical Clinic II, Carl-von-Basedow Clinic Saalekreis, Merseburg
  • Oncologic Center St. Elisabeth and St. Barbara Halle (Saale), Halle (Saale)
  • Clinic for Internal Medicine II, Martha-Maria Hospital Halle-Dölau, Halle (Saale)
  • Radiation Clinic, University Hospital Erlangen, Erlangen
  • Medical Clinic with focus on oncology, hematology and tumor immunology (Campus Charité Mitte), Charité Comprehensive Cancer Center, Berlin
  • Medical Clinic with focus on oncology, hematology and tumor immunology (Campus Virchow-Klinikum), Charité Comprehensive Cancer Center, Berlin

Summary

Background:

Although modern cancer medicine allows the treatment of very old patients, the transferability of therapy recommendations of current guidelines to individual cases is limited due to age-related heterogeneity, e. g. reflected in the number and severity of comorbidities or different physical and cognitive functioning. In addition to health and context-related factors, older cancer patients also differ in terms of their attitudes regarding quality of life, existential issues, and treatment related expectations. Shared decision-making (SDM) integrates these individual aspects and values to ensure the legally and ethically required right of patients’ self-determination. Prerequisites of SDM are the assessment of personal resources and risk factors and the exploration of values and preferences, to enable individual assessment and appropriate communication of the benefits and risks of different therapy options. Based on this approach patients can be empowered to participate in the decision making process.

Aim:

This project aims to further develop and pilot an interprofessional concept to promote SDM in clinical practice with a special focus on ethical and legal aspects for vulnerable patients with complex health problems.

Methods:

The study design comprises a controlled, consecutive multicenter approach comparing two PEF interventions for elderly cancer patients with standard care in nine German clinics.

Three groups are consecutively recruited and compared:

  • Pre (control group, n=92): Receives standard care.
  • Post I (intervention group 1, n=92): Receives comprehensive geriatric assessment of individual risk factors and resources (comorbidities, medication, physical function, nutritional status, cognition, emotional and social situation, independence, quality of life) in addition to standard care. The results of the assessment will be summarized, discussed with the patients, and, in combination with individual preferences, incorporated into the decision-making consultations. Participating patients also receive supporting materials e.g. Question Prompt Lists. The interprofessional care team will be trained in SDM in geriatric oncology. Training topics include: Communication with the older patients and specific risk communication, exploration of patient preferences, guideline-based consultation, and structured documentation of the decision-making consultations.
  • Post II (Intervention Group 2, n=92): Receives decision coaching from trained nurses in addition to standard care and the intervention described in Post I. The nurses will also participate in decision-making consultations and support patients after decision-making. 

Inclusion criteria:

Patients ≥ 70 years with acute myeloid leukemia or colorectal carcinoma, or brain metastases from various primary tumors.

Outcomes:

Primary endpoint of the evaluation is the extent of the patient's involvement in decision-making, assessed by the Multifocal approach to the 'sharing' in Shared Decision Making instrument (MAPPIN'SDM) and a patient-based assessment (MAPPIN-Qpatient). Secondary endpoints include physician and nurse perceptions of patient involvement (MAPPIN-Qphysician and MAPPIN-Qnurse), agreement on MAPPIN ratings between MAPPIN-Qpatient, MAPPIN-Qphysician/MAPPIN-Qnurse, and decision regret, quality of life, independence, treatment discontinuation, and clinical course. In addition, a process evaluation focuses on the feasibility and required resources of the intervention as well as on its acceptance and benefit from the participants' perspective.

Expected results:

We expect findings regarding potential benefits of the intervention for patients to improve participation and informed decision-making with relevance for clinical practice. In this context, potential needs for optimization of the ethically, legally, and medically relevant process of SDM may be identified.

A feasible interprofessional concept to prepare and implement informed SDM will be developed and evaluated with relevance for clinical practice as well as interprofessional teaching, education, and training. Due to its generic approach, this concept is transferable to complex decision-making situations in older cancer patients and can contribute to the support of patient-centered oncological care. In case of a positive evaluation, implementation studies and a health economic analysis are planned.

Short title:

  • PEKo 1.1

Duration:

  • October 2020 – December 2022

Principal investigator:

  • Prof. Dr. phil. Gabriele Meyer

Scientific staff:

  • Natalie Nguyen

Partners:

  • University of Cologne
  • University of Lübeck
  • Fulda University of Applied Sciences

Funding:

  • Techniker Krankenkasse “Technicians’ Health Insurance Fund”, Hamburg

More details can be found here: https://peko-gegen-gewalt.de/ (in German)

Summary:

The follow-up study PEKo 1.1 aims at a long-term implementation from the previous violence prevention project PEKo which comprised the participatory development and evaluation of a multimodal concept for the prevention of violence in nursing homes.

The project contains two different components:

  • Participating facilities from the previous project are offered follow-up support by the study centres. This is intended to support the facilities in the completion and long-term implementation of prevention concepts and interventions that have already been developed.
  • Based on the results and experiences of PEKo as well as current scientific evidence, a module manual (tool kit) will be developed, the feasibility of which will be tested with newly recruited institutional long-term care facilities. The participating nursing homes will be empowered using the tool kit mostly independently to develop a violence prevention concept for their facility. The study centres will support the nursing homes initially by providing training on how to use the tool kit and during the project by offering counselling. The implementation will be scientifically evaluated.

Short title:

  • PEKo 2.0 Hospital
  • PEKo 2.0 Outpatient Setting

Duration:

  • May 2021 until February 2023

Principal investigator:

  • Prof. Dr. phil. Gabriele Meyer

Scientific staff:

  • Dr. Christin Richter
  • Natalie Nguyen

Partners:

  • University of Cologne
  • University of Lübeck
  • Fulda University of Applied Sciences

Funding:

  • Techniker Krankenkasse “Technicians’ Health Insurance Fund”, Hamburg

Further details can be found here: https://peko-gegen-gewalt.de/ (in German)

Summary:

Violence in care is a relevant issue not only in inpatient long-term care, but also in hospitals and outpatient settings. However, the needs for targeted prevention measures are as diverse as the settings themselves. Building on the previous PEKo violence prevention project, the PEKo 2.0 project "Violence Prevention in Hospitals and Outpatient Settings" aims to develop sustainable violence prevention concepts with employees in a participatory manner and to implement them in hospitals and outpatient organizations as well as to evaluate them scientifically. The guiding principles are transparency and participation, a systematic approach, and sustainable integration into facility structures.

Hospital setting

The project will be carried out in twelve hospitals at the study sites in Cologne, Lübeck, Fulda and Halle (Saale). The following standardized intervention components will guide action while maintaining the participatory character of the project:

  • Kick-off event in the participating hospitals
  • Appointment of PEKo representatives as contact person(s)
  • Formation of a hospital-internal PEKo team with interested employees
  • Monthly PEKo team meetings moderated by study team members
  • Quarterly, cross-facility meetings of representatives of the PEKo teams (PEKo circles)

Outpatient setting

Unlike in the inpatient setting, the project in the outpatient setting proceeds in two phases.

1) In the first phase, a violence prevention concept is developed within six months with representatives of various outpatient organizations (outpatient care services, counseling centers, self-help groups/volunteer organizations).

2) In the second phase, this violence prevention concept will be implemented on a demand-oriented basis in nine organizations at the three study centers Cologne, Fulda and Halle over a project period of 12 months.

Focus groups, individual interviews, standardized surveys and a structured evaluation of the study documentation will be conducted as part of the process evaluation.

Short title

  • PfleKoRo

Period

  • May 2020 - April 2023

Project leader in Halle

Assistant

Project coordination

  • Chris Diers, DIERS International GmbH

Consortial partners

  • Prof. Dr. Catherine Disselhorst-Klug, Rehabilitation and Prevention Technology, RWTH Aachen
  • Maike Ketelhut, Institute for Control Technology, RWTH Aachen
  • Prof. Dr. Astrid Stephan, Nursing Director University Clinic, RWTH Aachen
  • Bernd Bogert, St Gereon Seniorendienste GmbH
  • Prof. Dr. Gernot Marx, Clinic for Operative Intensive Medicine and Intermediate Care, RWTH Aachen

Funding

  • Federal Ministry for Education and Research - Fkz: 16SV8440

Abstract

PfleKoRo aims at providing physical and temporal relief for nursing staff in the care of severe and very severely bedridden patients. For this purpose, a robotic system is to be designed that gives needs-oriented support, integrates itself smoothly into the actual nursing tasks, and takes over physically strenuous lifting and repositioning tasks. The challenge here is to coordinate the robotic assistance and human interaction, taking into consideration the needs of both the nursing staff and patients according to the actual situation. This challenge is met by an iterative development process jointly supported by nursing professionals, care recipients and developers. The final result should be the PfleKoRo system.

Short title:

  • PoiSe

Period:

  • March 2020 - February 2024

Project team leader in Halle:

Project staff:

Consortium leaders:

  • Dr. med. Filipp Filippopulos (project leader), German Vertigo and Balance Center (DSGZ) and Clinic and Policlinic for Neurology, LMU Munich
  • Prof. Dr. med. Doreen Huppert (deputy project leader), German Vertigo and Balance Center (DSGZ), LMU Munich
  • Prof. Dr. med. Thomas Brandt, German Vertigo and Balance Center (DSGZ), LMU Munich
  • Prof. Dr. Eva Grill, German Vertigo and Balance Center (DSGZ) and Institute for Medicinal Information Processing, Biometry and Epidemiology (IBE), LMU Münich

Konsortialpartners

  • AOK Bavaria
  • Association of Statutory Health Insurance Physicians, Bavaria (KVB)
  • Institute for Health and Nursing Science (IGPW) at the Martin Luther University Halle-Wittenberg (Evaluation)

Funding:

  • Joint Federal Committee Innovation Fund, Reg.-No. 01NVF19030

Abstract:

Vertigo is one of the most frequent complaints with which patients confront their doctors. It can have a severe impact on the daily life of those affected, up to and including loss of work and greatly reduced quality of life. Although many causes of vertigo are easily recognizable and treatable, general practitioners often perform unnecessary and stressful diagnostic procedures. This can lead to a longer treatment period and to chronification of the complaints or overlaying through somatization processes.

The cluster-randomized intervention study aims at improving the care and quality of life of patients treated for vertigo by general practitioners. The intervention is based on the following elements: 

  • Training for the participating physicians
  • PoiSe web platform for physicians to support the diagnosis, monitor the course of the illness and for interdisciplinary exchange with a network of experts   
  • PoiSe application for installation on the patient’s smart phone, providing information about therapy, checking the course of the symptoms, and giving warnings if the therapy has no response.    

After three months, all patients will be invited to the German Center for Vertigo and Balance in the Clinic Großhadern where the quality of the diagnosis will be checked.

Short title

Period

  • Sept. 2021 bis August 2024

Consortium leader

  • Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Dr. rer. medic. Anja Bieber

Consortium partners

  • Universität zu Köln, Heinrich-Heine-Universität Düsseldorf

Funding:

  • Bundesministerium für Gesundheit - FKz ZM/1-2521FSB98A

Summary:

PraWiDem is a project within the National Dementia Strategy and aims at networking care practice and science.

PraWiDem involves the adaptation and evaluation of the so-called Living Lab approach, a structure of science-practice transfer in long-term care originating from the Netherlands. Scientists and practice representatives work together as "linking pins" in concrete research projects, which are developed from the needs of the cooperating care institutions. A team of experts from practice and science as well as patient representatives accompany the project.

Three project phases are planned:

Phase 1: Development of a concept for adapting the Living Lab approach to the topic of care and provision in dementia, taking into account the national context, as well as the initiation of a working group on dementia care research in cooperation with the German Alzheimer's Association.

Phase 2: The concept developed in phase 1 will be tested. For this purpose, cooperations will be established between the universities and the practice partners, i.e. the providers of inpatient and outpatient care facilities in Halle (Saale), Aue and Krefeld. At each location, a liaison person from the university and the practice partner work together regularly and under the supervision of a team of experts.

Phase 3: The model implementation is evaluated with the participation of all stakeholders and recommendations for the regular participation of relevant professional groups in dementia care are derived. 

Short title

  • PRO-LQ

Project leaders

Clinical leader

  • Prof. Dr. med. Vordermark

Project assistant

Partners

  • University Clinic and Polyclinic for Radiation Therapie, Halle (Saale)
  • Central Services 1 - Information and Communication, University Clinic Halle (Saale)
  • Krukenberg Cancer Center, University Clinic Halle (Saale)
  • Evaluation Software Development

Funding

  • European Fond for Regional Development (EFRE)

Abstract

Background

The assessment of patient-reported, health-related quality of life (HRQOL=Health-Related Quality of Life) provides relevant information about how cancer patients experience their illness and therapy and what strain this places on them. It helps to involve the patieneets’ perspective more in the treatment process. Although many studies verify the benefit of systematic supportive therapy, up to now a standard assessment of HRQOL does not take place in most clinics. One reason for this is the fact that incorporating it in the clinical routine would amount to a complex intervention for which many aspects, components and involved people would have to be taken into account. Therefore, a scientifically based, carefully planned and structured approach is essential.

Aim

This project aims to plan, conduct and evaluate the implementation of the electronic assessment of HRQOL in an oncological department and according to scientific standards. Based on the knowledge gained during the process evaluation, a guideline for the implementation in other clinical settings is to be developed.

Methods

The project will be carried out in five stages:  1. Identification of optimization requirements and department-specific support factors and barriers to implementation through a current status analysis with internship as observer, documentation analysis and survey; 2. Selection of tools and development of treatment paths for relevant findings of the HRQOL assessment (e.g. for specific symptoms); 3. Development and implementation of a training session for clinic personnel on how to deal with the electronic HRQOL assessment; 4. Step-by-step implementation accompanied by continuous monitoring; 5. Evaluation of the success of the implementation by means of documentation analysis, assessment of patient satisfaction by means of a survey, and creating the guideline for the implementation.

Expected findings

The project is expected to provide knowledge about setting-specific supportive factors and barriers to the implementation of the electronic assessment of HRQOL. These will serve as a basis for creating a guideline for the implementation in other clinical settings. The guideline is to be tested within the framework of a subsequent multicentered study in order to improve the generalizability and to promote the use of further implementations of routine HRQOL assessment in various departments.

Short title

  • PPE

Period

  • April 2018 – March 2021

Project tetam leader in Halle

Staff members

Consortium leader

  • Prof. Dr. Jonas Schreyögg, Hamburg Center for Health Economics (HCHE)

Other consortium partners

  • Techniker Krankenkasse (Hamburg)

Funding

  • Joint Federal Committee Innovation Fund (Reg.-No.: 01VSF17038)

Abstract

The PPE project is investigating the relation between quality and outcome of nursing care and nurse staffing levels. So-called routine data from hospitals and health insurance companies that are usually used for documentation and billing, will be evaluated. To include the subjectively experienced treatment quality, patients will be asked about their stay in hospital.

The findings can supply valuable information about how the hospitals can use their nursing staff to achieve the best nursing care. The results can also be used by health policy makers to utilize subsidies for care improvement in the best possible way.  

Background

In hospitals, the quality of nursing care can have a relevant influence on the quality and success of treatment. The nurse-patient-ratio must be seen as a structural component and is at the same time a prerequisite for the quality of care. It outlines the number of patients that one nurse must care for and provides information about the care intensity. It is also interesting to discover whether the care provided corresponds to the needs of the patients. The success of the nursing care can be seen after the patient has been discharged, for example from the physical condition of the patient (through so-called care-sensitive outcome indicators).

Knowledge about the relation between the care intensity in hospital and care-sensitive outcome indicators provide a basis on which the quality (of care) in hospitals can be improved and in which departments/wards more staff must be allocated in order to ensure high-quality and safe care. By introducing minimum standards in the allocation of staff to care-sensitive departments/wards, it might be possible to provide more certainty for the patients when selecting a hospital and also improve the patient orientation.

To date, the relation between the staffing levels and patient-related outcomes has rarely been empirically examined. Previous research dealt mainly with patient-related outcomes that could be proven during the stay in hospital. In contrast, the perspective of post-discharge care and the patient perspective have been largely neglected.

Objective

The PPE study investigates the relation between the staffing levels in German hospitals and the post-discharge outcomes of the patients cared for there.  A further aim is to determine nurse-patient-ratios, particularly with regard to the care-sensitive departments/wards where an increase in staff levels might achieve the best improvement in care quality.

Methods

Care-sensitive patient outcomes will be identified systematically from the literature. Indicators that can be recorded not only during, but also after hospitalization are of particular interest. These indicators are collected from the billing data of inpatient and outpatient service providers. In addition, a standardized questionnaire will be used to collect information from the patient's perspective with regard to the quality of care on the ward and adverse events and conditions of care that occurred after the hospitalization.

Subsequently, these data can be put in relation to the nurse-patient-ratio. Information regarding staffing on the wards will be taken from the hospitals’ quality reports.

Short title

  • REHA-Post

Period

  • 01.03.2021 - 31.08.2022

Project team leader

Consortium partner

Medical Advisory Service of the German Social Health Insurance (MDS)

Staff members

Funding

  • GKV Spitzenverband (Central Association of Statutory Health Insurances)

Background

The Medical Advisory Service of Social Health Insurance is obliged to use care assessments to check whether there is an indication for rehabilitation treatment. If this is the case, a rehabilitation recommendation is made which activates simplified access to rehabilitation through the insured person’s consent. However, determining the indication for rehabilitation is preceded by a complex decision process, whereby in individual cases a clear decision for or against rehabilitation treatment can be associated with some uncertainty.

Objective

In a joint project between the Institute for Health and Nursing Science, the Institute for Rehabilitation Medicine and the Medical Advisory Service of Social Health Insurance, this area of uncertainty is to be described for the first time in terms of its quantitative scale and underlying causes. The aim is to reveal the complex process of decision-making that leads to a rehabilitation indication and to derive further optimization potentials.

Methods

The first methodical stage focuses on the experiences of the experts of the Medical Advisory Service of Social Health Insurance (MDS) relating to establishing the need for rehabilitation. Qualitative interviews will be conducted with experts who have nursing and medical backgrounds. The results from this stage will form the basis for a standardized survey with other MDS experts. In an expert workshop, the results of the qualitative and standardized survey will be used to derive recommendations for improving the reliability of the expert's assessment of the need for rehabilitation.

Short title

  • RehaTransHome

Period

  • November 2020 - April 2022

Project leader

Staff member

Cooperation partners

Funding

TDG Translationsregion für digitalisierte Gesundheitsversorgung über das Bundesministerium für Bildung und Forschung (...) (Translation region for digitalized healthcare – through the Federal Ministry for Education and Research)

Abstract

Background

Knowledge about the respective context for which participation is required is fundamental for participation orientation in medical rehabilitation. For older patients with chronic mobility restrictions the safe return to the domestic environment is generally foremost in the discharge management.

Within the frame of the discharge management the rehabilitation clinic examines the task (SGB V, §39 para. 1a,) of determining which follow-up measures are required after rehabilitation in order to ensure the success of the rehabilitation, advising the patients about suitable services and supporting them in their application. In this respect, an individual living space assessment can provide information about the environmental demands on the functional abilities needed by patients, thus contributing considerably to participation orientation by providing auxiliary aids and living space adjustments, and to the development of individually relevant participation-oriented training content and therapy goals.

A digitally supported, structured living space assessment (Smart Living Space Assessment) carried out by third parties can help reduce traveling times and additional burdens for rehabilitation patients and therapists during the stay in the clinic and give a concrete picture of the living environment. With the help of this information, a basis for a better participation-oriented therapy and timely preparation of the home environment can be created and contributed to by reducing resource consumption (misuse of auxiliary aids).

Aim

The scientific target of the project is to develop a complex intervention (modelling phase) that best integrates the smart living space assessment into clinical care, and to test this intervention for feasibility and acceptance among key user groups (feasibility and piloting phase). In addition, initial indications of potential care improvement effects should be gained and barriers to use and other influencing contextual factors of practice identified.

For this, an IT solution will be developed and piloted as a core element integrated into a clinical process pathway for discharge management. The IT solution will be modeled by means of a prototype and roughly subdivided into the parts for the acquisition of living space data, its structuring/processing and the use of the data in VR applications. The data collection of the living space is based on existing technical solutions and service providers.

Short title

  • TeCoDem

Period

  • 01.07.2021- 31.12.2022

Project leaders

  • Dr. Anja Bieber

Staff members:

  • Dorothee Bauernschmidt
  • Julian Hirt
  • Fabian Wilde
  • PD Dr. Gero Langer
  • Prof. Dr. Gabriele Meyer

Funding:

  • Bundesministerium für Bildung und Forschung, FKZ: 01KG2110

Abstract

Dementia is one of the most frequent reasons for dependency in older people. The memory and intellectual capacities decline in the course of the dementia, attentiveness decreases and speech fades away, so that those affected need more support from other people as time goes on. In many cases, family members take over the necessary care and nursing, and during the course of the dementia these carers require information and advice concerning care techniques, coping with care problems and also about the possibilities of professional support. Technology-based counselling services are one option for overcoming access barriers such as the lack of local services or contact restrictions in the Corona pandemic, but can also be of help in cases where there is a sense of shame. However, to date there are not many counselling services available for people with dementia, and scientific evaluations are rare. According to the findings so far, telephone counselling is suitable for reducing the burden on caregiving family members; however, other technical solutions are becoming more and more popular, i.e. online counselling or mobile applications (apps).

In this study the Qualitative Comparative Analysis (QCA) research method will be applied, a method which so far has hardly been used in the field of caring and nursing people with dementia. The QCA enables us to use the available literature to find out the conditions and characteristics of certain features and also to describe these in connection with the objectives mentioned by the counseling services. In short, we will examine exactly what distinguishes a good counselling service and which technology-based services have proved effective in dealing with dementia. For this purpose, we will systematically analyze all the studies that compare two or more study groups.

Thus, a mix of methods will be used in the study with which more far-reaching findings can be obtained than would be possible with simple cause-and-effect analyses.

Short title

Period

  • 01.10.2018 - 30.09.2022

Project leader

Staff members

Funding

  • European Commission, Horizon 2020, Call: H2020-MSCA-ITN-2018, Marie Skłodowska-Curie Innovative Training Networks

Coordinator

  • Katholieke Universiteit Leuven, Belgium

Partners

  • Curaviva, Switzerland, Basel University
  • Uniwersytet Jagiellonski, Poland
  • State University for Applied Sciences for Health Professions, Claudiana, Italy
  • Maastricht University, Netherlands
  • Federatie van Wit-Gele Kruisverenigingen van Vlaa, Belgium
  • Rabin Medical Center, Beilinson Hospital, Petah-Tiqva, Israel

Background

TRANS-SENIOR trains young researchers who are dedicated to finding innovative solutions for the care and health of older citizens. The TRANS-SENIOR promotion projects have two perspectives:

  1. The avoiding of unnecessary transitions between care settings in the trajectory of illness, care, and treatment, such as unscheduled hospital or nursing home admissions  
  2. The optimization of transitions if these are inevitable. 

With TRANS-SENIOR it is intended to gain scientific insights 

  1. about where transitions are avoidable, 
  2. on the advantages of innovative transition models,
  3. on methods of involving senior citizens actively in nursing/care innovations and of implementing interventions sustainably to avoid unnecessary transitions as well as methods of optimizing the transitions.

TRANS-SENIOR includes 13 young researchers. Each doctoral student will be supervised by two universities, both of which will award the PhD. Contacts to praxis partners in the projects are contractually secured. 

Kurztitel

  • VIN

Zeitraum

  • November 2021 - Oktober 2023

Projektleitung Standort Halle: 

Mitarbeiter: 

Konsortialpartner: 

  • VirtuaLounge GmbH, Braunschweig

Förderung

  • „TDG - Translationsregion für digitalisierte Gesundheitsversorgung“ im Rahmen des BMBF Programms „WIR! - Wandel durch Innovation in der Region“ (FKZ: 03WIR3105A)

Zusammenfassung

Hintergrund: Etwa 23 Millionen Personen in Deutschland sind von chronischen Schmerzen betroffen. Therapeutisch werden vorwiegend schmerzlindernde Medikamente eingesetzt, bei deren dauerhafter Einnahme nicht selten das Risiko einer Abhängigkeit besteht. Die aktuelle Forschung untersucht physiotherapeutische Behandlungsansätze für Menschen mit chronischen Schmerzen als Alternativen zur medikamentösen Behandlung, u.a. die Spiegeltherapie. Die Ergebnisse zeigen, dass Spiegeltherapie unter der Annahme schmerzlindernd wirkt, Funktionsvertrauen in schmerzbetroffene Körperabschnitte zu initiieren und schmerzerhaltende Verschaltungsmuster beteiligter Hirnzentren zu reorganisieren. Ein weiterer Ansatz ist der Einsatz von Virtueller Realität (VR) in der Bewegungstherapie. Es wird davon ausgegangen, dass das „Eintauchen“ in virtuelle Spielewelten von der Schmerzwahrnehmung ablenkt und so eine Schmerzreduktion erzielt wird.

Das Behandlungsverfahren der Virtuell Invertierten Neurotherapie (VIN) führt Komponenten der Spiegeltherapie und des Einsatzes von VR zusammen.

Projektziel: Ziel des Vorhabens ist es, eine anwendungsreife technische Lösung zur Umsetzung der VIN zu entwickeln und diese in einem supervidierten Heimanwendungsprogramm für Patientinnen und Patienten mit chronischen Schmerzen auf Eignung zu überprüfen sowie erste Hinweise zur Wirksamkeit zu gewinnen.

Methodik: Ausgehend von einer systematischen Literaturübersicht wird ein logisches Modell zur Wirkweise der VIN, ein Interventionsprotokoll sowie ein Pilotierungs- und Evaluationskonzept entwickelt. Von Beginn an werden in Form eines Projektbeirates Menschen mit chronischen Schmerzen sowie Therapeutinnen und Therapeuten in die inhaltliche und technische Entwicklung der Intervention einbezogen. Die Virtuell Invertierte Neurotherapie VIN-Umsetzung wird anschließend in einer randomisierten Pilotstudie erprobt. Hierfür werden 20 Personen mit chronischen primären oder sekundären muskuloskelettalen/neuropathischen Schmerzen im Alter von mind. 18 Jahren, die bei abgeschlossener Diagnostik und konstantem Behandlungsregime in den vergangenen 3 Monaten keine multimodale Therapie oder operative Eingriffe erhielten, in die Studie eingeschlossen. Ein hinreichendes Sehvermögen und die selbstständige Bewältigung des Alltags sollte für die Studienteilnahme gegeben sein. Die Kontrollgruppe erhält Spiegeltherapie in supervidierter Heimanwendung ohne digitale Umsetzung. Experimental- und Kontrollintervention umfassen 6 Wochen. Eine begleitende Prozessevaluation untersucht u.a. den Umsetzungsgrad und Barrieren der Anwendung.

Ausblick: Die Pilotstudie liefert erste Hinweise zur Wirksamkeit der VIN als Heimanwendung für Patientinnen und Patienten mit chronischen Schmerzen. Erkenntnisse zur Umsetzbarkeit der Intervention, der Rekrutierungs- und Implementierungsstrategien sowie der Datenerhebungsprozesse werden für die Planung einer nachfolgenden Wirksamkeitsstudie gewonnen. Lassen die Ergebnisse auf die Anwendbarkeit und Wirksamkeit der VIN schließen, kann in einem nächsten Schritt der Einsatz von VIN für weitere Therapiezielstellungen erprobt werden.

Stichworte

  • Logisches Modell zur Wirkweise
  • randomisierte Pilotierungsstudie
  • digitale Spiegeltherapie
  • Heimanwendung
  • Chronischer Schmerz