49 research outputs found
National disaster preparedness and emergency response of nurses in Germany: An exploratory qualitative study
Aim: This study aimed to explore the German nursesâ perceptions of their knowledge, roles and experience in the field of national preparedness and emergency response.
Methods: An exploratory qualitative design was used with open-ended questions during semi-structured interviews with qualified nurses currently working in hospitals. The setting of the study consisted of wards of different hospitals in three northern federal states of Germany. The data analysis was done by summarizing analysis of the contents. From a convenient sample of n=31 hospitals, n=13 nurses were included in the study.
Results: The median age of the participants was 45 years and 38% were female. Within the three professional socialization fields, knowledge, roles and experience, 17 themes were clustered.
Conclusion: Within the themes of knowledge, role and experience in national disaster prepared-ness and emergency response, similarities and differences were explored in comparison to inter-national literature.
Source of funding: This study did not receive any form of financial or other support.
Acknowledgements: We would like to thank the nurses who participated in this study. We would also like to thank the nursing managers of the hospitals, the head of the departments and the head nurses for approaching their employees and colleagues.
Conflict of interest: None declare
National disaster preparedness and emergency response of nurses in Germany: An exploratory qualitative study
Aim: This study aimed to explore the German nursesâ perceptions of their knowledge, roles and experience in the field of national preparedness and emergency response.
Methods: An exploratory qualitative design was used with open-ended questions during semi-structured interviews with qualified nurses currently working in hospitals. The setting of the study consisted of wards of different hospitals in three northern federal states of Germany. The data analysis was done by summarizing analysis of the contents. From a convenient sample of n=31 hospitals, n=13 nurses were included in the study.
Results: The median age of the participants was 45 years and 38% were female. Within the three professional socialization fields, knowledge, roles and experience, 17 themes were clustered.
Conclusion: Within the themes of knowledge, role and experience in national disaster prepared-ness and emergency response, similarities and differences were explored in comparison to inter-national literature
Nursesâ roles, knowledge and experience in national disaster pre-paredness and emergency response: A literature review
Aim: Nurses play a central role in disaster preparedness and management, as well as in emergency response, in many countries over the world. Care in a disaster environment is different from day-to-day nursing care and nurses have special needs during a disaster. However, disaster nursing education is seldom provided and a lack of curricula exists in many countries around the world. The aim of this literature review is to provide an overview of nursesâ roles, knowledge and experience in national disaster preparedness and emergency response.
Methods: An electronic search was conducted using multiple literature databases. All items were included, regardless of the publication year. All abstracts were screened for relevance and a synthesis of evidence of relevant articles was undertaken. Relevant information was extracted, summarized and categorized. Out of 432 reviewed references, information of 68 articles was included in this review.
Results: The sub-themes of the first main theme (a) roles of nurses during emergency response include the expectations of the hospital and the public, general and special roles of nurses, assignments of medical tasks, special role during a pandemic influenza, role conflicts during a disaster, willingness to respond to a disaster. For (b) disaster preparedness knowledge of nurses, the corresponding sub-themes include the definition of a disaster, core competencies and curriculum, undergraduate nursing education and continuing education programs, disaster drills, training and exercises, preparedness. The sub-themes for the last theme (c) disaster experiences of nurses include the work environment, nursing care, feelings, stressors, willingness to respond as well as lessons learned and impacts.
Conclusion: There is consensus in the literature that nurses are key players in emergency response. However, no clear mandate for nurses exists concerning their tasks during a disaster. For a nurse, to be able to respond to a disaster, personal and professional preparedness, in terms of education and training, are central. The Framework of Disaster Nursing Competencies of the WHO and ICN, broken down into national core competencies, will serve as a sufficient complement to the knowledge and skills of nurses already acquired through basic nursing curricula. During and after a disaster, attention should be applied to the work environment, feelings and stressors of nurses, not only to raise the willingness to respond to a disaster. Where non-existent, national directives and concepts for disaster nursing should be developed and nurses should be aware of their duties. Nursing educators should prepare nurses for disasters, by adjusting the curricula and by meeting the increased need for education and training in disaster nursing for all groups of nurses. The appropriateness of theoretical and practical preparation of disaster nursing competencies in undergraduate nursing courses and continuing education programmes should be evaluated
Nursesâ roles, knowledge and experience in national disaster pre-paredness and emergency response: A literature review
Aim: Nurses play a central role in disaster preparedness and management, as well as in emergency response, in many countries over the world. Care in a disaster environment is different from day-to-day nursing care and nurses have special needs during a disaster. However, disaster nursing education is seldom provided and a lack of curricula exists in many countries around the world. The aim of this literature review is to provide an overview of nursesâ roles, knowledge and experience in national disaster preparedness and emergency response.Methods: An electronic search was conducted using multiple literature databases. All items were included, regardless of the publication year. All abstracts were screened for relevance and a synthesis of evidence of relevant articles was undertaken. Relevant information was extracted, summarized and categorized. Out of 432 reviewed references, information of 68 articles was included in this review.Results: The sub-themes of the first main theme (a) roles of nurses during emergency response include the expectations of the hospital and the public, general and special roles of nurses, assignments of medical tasks, special role during a pandemic influenza, role conflicts during a disaster, willingness to respond to a disaster. For (b) disaster preparedness knowledge of nurses, the corresponding sub-themes include the definition of a disaster, core competencies and curriculum, undergraduate nursing education and continuing education programs, disaster drills, training and exercises, preparedness. The sub-themes for the last theme (c) disaster experiences of nurses include the work environment, nursing care, feelings, stressors, willingness to respond as well as lessons learned and impacts.Conclusion: There is consensus in the literature that nurses are key players in emergency response. However, no clear mandate for nurses exists concerning their tasks during a disaster. For a nurse, to be able to respond to a disaster, personal and professional preparedness, in terms of education and training, are central. The Framework of Disaster Nursing Competencies of the WHO and ICN, broken down into national core competencies, will serve as a sufficient complement to the knowledge and skills of nurses already acquired through basic nursing curricula. During and after a disaster, attention should be applied to the work environment, feelings and stressors of nurses, not only to raise the willingness to respond to a disaster. Where non-existent, national directives and concepts for disaster nursing should be developed and nurses should be aware of their duties. Nursing educators should prepare nurses for disasters, by adjusting the curricula and by meeting the increased need for education and training in disaster nursing for all groups of nurses. The appropriateness of theoretical and practical preparation of disaster nursing competencies in undergraduate nursing courses and continuing education programmes should be evaluated. Â
Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)
Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (â0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL
Recruitment and Baseline Characteristics of Participants in the âSanadakâ Trial: A Self-Help App for Syrian Refugees with Post-traumatic Stress
Many Syrian refugees residing in Germany have been exposed to traumatizing events, while treatment options are scarce. Therefore, the self-help app âSanadakâ was developed to target post-traumatic stress in Syrian refugees. We aimed to inspect the recruitment and baseline characteristics of the participants in the trial, which is conducted to evaluate the app. Analyses were based on the recruitment sample (n = 170) and the trial sample (n = 133). Data were collected during structured face-to-face interviews in the Arabic language. Targeted outcomes included post-traumatic stress (primary; Post-traumatic Diagnostic Scale for DSM-5/PDS-5) and depressive symptoms, anxiety, resilience, among others (secondary). Recruited individuals were M = 32.8 (SD = 11.2, range = 18â65) years old; 38.8% were women. The average PDS-5 score was 23.6 (SD = 13.2) regarding trauma exposure, which was most frequently related to experiencing military- or combat-related events (32.9%). Moreover, 46.5% had major depression and 51.8% showed low resilience. Anxiety was present in 40.6% of the trial participants. Psychological distress was high in Syrian refugees residing in Germany, enrolled in a trial targeting post-traumatic stress. This underlines the need for intervention. Our results provide important figures on the mental health of a not well-studied population group in Germany
Mental Health Self-Stigma of Syrian Refugees With Posttraumatic Stress Symptoms: Investigating Sociodemographic and Psychopathological Correlates
Background: The high prevalence of mental disorders related to posttraumatic stress
among Syrian refugees is often in contrast with their low utilization ofmental health care in
the host countries. Mental health self-stigma, i.e., internalized stigma of having a mental
disorder, could prevent individuals from seeking mental health care. Therefore, we aimed
to provide evidence on different aspects of mental health self-stigmatization among adult
Syrian refugees with posttraumatic stress symptoms residing in Germany. Moreover, we
investigated associations with sociodemographic and psychopathological variables in
order to identify those at higher risk of self-stigmatization.
Material and Methods: Overall, 133 participants with mild to moderate posttraumatic
stress symptoms were recruited in the metropolitan areas of Leipzig, Dresden and Halle,
Germany, using a multimodal approach. Mental health self-stigma was assessed using
the Self-Stigma of Mental Illness Scale â Short Form (SSMIS-SF), consisting of four
subscales (Stereotype awareness, Stereotype agreement, Application to self, Harm to
self-esteem), each scoring from 5 (low) to 45 (high) points. Linear regression analysis
was used to test associations of sociodemographic and psychopathological variables
with self-stigma subscales.
Results: On average, self-stigma ratings ranged from 16.5 (SD = 6.6) points on
Application to self to 28.3 (SD = 7.5) points on Stereotype awareness. Results showed
higher scores on Application to self for individuals who were younger (t =2.65, p=0.009)
and single (F = 5.70, p = 0.004). Regression analyses yielded statistically significant
associations between having multiple comorbidities and a higher Application to self
stigma ( = 0.18, p = 0.044), controlling for sociodemographic covariates.
Discussion: Mental health self-stigma was increased among Syrian refugees in
Germany. Correlates of increased self-stigma could inform efforts to improve access to
mental health care among Syrian refugees with mental ill-health. Longitudinal studies
following an intersectional approach by concurrently examining multiple forms of public
and internalized stigma could provide helpful insights for developing tailored stigma
reduction efforts in this context
Traumatized Syrian Refugees with Ambiguous Loss: Predictors of Mental Distress
Refugees from war zones often have missing significant others. A loss without confirmation is described as an ambiguous loss. This physical absence with simultaneous mental persistence can be accompanied by economic, social or legal problems, boundary ambiguity (i.e., uncertainty about who belongs to the family system), and can have a negative impact on mental health. The aim of this study was to identify sociodemographic and loss-related predictors for prolonged grief, anxiety, depression, post-traumatic stress disorder (PTSD) and somatization in treatment-seeking Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. For the present study, data were based on the treatment-seeking baseline sample of the âSanadakâ randomized-controlled trial, analyzing a subsample of 47 Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. Sociodemographic and loss-related questions were applied, along with standardized instruments for symptoms of prolonged grief (ICG), anxiety (GAD-7), depression (PHQ-9), PTSD (PDS-5) and somatization (PHQ-15). Linear regression models were used to predict mental health outcomes. Having lost a close family member and higher boundary ambiguity showed a statistically significant association with higher severity in prolonged grief. The overall model for somatization reached statistical significance, while no predictor independently did. Boundary ambiguity showed a statistically significant positive association with depression, while the overall model showed no statistically significant associations. Boundary ambiguity and missing family members seemed to be important predictors for prolonged grief. These findings support the importance of reunification programs and suggest an inclusion of the topic into psychosocial support structures, e.g., including psychoeducational elements on boundary ambiguity in support groups for traumatized individuals and families experiencing ambiguous loss. Further research is needed for a more detailed understanding of the impact of ambiguous loss on refugee populations
Cost-effectiveness of integrated collaborative care for comorbid major depression in patients with cancer
OBJECTIVES: Comorbid major depression is associated with reduced quality of life and greater use of healthcare resources. A recent randomised trial (SMaRT, Symptom Management Research Trials, Oncology-2) found that a collaborative care treatment programme (Depression Care for People with Cancer, DCPC) was highly effective in treating depression in patients with cancer. This study aims to estimate the cost-effectiveness of DCPC compared with usual care from a health service perspective. METHODS: Costs were estimated using UK national unit cost estimates and health outcomes measured using quality-adjusted life-years (QALYs). Incremental cost-effectiveness of DCPC compared with usual care was calculated and scenario analyses performed to test alternative assumptions on costs and missing data. Uncertainty was characterised using cost-effectiveness acceptability curves. The probability of DCPC being cost-effective was determined using the UK National Institute for Health and Care Excellence's (NICE) cost-effectiveness threshold range of ÂŁ 20,000 to ÂŁ 30,000 per QALY gained. RESULTS: DCPC cost on average ÂŁ 631 more than usual care per patient, and resulted in a mean gain of 0.066 QALYs, yielding an incremental cost-effectiveness ratio of ÂŁ 9549 per QALY. The probability of DCPC being cost-effective was 0.9 or greater at cost-effectiveness thresholds above ÂŁ 20,000 per QALY for the base case and scenario analyses. CONCLUSIONS: Compared with usual care, DCPC is likely to be cost-effective at the current thresholds used by NICE. This study adds to the weight of evidence that collaborative care treatment models are cost-effective for depression, and provides new evidence regarding their use in specialist medical settings
Health-Related Quality of Life of Persons with Direct, Indirect and No Migration Background in Germany: A Cross-Sectional Study Based on the German Socio-Economic Panel (SOEP)
Global migration towards and within Europe remains high, shaping the structure of populations. Approximately 24% of the total German population had a migration background in 2017. The aim of the study was to analyze the association between migration background and health-related quality of life (HrQoL) in Germany. The analyses were based on 2014 and 2016 data of the German Socio-Economic Panel. Differences in sociodemographic characteristics between migrant and non-migrant samples were equal by employment of the entropy balancing weights. HrQoL was measured using the physical (PCS) and mental (MCS) component summary scores of the SF-12v2. Associations between PCS and MCS scores and migration background were examined using Studentâs t-test. The mean PCS and MCS scores of persons with migration background (n = 8533) were 51.5 and 50.9, respectively. Persons with direct migration background had a lower PCS score (â0.55, p < 0.001) and a higher MCS score (+1.08, p < 0.001) than persons without migration background. Persons with direct migration background differed with respect to both physical and mental HrQoL from persons without migration background in the German population. Differences in HrQoL for persons with indirect migration background had p = 0.305 and p = 0.072, respectively. Causalities behind the association between direct migration background and HrQoL are to be determined