Comparing Continuous and Dichotomous Scoring of Social Desirability Scales: Effects of Different Scoring Methods on the Reliability and Validity of the Winkler-Kroh-Spiess BIDR Short Scale

Survey researchers often include measures of social desirability in questionnaires. The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1991) is a widely used instrument that measures two components of socially desirable responding: self-deceptive enhancement (SDE) and impression management (IM). An open question is whether these scales should be scored dichotomously (counting only extreme values) or continuously (taking the mean of the answers). This paper compares the two methods with respect to test-retest reliability (stability) and internal consistency using a short German version of the BIDR (Winkler, Kroh, & Spiess, 2006). Tests of criterion validity are also presented. Data are taken from a post-stratified national probability sample of German family doctors (n = 166). All retest reliabilities exceed .70. No significant differences in test-retest reliability are found for the SDE subscale and the combined scale; the IM subscale attains significantly higher test-retest reliability when scored continuously. Internal consistency is significantly higher for the continuously scored scales in one of two Waves. Tests of criterion validity yield expected results. Overall, these results suggest that the short German scale is a valid measure of socially desirable responding and support the case for continuous rather than dichotomous scoring of BIDR scales

Expanding the Health Information National Trends Survey Research Program Internationally to Examine Global Health Communication Trends: Comparing Health Information Seeking Behaviors in the U.S. and Germany

The Health Information National Trends Survey (HINTS) is a well-established U.S.-based research program administered by the National Cancer Institute to track the public access to and use of health information. This paper introduces a German research initiative, part of the International Studies to Investigate Global Health Information Trends (INSIGHTS) research consortium. This adaptation of the HINTS is important for initiating analyses of global health communication practices and comparing health information seeking behaviors (HISB) across nations to pinpoint potentials and challenges of health information provision and contribute to a deeper understanding of socio-contextual determinants of HISB. First cross-country comparisons revealed that the share of residents seeking for health information is high in the U.S. (80%) and Germany (74%), but different primary sources are used. Whereas a clear majority of U.S. residents chose the Internet to gather health information (74.9%), Germans most often turn to health professionals (48.0%). Socio-structural and health(care)-related predictors were found to contribute to the explanation of HISB in both countries, whereas information-related predictors were only relevant in Germany. The results indicate the need to engage in patient-provider communication to initiate HISB and to improve the access to information for residents with lower socio-economic backgrounds

Informal caregivers during the COVID-19 pandemic perceive additional burden: findings from an ad-hoc survey in Germany

Background: While the relation between care involvement of informal caregivers and caregiver burden is well-known, the additional psychosocial burden related to care involvement during the COVID-19 pandemic has not yet been investigated. Methods: A total of 1000 informal caregivers, recruited offline, participated in a cross-sectional online survey from April 21 to May 2, 2020. Questionnaires were used to assess COVID-19-specific changes in the care situation, negative feelings in the care situation, problems with implementation of COVID-19 measures, concerns/excessive demands, loss of support, change in informal caregivers' own involvement in care and problems with provision, comprehension & practicability of COVID-19 information, and to relate these issues to five indicators of care involvement (i.e., being the main caregiver, high expenditure of time, high level of care, dementia, no professional help). Binomial and multiple regression analyses were applied. Results: Across indicators of care involvement, 25.5-39.7% reported that the care situation rather or greatly worsened during the COVID-19 pandemic, especially for those caring for someone with dementia or those usually relying on professional help. In a multiple regression model, the mean number of involvement indicators met was associated with age (beta = .18; CI .10-.25), excessive demands (beta = .10, CI .00-.19), problems with implementation of COVID-19 measures (beta = .11, CI .04-.19), an increase in caregiving by the informal caregivers themselves (beta = .14, CI .03-.24) as well as with no change in the amount of caregiving (beta = .18, CI .07-.29) and loss of support (beta = -.08, CI -.16-.00). No significant associations with the mean number of involvement indicators met were found for gender, educational level, change in the care situation, negative feelings, and provision, comprehension & practicability of COVID-19 information. Conclusion: Those caregivers who perceived extensive care burden were those who suffered most during the pandemic, calling for structural support by the healthcare system now and in the future

Complementary and Integrative Medicine in Nursing Homes: Results of a Cross-Sectional Study in Residents and Caregivers

Objective: Some nursing homes for the elderly in Germany integrate complex complementary and integrative medicine interventions in the form of hydrotherapy, herbal and mind-body therapies, physical activities, and healthy eating, known as Kneipp therapy (KT), in care. This pilot study explored health- and work-related characteristics and acceptance of KT amongst residents and caregivers. Methods: Within a mixed-methods cross-sectional study in nursing homes who had integrated KT, we assessed work ability, psychosocial burden at work and health-related quality of life of caregivers, as well as a broad selection of health-related data of residents by questionnaires and assessments. Data were analyzed descriptively. Results: The data from 29 female caregivers (42.0 ± 11.7 years) and 64 residents (83.2 ± 8.1 years) were analyzed. Both caregivers (96%) and residents (89%) considered KT to be beneficial for health and well-being. Ninety percent of the caregivers indicated an improved relationship to residents since implementing KT. Caregivers showed a good work ability and quality of life. Residents attained remarkable ratings in social relation and affect-related aspects of quality of life. Conclusion: The results of this cross-sectional study indicate a high acceptance of integrating KT by residents and caregivers. The effectiveness and safety of KT should be explored in further comparative studies.Hintergrund: Einige Senioreneinrichtungen in Deutschland integrieren die Kombination aus Hydrotherapie, Phytotherapie, Ordnungstherapie, Bewegung und gesunder Ernährung als Kneipp-Therapie (KT) in die Pflege und Betreuung von Bewohnern. Diese Pilotstudie zielte darauf ab, gesundheits- und arbeitsbezogene Charakte­ristika und die Akzeptanz von KT bei Bewohnern und ­Mitarbeitern dieser Pflegeeinrichtungen zu untersuchen. Methoden: Im Rahmen einer Mixed-Methods-Querschnittsstudie in vier Senioreneinrichtungen, die KT integrierten, wurden unter anderem die Arbeitsfähigkeit, die psychosoziale Belastung am Arbeitsplatz und die gesundheitsbezogene Lebensqualität der Pflegekräfte sowie eine breite Auswahl an gesundheitsbezogenen Daten und die Lebensqualität der Bewohner durch Fragebögen erhoben. Alle Daten wurden deskriptiv analysiert. Ergebnisse: Es wurden die Daten von 29 Mitarbeiterinnen (42,0 ± 11,7 Jahre) und 64 Bewohnern (83,2 ± 8,1 Jahre) analysiert. Sowohl die Pflegekräfte (96%) als auch die Bewohner (89%) betrachteten KT als vorteilhaft für die Gesundheit und das Wohlbefinden. Ausserdem gaben 90% der Mitarbeiterinnen eine verbesserte Beziehung zu den Bewohnern seit der Einführung von KT an. Die Mitarbeiterinnen zeigten eine gute Arbeitsfähigkeit und Lebensqua­lität. Die Bewohner zeigten gute Bewertungen von Aspekten der Lebensqualität, die mit sozialer Beziehung und Affekt zusammenhängen. Fazit: Die Ergebnisse zeigen, dass KT in den untersuchten Senioreneinrichtungen von den Bewohnern und Betreuern gut angenommen wurde. Die spezifische Wirksamkeit und Sicherheit von KT sollten in weiteren vergleichenden Studien untersucht werden

results of a mixed methods pilot study

Background ‘Kneipp Therapy’ (KT) is a form of Complementary and Alternative Medicine (CAM) that includes a combination of hydrotherapy, herbal medicine, mind-body medicine, physical activities, and healthy eating. Since 2007, some nursing homes for older adults in Germany began to integrate CAM in the form of KT in care. The study investigated how KT is used in daily routine care and explored the health status of residents and caregivers involved in KT. Methods We performed a cross-sectional pilot study with a mixed methods approach that collected both quantitative and qualitative data in four German nursing homes in 2011. Assessments in the quantitative component included the Quality of Life in Dementia (QUALIDEM), the Short Form 12 Health Survey (SF-12), the Barthel-Index for residents and the Work Ability Index (WAI) and SF-12 for caregivers. The qualitative component addressed the residents’ and caregivers’ subjectively experienced changes after integration of KT. It was conceptualized as an ethnographic rapid appraisal by conducting participant observation and semi-structured interviews in two of the four nursing homes. Results The quantitative component included 64 residents (53 female, 83.2 ± 8.1 years (mean and SD)) and 29 caregivers (all female, 42.0 ± 11.7 years). Residents were multimorbid (8 ± 3 diagnoses), and activities of daily living were restricted (Barthel-Index 60.6 ± 24.4). The caregivers’ results indicated good work ability (WAI 37.4 ± 5.1), health related quality of life was superior to the German sample (SF-12 physical CSS 49.2 ± 8.0; mental CSS 54.1 ± 6.6). Among both caregivers and residents, 89% considered KT to be positive for well-being. The qualitative analysis showed that caregivers perceived emotional and functional benefits from more content and calmer residents, a larger variety in basic care practices, and a more self-determined scope of action. Residents reported gains in attention and caring, and recognition of their lay knowledge. Conclusion Residents showed typical characteristics of nursing home inhabitants. Caregivers demonstrated good work ability. Both reported to have benefits from KT. The results provide a good basis for future projects, e.g. controlled studies to evaluate the effects of CAM in nursing homes

Complementary Medicine in Nursing Homes - Results of a Mixed Methods Pilot Study

BACKGROUND: ‘Kneipp Therapy’ (KT) is a form of Complementary and Alternative Medicine (CAM) that includes a combination of hydrotherapy, herbal medicine, mind-body medicine, physical activities, and healthy eating. Since 2007, some nursing homes for older adults in Germany began to integrate CAM in the form of KT in care. The study investigated how KT is used in daily routine care and explored the health status of residents and caregivers involved in KT. METHODS: We performed a cross-sectional pilot study with a mixed methods approach that collected both quantitative and qualitative data in four German nursing homes in 2011. Assessments in the quantitative component included the Quality of Life in Dementia (QUALIDEM), the Short Form 12 Health Survey (SF-12), the Barthel-Index for residents and the Work Ability Index (WAI) and SF-12 for caregivers. The qualitative component addressed the residents’ and caregivers’ subjectively experienced changes after integration of KT. It was conceptualized as an ethnographic rapid appraisal by conducting participant observation and semi-structured interviews in two of the four nursing homes. RESULTS: The quantitative component included 64 residents (53 female, 83.2 ± 8.1 years (mean and SD)) and 29 caregivers (all female, 42.0 ± 11.7 years). Residents were multimorbid (8 ± 3 diagnoses), and activities of daily living were restricted (Barthel-Index 60.6 ± 24.4). The caregivers’ results indicated good work ability (WAI 37.4 ± 5.1), health related quality of life was superior to the German sample (SF-12 physical CSS 49.2 ± 8.0; mental CSS 54.1 ± 6.6). Among both caregivers and residents, 89% considered KT to be positive for well-being. The qualitative analysis showed that caregivers perceived emotional and functional benefits from more content and calmer residents, a larger variety in basic care practices, and a more self-determined scope of action. Residents reported gains in attention and caring, and recognition of their lay knowledge. CONCLUSION: Residents showed typical characteristics of nursing home inhabitants. Caregivers demonstrated good work ability. Both reported to have benefits from KT. The results provide a good basis for future projects, e.g. controlled studies to evaluate the effects of CAM in nursing homes

Pflegerische Bedarfslagen und Versorgungsqualität in der ambulanten Pflege in Deutschland

In den empirischen Arbeiten dieser Habilitationsschrift wird die Versorgungssituation Pflegebedürftiger in der ambulanten Pflege in Deutschland beleuchtet und hierzu pflegerische Bedarfslagen sowie ausgewählte Aspekte der Versorgungsqualität analysiert. Es wird gezeigt, dass für den Großteil der ambulant Gepflegten die Versorgung mit Leistungen ambulanter Pflegedienste als bedarfsadäquat angesehen werden kann. Allerdings wird für alleinlebende Pflegebedürftige und pflegebedürftige Frauen Mehrbedarf an Unterstützung durch ambulante Dienste nachgewiesen. Zudem wird die Inkontinenzversorgung sowie die Unterstützung bei der Nahrungsaufnahme und Mobilität als Bereiche der pflegerischen Unterversorgung in der ambulanten Pflege in Deutschland identifiziert. Durch bundesweite repräsentative Querschnittserhebungen werden die Punktprävalenzen der Mangelernährung, chronischer Schmerzen und der Harninkontinenz bei Pflegebedürftigen in der ambulanten Pflege in Deutschland geschätzt. Die ermittelten Prävalenzen unterstreichen die Bedeutung der Mangelernährung, chronischer Schmerzen und der Harninkontinenz für den ambulant-pflegerischen Versorgungsbereich sowie die Relevanz von Maßnahmen zur Vermeidung dieser drei pflegerelevanten Gesundheitsprobleme. Dahingehend können für die drei geriatrischen Syndrome mögliche Ansatzpunkte zur Prävention von Pflegebedarfen sowie zur Verbesserung der Qualität der ambulanten Pflege in Deutschland aufgezeigt werden. Zur Identifikation von Einflussfaktoren auf pflegerische Bedarfslagen und die Versorgungsqualität in der ambulanten Pflege wird eine umfassende Strukturanalyse ambulanter Pflegedienste in Deutschland vorgenommen. Bei insgesamt vergleichbaren Strukturparametern der ambulanten Einrichtungen zeigen sich zwischen privaten und nicht privaten Anbietern im Personalbereich einige statistisch signifikante Unterschiede hinsichtlich des Anteils angestellter Pflegefachkräfte sowie der Fachkraftstunden, die bei der Pflege durch einen Dienst im Durchschnitt klientenbezogen aufgewandt werden. Mit den eingesetzten Methoden kann jedoch kein Zusammenhang zwischen den erhobenen Strukturunterschieden und der pflegerischen Ergebnisqualität nachgewiesen werden