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Biomedical subjects

Cornelia Mahler

Publications and source records attributed to Cornelia Mahler.

7 recordsLinked to original sources
PubMed2006

Problems and needs for improving primary care of osteoarthritis patients: the views of patients, general practitioners and practice nurses.

BACKGROUND: Osteoarthritis (OA) is highly prevalent and has substantial impact on quality of life as well as on healthcare costs. The general practitioner (GP) often is the first care provider for patients with this chronic disease. The aim of this study was to identify health care needs of patients with OA and to reveal possible obstacles for improvements in primary care management of OA patients. METHODS: We performed semi-structured interviews with a stratified sample of 20 patients, 20 GPs and 20 practice nurses. RESULTS: Diagnosing OA posed no major problem, but during the course of OA, GPs found it difficult to distinguish between complaints resulting from the affection of the joints and complaints related to a concomitant depression. Patients felt to be well informed about the degenerative nature of the disease and possible side effects of medications, but they lacked information on individual consequences of the disease. Therefore, the most important concerns of many patients were pain and fear of disability which they felt to be addressed by GPs only marginally. Regarding pain treatment, physicians and patients had an ambivalent attitude towards NSAIDs and opiates. Therefore, pain treatment was not performed according to prevailing guidelines. GPs felt frustrated about the impact of counselling regarding life style changes but on the other hand admitted to have no systematic approach to it. Patients stated to be aware of the impact of life style on OA but lacked detailed information e.g. on how to exercise. Several suggestions were made concerning improvement. CONCLUSION: GPs should focus more on disability and pain and on giving information about treatment since these topics are inadequately addressed. Advanced approaches are needed to increase GPs impact on patients' life style. Being aware of the problem of labelling patients as chronically ill, a more proactive, patient-centred care is needed.

Adult↗
PubMed2006

IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study.

BACKGROUND: Factors of IT adoption have largely been discussed in the literature. However, existing frameworks (such as TAM or TTF) are failing to include one important aspect, the interaction between user and task. METHOD: Based on a literature study and a case study, we developed the FITT framework to help analyse the socio-organisational-technical factors that influence IT adoption in a health care setting. RESULTS: Our FITT framework ("Fit between Individuals, Task and Technology") is based on the idea that IT adoption in a clinical environment depends on the fit between the attributes of the individual users (e.g. computer anxiety, motivation), attributes of the technology (e.g. usability, functionality, performance), and attributes of the clinical tasks and processes (e.g. organisation, task complexity). We used this framework in the retrospective analysis of a three-year case study, describing the adoption of a nursing documentation system in various departments in a German University Hospital. We will show how the FITT framework helped analyzing the process of IT adoption during an IT implementation: we were able to describe every found IT adoption problem with regard to the three fit dimensions, and any intervention on the fit can be described with regard to the three objects of the FITT framework (individual, task, technology). We also derive facilitators and barriers to IT adoption of clinical information systems. CONCLUSION: This work should support a better understanding of the reasons for IT adoption failures and therefore enable better prepared and more successful IT introduction projects. We will discuss, however, that from a more epistemological point of view, it may be difficult or even impossible to analyse the complex and interacting factors that predict success or failure of IT projects in a socio-technical environment.

Anxiety↗
PubMed2004

[The application of hydrocolloids in genital skin care of pre-term infants].

Since 1994 the neonatal care research of the Division of Neonatology, Department of Pediatrics, University of Heidelberg has been occupying itself with skin damage and skin hygiene in newborn and pre-term infants. Due to positive practical experiences when applying a hydrocolloid to pre-term infants with skin damage in genitalia, a randomized controlled study was conducted to investigate whether the application of the hydrocolloid or the valid guideline would promote the healing of the damaged skin. A protocol was developed and data was collected over a period of 19 months. The results show, that the length of time needed for skin recovery was shorter when applying a hydrocolloid in comparison to the guideline. A number of further issues were anticipated to be investigated, however could not be evaluated. Reasons for this are in the structural circumstances/conditions while executing/performing the study as well as the study design. These important discoveries, regarding the execution of studies during everyday clinical practice are regarded as important results/findings in this study.

Colloids↗
PubMed2003

[Effects of a computer-assisted system for nursing care documentation on quality and quantity of nursing care documentation].

The University Hospital in Heidelberg has been gathering experience with the computer based nursing documentationsystem PIK since 1998. Its introduction on four pilotwards was systematically evaluated in an intervention study, gaining data to acceptance issues as well as to the quality of nursing documentation, as the nursing process is often not documented in an appropriate manner. Data to quantity and quality of nursing documentation before and after the intervention was gathered by means of a quality checklist, which was developed on the basis of an intensive literature review. To measure a difference in the quality of nursing documentation 20 documents from each of the four wards were assessed at the three assigned points of time by two nursing experts. The assessors stated a significant improvement in documentation quality due to the increase in formal completeness when documenting the nursing process. The content of the documentation as well as the individualization of the nursing care plan still need to be improved.

Attitude to Computers↗
PubMed2002

Are quantitative methods sufficient to show why wards react differently to computer-based nursing documentation?

Computer-based documentation of the nursing process is being introduced into hospitals more and more. Frequently, the introduction is followed by an evaluation of positive and negative effects. However, the often-used quantitative evaluation methods cannot fully illuminate the different success factors of computer-based nursing documentation systems. We introduced a computer-based nursing documentation system on four wards of the University Medical Centre of Heidelberg and systematically evaluated its effects in a two-year study. The quantitative analysis of the results showed that the wards reacted differently to the documentation system. In this paper, we will first take a look at the quantitative results of our evaluation study, and will then discuss possible reasons for the detected differences. We will then argue that only qualitative methods can help to fully reveal both expected and unexpected reasons for differences between the wards. Analysing the reasons for the different reactions will help lead to a better understanding of the factors that lead influence the successful introduction of a computer-based nursing documentation system. Both quantitative analysis and qualitative analysis have a role in this information system evaluation.

Academic Medical Centers↗