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Theo Dassen

Publications and source records attributed to Theo Dassen.

At least 37 records · Page 2Linked to original sources
PubMed2005

Risk factors for urinary incontinence in nursing home residents.

QUESTION: What are potential risk factors for urinary incontinence in nursing home residents older than 65 years at the time of admission and over time? METHOD: Secondary analysis of data from the Minimum Data Set of the Resident Assessment Instrument in a cross-section as well as a longitudinal section. The sample contained data of 2722 residents from 42 different geriatric and nursing homes in north-west Switzerland. RESULTS: The cross-sectional analysis showed the variable "moving in bed" as the most important personal variable for incontinence at admission. LONGITUDINAL ANALYSES: The most important risk factor was 'moving in bed' as it continued its action even at 12 months. In a further analysis (incontinence one year after admission with the risk factors at admission) the items "long-term memory, state season and walking in room" were important factors. CONCLUSION: The data suggest that mental and physical exercises could be a way to reduce urinary incontinence. However, physical exercises would be the most important, because "moving in bed" continued its action even at 12 months. Despite some limitations attributable to the data collection, this is the first study in Switzerland to examine risk factors for urinary incontinence among nursing home residents.

Age Factors↗
PubMed2005

[Experiencing the disease of breast cancer and getting life under control again].

Women experiencing breast cancer are confronted with a live threatening disease and find themselves in a situation that changes and restricts their life psychologically, physically and socially. This qualitative investigation examined the experience of living with breast cancer from the perspective of newly diagnosed women. Ten women were interviewed at the end of their radiotherapy. The interviews are analysed with the method of content analysis. The findings show three domains. First domain: From living in fear of having breast cancer to the confirmation of its diagnosis. These women perceive the confirmation of the diagnosis as a shock and initially plunge into an existential crisis. The life threatening disease with an unpredictable future, feelings of vulnerability, uncertainty, hopelessness and anxiety often make them depressed. They need all their energy to maintain control over their life, by suppressing emotions to protect themselves from overwhelming feelings and suffering. Second domain: Experiencing the therapy. The women undergo weakening aggressive and invasive treatment regimes, leaving them in a condition worse than before. Physically exhausted, they sometimes don't know how to go through and overcome this time. Lack of energy, tiredness and fatigue are ongoing problems. Being diagnosed with breast cancer, the suddenly become patients, having to cope with a complex healthcare system. From doctors and nurses they expect empathy, caring and expertise. When in contact with health care, they often hide their suffering, while in fact, they are extremely vulnerable and in deep despair. Third domain: Hold out and live. Women living with breast cancer have no choice but to go through this situation. By motivating their self they regain and mobilise their vital energy. They try to suppress their suffering and dark, intrusive memories. Support from relatives is very important, however, such women tend to protect them from their suffering. The definition of the role of these relatives and their suffering remain unclear. In a future study, research is needed to determine precisely which psychosocial variables are effective in promoting greater health for women with breast cancer and their families, taking into consideration the dynamic of the relationship between women with breast cancer and their relatives as well as the influence of their mutual support.

Adaptation, Psychological↗
PubMed2005

Non-somatic effects of patient aggression on nurses: a systematic review.

AIM: This paper describes a systematic review of the predominant non-somatic effects of patient assault on nurses. Background. Patient aggression towards nurses is a longstanding problem in most nursing domains. Although reports on the consequences of physical aggression are more numerous, the non-physical effects create much suffering. METHOD: A systematic review of literature from 1983 to May 2003 was conducted using the Medline, CINAHL, PsychINFO and PSYINDEX databases. Articles from international journals in English or German and reporting at least three non-somatic responses to patient aggression were included. FINDINGS: The electronic search produced 6616 articles. After application of the inclusion and exclusion criteria, 25 texts from eight countries and four domains of nursing remained. Twenty-eight main effects were found, and these were categorized using a system suggested by Lanza and including bio-physiological, emotional, cognitive, and social dimensions. The predominant responses were anger, fear or anxiety, post-traumatic stress disorder symptoms, guilt, self-blame, and shame. These main effects occurred across most countries and nursing domains. CONCLUSION: Despite differing countries, cultures, research designs and settings, nurses' responses to patient aggression are similar. Standardized questionnaires could help improve estimations of the real prevalence of non-somatic effects. Given the suffering caused by non-somatic effects, research should be aimed at preventing patient aggression and at developing better ways to prepare nurses to cope with this problem.

Aggression↗
PubMed2005

Prevalence of pressure ulcers in Germany.

AIMS AND OBJECTIVES: This article establishes the prevalence of pressure ulcers in hospitals and nursing homes for national and international comparison. BACKGROUND: Although many European countries evaluate the prevalence of pressure ulcers, it has not recently been examined in German healthcare facilities. DESIGN: Descriptive study design, point prevalence survey in 2001 and 2002. A total of 11 584 patients and residents in 66 institutions throughout Germany took part in the study. METHODS: Prevalence rates were calculated for the different types of institutions, different years, different risk groups and different disciplines. All calculations were made by including as well as excluding pressure ulcer grade 1. The Braden scale (cut-off < or =20) was applied to define at risk and not at risk patients/residents. RESULTS: The prevalence including (excluding) grade 1 pressure ulcers was 11.7% (5.2%) for the whole sample, while in the group at risk it was 24.5% (11.5%). The size of the group at risk in the nursing homes was 63.9% and less than 40% in the hospitals. Comparisons between disciplines showed a great range of prevalence rates. The use of special surface devices for persons at risk was more common in nursing homes than in hospitals. CONCLUSION: The prevalence of pressure ulcers bears resemblance to results produced by other studies, but it is uncertain if these similarities are more than coincidental. Due to the influence of sampling the use of a standardized samples method is essential. For comparisons of groups with differences regarding their risk assessment it would be more appropriate to use the prevalence of patients and residents at risk. RELEVANCE TO CLINICAL PRACTICE: The study provides accurate data about the extent of the problem of pressure ulcers in German healthcare facilities.

Age Distribution↗
PubMed2005

Ageing, care dependency, and care for older people in Egypt: a review of the literature.

AIMS: The purpose of this study was to gain an overview of the current situation of ageing and elderly care in Egypt and to consider the ensuing socio-economical problems, which provide the framework for the provision of care. BACKGROUND: Recent discussions about demographic transition in developing countries suggest a change in their age group composition. Possible implications of this development for nursing care require closer examination. METHOD: Literature about ageing and elderly care in Egypt of the period from 1980-2004 was researched and reviewed. RESULTS: Despite the scarcity of literature and the lack of precision in many cases, it is possible to outline an overall development. Ageing is a slowly emerging phenomenon in Egypt contributing to a change in the country's age group composition. The ensuing care dependency appears to become a problem especially for lower and middle class members due to economical restrictions and life-style changes. In relation to the need, there is a shortage of care-providing institutions. Furthermore, geriatric homes seem to differ in their quality according to the residents' social status. CONCLUSION: The existing types of geriatric homes will serve as prototypes for future development. There is however, a need for additional homecare services to reduce care givers' strain in the families.

Age Distribution↗
PubMed2005

The Impact of Patient Aggression on Carers Scale: instrument derivation and psychometric testing.

Patient aggression towards carers constitutes a problem for patients and carers alike. Patients' aggressive behaviour often leads to adverse consequences for carers, especially nurses. Various extensive instruments have been developed to measure such adverse effects on carers. The 'Impact of Patient Aggression on Carers Scale' (IMPACS) is a short instrument intended for use in monitoring negative consequences of such incidents. The items of the IMPACS were derived basically from a review of the literature on negative effects of patient aggression on nurses. The IMPACS was administered to a convenience sample of nurses working on 14 psychiatric acute admission wards in the German speaking part of Switzerland. Factor analysis led to the exclusion of three of the original items and to an interpretable three-factor solution with all factors demonstrating eigen values higher than 1. The factors demonstrate moderate to good internal consistency. Canonical correlation analysis using the dimensions of the Maslach Burnout Inventory (MBI) produced a correlation coefficient of 0.457, thus demonstrating external reliability. In spite of some caveats such as possible response bias and the necessity of the investigation of the test-retest stability of the scale this study suggests that the IMPACS is a good measure of adverse effects and thus merits further development.

Adult↗
PubMed2005

The effect of a training course on nursing students' attitudes toward, perceptions of, and confidence in managing patient aggression.

Patient aggression is a problem in many health care settings, and nursing students are among the most vulnerable to experiencing such aggression. Training courses have been suggested to help nurses better manage patient aggression. Such courses can lead to changes in attitudes toward and perceptions of, as well as greater confidence in managing, aggression. In this quasi-experimental study, we investigated the effect of a training course on nursing students' attitudes toward, perceptions of, and confidence in managing patient aggression. Students in the intervention group demonstrated enhanced confidence but no change in attitude after the training course, while students in the control group remained stable on all measures. The short time frame of the study, the training course itself, and the instruments used for monitoring attitudes toward aggression are possible reasons for these results. We tentatively conclude that it is possible to enhance nursing students' perceived confidence in managing patient aggression without changing their fundamental views of it.

Adaptation, Psychological↗
PubMed2004

A comparison of pressure ulcer prevalence: concerted data collection in the Netherlands and Germany.

OBJECTIVES: Because of a lack of epidemiological data of pressure ulcer (PU) among care dependent patients yearly prevalence measurements are held in the Netherlands and in Germany with identical methods. A comparison shows remarkable differences in the PU prevalence so that further analysis is needed to enlighten the reasons. DESIGN: With a standardized questionnaire all patients were examined by trained nurses of the participating facilities. SETTING: In-patients in 42 Dutch and 10 German acute care Hospitals. PARTICIPANTS: All patients who handed in their informed consent were included. In the Netherlands n = 8734, and in Germany n = 2832. MAIN OUTCOME MEASURES: For calculating the PU prevalence the sample was divided inpatients at risk and not at risk for PU in accordance to the Bradenscale. Comparisons between the Netherlands and Germany refer to population details, quota of patients at risk for PU and PU prevalence. Finally the impact of eight controlled variables on the PU occurrence was calculated in a logistic regression. RESULTS: Both samples showed the same sex distribution, the same mean age and the same distribution among the medical specialties. The share of patients at risk for PU is higher in the Netherlands (55%) than in Germany (38%). The frequency of PU is higher in the Dutch population (22%) than in the German one (12%). Regarding only the risk-patients the differences reduce. The prevalence in the Netherlands was 33%, in Germany it was 28%. The highest impact on PU occurrence had the age and the length of stay in hospital. The Country ranges on third position. CONCLUSIONS: The Dutch sample had a higher share of risk-patients and a higher PU frequency. A standardization appropriate to a risk assessment reduce the differences. For enlightening the remaining differences further research is needed.

Aged↗
PubMed2004

[Recommendations for evidence based oral hygiene of clients in health and care institutions].

An extensive study of literature, from which recommendations for oral hygiene could be deduced, forms the base of this essay. The group of geriatric clients is also taken into consideration. At the beginning it lists frequent risks in medical and nursing situations that may lead to changes of the oral cavity. It then gives recommendations as to how and with which assessment instruments the oral cavity can be assessed. The main part of the essay contains an overview of means of nursing as well as instruments and methods for the treatment of oral problems. Evidence based intervention possibilities are compiled for essential problems relevant to nursing (unclean mouth, dryness of the mouth, inflammations, infections) and are completed by practical advice on actions. The concluding part consists of further general aspects to be considered by all nursing staff dealing with patients suffering from changes of the oral cavity.

Aged↗
PubMed2004

[Autonomy and informed consent in surgical care-patients' and staff perceptions].

The aim of this study was to describe autonomy and informed consent in surgical care. The study is a part of the international BIOMED 2 project "Patients' Autonomy and Privacy in Nursing Interventions" (BIOMED2, BMH4-CT98-3555; 1998-2001) supported by the European Commission. For this study, data of patients (n = 254) and nurses (n = 205) in eleven Berlin hospitals and three hospitals outside Berlin were collected by means of a structured questionnaire. The findings of the study indicate, that information-giving was more positive than decision-making. Patients perceived they were more frequently informed about their surgery than about their care. According to the perceptions of nurses the case was reversed. The perceptions of both groups differed, since from the point of view of nurses, patients' autonomy was more frequently heeded and their consent was sought more often than from the point of view of the patients. Patients admitted as emergencies and in multi-bed rooms perceived their autonomy more negatively than those with a planned surgery or in single rooms. Elderly nurses were more frequently than younger nurses of the opinion to grant patients autonomy. Nurses with a longer working experience in nursing care perceived that patients were more frequently asked their consent. Further, nurses with a higher educational qualification and with a higher occupational status perceived decision-making more negatively. The findings of the present study give implications for clinical practice, nursing education, and for further research.

Adolescent↗
PubMed2004

[Verbal patient information through nurses--a case of stroke patients].

The article represents results of a theoretical work in the field of nursing education, with the topic: Verbal Patient Information through Nurses--A Case of Stroke Patients. The literature review and analysis show that there is a shortage in (stroke) patient information generally and a lack of successful concepts and strategies for the verbal (stroke) patient information through nurses in hospitals. The authors have developed a theoretical basis for health information as a nursing intervention and this represents a model of health information as a "communicational teach-and-learn process", which is of general application to all patients. The health information takes place as a separate nursing intervention within a non-public, face-to-face communication situation and in the steps-model of the nursing process. Health information is seen as a learning process for patients and nurses too. We consider learning as information production (constructivism) and information processing (cognitivism). Both processes are influenced by different factors and the illness-situation of patients, personality information content and the environment. For a successful health information output, it is necessary to take care of these aspects and this can be realized through a constructivational understanding of didactics. There is a need for an evaluation study to prove our concept of health information.

Communication Methods, Total↗
PubMed2004

Bed articles for nursing care--state of the art in two German hospitals.

BACKGROUND: Bed articles are basic instruments for positioning. Research about this topic has concentrated on evidence for better practice. However, little is known about what practitioners really do. AIMS AND OBJECTIVES: This study intended to identify the most common bed articles used for positioning in two German hospitals, and to determine the decision-maker for their application and the purposes and criteria for their choice. METHODS: Nursing experts from 100 wards were interviewed with the help of a structured questionnaire and based on these data a list of the 10 most frequent devices was compiled. RESULTS: Supporting the body position was the most frequent intervention performed by German nurses, mainly with the help of hydraulic beds, pillows and blankets. Nurses were the main decision-makers for the use of these bed articles. Their choice was mainly based on work experience and patients' desires. Guidelines and literature played a minor role in this process. RELEVANCE TO CLINICAL PRACTICE: If nurses, despite the medical doctors' role as the main decision-maker in German hospitals, exert significant influence on this aspect of care, they can support their position by evidence-based practice.

Beds↗
PubMed2004

Self-determination in surgical patients in five European countries.

OBJECTIVE: To analyze the effects of informational support, desire for behavioral involvement in health decision-making (behavioral involvement), opportunities to make decisions, and independence on subjective health status in surgical patients. A theoretical model of self-determination was applied and tested. METHODS: The data were collected by structured questionnaires with a sample of 1,454 surgical patients in five European countries. LISREL analyses were used to test the theoretical causal model of self-determination. RESULTS: Patients' perceptions of informational support received from nursing professionals and their desired involvement in health decision-making affected patients' opportunities to make decisions and further their independence level, which in turn affected patients' subjective health status. CONCLUSIONS: Understanding of factors that increase self-determination in patients can help health care professionals to promote patients' well-being.

Activities of Daily Living↗
PubMed2003

[Prevention of decubitus ulcer: theory and practice].

In Spring 2001, the Department of Nursing Science, Humboldt-University in Berlin, conducted a pressure ulcer prevalence study on 3012 patients of eleven hospitals. The investigation revealed the use of pressure ulcer prevention on patients with different stages, or without a pressure ulcer. The study also focused on the use of interventions and bed-aids on patients both at risk and not at risk. Interventions without the use of bed-aids were used more often than interventions using bed-aids. The main type of intervention used was the mobilisation of the patient. This was found in all groups (at risk or not at risk; with or without a pressure ulcer). The bed-aids which were most frequently used were pressure-relieving cushions and heel-protectors. Because of the differences in pressure ulcer management among the hospitals, this article also shows evidence on bed-aids and the interventions as known from literature. In four of the interventions as used in practice, the highest degree of evidence could be found. However, in five cases no evidence could be found at all. The comparison of the use in practice and the literature revealed that interventions which are often used as pressure reduction are well tested and can be recommended. However, the (sheep-) skins, which are frequently used, are not reducing the pressure significantly.

Aged↗