Michael Galatsch

Aim: In Germany, the need for care will rise significantly. However, most nurses want to retire before reaching the official retirement age. The preferred retirement age is a critical factor of the retirement decision. This study examines contributing factors of the preferred retirement age and reasons for early retirement preference of older nurses. Methods: Interview data from the fourth wave 2022/2023 of the representative German lidA cohort study was analyzed (N_nurses = 418). Proportions, including 95 %-confidence interval (CI) of twelve reasons for an early exit preference were investigated. Linear regression models were used to investigate the effects of personal and work-related factors of nurses’ preferred retirement age. Results: The majority (70.6 %) preferred to retire early. The most significant reason for this preference was the desire for more leisure time (79.3 %). A higher age, better health, lower household income, long-term care settings, job satisfaction (B = 0.68, 95 %-CI = 0.38; 0.99) and job involvement (B = 0.68, 95 %-CI = 0.22; 1.15) were positively associated with nurses’ preferred retirement age. Whereas physical strain (B = -0.36, 95 %-CI = -0.65; -0.08) and psychosocial stress (B = -0.65, 95 %-CI = -0.94; -0.37) were negatively associated with the outcome. Conclusion: Our results highlight the need for healthy and stimulating work conditions that fit with nurses’ life circumstances. Besides the widely recognized physical and psychosocial work-related burdens, organizations should prioritize creating favorable conditions for job satisfaction and involvement. This is essential to motivate these urgently needed professionals to remain longer.

(1) Background: Water drinking is essential to reduce obesity in children, but effective means for implementation remain controversial. Our study assesses students’ and teachers’ use of and attitudes towards drinking fountains in two urban secondary schools. (2) Methods: In a cross-sectional study, answers from students and teachers to a 28- and 19-item questionnaire, respectively, containing closed- and open-ended questions and short interviews with the schools’ two principals were described and analysed using the question-specific number of responses as the denominator. (3) Results: Questionnaires of one hundred sixty-two students and ten teachers were analysed; 36.1% of students responded. Students viewed the schools’ two fountains as a good idea (73.3%, n = 118), recommended them to other schools (73.1%, n = 117), and felt able to distinguish healthy from unhealthy drinks (70.5%, n = 110). In contrast, 55.7% (n = 88) reported using the fountains regularly; over a week, 39.8% (n = 47) used them less than once; 26.3% (n = 31) used them one to two times. Only about a third (26.5%, n = 43) reported consuming more water since the fountains’ installation. Teachers’ responses were similar to students’; principals stressed planning and costs. (4) Conclusions: A discrepancy between a good attitude towards and actual use of drinking fountains may exist; school communities may need to look for measures to overcome it.

Germany has an ambitious global health strategy, yet its universities provide few opportunities for global child health researchers. Improved understanding of the reasons and the academic role of g...

Background. Madagascar needs major efforts to achieve the UN Sustainable Development Goals, despite the considerable reduction of child mortality during past years. In this context, implementation of emergency triage assessment and treatment (ETAT) plays an important role. In recent years, ETAT training activities rarely took place in Madagascar. To strengthen ETAT in Madagascar, a pilot training course was conducted in December 2019 at the University Hospital Mahajanga. Objective. This study aims to evaluate if the ETAT+ pilot training content matches clinical needs in Madagascar and whether participants achieved their learning objectives. Methods. In this cross-sectional mixed-methods study, a 41-item questionnaire was used at the end of the ETAT+ training to evaluate their learning experience from the 12 participants (paediatricians, physicians, nurses and midwives). Six weeks after the training, guided interviews were conducted among five participants to describe how training content could be transferred into clinical practice in five health facilities. Results. Results suggest that this pilot project designed to contribute to the re-establishment of ETAT in Madagascar meets participants' needs and is adapted to clinical realities in terms of transmitted knowledge, skills and competencies. However, results also show that considerable multi-disciplinary efforts are needed to advance ETAT+ implementation in Madagascar. Conclusions. Implementation processes of ETAT training programmes need re-evaluation to assure their validity to contribute to quality of care improvements efficiently. Further operational research is required to evaluate sustainable, innovative implementation strategies adapted to contexts in Madagascar.

Background: Children and adolescents who provide care, assistance or support for a chronically ill family member are called young carers. While there is a growing body of research about their specific situation, needs and impact of caring, only very few studies provide information on prevalence rates.Objectives: The aim was to provide prevalence data for young carers in Germany, and to describe and quantify the nature and extent of their help.Design: A cross‐sectional study.Settings: Data collection took place between 2016 and 2017 in 44 secondary schools (fifth to 13th grade) in North Rhine‐Westphalia, Germany.Participants: A total of 6313 students aged from 10 to 22 years participated in this study. They represent 0.5% of the basic population.Methods: Based on the results of a preliminary qualitative study, a standardised electronic questionnaire was developed, which comprised four subject areas: socio‐demographic information, general daily aids, health‐related quality of life and chronic illness within the family. Statistical analyses included chi‐square tests for nominal data and univariate analyses of variance for metrical data together with 95% confidence intervals.Results: 19.6% (n = 1238) of all respondents state that someone in their family needs help due to a chronic illness. Nevertheless, not all of them are involved in caring activities. The prevalence of those defined as young carers in this study is 6.1% (n = 383), 64% are girls. They take on a wide range of activities. In addition to domestic work, they help their ill relatives with mobility, dressing and undressing, medication, feeding, personal hygiene and with intimate care.Conclusions: The data provide a good insight into the situation of young carers. The prevalence rate is higher than expected. It refers to the social relevance of this topic and the need for further investigations.

Lay family caregivers of patients receiving palliative care often confront stressful situations in the care of their loved ones. This is particularly true for families in the home-based palliative care settings, where the family caregivers are responsible for a substantial amount of the patient’s care. Yet, to our knowledge, no study to date has examined the family caregivers’ exposure to critical events and distress with home-based palliative care has been reported from Germany. Therefore, we attempt to assess family caregiver exposure to the dying patient’s critical health events and relate that to the caregiver’s own psychological distress to examine associations with general health within a home-based palliative care situation in Germany. A cross-sectional study was conducted among 106 family caregivers with home-based palliative care in the Federal State of North Rhine Westphalia, Germany. We administered the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale. Descriptive statistics and linear regression models relating general health (SF-36) were used to analyze the data. The frequency of the caregiver’s exposure, or witness of, critical health events of the patient ranged from 95.2% “pain/discomfort” to 20.8% “family caregiver thought patient was dead”. The highest distress scores assessing fear and helpfulness were associated with “family caregiver felt patient had enough’” and “family caregiver thought patient was dead”. Linear regression analyses revealed significant inverse associations between SCARED critical health event exposure frequency (beta = .408, p = .025) and total score (beta = .377, p = .007) with general health in family caregivers. Family caregivers with home-based palliative care in Germany frequently experience exposure to a large number of critical health events in caring for their family members who are terminally ill. These exposures are associated with the family caregiver’s degree of fear and helplessness and are associated with their worse general health. Thus the SCARED Scale, which is brief and easy to administer, appears able to identify these potentially upsetting critical health events among family caregivers of palliative care patients receiving care at home. Because it identified commonly encountered critical events in these patients and related them to adverse general health of family caregivers, the SCARED may add to clinically useful screens to identify family caregivers who may be struggling.

Aim: The aim of this study was to give an overview of family caregiver satisfaction within the home palliative care situation in North Rhine-Westphalia, Germany. Design: A cross-sectional study. Methods: An anonymous questionnaire, with seven validated scales, and comprising of 71 items, was used. The items investigated perceived needs and burdens of families within a home-based palliative care situation. The satisfaction of the family caregivers with the services delivered by palliative care teams was measured by the FAMCARE-2 Scale. Descriptive statistics and analysis of covariance (ANCOVA) were performed. Results: A convenience sample of 106 family members agreed to participate in the study. Overall, we found high satisfaction within our sample. There was high satisfaction with how the services respected the dignity of families, and how they provided comfort to patients. Satisfaction was lower with regard to information about patients. Conclusion: High or low satisfaction with palliative care, tells us little about the quality of services. The high satisfaction within this study could be interpreted as a sign that palliative care was important to families at the time of availability. Regular and continuous assessment can serve to inform the continuous quality of care provision for patients and their families. Keywords: family, home, palliative care, quantitative research, satisfaction of care.

Hintergrund: Seit der WHO-Studie «Family Health Nursing» (FHN) hat sich das FHN-Konzept in Europa unterschiedlich etabliert und entwickelt. Aus diesem Grund werden im internationalen Projekt «Family Health Nursing in European Communities» ein einheitliches Ausbildungskonzept für die Family Health Nurse entwickelt. Ziel: Ziel war es, die unterschiedlichen Voraussetzungen in den beteiligten Ländern darzustellen und aktuelle Problemfelder auf Länder- und EU-Ebene zu verdeutlichen. Methode: Hierzu wurden ein Review über grundlegende und länderspezifische Informationen, eine Delphi-Studie, eine Kompetenz- und Anforderungsanalyse und eine Übersicht über vorhandene Aus- und Weiterbildungskonzepte mit FHN-ExpertInnen aus den Projektländern durchgeführt. Ergebnisse: Die Ergebnisse des Reviews spiegeln auch im internationalen Kontext deutliche Unterschiede im Grad der Implementierung des FHN-Konzeptes wieder. Neben unterschiedlichen konzeptionellen Ausrichtungen haben sich mit der Zeit verschiedene Berufsbezeichnungen etabliert. Die Ergebnisse der Delphi-Studie ergaben, dass die Bezeichnung «Family Nurse» (46,3 %) bevorzugt wird, als Hauptaufgaben werden Gesundheitsförderung und Präventionsarbeit betrachtet (85,8 %). Aus diesem Grund sehen die befragten ExpertInnen den Bedarf einer spezialisierten Ausbildung auf Bachelorniveau (81,5 %). Schlussfolgerung: Das Projekt verdeutlicht das Streben der Länder nach einer hochwertigen familialen Versorgung, die durch ein einheitliches FHN-Konzept nachhaltig unterstützt werden könnte.

Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule.

Aggressive behavior and violence in patients, residents or clients are growing challenges in nursing. Aggressive behavior can have both, physical and psychological consequences for nurses and can lead to a reduced performance at work, demotivation, sickness absence and the premature exit from the nursing profession. To develop purposive strategies and to deal with aggressive behavior and health promotion programs, it is crucial to know more about the prevalence of aggressive behavior from patients and the effect on the work ability of nurses in different types of institutions. Data of 1735 German nurses was derived from the European NEXT-Study. Description and analysis of variance for each working area (hospital ward, Intensive Care Unit, psychiatric ward, nursing home and home care) were conducted. The work ability was measured with the Work Ability Index (WAI). The aggressive behavior was measured by one item developed by the NEXT Study Group. Linear regression models were applied to analyze the effect of aggressive behavior on the work ability of nurses in a comparison of the five different working areas. A total of 84.9 percent of the nurses were "sometimes" or "often/always" confronted with aggressive behavior from patients. In the comparison of the five working areas, nurses were exposed to different levels of aggressive behavior, while differences in the work ability of nurses were also observed. It was found that aggressive behavior from patients was associated with reduced work ability in nurses working in hospital wards, nursing homes and home care, but not nurses working in ICUs and psychiatric wards. The findings indicate that many nurses in Germany are exposed to aggressive behavior from patients, which has negative effect on the nurses' work ability. However, it is assumed that strategies to deal with aggressive behavior could play a buffer role between aggressive behavior and work ability of nurses, highlighting one possibility of intervention in future.