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ABSTRACT: Nursing is associated with high levels of emotional strain and heavy workloads. Changing working conditions raise the importance of investigating job satisfaction, stress and burnout and its consequences for nurses. The aim of the study was to investigate whether work-related behaviour and experience patterns are associated with mental and physical health status in nurses. A sample of 356 nurses in four German hospitals were interviewed using questionnaires regarding work-related behaviour and experience patterns, work stress, depression, anxiety and physical symptoms ('Work-related Behaviour and Experience Pattern'--AVEM and ERI). The main result of this study is that unhealthy work-related behaviour and experience patterns (i.e. the excessive ambitious type and the resigned type) are associated with reduced mental and physical health. Preventive, as well as intervention, strategies are needed that focus both on the individual as well as on working conditions.
Journal of Psychiatric and Mental Health Nursing 06/2011; 18(5):411-7. · 0.80 Impact Factor
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ABSTRACT: It is known that many patients with schizophrenia show non-adherence with regard to antipsychotic medication. Furthermore, many studies indicate cognitive deficits in schizophrenic patients. In this review, we compare the results of studies examining the relationship of non-adherence and cognitive performance.
Based on a systematic literature review, the impact of cognitive performance on the adherence behaviour of patients with schizophrenia was examined.
We found 18 studies analysing the impact of cognitive performance on adherence behaviour. Most studies indicated that patients with stronger cognitive impairments show lower adherence behaviour. Possible causal mechanisms are discussed.
Fortschritte der Neurologie · Psychiatrie 02/2011; 79(2):73-82. · 0.74 Impact Factor
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ABSTRACT: Although coercive measures are one of the indicators for the quality of psychiatric in-patient care, reliable and valid data comparing the practices are hardly available. The purpose of this study was to analyse the incidence and duration of mechanical restraint and seclusion in psychiatric hospitals in Germany. We hypothesised that the duration of these coercive measures is associated not only with gender and diagnosis of the patients, but also with the clinics themselves.
Incidence and duration of coercive measures (mechanical restraint and seclusion) among patients in the year 2004 were analysed in six German psychiatric hospitals. Furthermore, the association of the length of these coercive measures with diagnosis, gender, and hospital was analysed using non-parametric statistical tests.
3.0% of 10,352 cases treated in 2004 were exposed to mechanical restraint and seclusion with a range from 1.9-7.4% on comparing the hospitals. On average, these measures were applied 3.7 times per patient (case) with each single intervention lasting 5.0 h (mean, range <0.1-290.8). The incidence and duration of coercive measures varied highly between different diagnostic groups and different hospitals. The length of these measures differed significantly between hospitals (p<0.001) and diagnoses (p<0.001). In patients with organic psychiatric disorders (ICD-10: F0) we observed the longest duration. Furthermore the duration of coercive measures in female patients was shorter than that for male patients (p<0.05).
Data interpretation should consider numerous confounding factors such as case mix and hospital characteristics. The handling of coercive measures is an important quality feature. Therefore standardised survey methods should be developed and nationwide implemented.
Das Gesundheitswesen 02/2010; 73(2):105-11. · 0.94 Impact Factor
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ABSTRACT: Hospital-based gerontopsychiatric wards are located at an important interface within the healthcare system. If home caring needs continue in inpatient settings nursing resources have to be allocated. The amount of work of professional care in a gerontopsychiatric hospital can be calculated by different systems: the system of the long-term care insurance (SGB XI) and the system of the Psychiatry Personnel Act (PsychPV). The aim of the study was to compare both systems regarding their calculation of allocated nursing resources.
A comprehensive survey over six months was accomplished in an inpatient department for gerontopsychiatric patients with special wards for dementia, psychosis and depression in older people. Data from the long-term care insurance (SGB XI) and the system of the Psychiatry Personnel Act (PsychPV) were calculated and contrasted.
209 datasets could be included (69.7% of all admitted patients). The long-term care insurance system calculated more needed resources than the Psychiatry Personnel Act, especially for people with dementia.
Since both systems calculate extremely diverging results, more research is needed to develop valid systems for the measurement and the requirement of nursing resources in gerontopsychiatric hospitals.
Das Gesundheitswesen 07/2009; 72(4):233-9. · 0.94 Impact Factor
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ABSTRACT: The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.
Journal of Psychiatric and Mental Health Nursing 05/2009; 16(3):225-33. · 0.80 Impact Factor
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ABSTRACT: This study investigated the aggressive behaviour of all mentally ill patients within a whole psychiatric hospital with a catchment area of 325 000 inhabitants over a 1-year period (i) to assess the 1-year prevalence and characteristics of aggressive episodes and index inpatients, and (ii) to identify predictors of patients at risk by a multivariate approach. Staff Observation of Aggression Scale was used to assess aggressive behaviour. Characteristics of index inpatients were compared with those of non-index inpatients. Logistic regression analysis was applied to identify risk factors. A total of 171 out of 2210 admitted patients (7.7%) exhibited 441 aggressive incidents (1.7 incidents per bed per year). Logistic regression analyses revealed as major risk factors of aggression: diagnoses (organic brain syndromes OR = 3.6, schizophrenia OR = 2.9), poor psychosocial living conditions (OR = 2.2), and critical behaviour leading to involuntary admission (OR = 3.3). Predictors of aggressive behaviour can be useful to identify inpatients at risk. Nevertheless, additional situational determinants have to be recognized. Training for professionals should include preventive and de-escalating strategies to reduce the incidence of aggressive behaviour in psychiatric hospitals. The application of de-escalating interventions prior to admission might be effective in preventing aggressive behaviour during inpatient treatment especially for patients with severe mental disorders.
Journal of Psychiatric and Mental Health Nursing 03/2007; 14(1):92-9. · 0.80 Impact Factor
