Beate Blättner’s research while affiliated with Fulda University of Applied Sciences and other places

Aim Extreme heat events caused by climate change continue to increase in frequency, duration, and intensity. People living in cities in particular are exposed to heat as a result of the urban heat island effect. Although negative effects can be mitigated by heat health action plans (HHAPs), it remains unknown how many German cities have implemented such plans or other measures to reduce the health risks from heat. Therefore, this study surveyed the status of planned or published HHAPs and measures in German cities. Subject and methods Approximately 10% of German cities with the greatest population density were sampled for the study (n = 70 cities). A frequency analysis of city concepts and city webpages was conducted to determine whether cities have already introduced concepts for climate adaptation, climate protection or an HHAP, and which measures are planned in detail. Results Fifty-one cities have implemented measures to protect health from heat events. Forty-one cities integrated such measures into concepts, and only one city formulated an HHAP. Large cities in particular published measures. Long-term measures proved most common, for example, improved building envelope insulation and urban greening. Other than advice on individual behavior, hardly any acute heat health measures are being taken. Conclusion Public health authorities can play an active role in communicating the health risks of heat and implementing HHAPs. To this end, the health risks of climate change need to be addressed consistently by all policy fields in Germany. There is also a need for further research in the evaluation of measures and HHAPs.

The number of people employed in household-related services has increased sharply in recent years. However, little is known about the conditions in which they work and about their health and social effects. The little information available points to specific disadvantage characteristics and suggests target group-oriented concepts of prevention and health promotion as well as starting points for a humane work design. The BMBF-funded research project „Gekonnt hanDeln“ (Gesund und kompetent in haushaltsnahen Dienstleistungen – Healthy and Competent in Household-Related Services) comprises a multi-method inventory, which serves as a basis for the development of needs- and requirement-oriented interventions. In the present contribution, the significance of employment relationships in private households is described and the relationship to the community health approach is elaborated. Subsequently, the project „Gekonnt hanDeln“ and results from guideline interviews with legally and non-legally employed domestic helpers are presented.

Zusammenfassung Gewalt in der Pflege kann gegen Pflegende oder gegen Pflegebedürftige bzw. Patient*innen gerichtet sein. Es gibt keine robust untersuchten Präventionsansätze. In einem Konsortium aus vier pflege- bzw. gesundheitswissenchaftlichen Standorten wird eine komplexe Intervention durchgeführt und evaluiert. Die Intervention folgt einem partizipativen Ansatz. Nach einer ersten Projektphase in stationären Altenpflegeeinrichtungen erfolgt eine Ausweitung auf die Settings Krankenhaus und ambulante Pflege.

Violence and Violence Prevention in Nursing Homes during the COVID-19 Pandemic - A partial analysis of Interviews with Managers or Team Leaders Abstract. Background: During the first wave of the COVID-19 pandemic, strict infection control measures were in force in long-term residential care in Germany that burdened staff and isolated residents socially. Both are considered risk factors for violence in long-term residential care. Questions: How does violence develop in nursing homes under pandemic conditions from the point of view of managers and how do strategies for preventing violence change? Methods: Semi-structured telephone interviews were conducted with staff in 43 nursing homes: 25 with service managers, 15 with nurse managers, 28 with nursing team leaders and 10 with registered nurses with extended tasks. The interviews were recorded as audio, transcribed and analysed in five steps following the "Thematic Framework Analysis". Results: The infection control measures were partly perceived as deprivation of freedom. Residents, relatives and staff partly reacted most with verbal violence. Nevertheless, the issue of violence was not a major concern for management and preventive measures were not carried out. Conclusions: The results show that strategies to prevent violence might not be sufficiently established in the institutions involved and would have to be adapted to the conditions of the pandemic. Further research is needed to evaluate infection control measures in their potential to increase the incidence of violence.

Zusammenfassung Die Integration von in anderen Ländern qualifizierten Hebammen in das Versorgungssystem in Deutschland ist eine der Strategien zur Reduktion des Hebammenmangels. In den Bundesländern ist diese Strategie von heterogener Bedeutung. Trotz gemeinsamer Mindeststandards sind schon in der EU die Ausbildung und das Berufsverständnis unterschiedlich. Mangelnde Vorbereitung von bestehenden Teams auf die Integrationsarbeit und mangelnde Anerkennung der geleisteten Arbeit durch die Einrichtung führt zu einem defizitären Blick auf die Kolleg*innen. Damit gehen Chancen, von den international Qualifizierten für die Versorgungspraxis zu lernen, verloren.

Background Millions of people worldwide are on the run due to persecution, political discrimination or war. Refugees belong to a vulnerable and health-disadvantaged population group, which in Germany has at the same time only limited access to medical care and preventive measures. Thus, they need special attention in health promotion.Objectives Refugees living in Germany were interviewed about their experiences and needs.Methods In all, 13 guideline-based interviews were conducted with a total of 30 refugees from Afghanistan, Iraq, Somalia and Syria, who either live in refugee accommodations or in their own apartments. Families were interviewed in a group interview as well as men and women individually on their experiences in everyday life and while they were fleeing their country of origin and on the subject of health.ResultsRefugees have invested significant resources to get to Germany and are investing a lot of resources in order to get closer to their goal of self-determination over their lives. Their residence status, unrecognized qualifications and lack of job opportunities, the perception of mistrust, arbitrariness and exclusion, language barriers, health impairments and restricted access to the health system make it difficult to achieve their goals.Conclusions Due to the loss of self-determination and a lack of experience in participating in socially recognized activities in the new country where they have settled, there may be a decrease in health resources. Therefore, there is a need for constant support to help refugees to maintain or develop a sense of coherence.

Die steigende Häufigkeit und Intensität von Hitzeextremen ist mit gesundheitlichen Risiken verbunden. Vulnerable Gruppen sind Ältere, akut oder chronisch kranke oder beeinträchtigte Menschen, ungeborene Kinder, Säuglinge und Kleinkinder sowie Patienten, die bestimmte Medikamente einnehmen. In der Akutversorgung muss mit einer Erhöhung von Notfalleinweisungen gerechnet, in der Langzeitpflege erhöhter Mortalität vorgebeugt werden. Auch das Personal muss vor Hitze geschützt werden. Hitzeaktionspläne berücksichtigen langfristige wie auch Schutzmaßnahmen während der Hitzeperiode. Entsprechende Pläne können Teil des Qualitätsmanagements der Einrichtung sein. Obwohl eine Vorbereitung der Gesundheitssysteme politisch gefordert wird, gibt es in Deutschland bislang kaum Best Practice Beispiele.

Die Wiederbelegung von Public Health in Deutschland Ende der 1980er Jahre erfolgte über die Stärkung der Forschung, aber insbesondere über den Aufbau postgradualer, universitärer Public Health-Studiengänge. Um 2000 haben sich die Hochschulen für angewandte Wissenschaften hier mehr und mehr engagiert. Gegenwärtig besteht die Herausforderung darin, Public Health Studierenden Kompetenzen auf allen drei Ausbildungsniveaus zu vermitteln, die internationalen Standards und den Anforderungen des Arbeitsmarktes entsprechen. Gleichzeitig geht es darum, mit der Heterogenität der Lernvoraussetzungen der Studierenden angemessen umzugehen sowie ethische Fragen und eine globale Perspektive mehr denn je zu fokussieren.