Zusammenfassung Einleitung Im Regionalen Palliativzentrum f?r das s?dliche Sachsen-Anhalt werden seit April 2009 Patienten aller Kassenarten durch ein Palliative-Care-Team der spezialisierten ambulanten Palliativversorgung (SAPV) betreut. Der dazu mit der AOK Sachsen-Anhalt geschlossene Versorgungsvertrag sieht unter anderem eine externe Evaluation mit einer Erfassung des Leistungsspektrums vor. Ziel des Beitrages ist es, einen aufschlussreichen Erst?berblick zur Versorgungssituation der Patienten im Raum Halle (Saale) zu geben und einen Beitrag zum Bedarf, das Leistungsspektrum der SAPV dokumentieren und evaluieren zu k?nnen, zu leisten. Methodik Das Evaluationskonzept bezieht alle Patienten, die im Zeitraum vom 1.4.2009 bis 30.6.2010 in die Versorgung eingeschlossen waren, in eine statistische Auswertung ein. F?r die strukturierte Datenerhebung wurde ein Dokumentationsanalyseinstrument entwickelt, mit dessen Hilfe es dem Anwender m?glich wurde, aus abgeschlossenen Patientendokumentationen heraus empirische Daten zum Leistungsspektrum der SAPV zu erfassen. Ergebnisse Der ?berwiegende Anteil der 146 eingeschlossenen Patienten sind Betroffene einer onkologischen Hauptdiagnose (86,3?%). Mit einem komplexen Symptomgeschehen sind sie schwerst erkrankt und bed?rfen bei gleichzeitigen 5 Symptomen starken Ausma?es einer besonders aufwendigen Versorgung. Entsprechend der momentanen Ausrichtung des Erhebungsinstrumentes spiegelt sich in der 24-h-Versorgung ein ?berwiegend medizinisch-pflegerisches Leistungsspektrum wider. 118 Patienten (91?%) versterben in ihrer vertrauten Umgebung. Zwei Patienten werden in ein Krankenhaus eingewiesen, in welchem einer von ihnen verstirbt. Folgerungen Mithilfe des Dokumentationsanalyseinstrumentes k?nnen erste Ans?tze zur Quantifizierung eines spezialisierten Leistungsspektrums der SAPV abgebildet werden. Eine Weiterentwicklung des Instrumentes wird jedoch zur Erfassung psychosozialer und spiritueller Aspekte notwendig. Die Ergebnisse einer derzeit laufenden Erhebung in den regionalen Palliativzentren Sachsen-Anhalts k?nnten dazu weitere Beitr?ge leisten.

BackgroundTo date in Germany, only few studies have been conducted concerning the efficacy of care and case management (CCM) for older people and about using communication technology during monitoring.AimWith this study, it is intended to gain a better understanding of how CCM in general is perceived by older people (65+) living alone and in particular what they think about the CCM monitoring process used during video conferences.MethodThe sampling and work cycle were based on the Grounded Theory. Two different subsamples (each n = 20; total sample: 70% women; age range: 64–92 years) were recruited. Interviews were conducted with the focus on CCM contributions (Subsample I) and monitoring supported by video conferences (Subsample II). All participants had received CCM from external providers (care support centres) in two German federal states. The intervention of CCM ranged between four and twelve months. Participants of Subsample II received additionally moderated video conferences via tablet PCs for and with older people over an intervention period of nine months.ResultsCare and case management was experienced as a possibility for receiving individual support and for improving the user's everyday life. Within a short time, video conferences were a familiar communication tool. They enabled particularly people with reduced mobility to get barrier‐free access to case managers, compensated for isolation and enabled participation.ConclusionsAccording to the view of older CCM users with multimorbidity living alone, CCM offers formative and organisational support in various life‐domains. Combined with video conferences, the exchange of information becomes barrier‐free and instantaneous, and the sense of security in health questions is reinforced.

Zusammenfassung Aus ethischer Perspektive ist eine ganzheitliche, auf die Sichtweise der Patientinnen und 2.1

The project "Family midwives in Saxony-Anhalt" was evaluated by a multidimensional approach in order to document the subjective perspective of the mothers as well as the networking of health care and child welfare professionals, while caring for highly vulnerable families. The documentation of 734 cases and quantitative data of 33 family midwives were analyzed. Ten mothers were interviewed and problem-focused expert interviews were carried out with 39 health care and child welfare professionals. The method of coding the interview texts was both open and guided by the research questions. After finishing the qualification course and while caring for highly vulnerable families, the networking of family midwives with child welfare professionals significantly increased. Besides the family midwives and the youth welfare office, the antenatal counseling centers were important "gatekeepers". An important ingredient for constructive networking and care for families is trust which draws on client-oriented care, availability, and advocacy by the family midwives. While the family midwives are respected as partners by the professionals of the child welfare system, networking with obstetricians and hospitals is unsatisfactory. In order to improve this, the latter must be a future goal.

The aim of this descriptive study was to identify the situation of conversation between hospital nurses and physicians and their patients about diagnosis and illness and to unweave the structure of communication in the interdisciplinary team that influences the personel's behaviour in the conversation. The rate of rebound in this postal debriefing amounted to 42 percent. 144 nurses from nursing and 46 medical staff participated. The examination showed that there are influencing factors, shown as formal (ward round, committing conversations, team conversations and documentation systems) and informal (colleagues and flair) structure of communication. In consequence of the non-homogenous structure of communication the hospital staff is not homogenous informed about the awareness of patients concerning diagnosis and illness. That's why hospital staff is without self-confidence in conversations with patients and avoids talks. Furthermore, a lack in teaching communication skills was revealed both in medical and nursing education and it became evident that nursing staff are not yet informed about juridical aspects of information talks. A documentation of patient's information status enables a congruent and authentic contact between staff and patient.