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Media type:
E-Book;
Thesis
Title:
Die Wissensvermittlung und die Angehörigenintegration bei der Betreuung von über 65 Jahre alten Hämodialysepatienten
:
die Sicht der Patienten und der Pflegekräfte
Description:
Simultaneously anonymous survey in Germany among dialysis care teams and hemodialysis patients, knowledge of care-related issues, knowledge transfer, family engagement, collaboration of doctors and care staff as equals, the role of ''narrative-based medicine'' and ''effective communication''.
Professional nursing care for patients on dialysis is aimed at life-sustaining measures that ensure a good quality of life whilst maintaining the highest-possible level of independence for the patient. Intensive communication with patients and the timely engagement of families in the care process form an important part of this. This study demonstrates the results of an anonymous survey in Germany that was conducted simultaneously among dialysis care teams and hemodialysis patients aged 65 and over. This report sets out to evaluate the results obtained in relation to failures in the communication of information as part of consultations and training events. Such instances related to the timing and volume of information, as well as to how well the information was adapted to suit the patient's condition, whether it was made accessible and whether it was relevant in terms of its applicability in prac-tice. Hemodialysis patients were found to have only limited knowledge of care-related issues. Delivery of normal patient care was rendered more work-intensive as a re-sult, leading to a shortfall in terms of the amount of time available for specialist care. While families accounted for the largest proportion of care provided in the home, clear deficits were noted with regard to the way this contribution was being integrat-ed as part of an overall care strategy. The reason for this was the failure of nursing and care staff to gauge the true nature of the role and behavior of family members. Similarly, hemodialysis patients underestimated the real impact of dialysis on family members. The only way to eliminate the shortcomings identified by this report is to increase the role of "narrative-based medicine" and "effective communication" in patient care. This will involve contributions not only from care staff but also from doctors, who remain the patients' preferred source of information. Part of this task will be to pro-vide both patients and their relatives with information that is relevant to the stage of the patient's kidney disease, and to ensure that this information is presented in a well-structured manner. The implementation of these steps will require these ser-vices to be eligible for reimbursement by health insurance funds (as a stimulus), subject to mandatory reporting as part of medical record keeping procedures, and to form part of a care quality strategy that includes both knowledge transfer and family engagement. In the fields of nephrology and dialysis, "narrative-based medicine" and "effective communication" still do not receive the attention or recognition they deserve - and should be valued more highly. Care staff should be given clearly defined responsibilities as part of an overall knowledge transfer and family engagement strategy. This will require a well-coordinated approach involving the close collaboration of doctors and care staff, who will need to work together as equals. A welcome consequence of this approach could be an enhanced professional status for nursing and care staff, and improved recognition for the profession as a whole.