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Gewählte Publikation:

Schüssler, S.
Care dependency and nursing care problems in nursing home residents with and without dementia
Doktoratsstudium der Sozial- und Wirtschaftswissenschaften; Gesundheits- und Pflegewissenschaft; [ Dissertation ] ; 2015. pp. [OPEN ACCESS]


Autor/innen der Med Uni Graz:
Schüssler Sandra
Lohrmann Christa

Over time, chronic diseases, such as dementia, may lead to care dependency and various nursing care problems (e.g. incontinence, malnutrition), which often necessitates a nursing home stay. Negative consequences of care dependency and nursing care problems include reduced quality of life, high health care costs and an increased risk of mortality. The overall aim of this doctoral thesis is to explore the extent and change of care dependency and nursing care problems (pres-sure ulcers, malnutrition, incontinence, falls, restraints) in Austrian nursing home residents with and without dementia. In this context a series of studies have been performed. Chapter 1 begins with a general introduction, presenting an overview of dementia, care dependency and nursing care problems. Afterwards the research gaps, the overall aim of the doctoral thesis as well as the specific research aims and -questions of the studies conducted are laid out. The chapter ends with an outline of the content of the doctoral thesis. Chapter 2 provides a brief overview of the methods used in the studies conducted and Chapters 3 to 6 present the studies 1-3 (part 1, part 2) that have been published or submitted in international peer-reviewed journals. The main results of the studies showed that nursing home residents with dementia were frequently affected by care de-pendency and the nursing care problems of pressure ulcers, malnutrition, incontinence, falls and restraints. The comparison between residents with and without dementia showed that both groups were most care dependent in the basic human needs hygiene, continence, getting (un)dressed and avoiding danger, but residents with dementia to a significantly greater extent. With regard to the nursing care problems assessed, incontinence (urinary-, fecal- and double incontinence) showed the highest prevalence among residents with and without dementia, but again, residents with dementia were affected to a significantly greater extent. In view of the changes in care de-pendency and nursing care problems, residents with dementia showed a significant increase in care dependency over 2 years in all 15 basic human needs, assessed with the Care Dependency Scale. The highest increase was in day and night pattern, contact with others, sense of rules/values and communication. In comparison, care dependency in residents without dementia increased significantly in 4 of the 15 needs, with the highest increase in the need continence, fol-lowed by getting (un)dressed, mobility and avoiding danger. Regarding changes in nursing care problems, residents with dementia experienced a lower increase in urinary incontinence, but a higher increase in fecal- and double incontinence compared to residents without dementia. All other nursing care problems revealed no significant differences between the two groups. The studies carried out identified basic human needs and nursing care problems where potential im-provements for nursing home residents with dementia exist. The knowledge gained could support the planning of dementia-specific (preventive) interventions in nursing homes. Finally, the results of the thesis are briefly summarized in Chapter 7. A discussion of the main results and methodo-logical aspects is followed by recommendations for nursing practice and research.

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