Background The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch’s t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales ‘quantitative demands’, ‘hiding emotions’, ‘work-privacy conflicts’, ‘role conflicts’, ‘quality of leadership’, ‘support at work’, ‘recognition’, ‘physical demands’, ‘intention to leave profession’, ‘burnout’, ‘presenteeism’ and ‘inability to relax’. The interviews (n = 15) revealed six main themes related to nurses’ psychosocial stress: ‘overall working conditions’, ‘concern for residents’, ‘management of relatives’, ‘inability to provide terminal care‘, ‘tensions between being infected and infecting others’ and ‘technicisation of care’. ‘Enhanced community cohesion’ (interviews), ‘meaning of work’ and ‘quantity of social relations’ (COPSOQ III) were identified as positive effects of the pandemic. Conclusions Results clearly illustrate an aggravation of geriatric nurses’ situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses’ strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.
ObjectivesIn order to better understand the continued barriers to the provision of vascular endothelial inhibitor therapy, this study aims to investigate patients’ experiences with neovascular age-related macular degeneration (nvAMD) in Germany during the injection process and how they deal with it.Design and participantsThis analysis is part of the qualitative arm of a wider mixed-methods study. We recruited participants all over Germany via ophthalmologists, eye clinics, general practitioners, care bases and support groups between June 2018 and December 2020 and selected a subsample of study participants with nvAMD who were either undergoing or had previously undergone vascular endothelial growth factor inhibitor therapy. We conducted narrative, semistructured, face-to-face interviews at the participants’ homes, which were audio-recorded. The interviews were thematically analysed.ResultsTwenty-two participants were included in this analysis. Experiencing neovascular macular degeneration was dominated by the injection experience. Study participants perceived the treatment with vascular endothelial inhibitor injections as uncomfortable, and they described undergoing varying levels of anxiety during the whole injection process. After some years of receiving multiple injections, the pain and not experiencing any positive effects made participants with significant vision loss want to discontinue therapy. Furthermore, they narrated negative injection experiences in association with their interactions with medical staff and doctors.ConclusionAlthough time in the medical setting is limited, efficient and good doctor-patient relationships seem crucial for satisfying care experiences. A respectful and humane relationship may be one key to achieving treatment adherence.
Background Due to the demographic change visual impairment and blindness in the elderly caused by chronic eye diseases become major public health themes. Age- related macular degeneration (AMD) is one of the most common causes of visual impairment and blindness in older adults above 60 years of age in the western countries, followed by glaucoma and diabetic retinopathy. Objectives: The purpose of this study is to find out how patients with AMD assess their medical care, tool-based and psychosocial counseling services in Germany. Methods Data was collected by using narrative, semi-structured interviews. A purposive sampling strategy was used to sample the study population with patients with AMD, which is characterized by a variety of different life experiences of the patients. The data analysis followed the principles of grounded theory. Results The interviewed AMD patients were between 72 and 87 years old. Before the patients were diagnosed with AMD, AMD was not known to them and suffering from an unrecoverable disease resulting in blindness, made many of the patients anxious. Patients with AMD complained about missing information about the AMD and its treatment. Tool-related and psychosocial counseling services and their benefits were unknown to most of the patients. Therapy with Anti-VEGF injections gives hope to many patients with neovascular AMD, but at the same time it is associated with a time, psychological and physical strain. The time spent in clinics and practices, the waiting for appointments, the number of examinations and injections, communication problems with the medical staff, information deficits, the injections themselves and their side effects were often severe and nerve-wracking for the elderly. Conclusions New strategies need to be developed to facilitate access to AMD information for patients with AMD, as well as to reduce the time required for medical treatment, e.g. waiting times in clinics and practices. Key messages Therapy with Anti-VEGF injections gives hope to many patients with neovascular AMD, but at the same time it is associated with a time, psychological and physical strain. Patients with AMD complained about missing information about the AMD and its treatment.
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