Papers by Christa Lohrmann
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International Journal of Older People Nursing, Feb 25, 2023
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Scandinavian Journal of Caring Sciences, Nov 9, 2022
BackgroundAdults aged 80 years and older form a vulnerable group regarding perceived ageism, beca... more BackgroundAdults aged 80 years and older form a vulnerable group regarding perceived ageism, because they are often stereotyped as being frail and dependent. Nurses often display biased behaviour and hold negative attitudes towards this age group, due to the fact that they have frequent contact with patients who need complex care. As this frequent contact can negatively influence the quality of care, we performed this study to assess nurses' attitudes towards adults aged 80 and older and their views regarding their care, as well as to identify factors that influence attitudes.MethodsA cross‐sectional study design was used. A convenience sample of 1179 Austrian nurses was taken, and their attitudes were measured using the Ageing Semantic Differential (ASD) Scale. Their views on caring for older adults were assessed with the Perspectives on Caring for Older People (PCOP) Scale. Multiple linear regression was used to examine factors that influence nurses' attitudes. The Ethics Committee of the Medical University of Graz (EK Number 31‐320 ex 18/19) gave their ethical approval for this study.ResultsNurses display neutral to positive attitudes towards adults aged 80+ and view caring for them positively. Positive attitudes were indicated, for example, by the factors of a positive view towards the care of older patients, a higher education and a personal relationship with older adults. Negative attitudes were indicated by the factors of being female and interacting more frequently with older care receivers.ConclusionsAlthough the nurses' attitudes were not negative, they should be encouraged to view this patient population more positively. Educational interventions to alter nurses' attitudes and thus to improve the quality of care are recommended. As the ASD measures some aspects of ageism, it is recommended to consider qualitative methods in future studies to obtain a deeper knowledge of ageism in nursing care.
Aktuelle Ernährungsmedizin, Apr 1, 2019
Aktuelle Ernährungsmedizin, Jun 1, 2017
European Journal of Cancer Care, Aug 30, 2020
Abstract Objective This systematic review aimed to identify the most relevant problems related to... more Abstract Objective This systematic review aimed to identify the most relevant problems related to malnutrition in adult patients undergoing haematopoietic stem cell transplantation (HSCT) and to identify non‐pharmacological interventions to treat these problems. Methods A systematic search for each research question was performed in MEDLINE, CINAHL, Embase, the Cochrane Library, Google Scholar and reference lists in the period 2009–2019. Results Six and nine studies were included respectively. Quantitative pooling of data was not possible due to the heterogeneity of the studies. Oral mucositis (OM), nausea/vomiting, diarrhoea and dysgeusia were the most frequently reported nutritional problems. Cryotherapy and laser therapy seem to be effective in the prevention and treatment of OM. Recommendations for or against the use of mouth rinses and light therapy in the treatment of OM cannot be made, as too few studies have been conducted in this area. The evidence for non‐pharmacological treatment options in the case of nausea/vomiting and diarrhoea is rather limited. No study was identified with regard to treatment of dysgeusia. Conclusion Nutrition in HSCT patients has not yet been studied to a satisfactory extent. There is an urgent need for high‐quality studies to be conducted in this area to optimise the care of patients undergoing haematopoietic stem cell transplantation.
European Geriatric Medicine, Jan 9, 2019
Purpose Malnutrition is a condition which is highly prevalent, especially in older persons. Physi... more Purpose Malnutrition is a condition which is highly prevalent, especially in older persons. Physicians play an important role in multidisciplinary nutritional management, but often feel inadequately prepared to provide nutritional information/therapy to their patients. The aim of this study was to gather information on curricular content on malnutrition in older persons in basic study programs for medical doctors. Methods We selected a cross-sectional study design and used a Web-based online survey. We emailed the Web link to those persons responsible for curriculum development at 310 medical schools in 31 European countries. Results A total of 26 (8.4%) medical schools in 12 European countries completed the questionnaire. The topic of malnutrition in older adults was included as part of the medical students' curricula at 50.0% (13 out of 26) of the participating institutions. Most commonly topics taught in the institutions were causes of malnutrition (13, 50%), assessment of malnutrition (13, 50%) and consequences of malnutrition (12, 46.2%). The topic of malnutrition screening was addressed in nine (35%) of the institutions. Conclusions Based on our results, we strongly recommend including the topic of malnutrition in older adults in the undergraduate curricula of medical students in Europe. A special focus should be placed on multidisciplinary cooperation. Integrative teaching that targets all professional groups could be one option. Initiatives need to be carried out to create a higher level of awareness and promote improvements in nutrition education for medical doctors.
Research Square (Research Square), Jul 7, 2021
Background: The prevalence of pressure injuries among community-dwelling older adults in countrie... more Background: The prevalence of pressure injuries among community-dwelling older adults in countries worldwide is still a serious problem. In Indonesia, older adults mostly rely on family members for (medical) care. Therefore, involving family members in the prevention and treatment of PIs could potentially decrease its prevalence rates. However, family members are usually not trained for such tasks. Hence, it is essential to rst get more insight into the current state of affairs on family members' knowledge, attitude and actual practice of preventing PIs. Due to the lack of an existing instrument to measure knowledge, attitude and practice of family caregivers in preventing PIs, this study focuses on the development and evaluation of psychometric properties of such an instrument. Methods: Three phases of instrument development and evaluation were used, including item generation, instrument construction and psychometric testing of the instrument. A total of 372 family caregivers of community-dwelling older adults who randomly selected participated in this study. Statistical analysis of exploratory analysis, con rmatory factor analysis and Cronbach's alpha were used for the evaluation. Results: The nal version of the KAP-PI-instruments consists of a 12-item knowledge domain, a 9-item attitude domain, and a 12-item practice domain with Cronbach's Alpha values of 0.83, 0.93 and 0.89, respectively. The instrument appeared to be both reliable and valid. Conclusion: The KAP-PI instrument can be used in family nursing or community nursing practice, education, and research to assess knowledge, attitude and practice of pressure injury prevention of family caregivers.
International Journal of Older People Nursing, Jan 25, 2018
In this study, we describe the development of evidence-and theory-based fall prevention education... more In this study, we describe the development of evidence-and theory-based fall prevention educational material and its evaluation from the users' perspectives. Background: To reduce risk factors for falling in nursing homes, nursing staff must enact multifactorial fall prevention intervention programmes. A core component of these programmes is to educate residents and their family members, both verbally and in a written form. However, users can only benefit from educational material if it is based on current scientific evidence, easy to understand and process and customised. Design: We followed a structured procedure during the development process, while considering various aspect of quality. To assess the understandability and usefulness of the resulting educational materials, we conducted a qualitative content analysis study. Methods: The educational materials development process incorporated several iterative steps including a systematic literature search and the application of frameworks for designing and writing the materials. To evaluate the material, we performed six focus group discussions separately with residents, family members and nursing staff from two nursing homes (total of 32 participants). Results: Residents' brochures included clear information on avoiding external risks as well as coping strategies after a fall event. Family members' brochures were more comprehensive, including both concrete tips and outlining the advantages and disadvantages of interventions. Residents and family members had no difficulties understanding the material and tried to apply the content to their individual situations. Nursing staff commented on some ambiguities and incongruities relating to current nursing care practice. Conclusions: By involving users in the development of evidence-based educational materials, nursing staff can achieve a high acceptance rate for the materials and motivate users to address the topic. Implications for practice: The involvement of users is essential for developing educational material that meets users' needs. Educational material should be used as part of an overall strategy to educate residents and family members in nursing homes. How to cite this article: Schoberer D, Eglseer D, Halfens RJG, Lohrmann C. Development and evaluation of brochures for fall prevention education created to empower nursing home residents and family members.
BMC Health Services Research, Feb 1, 2023
Background The increasing cultural diversity in healthcare in European countries, including Austr... more Background The increasing cultural diversity in healthcare in European countries, including Austria, has highlighted the need to enhance nurses' cultural competence. Assessing cultural competence and identifying relevant influencing factors can help to improve culturally competent care. The aim of this study was to assess the cultural competence of nurses and nursing students working in Austrian acute care settings and to identify influencing factors using the Cultural Competence Assessment scale. Methods A cross-sectional design was used. Data collection was carried out in March 2021 with nurses and nursing students in the last year of their studies who were working in Austrian acute care settings. Descriptive analysis was applied to display the general characteristics of the study participants and the levels of their overall cultural competence. A multiple linear regression analysis was conducted to analyze the influencing factors of cultural competence. Results The nurses' cultural competence level was moderate to high (mean = 3.89; SD = .48). Their age, educational level, cultural diversity training and self-perceived cultural competence significantly influenced the level (F (6, 875) = 18.971, p < .0000, adj. R2 = 1.09). Conclusions Providing culturally competent healthcare services for culturally diverse patients is essential for all healthcare professionals, and especially for nurses who spend the most time with patients. Effective interventions, such as educational training, need to be implemented in order to deliver culturally competent care and potentially reduce disparities in healthcare and improve patient outcomes.
International Wound Journal, Nov 15, 2018
This cross-sectional, multicentre study was conducted in hospitals to investigate nutritional int... more This cross-sectional, multicentre study was conducted in hospitals to investigate nutritional interventions conducted in patients aged 70 years or older with (risk of) pressure injuries. A total of 1412 patients from 33 hospitals with 208 wards participated in the study. A standardised questionnaire was used to collect demographic data and data on care dependency, malnutrition risk, risk for/prevalence of pressure injuries, and nutritional interventions. Data analyses were conducted by using descriptive statistics, chi-square tests, or independent t-tests. According to the Braden Scale, 678 (48.0%) of the patients were at risk of developing pressure injuries, and 71 patients (5.0%) had at least one pressure injury (assessed by skin inspection). The most frequently conducted nutritional interventions in patients with pressure injuries were providing support during mealtimes (50.7%), food specifically desired by the patient (40.8%), and conducting a malnutrition screening (39.4%). One quarter of the patients with pressure injuries were referred to a dietitian. The provision of an energy-enriched/protein-enriched diet (18.3%), energy-enriched/ protein-enriched snacks (12.7%), or oral nutritional supplements (8.5%) was rare. Nutritional care in older patients with risk of pressure injuries is suboptimal. Health care professionals need to raise awareness regarding the importance of nutrition in the management of patients with pressure injuries.
European Journal of Cardiovascular Nursing, Jul 1, 2022
Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): “Austrian R... more Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): “Austrian Research Fund (COMET K-project No. 825329)” Introduction Depression has been recognized as a cardiovascular (CVD) risk factor. However, depression is often under-recognized and larger attention should be given to this frequent problem, also in relation to CVD sequelae. There are differences in prevalence of CVD risk factors and CVD care and prevention in Europe. Therefore, it is vital to identify the focus of CVD prevention to implement specific and country-based programs to reduce CVD burden, especially for people with depression. Purpose The aim of this study is to investigate the association between common CVD risk factors hypertension, body mass index (BMI), and smoking with the severity of depression in an adult Austrian population and to characterize sex-related differences. Method This current thesis is a cross-sectional study examining the baseline data of the population from the BioPersMed (Biomarkers of Personalized Medicine) cohort at our Medical University. The initial non-probability recruitment started between 2011 and 2015, resulting in a study population of 1,022 adult men and women who live in the greater Graz area. Three CVD risk factors were examined for this paper and assessed by trained doctors and nurses at baseline: self-reported diagnosis of hypertension, self-reported smoking status, and BMI (kg/m2) by measuring the height and weight of each participant. The PHQ-9 (Patient Health Questionnaire) was analyzed by recording the total score value in three groups. Descriptive statistics, statistical correlation analysis, and an ordinal regression analysis was performed. Results 977 participants were included in the data analysis, with a mean age of 57.3 years. More than half of the participants (56%) were female. Results show a significant association between hypertension and the severity of depression (p&lt;0.01) and between males and all three CVD risk factors, and between females and overweight. People with hypertension and elevated BMI, adjusted for age, sex, diagnosis of depression, and smoking were more likely to fall into a higher level of depression (BMI: increase of 0.033 in the log odds, p&lt;0.5; hypertension: increase of 0.339 in the log odds, p&lt;0.01). Moreover, men were more likely to show a lower level of depression than women (decrease of 0.435 in the log odds, p&lt;0.5). Conclusion This is the first cross-sectional study to examine the association between CVD risk factors and the severity of depression in an adult Austrian population. Further research for causality and longitudinal analyses in a larger sample size are recommended to thoroughly examine and confirm these findings. The results are an important indication for CVD prevention programs in Austria to incorporate specific screening (CVD and Depression) and management of cardiovascular risk factors in their protocols and readapt them according to depression severity.
Nutrition Bulletin, 2017
In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in t... more In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A Healthy Diet for a Healthy Life (HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNuEL consortium consists of 22 research groups from seven countries (Austria,
Advances in Skin & Wound Care, Jun 3, 2019
OBJECTIVE: To evaluate if the use of a pressure injury (PI) risk assessment is associated with th... more OBJECTIVE: To evaluate if the use of a pressure injury (PI) risk assessment is associated with the more frequent use of international evidence-based guideline interventions in patients at risk of PI. METHODS: Data were collected through a multicenter cross-sectional prevalence study conducted on November 14, 2017. Study authors analyzed data from 532 patients 65 years at risk of PI or older in Austrian hospitals. MAIN OUTCOME MEASURES: Repositioning, mobilization, floating heels/heel devices, moisture/barrier cream, patient education, malnutrition screening, referral to a dietitian, and hydration/nutrition management. MAIN RESULTS: The risk assessment was documented on admission for 80% (n = 435) of the at-risk patients. Patients for whom a PI risk assessment was conducted were older and more care dependent, and nearly 20% had a PI compared with patients for whom no risk assessment was conducted upon admission. Conducting a risk assessment led to a statistically significantly higher number of internationally recommended PI preventive interventions being performed for at-risk patients, such as provision of moisture/barrier cream, mobilization specific for PI, malnutrition screening, and floating heels or heel suspension devices. CONCLUSIONS: These results showed that conducting and documenting a risk assessment led to more recommended interventions being performed. Although such interventions are recommended for all patients, these findings are especially relevant for patients at mild or moderate risk of PI who might be otherwise overlooked, which in turn could reduce hospital-acquired PI rates.
BMC Nursing, Aug 11, 2022
Background: The prevalence of pressure injuries among community-dwelling older adults in countrie... more Background: The prevalence of pressure injuries among community-dwelling older adults in countries worldwide is still a serious problem. In Indonesia, older adults mostly rely on family members for (medical) care. Therefore, involving family members in the prevention and treatment of pressure injuries (PIs) could potentially decrease its prevalence rates. However, family members are usually not trained for such tasks. Hence, it is essential to first get more insight into the current state of affairs on family members' knowledge, attitude and actual practice of preventing PIs. Due to the lack of an existing instrument to measure knowledge, attitude and practice of family caregivers in preventing PIs, this study focuses on the development and evaluation of psychometric properties of such an instrument. Methods: Three phases of instrument development and evaluation were used, including item generation, instrument construction and psychometric testing of the instrument. A total of 372 family caregivers of community-dwelling older adults who randomly selected participated in this study. Principal factor analysis, confirmatory factor analysis and Cronbach's alpha were performed to evaluate factor structure and internal consistency of the Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) instrument. Results: The final version of the KAP-PI-instrument consists of a 12-item knowledge domain, a 9-item attitude domain, and a 12-item practice domain with Cronbach's Alpha values of 0.83, 0.93 and 0.89, respectively. The instrument appeared to be both reliable and valid. Conclusion: The KAP-PI instrument can be used in family nursing or community nursing practice, education, and research to assess knowledge, attitude and practice of pressure injury prevention of family caregivers.
Clinical Nutrition, Sep 1, 2018
normalization. Gait speed (m/s), hand grip strength (kg) and knee extension strength (kg) were me... more normalization. Gait speed (m/s), hand grip strength (kg) and knee extension strength (kg) were measured as functional parameters. Results: 103 old inpatients (76.9±5.2 years, 53.4% women) and 56 healthy controls (72.9±5.9 years, 57.1% women) were included in the analysis. Gait speed correlated significantly with GDF-15 (r¼À0.537), IFN-g (r¼À0.233), IL-6 (r¼À0.413) and TNF-a (r¼À0.229, all analyses p<0.001). Knee extension strength correlated with GDF-15 (r¼À0.389), IFN-g (r¼À0.235) and IL-6 (r¼À0.348, all analyses p<0.001), Grip strength with GDF-15 (r¼À0.201, p<0.05), IFN-g (r¼À0.165, p<0.05) and IL-6 (r¼À0.231, p<0.001). Conclusions: Our findings suggest that high cytokine levels in old adults are associated with impaired muscle strength and function. The stronger correlations regarding knee extension and gait speed may suggest a greater effect of GDF-15, IFN-g and IL-6 on lower extremity muscle and function. References: [1] Figaro et al. 2006.
BMC Nursing, Apr 1, 2022
Background: Adapting practices to respond sensitively to increasingly culturally diverse patients... more Background: Adapting practices to respond sensitively to increasingly culturally diverse patients can be challenging. Therefore, cultural competence among nurses needs to be assessed to evaluate their current cultural competence and the need for interventions to improve daily nursing practice. Little is known about cultural competence of nurses in German-speaking countries, including Austria, as there is currently no validated tool in German to assess cultural competence in nurses. The aims of this study were to translate and cross-culturally adapt the Cultural Competence Assessment scale in German and to evaluate its psychometric properties. Methods: This is a methodology study with a cross-sectional design. Conducting a convenience sampling, Austrian nurses working in the direct care of patients in acute care settings were invited to participate in this study. Data collection was conducted in March 2021. The translation and cross-cultural adaptation were conducted by following the guidelines of Sousa et al. (J Eval Clin Pract 17:268-74, 2011) and Beaton et al. (Spine 25:3186-91, 2000). The face and content validity, structural validity, and internal consistency reliability of the Cultural Competence Assessment scale, which consists of 25 items, was evaluated. Data were analysed using content validity index, confirmatory factor analyses as well as McDonald's Omega. Descriptive statistics were computed with the statistical software IBM SPSS Statistics 26, while the confirmatory factor analysis was conducted with the R package Lavaan. Results: Overall, 915 nurses completed the questionnaire. Twenty items had an acceptable item content validity index. Using confirmatory factor analyses, a two-factor model with 14 items yielded a good fit (x 2 /df = 3.16; CFI = .923; TLI = .908; RMSEA = .055 (.049-.062) and SRMR = .039). Internal consistency reliability was found to be acceptable, as indicated by a Omega of .87. Conclusion: The German version of the Cultural Competence Assessment scale (CCA-G) can be recommended for measuring cultural competence behaviour of nurses in acute care settings. The 14-item scale showed strong construct validity and acceptable internal consistency. Further research using repeated measures could determine the cultural sensitivity and indicate if the tool is applicable in other healthcare settings and for other healthcare professionals.
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Papers by Christa Lohrmann