Ein speziell geschultes Team mit hoher Fachexpertise und ein strukturiertes Behandlungskonzept ma... more Ein speziell geschultes Team mit hoher Fachexpertise und ein strukturiertes Behandlungskonzept machen Stroke-Units zur optimalen evidenzbasierten Versorgungsform für Menschen mit einem Schlaganfall. Pflegefachpersonen übernehmen in allen Behandlungsphasen eine zentrale Rolle, wie ein Beispiel aus dem Universitätsspital Zürich zeigt.
Aim: This study focuses on nursing practice for patients with chronic heart failure (CHF). The ai... more Aim: This study focuses on nursing practice for patients with chronic heart failure (CHF). The aim is to reflect on a practice development project to improve patient care in a person-centred way and to implement evidence into practice. The project consists of two phases with individual aims and evaluation processes. Part one describes the development, implementation and evaluation of an education programme for CHF patients. The goal is to change nursing culture by involving the healthcare team and to build up skills and expertise. Part two describes the further development of the programme through integration of the patients’ perspective. Methods: A person-centred approach formed the basis for changing nursing practice. The development and implementation of the CHF programme was carried out via action research, to expand the healthcare team’s knowledge and improve patient outcomes. A mixed methods design was chosen for the evaluation of the pilot programme. Grounded theory was used ...
Die Betreuung von Patienten mit chronischer Herzinsuffizienz (CHF-Pat) bedeutet eine Herausforder... more Die Betreuung von Patienten mit chronischer Herzinsuffizienz (CHF-Pat) bedeutet eine Herausforderung. Sie setzt das Bewusstsein für die Lebenswelt der CHF-Pat und ihre Problemstellungen im Alltag voraus. Ziel dieses narrativen Literaturreviews ist, die Perspektive der CHF-Pat von der Diagnose und den Umgang mit der CHF aufzuzeigen. Die Literatur wurde in wissenschaftlichen Datenbanken in den Jahren 2011/12 gesichtet. Eingeschlossen wurden 18 qualitative Studien. Die Resultate zeigen Wege zur Diagnose und den Übergang vom akuten zum chronischen Zustand. Therapie, Lebensstilempfehlungen und Symptome erfordern Anpassungen in der Alltagsgestaltung. Professionelle und Familien bilden ein wichtiges unterstützendes Netz. Unterschiedliche Copingstrategien kommen zum Einsatz. CHF-Pat erwarten eine partizipative Zusammenarbeit mit den Professionellen. Eine gute Betreuung setzt Offenheit voraus, sich auf einen gemeinsamen Lernprozess einzulassen und die Auseinandersetzung über gesundheitsförde...
In the first year after kidney transplantation patients are challenged with incorporating new beh... more In the first year after kidney transplantation patients are challenged with incorporating new behaviour patterns into their daily lives. Due to the higher risk of cardiovascular disease amongst kidney transplant recipients, behaviours such as preventing undesired weight gain, exercising, avoiding smoking, and managing medications take on crucial importance. The aim of the project was to develop a programme based on prevailing evidence to promote self-management skills in this patient population. To this end a participatory action research approach was chosen. The programme was developed with inter-professional collaboration under the direction of an advanced practice nurse. As theoretical framework for the development of the intervention models of behaviour change and self-management were chosen. The content is based on current literature and includes the viewpoints of both patients and nursing experts. The programme consists of three elements: 1) Educational brochures developed thr...
This article presents the current state of the art regarding the concept of families living with ... more This article presents the current state of the art regarding the concept of families living with HIV and Aids. The literature reflects a comprehensive view including families of origin, families of choice and partnerships. It is evident that family networks of homosexual men are most systematically described in the literature; to a lesser extent families with hemophilia and i.v. drug users and even fewer studies are found regarding families with a heterosexual transmission background and especially female family caregivers. This paper also focuses on the wide range of support offered by these family systems. The acute and mostly terminal infectious disease Aids, as observed in the 80 Dies, has now become a predominantly chronic-progressive illness. Since the mid 90 Dies, the new antiretroviral therapies have further decreased morbidity and mortality, leading to less personal care, high-tech nursing requirements and household support. This development places families in a position of...
In Switzerland, HIV incidence has increased considerably during the past two years. This fact has... more In Switzerland, HIV incidence has increased considerably during the past two years. This fact has raised concern both in the media and in the health care system. However family caregivers have not been considered in these debates, although their figures are increasing as well. In Switzerland, a few research studies were conducted focussing on the situation of family caregivers affected by HIV/AIDS. This particular qualitative research project focuses on the questions as to what kind of work these family caregivers are doing, under which conditions they are working, and which consequences arise from their work. Data were collected by conducting eleven semi-structured interviews, and data analysis was done through a content analysis. Results show that family caregivers provide a wide range and a large amount of family work. Not only are family caregivers working for the HIV-positive persons, but also for the benefit of other family members and friends as well as for themselves. Family...
Developing and establishing an advanced nursing practice is an essential step toward future-orien... more Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the s...
Ein speziell geschultes Team mit hoher Fachexpertise und ein strukturiertes Behandlungskonzept ma... more Ein speziell geschultes Team mit hoher Fachexpertise und ein strukturiertes Behandlungskonzept machen Stroke-Units zur optimalen evidenzbasierten Versorgungsform für Menschen mit einem Schlaganfall. Pflegefachpersonen übernehmen in allen Behandlungsphasen eine zentrale Rolle, wie ein Beispiel aus dem Universitätsspital Zürich zeigt.
Aim: This study focuses on nursing practice for patients with chronic heart failure (CHF). The ai... more Aim: This study focuses on nursing practice for patients with chronic heart failure (CHF). The aim is to reflect on a practice development project to improve patient care in a person-centred way and to implement evidence into practice. The project consists of two phases with individual aims and evaluation processes. Part one describes the development, implementation and evaluation of an education programme for CHF patients. The goal is to change nursing culture by involving the healthcare team and to build up skills and expertise. Part two describes the further development of the programme through integration of the patients’ perspective. Methods: A person-centred approach formed the basis for changing nursing practice. The development and implementation of the CHF programme was carried out via action research, to expand the healthcare team’s knowledge and improve patient outcomes. A mixed methods design was chosen for the evaluation of the pilot programme. Grounded theory was used ...
Die Betreuung von Patienten mit chronischer Herzinsuffizienz (CHF-Pat) bedeutet eine Herausforder... more Die Betreuung von Patienten mit chronischer Herzinsuffizienz (CHF-Pat) bedeutet eine Herausforderung. Sie setzt das Bewusstsein für die Lebenswelt der CHF-Pat und ihre Problemstellungen im Alltag voraus. Ziel dieses narrativen Literaturreviews ist, die Perspektive der CHF-Pat von der Diagnose und den Umgang mit der CHF aufzuzeigen. Die Literatur wurde in wissenschaftlichen Datenbanken in den Jahren 2011/12 gesichtet. Eingeschlossen wurden 18 qualitative Studien. Die Resultate zeigen Wege zur Diagnose und den Übergang vom akuten zum chronischen Zustand. Therapie, Lebensstilempfehlungen und Symptome erfordern Anpassungen in der Alltagsgestaltung. Professionelle und Familien bilden ein wichtiges unterstützendes Netz. Unterschiedliche Copingstrategien kommen zum Einsatz. CHF-Pat erwarten eine partizipative Zusammenarbeit mit den Professionellen. Eine gute Betreuung setzt Offenheit voraus, sich auf einen gemeinsamen Lernprozess einzulassen und die Auseinandersetzung über gesundheitsförde...
In the first year after kidney transplantation patients are challenged with incorporating new beh... more In the first year after kidney transplantation patients are challenged with incorporating new behaviour patterns into their daily lives. Due to the higher risk of cardiovascular disease amongst kidney transplant recipients, behaviours such as preventing undesired weight gain, exercising, avoiding smoking, and managing medications take on crucial importance. The aim of the project was to develop a programme based on prevailing evidence to promote self-management skills in this patient population. To this end a participatory action research approach was chosen. The programme was developed with inter-professional collaboration under the direction of an advanced practice nurse. As theoretical framework for the development of the intervention models of behaviour change and self-management were chosen. The content is based on current literature and includes the viewpoints of both patients and nursing experts. The programme consists of three elements: 1) Educational brochures developed thr...
This article presents the current state of the art regarding the concept of families living with ... more This article presents the current state of the art regarding the concept of families living with HIV and Aids. The literature reflects a comprehensive view including families of origin, families of choice and partnerships. It is evident that family networks of homosexual men are most systematically described in the literature; to a lesser extent families with hemophilia and i.v. drug users and even fewer studies are found regarding families with a heterosexual transmission background and especially female family caregivers. This paper also focuses on the wide range of support offered by these family systems. The acute and mostly terminal infectious disease Aids, as observed in the 80 Dies, has now become a predominantly chronic-progressive illness. Since the mid 90 Dies, the new antiretroviral therapies have further decreased morbidity and mortality, leading to less personal care, high-tech nursing requirements and household support. This development places families in a position of...
In Switzerland, HIV incidence has increased considerably during the past two years. This fact has... more In Switzerland, HIV incidence has increased considerably during the past two years. This fact has raised concern both in the media and in the health care system. However family caregivers have not been considered in these debates, although their figures are increasing as well. In Switzerland, a few research studies were conducted focussing on the situation of family caregivers affected by HIV/AIDS. This particular qualitative research project focuses on the questions as to what kind of work these family caregivers are doing, under which conditions they are working, and which consequences arise from their work. Data were collected by conducting eleven semi-structured interviews, and data analysis was done through a content analysis. Results show that family caregivers provide a wide range and a large amount of family work. Not only are family caregivers working for the HIV-positive persons, but also for the benefit of other family members and friends as well as for themselves. Family...
Developing and establishing an advanced nursing practice is an essential step toward future-orien... more Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the s...
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Papers by Rebecca Spirig