@article{zuSaynWittgensteinSchneppLange2015, author = {zu Sayn-Wittgenstein, Friederike and Schnepp, Wilfried and Lange, Ute}, title = {Das subjektive Erleben chronisch kranker Frauen in der Zeit von Schwangerschaft, Geburt und Wochenbett - eine Analyse qualitativer Studien}, series = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, volume = {219}, journal = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, number = {04}, doi = {10.1055/s-0034-1398632}, pages = {161 -- 169}, year = {2015}, abstract = {Zusammenfassung Hintergrund und Fragestellung: Immer mehr Menschen sind weltweit und besonders in den Industrienationen chronisch erkrankt, dies betrifft auch die Gruppe der Schwangeren, Geb{\"a}renden und W{\"o}chnerinnen. Betroffene Frauen m{\"u}ssen die allgemeinen Herausforderungen des Mutter Werdens neben medizinischen Interventionen und medikament{\"o}sen Behandlungen bew{\"a}ltigen. {\"U}ber das subjektive Erleben und das Bew{\"a}ltigungshandeln der Frauen zu diesem Thema ist wenig bekannt. Methode: Die internationale Literaturrecherche in diversen Datenbanken wie Cinahl, Cochrane Library and Medline fand vom November 2013 bis M{\"a}rz 2014 statt. Es wurden Studien zu den Fragestellungen der grunds{\"a}tzlichen Bewertung der Schwangerschaftserfahrung, der Rolle des sozialen Umfelds, des Erlebens medizinischer Therapien und Diagnostiken, der Sorge um das Kind und der Effekte auf das Krankheitserleben ausgewertet. Ergebnisse: 11 qualitative Studien konnten als wesentlich im Sinne der Forschungsfragen identifiziert werden. Die Erfahrungen der Frauen mit chronischer Erkrankung in der Zeit des Mutter Werdens sind neben der Freude von einer hohen Anspannung gepr{\"a}gt, die sich aus der Sorge um das Kind vor dem Hintergrund m{\"o}glicher Komplikationen ergibt. Dies kann zu Konflikten bei Entscheidungen im Spannungsfeld eigener und kindlicher Gesundheit f{\"u}hren. Angebote und Informationen ber{\"u}cksichtigen selten ihre speziellen Bed{\"u}rfnisse und Fragstellungen. Dem Wunsch nach Normalit{\"a}t steht gegen{\"u}ber, dass betroffene Frauen einen Sonderstatus in der Gruppe der Schwangeren einnehmen. Diskussion: Konzepte f{\"u}r die Betreuung der Frauen mit chronischer Erkrankung in Schwangerschaft, Geburt und Wochenbett sollten besser auf diese Gruppe abgestimmt werden. Es besteht Forschungsbedarf betreffs der Frage, wie weit sich die Ergebnisse auf Deutschland {\"u}bertragen lassen, da sich das Versorgungssystem f{\"u}r Schwangere von den L{\"a}ndern, aus denen die Studien stammen, unterscheidet.}, language = {de} } @article{zuSaynWittgensteinSchneppLange2015, author = {zu Sayn-Wittgenstein, Friederike and Schnepp, Wilfired and Lange, Ute}, title = {Die Sicht von Schwangeren mit chronischer Erkrankung auf die Betreuung und Begleitung durch Hebammen, {\"A}rztinnen und {\"A}rzten}, series = {QuPuG : Journal f{\"u}r qualitative Forschung in Pflege- und Gesundheitswissenschaft}, volume = {2}, journal = {QuPuG : Journal f{\"u}r qualitative Forschung in Pflege- und Gesundheitswissenschaft}, number = {02}, pages = {136 -- 144}, year = {2015}, language = {de} } @article{zuSaynWittgensteinSchnepp2015, author = {zu Sayn-Wittgenstein, Friederike and Schnepp, Wilfried}, title = {Familien in der ambulanten palliativen Betreuung Operationalisierung von Bedarfen und Belastungen zur Entwicklung eines Screeninginstrumentes}, series = {Pflegewissenschaft}, volume = {17}, journal = {Pflegewissenschaft}, number = {1}, doi = {10.3936/1285}, pages = {46 -- 61}, year = {2015}, abstract = {Problem: Familien in der ambulanten palliativen Situation unterliegen vielen Belastungen, welche bislang in Deutschland nur unzureichend erforscht wurden. Fragestellung: Wie kann die Situation von Familien in der ambulanten palliativen Betreuung auf Grundlage des aktuellen Forschungsstands f{\"u}r eine schriftliche Befragung in Deutschland konzeptualisiert werden? Methode: Basierend auf einer Literaturrecherche wurden Publikationen identifiziert, welche die Bed{\"u}rfnisse und Belastungen der Familien untersuchten. Die Treffer wurden inhaltlich analysiert und kategorisiert. Auf dieser Grundlange wurden Instrumente recherchiert, welche die relevanten Kategorien adressieren. Die daraus ausgew{\"a}hlten Instrumente wurden zu einem Screeninginstrument zusammengefasst. Ergebnisse: Die 529 relevanten Publikationen beinhalten 38 Themengebiete in acht Kategorien. Hieraus wurde ein 71 Items umfassendes Screeninginstrument zusammengestellt, welches die palliative Situation der Familien in Deutschland erheben soll.}, language = {de} } @inproceedings{WolfMoellerBallenbergeretal.2019, author = {Wolf, Eduard and M{\"o}ller, Dirk and Ballenberger, Nikolaus and Zalpour, Christoff}, title = {Marker-based Method for Analyzing the Three-Dimensional Upper Body Kinematics of Violinists and Violists: Development and Clinical Feasibility}, url = {http://nbn-resolving.de/urn:nbn:de:bsz:959-opus-14253}, pages = {21}, year = {2019}, abstract = {Rationale: Three-dimensional (3D) motion analysis has proved helpful in the diagnosis of different musculoskeletal syndromes and identifying injurious movement patterns in high string players. Furthermore, an optoelectronic 3D motion capture system allows an accurate and objective assessment of upper body posture and motion during violin and viola performance. However, no reference upper body model of high string players has been proposed as yet. Moreover, a more physiological shoulder model that separates the joints of the shoulder complex has not been reported. Especially in view of given the role of the scapula in the normal movement of the humerus, it cannot be disregarded when evaluating musculoskeletal strain in the shoulder. The International Society of Biomechanics recommends definitions of joint coordinate systems for the report of upper body joint motion using anatomical landmarks as reference for the placement of surface markers. Using markers on the skin for some of the proposed locations is, however, inappropriate when an instrument is being played. There are skin movement artifacts, e. g. caused by the movement of the scapula underneath the skin, whereas some markers interfere with the instrument on the shoulder or might be occluded by the bowing arm in motion. Purpose: The aim of this study was to develop a marker-based method for quantifying 3D upper body kinematics of high string players and to demonstrate its clinical feasibility in violin and viola performance. The method is intended to provide an objective evaluation of high string players' motor strategies, especially in the shoulder complex, while minimizing skin movement artifacts, marker occlusions and limitations in instrument placement. Methods: A custom marker set was developed consisting of thirty-one single markers to define the anatomical coordinate systems of sixteen upper body segments including the pelvis, thorax, spine and head, as well as both scapulae, upper arms, forearms and hands. Twenty-one of these markers as well as two pre-built and four custom-made rigid marker clusters were used for tracking the segment motions. Twelve professional violinists without history of musculoskeletal or neurological problems were recruited for assessing the clinical feasibility of the method. They were asked to perform a single sequence of two consecutive musical notes on each of two adjacent strings (G- and D-string) in real time, played at 50 bpm with tempo audibly regulated by a metronome, and using a standardized violin and bow. The participants played up- and down-bow alternately using the whole length of the bow. A custom biomechanical model was applied to the motion capture data and the rotation angles of fifteen joints were calculated. The location of each glenohumeral joint rotation center was computed by upper arm movements with respect to the scapula based on a functional method. For a description of the motion patterns, minimum, maximum and range of angular motion were averaged across participants for each string and rotation. Inter-subject variability was assessed by calculating the standard deviation (SD) at each sample of the angle-time series between participants for each rotation and for both strings. Then SD was averaged over sequences for each rotation and string. For comparing mean rotation angles between strings over time, random effect models were used. Results: The highest range of motion was observed in the right elbow flexion and right wrist flexion/extension. Also, high ranges of motion (> 10°) were found in all right glenohumeral rotations and right wrist deviation and pronation/supination. In conclusion, lumbar and thoracic spine, thorax, neck, and left upper limb were quite static, while large motion occurred in the right upper limb during up and down bowing. Most rotation angles showed a reasonable inter-subject variability except for left and right glenohumeral plane of elevation as well as left glenohumeral internal/external rotation, and left and right wrist pronation/supination (> 10°). Significant differences in the rotation angles between G- and D-string bowing were detected especially in the left wrist and right shoulder joints. Conclusions: This is the first study that used quantitative 3D analysis to explore the upper body kinematics of high string players during performance, providing a detailed view of the motor control in the shoulder as well as in the lumbar and thoracic spine. The biggest advantage over previously published methods is the more physiological shoulder and spine models while providing a simple application. The method was found to give consistent motion patterns across participants and to be sensitive to differences between adjacent strings. Although the method appears to be valid, more rigorous validation is necessary. Since there is no gold standard with which we could compare results, we were only able to assess the clinical feasibility. We believe that our method represents a good compromise between accuracy and practicability for clinical application. Due to the inclusion of multi-segmented shoulder and spine models, it will improve understanding of the motor strategies adopted by high string players and may contribute to injury prevention, diagnosis and treatment.}, language = {en} } @article{SchlueterCruseSchneppzuSaynWittgenstein2016, author = {Schl{\"u}ter-Cruse, Martina and Schnepp, Wilfried and zu Sayn-Wittgenstein, Friederike}, title = {Interprofessional cooperation by midwives in the field of out-of-hospital obstetrical care: an integrative review}, series = {International Journal of Health Professions : The Journal of Verein zur F{\"o}rderung der Wissenschaft in den Gesundheitsberufen}, volume = {3}, journal = {International Journal of Health Professions : The Journal of Verein zur F{\"o}rderung der Wissenschaft in den Gesundheitsberufen}, number = {2}, doi = {10.1515/ijhp-2016-0025}, url = {http://nbn-resolving.de/urn:nbn:de:bsz:959-opus-14241}, pages = {136 -- 152}, year = {2016}, abstract = {The central objective of early prevention in Germany is an improved cooperation between professional groups of the health services and child and youth welfare in interprofessional networks. This objective derives from the realisation that proper care for families with infants can only be achieved if the various groups act in close integration. The 'Federal Initiative early prevention' explicitly calls for freelance midwives to be integrated in this context. However, only a few scientific findings on midwives' cooperation in networks of early prevention have been published to date. This integrative review aims to identify the central themes of interprofessional cooperation of midwives in out-of-hospital obstetrical care from national and international research literature. A systematic search of five research databases for publications between 2005 and 2015 was performed, complemented by a manual search. 25 studies were identified describing various contexts where midwives in out-of-hospital obstetrical care cooperate with other professional groups. Four key themes were analysed: contexts of cooperation, benefits of cooperation, facilitating and restrictive factors of cooperation, and competencies of cooperation. The studies show that there is only limited research coverage of the midwives' perspective regarding interprofessional cooperation. The existing studies examine the cooperation of midwives primarily with health care professionals, and secondarily with professionals in the social services. In order to expand knowledge on the cooperation of freelance midwives in the networks of early prevention, future research should focus on the perspective of midwives regarding cooperation with other professional groups, both in the health care sector and in the field of social services.}, language = {en} } @article{SchlueterCruseSchneppzuSaynWittgenstein2016, author = {Schl{\"u}ter-Cruse, Martina and Schnepp, Wilfried and zu Sayn-Wittgenstein, Friederike}, title = {Die Kooperation von Hebammen im Kontext der ambulanten Versorgung - Ergebnisse einer Literaturstudie}, series = {Zeitschrift f{\"u}r Hebammenwissenschaft}, volume = {04}, journal = {Zeitschrift f{\"u}r Hebammenwissenschaft}, number = {01}, doi = {10.3205/16dghwi13}, url = {http://nbn-resolving.de/urn:nbn:de:bsz:959-opus-14239}, pages = {25 -- 27}, year = {2016}, language = {de} } @article{SchneppzuSaynWittgenstein2016, author = {Schnepp, Wilfried and zu Sayn-Wittgenstein, Friederike}, title = {Die berufliche Praxis von Hebammen in der ambulanten Wochenbettbetreuung: eine Literaturanalyse}, series = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, volume = {221}, journal = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, number = {01}, doi = {10.1055/s-0042-106653}, pages = {12 -- 24}, year = {2016}, abstract = {Hintergrund Wochenbettbetreuung findet {\"u}berwiegend im ambulanten Sektor statt. Hebammen {\"u}bernehmen den gesundheitlichen Versorgungsauftrag und begleiten junge Familien. Die Literaturstudie geht den Fragen nach, wie Hebammen ihre Betreuungsprozesse in der ambulanten Wochenbettbetreuung gestalten und welche Aspekte Einfluss auf die Arbeit haben. Methode Zur Darstellung der Studienlage wurde eine systematische Literatursuche durchgef{\"u}hrt. Einbezogen wurden Studien, die die Perspektive von Hebammen zu ihrer T{\"a}tigkeit in der ambulanten Wochenbettbetreuung integrieren. Diese wurden auf Grundlage einer thematischen Analyse ausgewertet. Ergebnisse Neben der Beobachtung des gesundheitlichen Wohlbefindens von Mutter und Kind stehen psychosoziale Aspekte sowie die professionelle Begleitung und Beratung zu Fragen rund um die neue Lebenssituation als Familie im Vordergrund der Wochenbettbetreuung. Hebammen f{\"u}hlen sich nicht immer ausreichend in dem Umgang mit komplexen psychosozialen Problemen vorbereitet und w{\"u}nschen sich mehr Wissen sowie einen besseren Zugang zu Informationen. Neben zeitlichen Einschr{\"a}nkungen beeinflussen Kontinuit{\"a}t sowie unterschiedliche Betreuungsstrategien die Arbeit. Diskussion Die ambulante Wochenbettbetreuung stellt sich als komplexes Handlungsfeld in einer wichtigen Lebensphase von Frauen und Familien dar. Neben der M{\"o}glichkeit der Gew{\"a}hrleistung von Betreuungskontinuit{\"a}t sind entsprechende Wissensbest{\"a}nde und Fertigkeiten der Hebammen erforderlich. Fazit Die Entwicklung theoriegeleiteter Konzepte, eine Verbesserung der Aus- und Weiterbildungsprogramme sowie ein klar definierter Versorgungsauftrag k{\"o}nnen die berufliche Handlungspraxis von Hebammen unterst{\"u}tzen.}, language = {de} } @article{WilfriedzuSaynWittgenstein2016, author = {Wilfried, Schnepp and zu Sayn-Wittgenstein, Friederike}, title = {Die Bedeutung der Latenzphase der Geburt - eine historische Analyse}, series = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, volume = {220}, journal = {Zeitschrift f{\"u}r Geburtshilfe und Neonatologie}, number = {04}, doi = {10.1055/s-0041-111634}, pages = {155 -- 165}, year = {2016}, abstract = {Die Begriffe Latenzphase und aktive Er{\"o}ffnungsphase gliedern die Er{\"o}ffnungsperiode und gehen zur{\"u}ck auf die Arbeiten des US-amerikanischen Gyn{\"a}kologen Emanuel A. Friedman aus den 1950er Jahren. Seither geh{\"o}rt diese Differenzierung der Er{\"o}ffnungsperiode international sowohl in wissenschaftlichen Untersuchungen als auch in der klinischen Praxis zum {\"u}blichen Vorgehen. Auch wenn die Wurzeln f{\"u}r die detaillierte Betrachtung und Bewertung der ersten Geburtsphase im deutschsprachigen Raum liegen, hat sie sich in Deutschland bislang nicht fl{\"a}chendeckend durchgesetzt. In dieser Analyse ausgew{\"a}hlter Hebammenlehrb{\"u}cher und geburtshilflicher Lehrb{\"u}cher aus 5 Jahrhunderten sowie historischer als auch aktueller wissenschaftlicher Publikationen werden Merkmale und Verlauf der Phasen beschrieben und diskutiert. Die Differenzierung der Er{\"o}ffnungsperiode in Latenzphase und aktive Geburtsphase erm{\"o}glicht Hebammen und {\"a}rztlichen Geburtshelfern und -helferinnen eine spezifische und individuelle Geburtsleitung und Betreuung der Geb{\"a}renden w{\"a}hrend der gesamten Geburt.}, language = {de} } @article{zuSaynWittgenstein2018, author = {zu Sayn-Wittgenstein, Friederike}, title = {Sexual and Reproductive Healthcare for Women Asylum Seekers: Situation Analysis in Switzerland and Recommendations}, series = {BMC Health Services Research}, volume = {18}, journal = {BMC Health Services Research}, number = {712}, doi = {10.1186/s12913-018-3502-2}, url = {http://nbn-resolving.de/urn:nbn:de:bsz:959-opus-14204}, pages = {1 -- 12}, year = {2018}, abstract = {Background Forced migration significantly endangers health. Women face numerous health risks, including sexual violence, lack of contraception, sexually transmitted disease, and adverse perinatal outcomes. Therefore, sexual and reproductive healthcare is a significant aspect of women asylum seekers' health. Even when healthcare costs of asylum seekers are covered by the government, there may be strong barriers to healthcare access and specific needs may be addressed inadequately. The study's objectives were a) to assess the accommodation and healthcare services provided to women asylum seekers in standard and specialised health care, b) to assess the organisation of healthcare provision and how it addresses the sexual and reproductive healthcare needs of women asylum seekers. Methods The study utilised a multi-method approach, comprising a less-dominant quantitative component and dominant qualitative component. The quantitative component assessed accommodation conditions for women in eight asylum centres using a survey. The qualitative component assessed healthcare provision on-site, using semi-structured interviews with health and social care professionals (n = 9). Asylum centres were selected to cover a wide range of characteristics. Interview analysis was guided by thematic analysis. Results The accommodation in the asylum centres provided gender-separate rooms and sanitary infrastructure. Two models of healthcare were identified, which differed in the services they provided and in their organisation: 1) a standard healthcare model characterised by a lack of coordination between healthcare providers, unavailability of essential services such as interpreters, and fragmented healthcare, and 2) a specialised healthcare model specifically tailored to the needs of asylum-seekers. Its organisation is characterised by a network of closely collaborating health professionals. It provided essential services not present in the standard model. We recommend the specialised healthcare model as a guideline for best practise. Conclusions The standard, non-specialised healthcare model used in some regions in Switzerland does not fully meet the healthcare needs of women asylum seekers. Specialised healthcare services used in other regions, which include translation services as well as gender and culturally sensitive care, are better suited to address these needs. More widespread use of this model would contribute significantly toward protecting the sexual and reproductive integrity and health of women asylum seekers.}, language = {en} } @article{zuSaynWittgensteinSorberSchnepp2018, author = {zu Sayn-Wittgenstein, Friederike and Sorber, Michaela and Schnepp, Wilfried}, title = {Die Zeit auf der neonatologischen Intensivstation - Das Erleben von Eltern fr{\"u}hgeborener Kinder - Eine internationale Literaturrecherche}, series = {QuPuG : Journal f{\"u}r qualitative Forschung in Pflege- und Gesundheitswissenschaft}, volume = {5}, journal = {QuPuG : Journal f{\"u}r qualitative Forschung in Pflege- und Gesundheitswissenschaft}, number = {1}, pages = {26 -- 34}, year = {2018}, language = {de} }