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The purpose of this study was to investigate how family caregivers and nurses consider their mutual relationship and to develop a substantive theory on the relationship between formal and informal care. Interviews (n=88) with family caregivers, nurses and nurse managers have been conducted. Data collection and analysis were performed according to the grounded theory methodology. The relationship between formal and informal care is an encounter of two quite different perspectives that is focussed on the issue of how a particular amount of caregiving work is performed by means that are considered helpful. The perspectives of family caregivers and nurses on their relationship differ considerably, but both are engaged in a process of negotiating helpful action. While for family caregivers the proces is determined by the goal of facilitating work and care, the nurses everyday reality is focussed on shaping different realities in different households and with different people. How these different perspectives contribute to the negotiation process is influenced by interactive effects between nurses and family caregivers conceptualised as mutual dependency. From the caregivers point of view the beginning of a caregiving situation is conceptualized by the context of Facing new life circumstances. For family caregivers the consequence out of this context is coming to terms with competing demands. Family caregivers engage in a process of Developing a fitting arrangement. In this process family caregivers apply strategies of managing caregiving. The strategies for managing caregiving are intended to develop a caregiving arrangement that allows for the goal off facilitating work and care. From the nurses perspective becoming involved is an underlying condition of home care nursing. It is a prerequisite for the work of nurses in home care. Home care nursing is framed by three concepts: Framing home care nursing which conceptualises the context and which contains the legislative framework of home care nursing. Beside framing home care nursing, the nurses professional identity (Working in home care nursing) and the nurses personal identity (contributing one s own personality) influence the nursing perspective. The interplay between the home care framework and the nurses professional and personal identity results in the consequence of the nurses feeling restricted in their practice. The core of the nurses perspective is the process of shaping different realities. The concept of feeling restricted influences the process of shaping different realities. According to their professional and personal identities nurses apply professional (matching order and reality) and personal (balancing closeness and distance) strategies to shape different realities. The goal of the process of home care nursing is keeping people at home. The substantive theory adds to the understanding of the relationship between formal and informal care in home care. For nursing practice the substantive theory serves as a tool for evaluating existing practice and reconsider implicit professional assumptions in relation to an existing reality of family caregiving. ; The purpose of this study was to investigate how family caregivers and nurses consider their mutual relationship and to develop a substantive theory on the relationship between formal and informal care. Interviews (n=88) with family caregivers, nurses and nurse managers have been conducted. Data collection and analysis were performed according to the grounded theory methodology. The relationship between formal and informal care is an encounter of two quite different perspectives that is focussed on the issue of how a particular amount of caregiving work is performed by means that are considered helpful. The perspectives of family caregivers and nurses on their relationship differ considerably, but both are engaged in a process of negotiating helpful action. While for family caregivers the proces is determined by the goal of facilitating work and care, the nurses everyday reality is focussed on shaping different realities in different households and with different people. How these different perspectives contribute to the negotiation process is influenced by interactive effects between nurses and family caregivers conceptualised as mutual dependency. From the caregivers point of view the beginning of a caregiving situation is conceptualized by the context of Facing new life circumstances. For family caregivers the consequence out of this context is coming to terms with competing demands. Family caregivers engage in a process of Developing a fitting arrangement. In this process family caregivers apply strategies of managing caregiving. The strategies for managing caregiving are intended to develop a caregiving arrangement that allows for the goal off facilitating work and care. From the nurses perspective becoming involved is an underlying condition of home care nursing. It is a prerequisite for the work of nurses in home care. Home care nursing is framed by three concepts: Framing home care nursing which conceptualises the context and which contains the legislative framework of home care nursing. Beside framing home care nursing, the nurses professional identity (Working in home care nursing) and the nurses personal identity (contributing one s own personality) influence the nursing perspective. The interplay between the home care framework and the nurses professional and personal identity results in the consequence of the nurses feeling restricted in their practice. The core of the nurses perspective is the process of shaping different realities. The concept of feeling restricted influences the process of shaping different realities. According to their professional and personal identities nurses apply professional (matching order and reality) and personal (balancing closeness and distance) strategies to shape different realities. The goal of the process of home care nursing is keeping people at home. The substantive theory adds to the understanding of the relationship between formal and informal care in home care. For nursing practice the substantive theory serves as a tool for evaluating existing practice and reconsider implicit professional assumptions in relation to an existing reality of family caregiving.

Das Buch gibt den aktuellen Diskussionsstand zum Thema Pflegebedürftigkeit wieder und legt dabei den Fokus vor allem auf die Pflegebedürftigkeit im Alter. Beleuchtet werden die Bedeutungvon Pflegebedürftigkeit sowie welche Auswirkung unterschiedliche Definitionen von Pflegebedürftigkeit haben können. Dieser Aspekt wird mit Beispielen aus dem Ausland illustriert. Das dritte Kapitel befasst sich mit der Bedeutung von Pflegebedürftigkeit für ältere Menschen und ihre Angehörigen in ihrem Alltagsleben. Im vierten Kapitel geht es um die Bewältigung von Pflegebedürftigkeit. Dazu gehören informelle Hilfeleistungen im Familienkontext, professionelle Unterstützungsleistungen durch die an der Versorgung beteiligten Berufsgruppen sowie die Leistungen des sozialen Sicherungssystems zur Pflege. Im abschließenden Kapitel wird der Frage nachgegangen, warum und welche Unterstützungsleistungen in Anspruch genommen werden. Enthält u. a. Beiträge über Einführung, Grundprinzipien und Zielsetzung der Pflegeversicherung - Pflegebedürftigkeit als zukünftige Herausforderung - was ist Pflegebedürftigkeit - Selbstständigkeit und Selbstbestimmung - Pflege durch Angehörige - Charakterisierung pflegender Angehöriger - ambulante Pflege - gesetzliche Rahmenbedingungen der ambulanten Pflege - stationäre Pflege - Pflegeberatung - Unterstützungsleistungen.

Soziale Ungleichheiten im Kontext pflegerischer Versorgung stellen eine wachsende Herausforderung für die Sozial- und Gesundheitspolitik dar. Die Beiträge angewandter Pflegeforschung machen aus wissenschaftlicher wie praktischer Perspektive deutlich, wie gravierend Ressourcenunterschiede auf die Qualität der Versorgung Einfluss nehmen. Das gilt für die Ausgestaltung von Pflegearrangements, für die Effektivität und Effizienz der erbrachten Pflegeleistungen sowie für die Funktion der pflegerischen Versorgung bei der Reproduktion sozial bedingter gesundheitlicher Ungleichheiten. Der Band bietet a

"Begleitend zu den Beratungen eines Beirats des Bundesministeriums für Gesundheit zur Überprüfung des Pflegebedürftigkeitsbegriffs im SGB XI wurde ein neues Begutachtungsassessment (NBA) zur Feststellung der Pflegebedürftigkeit entwickelt, das auf einem pflegewissenschaftlich begründeten Verständnis von Pflegebedürftigkeit aufbaut. Darin werden gleichermaßen körperliche wie kognitive/ psychische Beeinträchtigungen und Verhaltensauffälligkeiten berücksichtigt und die derzeit geltende Engführung auf wenige körperbezogene Alltagsverrichtungen bei der Bestimmung von Pflegebedürftigkeit wird überwunden. Als Maßstab zur Einschätzung von Pflegebedürftigkeit wird im NBA nicht die Pflegezeit, sondern der Grad der Selbständigkeit bei der Durchführung von Aktivitäten oder der Gestaltung von Lebensbereichen verwendet. Das NBA ist auch für die Einschätzung der Pflegebedürftigkeit bei Kindern geeignet und hat sich bei einer bundesweiten praktischen Erprobung gut bewährt. Es wurde vom Beirat zur Überprüfung des Pflegebedürftigkeitsbegriffs als zukünftiges Instrument zur Begutachtung der Pflegebedürftigkeit im Rahmen der Pflegeversicherung empfohlen." (Autorenreferat)

Der nachfolgende Beitrag diskutiert die Herausforderungen des Einbezugs von betroffenen Kindern und Jugendlichen in die qualitative Forschung zum Thema lebenslimitierende Erkrankungen insbesondere unter dem Blickwinkel der methodischen Gestaltung dieses Einbezugs. Hierfür wird zunächst die Lebens- und Versorgungssituation lebenslimitierend erkrankter Kinder und Jugendlicher dargestellt. Anschließend werden Ergebnisse aus empirischen Studien erläutert und im Hinblick auf die Herausforderungen einer Beteiligung erkrankter Kinder, Jugendlicher und ihrer Familien diskutiert. Als Ergebnis dieser Analyse erfolgt eine Zusammenfassung zentraler Diskussionsstränge. Zudem werden Strategien für eine sensible Integration von schwerkranken Kindern und Jugendlichen abgeleitet und auf der Basis bestehender Erfahrungen aus qualitativen Studien konkretisiert. Vor dem Hintergrund einer laufenden Studie mit lebenslimitierend erkrankten Kindern liefert der Beitrag Anregungen für die methodische Planung, Durchführung und Evaluation von entsprechenden Forschungsvorhaben. (Autorenreferat)

Objetivo: Compreender o significado de viver saudável para usuários, profissionais e gestores de uma equipe Estratégia Saúde da Família (ESF). Métodos: Pesquisa de natureza qualitativa, baseada na grounded theory. Para a coleta de dados foram realizadas entrevistas com 25 participantes, dentre eles usuários, profissionais e gestores de uma equipe ESF, no período entre março e dezembro de 2009. Resultados: A coleta e a análise dos dados, conduzida de forma sistemática e comparativa, evidenciaram que o viver saudável pode ser caracterizado como um processo auto-organizador, intermediado pela atuação dos profissionais da equipe ESF, especialmente, pelo agente comunitário de saúde, por meio da criação de vínculos de confiança e estímulo às interações e associações comunitárias. Conclusão: Concluiu-se que o viver saudável é um fenômeno singular, complexo, interativo, associativo, político e social, conjugado pelo envolvimento ativo e participativo dos usuários e pelo engajamento efetivo e socialmente responsável dos profissionais, gestores e autoridades políticas instituídas. ; Objective: To understand the significance of healthy living for users, professionals and managers of the Family Health Strategy (FHS) team. Methods: Research of a qualitative nature, based on grounded theory. For data collection, interviews were conducted with 25 participants, including users, professionals and managers of a FHS team, during the period between March and December, 2009. Results: The collection and analysis of data was conducted in a systematic and comparative manner, demonstrating that healthy living can be characterized as a selforganizing process, mediated by the action of the FHS team professionals, especially by the community health agent, through creation of bonds of trust and stimulation of interactions and community associations. Conclusion: We concluded that healthy living is a singular phenomenon, complex, interactive, associative, political and social, coupled with the active involvement and participation of the users and by the engagement of effective and socially responsible professionals, managers and established political authorities.