Bergler R
Psychologischen Institut der Univesität Bonn.
Zentralbl Hyg Umweltmed. 1995 Apr;197(1-3):45-74.
In a random survey questions were put to 100 employees of home care centers (51 qualified nursing staff, 28 assistants and/or trainees, 21 young people doing community service as an alternative to military service).
(1) The job motivation is primarily of a private nature: social commitment, achievement motivation, being responsible for solving diverse human problems are at the centre of job orientation. (2) Huge disappointments (neglect of patients, stress, arrangement of working hours, bureaucracy, lack of self-responsibility) are in 62% of the cases the reasons for changing from a clinic to the home care centre. (3) The psychological results of home care nursing are only positive in 62% of the cases; 26% have thought of giving notice, 37% would not choose their job again. (4) The training qualification for home care nursing is only adequate for 60% of those questioned; deficiencies are experienced with regard to consulting competence, gerontopsychiatry, specific knowledge about illnesses, legal questions. Essential further training is neglected. Also initial instruction in the home care service is to a great extent unsatisfactory. (5) For economic reasons it is frequently necessary to limit daily care to basic nursing; the patients' communicative needs have to ignored. One's occupational self-importance dwindles away; the job increasingly becomes an everyday stress factor. (6) The high risk of infection in the case of home-care patients is considered to be above-average (bedsores, infection risks with regard to changing bandages/catheters, anuspraeter aids, incontinence, fungal diseases, food risks: not keeping to diets, food not suitable for the elderly, lack of appropriate storage for leftovers. (7) Nursing staff, as well as patients, regard soap, cleansing lotion, shampoo, tooth brushes and toothpaste as the main items for personal hygiene, for the prevention and treatment of bedsores. Beyond that, compared with nursing staff, patients have a greater need for personal hygiene products (deodorants, mouthwash, perfume, etc.): personal hygiene providing mental stimulation. (8) Doctors are not integrated sufficiently into the social network of nursing home-care patients. The required quality of cooperation with the nursing staff only exists in part. (9) Contact to the overworked relatives is generally positive. Cooperation can be optimized by imparting basic nursing knowledge, by getting the relatives to participate in one's own work, by enlisting the home-care centre early on and through psychological support by third parties (e.g. discussion courses).
在一项随机调查中，向100名家政护理中心的员工提出了问题（51名合格的护理人员、28名助手和/或实习生、21名作为替代服兵役而从事社区服务的年轻人）。
（1）工作动机主要是个人性质的：社会责任感、成就动机、负责解决各种人际问题是工作定位的核心。（2）在62%的情况下，巨大的失望（忽视患者、压力、工作时间安排、官僚作风、缺乏自主责任）是从诊所转到家政护理中心的原因。（3）家政护理的心理结果仅有62%是积极的；26%的人曾想过辞职，37%的人不会再次选择这份工作。（4）家政护理的培训资质对60%的受访者来说只是勉强够用；在咨询能力、老年精神病学、疾病的具体知识、法律问题方面存在不足。重要的进一步培训被忽视。而且家政服务的初始指导在很大程度上也不尽人意。（5）出于经济原因，日常护理常常不得不局限于基本护理；患者的沟通需求不得不被忽视。个人职业的重要性逐渐降低；这份工作日益成为日常压力因素。（6）家政护理患者的高感染风险被认为高于平均水平（褥疮、更换绷带/导管、肛门护理辅助器具、大小便失禁、真菌疾病、食物风险：不遵守饮食规定、食物不适用于老年人、剩菜缺乏适当储存）。（7）护理人员和患者都将肥皂、清洁乳液、洗发水、牙刷和牙膏视为个人卫生、预防和治疗褥疮的主要用品。除此之外，与护理人员相比，患者对个人卫生用品（除臭剂、漱口水、香水等）有更大需求：个人卫生能提供精神刺激。（8）医生没有充分融入疗养院护理患者的社交网络。与护理人员所需的合作质量只是部分存在。（9）与疲惫不堪的亲属的联系总体上是积极的。通过传授基本护理知识、让亲属参与自己的工作、尽早争取家政护理中心以及第三方提供心理支持（如讨论课程），合作可以得到优化。
