Refine
Document Type
- Article (4)
- Doctoral Thesis (1)
Is part of the Bibliography
- yes (5) (remove)
Keywords
- acceptance (5) (remove)
Ziel der Studie: Die langfristige Nutzung telemedizinischer Angebote hängt nicht nur von deren Wirksamkeit, sondern auch von der Akzeptanz und Zufriedenheit der Patienten ab. Für eine telemedizinische Bewegungstherapie für Patienten nach Implantation einer Knie- oder Hüft-Totalendoprothese und erfolgter Anschlussrehabilitation wurde die Wirksamkeit bereits in einer randomisiert kontrollierten Studie untersucht. Dieser Beitrag fokussiert die Akzeptanz und das Nutzungsverhalten der Patienten hinsichtlich des eingesetzten telerehabilitativen Systems.
Methodik: Zur Erfassung der Technikakzeptanz wurden 48 Patienten (53±7 Jahre; 26 Frauen; 35 Hüft-/13 Knie-TEP) im Anschluss an eine dreimonatige telemedizinische Bewegungstherapie mittels des Telehealth Usability Questionnaire befragt. Der Fragebogen besteht aus 21 Items (siebenstufige Likert-Skala) in sechs Skalen (z. B. Nützlichkeit, Qualität der Interaktionen, Verlässlichkeit). In einer zusätzlichen Skala wurden systemspezifische Fragen zusammengefasst. Die Ergebnisse wurden als Skalenprozent (100 ≙ vollkommene Zustimmung) dargestellt. Das Nutzungsverhalten wurde anhand systemgenerierter Prozessdaten zum Training sowie zu integrierten Sprach-/Textnachrichten untersucht.
Ergebnisse: Die TUQ-Skalen „Nützlichkeit“ (Mdn 95,2) sowie „Benutzerfreundlichkeit und Erlernbarkeit“ (Mdn 92,9) wurden am höchsten bewertet, während die „Verlässlichkeit“ (Mdn 57,1) und „Qualität der Interaktionen“ (Mdn 71,4) die geringsten Ausprägungen zeigten. Die systemspezifische Skala wurde im oberen Quartil eingeordnet (Mdn 85,7).
In der ersten Woche führten 39 Patienten (81%), in der zweiten 45 Patienten (94%) mindestens eine Trainingsübung mit dem System durch. Der Anteil aktiver Patienten (≥1 Übung/Woche) reduzierte sich im weiteren Verlauf auf 75% (n=36) in der 7. Woche und 48% (n=23) in der 12. Woche. Die systemeigenen Kommunikationsmöglichkeiten wurden nach Therapiestart zunächst häufig genutzt: in der ersten Woche sendeten 42 Patienten (88%) Nachrichten, 47 Patienten (98%) erhielten Nachrichten von ihrem Therapeuten. In der 7. Woche sendeten/erhielten 9 (19%) bzw. 13 (27%) Patienten Nachrichten über das System.
Schlussfolgerung: Die Patienten nahmen die telemedizinische Bewegungstherapie überwiegend als nützlich und benutzerfreundlich wahr und schienen im Wesentlichen mit dem System zufrieden, das sich damit für den kurzfristigen Einsatz von 6 bis 8 Wochen im Anschluss an eine Anschlussrehabilitation als gut geeignet zeigte.
Traditional ways of reducing flood risk have encountered limitations in a climate-changing and rapidly urbanizing world. For instance, there has been a demanding requirement for massive investment in order to maintain a consistent level of security as well as increased flood exposure of people and property due to a false sense of security arising from the flood protection infrastructure. Against this background, nature-based solutions (NBS) have gained popularity as a sustainable and alternative way of dealing with diverse societal challenges such as climate change and biodiversity loss. In particular, their ability to reduce flood risks while also offering ecological benefits has recently received global attention. Diverse co-benefits of NBS that favor both humans and nature are viewed as promising a wide endorsement of NBS. However, people’s perceptions of NBS are not always positive. Local resistance to NBS projects as well as decision-makers’ and practitioners’ unwillingness to adopt NBS have been pointed out as a bottleneck to the successful realization and mainstreaming of NBS. In this regard, there has been a growing necessity to investigate people’s perceptions of NBS. Current research has lacked an integrative perspective of both attitudinal and contextual factors that guide perceptions of NBS; it not only lacks empirical evidence, but a few existing ones are rather conflicting without having underlying theories. This has led to the overarching research question of this dissertation, "What shapes people’s perceptions of NBS in the context of flooding?" The dissertation aims to answer the following sub-questions in the three papers that make up this dissertation: 1. What are the topics reflected in the previous literature influencing perceptions of NBS as a means to reduce hydro-meteorological risks? (Paper I) 2. What are the stimulating and hampering attitudinal and contextual factors for mainstreaming NBS for flood risk management? How are NBS conceptualized? (Paper II) 3. How are public attitudes toward the NBS projects shaped? How do risk-and place-related factors shape individual attitudes toward NBS? (Paper III) This dissertation follows an integrative approach of considering “place” and “risk”, as well as the surrounding context, by analyzing attitudinal (i.e., individual) and contextual (i.e., systemic) factors. “Place” is mainly concerned with affective elements (e.g., bond to locality and natural environment) whereas “risk” is related to cognitive elements (e.g., threat appraisal). The surrounding context provides systemic drivers and barriers with the possibility of interfering the influence of place and risk for perceptions of NBS. To empirically address the research questions, the current status of the knowledge about people’s perceptions of NBS for flood risks was investigated by conducting a systematic review (Paper I). Based on these insights, a case study of South Korea was used to demonstrate key contextual and attitudinal factors for mainstreaming NBS through the lens of experts (Paper II). Lastly, by conducting a citizen survey, it investigated the relationship between the previously discussed concepts in Papers I and II using structural equation modeling, focusing on the core concepts, namely risk and place (Paper III). As a result, Paper I identified the key topics relating to people’s perceptions, including the perceived value of co-benefits, perceived effectiveness of risk reduction effectiveness, participation of stakeholders, socio-economic and place-specific conditions, environmental attitude, and uncertainty of NBS. Paper II confirmed Paper I's findings regarding attitudinal factors. In addition, several contextual hampering or stimulating factors were found to be similar to those of any emerging technologies (i.e., path dependence, lack of operational and systemic capacity). Among all, one of the distinctive features in NBS contexts, at least in the South Korean case, is the politicization of NBS, which can lead to polarization of ideas and undermine the decision-making process. Finally, Paper III provides a framework with the core topics (i.e., place and risk) that were considered critical in Paper I and Paper II. This place-based risk appraisal model (PRAM) connects people at risk and places where hazards (i.e., floods) and interventions (i.e., NBS) take place. The empirical analysis shows that, among the place-related variables, nature bonding was a positive predictor of the perceived risk-reduction effectiveness of NBS, and place identity was a negative predictor of supportive attitude. Among the risk-related variables, threat appraisal had a negative effect on perceived risk reduction effectiveness and supportive attitude, while well-communicated information, trust in flood risk management, and perceived co-benefit were positive predictors. This dissertation proves that the place and risk attributes of NBS shape people’s perceptions of NBS. In order to optimize the NBS implementation, it is necessary to consider the meanings and values held in place before project implementation and how these attributes interact with individual and/or community risk profiles and other contextual factors. With the increasing necessity of using NBS to lower flood risks, these results make important suggestions for the future NBS project strategy and NBS governance.
Mindfulness and acceptance describe the skills necessary to experience emotions and thoughts (e.g., performance-interfering cognitions) consciously and without judging them. This article introduces the mindfulness and acceptance approach and its potential in the context of competitive sports. Definitions as well as research results related to mechanisms of action and differential psychological aspects are given and the efficacy of the approach in the field of clinical psychology is reviewed. The rationale and implementation of the mindfulness-acceptance-commitment approach, an approach adapted for performance enhancement, is illustrated. Finally, evidence from psychotherapy research is presented, and a recommendation for the use of mindfulness and acceptance in the context of competitive sports is given.
People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues’ reactions towards a problematic worker dependent on the returning person’s reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.
The European potential for renewable electricity is sufficient to enable fully renewable supply on different scales, from self-sufficient, subnational regions to an interconnected continent. We not only show that a continental-scale system is the cheapest, but also that systems on the national scale and below are possible at cost penalties of 20% or less. Transmission is key to low cost, but it is not necessary to vastly expand the transmission system. When electricity is transmitted only to balance fluctuations, the transmission grid size is comparable to today's, albeit with expanded cross-border capacities. The largest differences across scales concern land use and thus social acceptance: in the continental system, generation capacity is concentrated on the European periphery, where the best resources are. Regional systems, in contrast, have more dispersed generation. The key trade-off is therefore not between geographic scale and cost, but between scale and the spatial distribution of required generation and transmission infrastructure.