Projects

Die Autonomie von Menschen mit Rehabilitationsbedarf in der medizinischen Rehabilitation ist eng mit dem grundlegenden Ziel der Selbstbestimmung und Teilhabe gemäß § 1 SGB IX sowie dem Rahmenkonzept der Deutschen Rentenversicherung Bund (DRV Bund, 2009) verknüpft. Um diesem übergeordneten Ziel gerecht zu werden, ist die Wahrung und Förderung der Autonomie von Rehabilitandinnen und Rehabilitanden von entscheidender Bedeutung.

Das Projekt zielt darauf ab, Erkenntnisse über den Stand der Autonomiewahrung und -Förderung im Setting der stationären medizinischen Rehabilitation zu gewinnen. Mittels einer Bedürfnisanalyse sollen Barrieren der Autonomiewahrung aus der Perspektive relevanter Akteurinnen und Akteure sowie autonomiefördernde Aspekte in der Rehabilitationspraxis identifiziert werden. Durch eine Kombination aus empirischer Untersuchung und normativ-theoretischen Überlegungen werden Fragen nach der Umsetzung des Autonomieprinzips, der Wahrnehmung der Autonomie durch beteiligte Akteurinnen und Akteure sowie der Identifikation von bewährten Praktiken beantwortet. Unter Einbezug von Expertinnen und Experten werden schließlich konsentierte Empfehlungen für die Praxis in Bezug auf die Wahrung und Förderung der Autonomie von Rehabilitandinnen und Rehabilitanden abgeleitet. Dadurch wird das übergeordnete Ziel der Selbstbestimmung und Teilhabe für Menschen mit Rehabilitationsbedarf unterstützt und gefördert.

Kontaktpersonen am IFAS: Prof. Dr. Silke Neuderth, Prof. Dr. Tanja Henking, LL.M., Dagmar Hindenburg, M.Sc. (Wissenschaftliche Mitarbeiterin)

Kooperationskliniken: Deegenbergklinik Bad Kissingen, Frankenlandklinik Bad Windsheim, Klinik Bad Oexen (Bad Oeynhausen), Bavariaklinik Bad Kissingen, Reha-Zentrum Schömberg, Hescuro Kliniken Bad Bocklet

Förderer: Deutsche Rentenversicherung Bund

Laufzeit: 2024-2027

The individual's autonomy and the securing of this autonomy are highly relevant factors in the health system. Especially people with chronical disease can experience reduced autonomy through disease or treatment. The increasing digitisation in the health sector creates opportunities to support patients and strengthen their autonomy. The term "technology-enabled care" (TEC) includes enhanced means of communication and the application of Big Data. The use of TEC creates numerous new digital applications, for doctors as well as for patients and their caregivers, provided that potential users have sufficient digital health competence.

The aim of the project "Autonomie Digital" is to assess digital tools available to patients with chronic disease and the extent to which patients' digital health competence meets these new opportunities. In addition, the autonomy needs of chronically sick people are evaluated so that suitable digital tools can be provided for different disease constellations in order to keep or improve the autonomy of chronically sick people.

Contact persons at IFAS: Luisa Falkenstörfer M.Sc., Prof. Dr. Silke Neuderth

Cooperation partners: Prof. Dr. Stefan Schulz (Julius-Maximilians-Universität Würzburg, Universität Trier)

Project period: 2022-2025

Autonomy has become one of the key concepts in the health sector - especially to characterise the relationship between patients and people in need of care and those persons administering and ensuring their care. The vulnerable person autonomously making informed decisions concerning their health is in the centre of autonomy-supporting care. However, autonomy and its perception can be threatened in certain constellations. The research focus autonomy in the health sector is concerned with situations and structures in health-related care constellations threatening autonomy.

Currently, questions of autonomy at the end of life are the main research topics. One of these topics is the support of autonomy of elderly people in need of care in the setting of inpatient nursing care and the development of a needs-oriented concept for the estimation of medical treatment and care at the end of life. One key element is the concept of Advance Care Planning (ACP), which aims to enable the decision-making of an individual regarding advance planning at the end of life through a dialogical extended conversational process in various contexts. This involves answering the fundamental question of the extent to which Advance Care Planning can adequately support autonomy in inpatient nursing.

 

Contact persons at the IFAS: Prof. Dr. Tanja Henking LL.M., Prof. Dr. Silke Neuderth, Prof. Dr. Theresia Wintergerst, Dr. Malte Klemmt

Cooperation partners: Prof. Dr. med. Birgitt van Oorschot (University Hospital Würzburg) and various local cooperation partners

Project period: 2018-2023

Funding: Bavarian State Ministry for Science and the Arts (StMWK)

For additional information, please visit the AuGe-Homepage

The digital transformation and the application of AI-based tools entail great changes for medical care. Within the scope of the DigiPsy project, the ethical and legal aspects of digitalised medical care for patients with psychological disorders are investigated. The perspective of (potential) users is to be taken into account to be able to provide recommendations for action for the application of digitised and AI-based applications in the area of mental health.

Great promises are made about the digital transformation of the healthcare system. Some people speak of a quantum leap in the field of psychiatric care, while others are warning about the huge amounts of data being created of a group that is seen as particularly vulnerable, and that affected persons are stigmatised, and that the field of medicine is de-personalised through it. Here, the matter of discussion is often the analysis and utilisation of individual digital data sets that are, for example, created by using smart phones or mobile sensors (“digital phenotyping”). Questions about autonomy, responsibility, and understanding of disease in connection with digital and AI-based tools in the field of mental health are in focus of this discussion. Besides discussing the topic, we conduct research on the perspective and conditions for acceptance of (potential) users through qualitative interviews and focus groups. Recommendations for action are derived from the normative and empirical parts.

Contact persons at IFAS: Professor Dr. Tanja Henking, LL.M.; Andrea Weber, M.Sc.

Project period: 2021 to 2024

"Healthy studies at THWS" is a prevention project funded by AOK Bayern with the aim to implement, evaluate and further develop a student health management at THWS. We strive to create a contact point at both THWS locations (Würzburg and Schweinfurt) that are close to campus, and which students can contact with all questions on mental, physical and social health for support and referral to the competent contact persons. Another major focus of the project is to create a network of internal and external parties like lecturers and service points. The team consists of one psychologist and two social workers and is located at the IFAS.

The thematic focuses of the project are health promotion, the communcation of information, networking and the promotion of existing structures, e.g. by educating programme advisors. The tasks particularly include prevention of mental, physical and social health issues, support and referral of students, and the bridging of waiting periods. Upon request, the contacts with students can also be anonymous and digital, which offers students the opportunity to find accessible help and assistance with their problems. Group offers and targeted PR work aims to continuously spread the topic throughout THWS. In an evaluation accompanying the process, relevant findings of the practical work are scientifically examined over the project period.

Contact persons at the IFAS: Prof. Dr. Neuderth (project management), Prof. Dr. Löbmann (project management), Jessica Thätz, Lisa Demar, Roxana Schweighart

Cooperation partners: AOK Bayern; AOK head offices of Würzburg and Schweinfurt

Project period: 2022 – 2024

Funding: AOK Bayern (funding according to the Prevention Act §§ 20, 20a SGB V)

For further information, please see the project website

Musical improvisation has proven as an effective method of musical therapy in the field of clinical therapy. It can also provide an important approach to clinical assessment and diagnosis. Through this, the behaviour of people with severe affective disorders, severe cognitive impairments and neuro-degenerative diseases, such as dementia or depression, becomes directly recognisable in the musical behaviour of the person concerned, instead of self-report in the context of questionnaires. The HIGH-M project is developing a procedure to automate the analysis of musical interaction in clinical improvisations and thus contributes to the applicability of music therapy methods in clinical diagnostics and assessment. The HIGH-M project (Human Interaction assessment and Generative segmentation in Health and Music) is carried out in cooperation with the AI network of the Nuremberg University of Music Artificial Creativity and Musical Interaction and with international partners such as the University of Jyväskylä, the University of Oslo and the Cambridge Institute for Music Therapy Research. In the joint scientific work, various analytical procedures come together that link the microanalysis of musical interactions (Improvisation Assessment Profiles Autonomy Micro - IAP-AM) with data-based structures and forms of representation (Music Therapy Toolbox - MTTB). The key elements are specific forms of interaction that can be used to qualify the relationship between client and therapist, primarily in the area of autonomous behaviour. The aim of the project is to create an A.I.-supported application that automatically recognises different forms and types of musical interaction and thus supports an effective assessment of clinical music therapy.

Contact persons at IFAS: Professor Dr. Thomas Wosch (Project Manager), Bastian Vobig, M.A. (Doctoral candidate)

Cooperation partners: Professor Dr. Sebastian Trump (A.I. Network Artificial Creativity and Musical Interaction of the Nuremberg University of Music), international cooperation with Professor Dr. Oliver Lartillot and Anna-Maria Christodouglou (Oslo University), Professor Dr. Jaakko Erkkilä (Jyväskylä University) and Professor Dr. Jörg Fachner (Cambridge Institute for Music Therapy Research)

Project period: 2021 to 2025

Funding: THWS-HTA Funding Line A

For further information, please contact bastian.vobig@thws.de

The majority of people suffering from dementia are cared for at home by relatives. The well-being of the carers as well as the cared for is a central concern in order to enable home care. HOMESIDE is investigating the effect of a music therapy and a reading therapy programme for people with dementia and their carers. We are working with our international partners from Australia, the UK, Norway and Poland. The research project is funded by the EU Joint Programme – Neuro-degenerative Disease Research (JPND). In Germany, the study is financially supported by the Federal Ministry of Education and Research (BMBF).

The study is aimed at people with dementia and their relatives. The caring relatives are guided and supported by trained professionals to use music or reading activities in everyday life in home care. These joint activities of the family caregivers with their affected relatives are intended to help regulate behavioural and psychological symptoms of dementia (e.g. restlessness or dejection), improve the well-being of both and strengthen the relationship. In addition, health economic analyses will be conducted to determine the cost-effectiveness of the music and reading therapy services for the family caregivers and their implementation in everyday life compared to the otherwise standard care. The results on cost-effectiveness will continue to be placed in the context of the health, social and care systems of Germany and Australia in particular. Overall, our project aims to support and facilitate informal, home-based care for people with dementia. In the process, new professional fields for music and reading therapists will also be developed in an evidence-based manner.

Contact persons at IFAS: Professor Dr. Thomas Wosch (Project Manager - Germany), Professor Dr. Sven Warnke (Sub-project: Health Economics), Dr. Laura Blauth (Study administrator), Carina Petrowitz (Deputy study administrator)

Cooperation partners: Professor Dr. Felicity Baker (Overall project manager of the group, The University of Melbourne), Dr. Imogen Clark (Project manager for Australia, The University of Melbourne), Professor Dr. Helen Odell-Miller, OBE (Project manager for the United Kingdom, Anglia Ruskin University), Professor Dr. Karette Stensaeth (Project manager for Norway, Norwegian Academy of Music), Dr. Ania Bukowska (Project manager for Poland, University of Physical Education, Krakow) and further, regional partners.

Project period: 2019 to 2022

Funding: EU Joint Programme – Neuro-degenerative Disease Research (JPND), Federal Ministry of Education and Research (BMBF)

For further information visit the THWS HOMESIDE project page (in German) and the international project page (in English).

Freiheitsentziehende Maßnahmen stellen einen massiven Eingriff in die persönlichen Freiheitsrechte einer Person dar und bedürfen daher einer besonderen Rechtfertigung. In unserem Forschungsprojekt untersuchen wir die Anwendung von FeM in Einrichtungen für volljährige Menschen mit Behinderungen. Diese Zielgruppe hat in bisherigen Untersuchungen kaum Beachtung gefunden. Die Erstellung des Gutachtens im Auftrag des Bayerischen Staatsministerium für Gesundheit und Pflege (StMGP Bayern) soll diese Forschungslücke schließen und dabei einen ersten Überblick über die Anwendung von Zwangsmaßnahmen in diesem Setting bieten. Dafür arbeiten wir mit unseren Projektpartnerinnen und -partnern aus Wissenschaft und Praxis zusammen. Es wird u.a. der Frage nachgegangen, welche freiheitsentziehenden Maßnahmen wann, wie, wie oft und in welchen Situationen durchgeführt werden. Werden sie fach- und sachgerecht angewandt und auf welche Begründungen stützt sich die Anwendung? Außerdem untersuchen wir mögliche Alternativen. Gibt es bauliche oder personelle Besonderheiten, die die Vermeidung von FeM begünstigen? Wie wirken sich Alternativen auf Bewohnende und die Atmosphäre in der Einrichtung aus? Zur Beantwortung dieser Fragen nutzen wir einen Mixed-Methods Ansatz (u.a. Literaturanalyse, teilnehmende Beobachtungen, Fragebogenvollerhebungen).

Kontaktpersonen am IFAS: Prof. Dr. Tanja Henking LL.M., Malte Klemmt M.A.

Kooperationsbeteiligte: Thomas Schmitt-Schäfer (transfer - Unternehmen für soziale Innovation), Prof. Dr. Peter Brieger (kbo- Isar-Amper Klinikum)

Projektlaufzeit: 2020-2022

Förderung: Bayerisches Staatsministerium für Gesundheit und Pflege (StMGP Bayern)

Ein Großteil der Menschen, die an Demenz erkrankt sind, werden zuhause von Angehörigen gepflegt. Das Wohlbefinden der Pflegenden sowie der Gepflegten ist dabei ein zentrales Anliegen, um häusliche Pflege zu ermöglichen. HOMESIDE untersucht die Wirkung von einem musiktherapeutischen und einem lesetherapeutischen Angebot für Menschen mit Demenz und ihre pflegenden Angehörigen. Dazu arbeiten wir mit unseren internationalen Partnerinnen und Partnern aus Australien, Großbritannien, Norwegen und Polen zusammen. Das Forschungsprojekt wird vom EU Joint Programme – Neurodegenerative Disease Research (JPND) gefördert. In Deutschland wird die Studie vom Bundesministerium für Bildung und Forschung (BMBF) finanziell unterstützt.

Die Studie richtet sich an Menschen mit Demenz und ihre Angehörigen. Die pflegenden Angehörigen werden von ausgebildeten Fachkräften angeleitet und dabei unterstützt, Musik- oder Leseaktivitäten im Alltag in der häuslichen Pflege einzusetzen. Diese gemeinsamen Aktivitäten der pflegenden Angehörigen mit ihren betroffenen Angehörigen sollen dabei helfen, verhaltensbezogene und psychologische Symptome der Demenz (z.B. Unruhe oder Niedergeschlagenheit) zu regulieren, das Wohlbefinden beider zu verbessern und die Beziehung zu stärken. Darüber hinaus werden gesundheitsökonomische Analysen durchgeführt, um die Kosteneffizienz von den musik- und lesetherapeutischen Angeboten für die pflegenden Angehörigen und deren Umsetzung im Alltag im Vergleich zu der sonst üblichen Regelversorgung zu bestimmen. Die Ergebnisse zur Kosteneffektivität werden im Projekt weiterhin insbesondere in den Kontext der Gesundheits-, Sozial- und Pflegesysteme Deutschlands und Australiens gestellt. Insgesamt soll mit unserem Projekt die informelle, häusliche Pflege von Menschen mit Demenz unterstützt und erleichtert werden. Dabei werden auch neue Berufsfelder für Musik- und Lesetherapeuten evidenzbasiert entwickelt.

Kontaktpersonen am IFAS: Prof. Dr. Thomas Wosch (Projektleitung Deutschland), Prof. Dr. Sven Warnke (Teilprojekt Gesundheitsökonomie), Dr. Laura Blauth (Studienleitung), Carina Petrowitz (stellv. Studienleitung)

Kooperationsbeteiligte: Prof. Dr. Felicity Baker (Konsortiumsleitung Gesamtprojekt, The University of Melbourne), Dr. Imogen Clark (Projektleitung Australien, The University of Melbourne), Prof. Dr. Helen Odell-Miller, OBE (Projektleitung Großbritannien, Anglia Ruskin University), Prof. Dr. Karette Stensaeth (Projektleitung Norwegen, Norwegian Academy of Musik), Dr. Ania Bukowska (Projektleitung Polen, University of Physical Education, Krakow) und weitere regionale Partner*innen

Projektlaufzeit: 2019 - 2022

Förderung: EU Joint Programme – Neurodegenerative Disease Research (JPND), Bundesministerium für Bildung und Forschung (BMBF)

Weitere Informationen auf der THWS-Projektseite HOMESIDE sowie der internationalen Projektseite in englischer Sprache.

Behaviour-Based Safety (BBS) is regarded as the best-studied and most effective method to change behaviour in the field of occupational safety. In this project, the research on BBS is to be extended to the field of work-safe behaviour of rescue workers of the German Red Cross (DRK). A method based on the BBS principles that can be implemented at the individual rescue stations is to be developed, through which the occupational safety of employees in the rescue service will be permanently improved. The project is being carried out at two rescue stations of the DRK - Region Hannover e.V. and is funded by the Federal and Railway Accident Insurance (UVB). BBS is a collection of methods based on applied behavioural analysis. Safe working behaviour is to be strengthened through

• the precise definition of safe behaviour.
• the direct observation of behaviour in the workplace.
• behavioural positive and constructive feedback.
• the setting of behavioural goals.
• the use of positive reinforcement.

BBS is used successfully in many industrial settings, especially outside Germany, but there is a lack of applied research in non-industrial settings. The work of rescue workers is risky and repeatedly leads to accidents or damage to health. The behaviour of rescue workers often plays a role, e.g. incorrect lifting and carrying, handling personal protective equipment or infection control. The project has the following main objectives:

• Analysis of the working conditions of rescue workers with regard to facilitating and aggravating factors for safe behaviour at work
• Transfer of the BBS method to the work of paramedics
• Development of an intervention based on BBS that can be implemented at the level of rescue stations to strengthen work-safe behaviour
• Support of the UVB in the dissemination of this intervention within the framework of prevention work at the DRK

Contact persons at IFAS: Professor Dr. Christoph Bördlein, Lisa Zeitler B.A. Cooperating partners: Jan Hetmeier, Antje Stöwesandt, Martin Kluth, Lutz Behrens, and Verena Goltz (of the UVB); Lars Weiß, Helge Vogt, and Lars Weber (of the German Red Cross)

Project period: 2019 to 2021

Funding: Unfallversicherung Bund und Bahn (UVB; Federal and Railway Accident Insurance)

For further information, please visit the BBS homepage.

Symptom checker apps (SCA) enable users to enter their symptoms into an app which uses AI-based algorithms to present the user with a potential diagnosis and recommendation for action. The project CHECK.APP assesses fundamental ethical, legal and social questions arising from the use of such apps. The study is carried out in cooperation with researchers of the Universität Tübingen and the University Hospital Tübingen. The joint project is part of a support measure of the Federal Ministry of Education and Research (BMBF) on research on ethical, legal and social aspects (ELSA) of digitisation, big data and artificial intelligence in health research and healthcare provision. The aim of this measure is to examine the impacts of new technologies on science and society and to move towards a socially acceptable and responsible framework for their use.

In close collaboration with the subproject Ethik, the subproject Recht focuses on the effects of digitisation on the interactions between doctors and patients, and on the behaviour and the individual perception of patients. This research includes possible shifting of the perception threshold of illness and health, which cannot only impact the caring and administration of patients but also the doctor-patient relationship. This involves legal questions from the German Patientenrechtegesetz (law on patient rights), Haftungsrecht (liability law), Verbraucherschutzrecht (consumer protection law) and Datenschutzrecht (data protection law). Patient autonomy and data autonomy are the main focus points. These can be promoted by SCAs, but they can also be threatened if body awareness, trust in the medical care system or individual doctors are impacted negatively. It must also be considered that the use of SCAs may result in attribution of responsibility. In close collaboration with other subprojects, differentiated recommendations for action are to be derived for people affected, developers and decision-makers.

Contact persons at the IFAS: Prof. Dr. Tanja Henking, LL.M. (sub-project lead), Dr. Malte Klemmt

Cooperation partners: Prof. Dr. Stefanie Joos (overall project lead), Prof. Dr. Monika A. Rieger, Dr. Roland Koch, Dr. Christine Preiser (all of the University Hospital Tübingen); Prof. Dr. Dr. Urban Wiesing, Prof. Dr. Hans-Joerg Ehni, Dr. Robert Ranisch, Regina Müller M.A. (all of Universität Tübingen )

Project period: 2020 - 2023

Funding: Federal Ministry of Education and Research (BMBF)

Further information can be found on the website of the BMBF 

Lack of knowledge and misconceptions about advance care documents (living will, enduring power of attorney for health care, appointment of legal representative for health care) on the part of health professionals and citizens lead to their potential not being fully utilised. In this project funded by the Federal Ministry of Health, the type and extent of these knowledge deficits will first be quantified by means of a survey instrument for various professional groups of health professionals and for citizens. Based on the survey results, a target-group-oriented information transfer in the form of training events will be developed and evaluated. The aim is to improve the health literacy of health care documents among health professionals and the population and thus to promote patient autonomy. Lack of information among health professionals (HP) regarding precautionary documents (living will, enduring power of attorney for health care) is mainly reflected in misconceptions about the nature, content and scope of these instruments. Misconceptions (e.g. "living wills must be notarised.") of the HP as well as of the people to be advised contribute to the fact that the potential of the instruments is not utilised to the full extent. The aim of the project is to quantify the type and extent of the knowledge deficits and to improve health literacy in this regard by providing information in a way that is appropriate for the target group. The target groups are, on the one hand, HPs of different occupational groups and settings where counselling on preventive health care instruments is not primarily part of the training and, on the other hand, the persons to be counselled. Based on a survey among HPs and persons to receive counselling, information concepts/training modules (face-to-face and e-learning) are developed and formatively evaluated for both target groups. A dissemination strategy is being developed.

Contact persons at IFAS: Professor Dr. Tanja Henking, LL.M., Professor Dr. Silke Neuderth, Franziska Zehl, M.A.

Cooperation partners: Professor Dr. Birgitt van Oorschot (Interdisciplinary Centre for Palliative Medicine at the University Hospital Würzburg), Professor Dr. Michael Schuler (HSG Bochum/JMU Würzburg, Clinical Epidemiology), Health Region Plus Würzburg City and Region, Centre Patient Education and Health Promotion e.V., Rehabilitation Research Network in Bavaria

Project period: 2020 to 2023

Funding: Federal Ministry of Health (BMG)

Please find further information on the website of the BMG (in German)

Patient autonomy takes a key role in the healthcare industry. In general, it is achieved through an informed consent. Due to certain medical conditions, the capacity to give informed consent may be impaired or non-existent. In cooperation with our project partners of the Heinrich Heine University of Düsseldorf and the OTH Regensburg, the SMART project investigates if and how Artificial Intelligence (AI) can be used to overcome challenges in the assessment of the patient's capacity to give consent and which ethical, legal, and social implications result from the application of AI. The SMART project is funded by the VW Foundation.

Despite the central role the informed consent takes in the healthcare industry, and numerous standardised assessment instruments available, the actual assessment of capacities is often beset with problems. On one hand, the instruments focus on cognitive and verbal abilities of patients (however, emotional abilities are rather neglected). Additionally, subjective factors by the assessing doctor may also influence the decision. To date, there has been no effort in the AI field to overcome the limitations in assessing patient's capacity to consent or make decisions. Within the scope of our project, we are investigating the role AI may play in this area. For this purpose, we are forming an interdisciplinary network of scientists to elaborate the weaknesses and limitations in connection with the assessment of the capacity of the patient to give consent. The work is complemented by empirical pre-studies with focus groups. Based on these results, we are looking to answer the question of and how the transfer of these results to AI systems is technically possible and socially, politically, legally, and ethically desirable.

Contact persons at IFAS: Professor Dr. Tanja Henking LL.M., Andrea Weber M.Sc.

Cooperation partners: Professor Dr. Heiner Fangerau, Vasilija Rolfes M.A., Uta Bittner M.A. (all three work at the University of Düsseldorf), Professor Dr. Christoph Palm, Professor Dr. Karsten Weber, Helene Gerhardts M.A., Linda Kokott M.A. (working at OTH Regensburg)

Project period: 2020 to 2021

Funding: VW-Foundation (Planning Grant)

For further information, please see the website of the VW-Foundation