Projects

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

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).

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