Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

Introduction: Patient involvement is essential for relevant, feasible, and transparent research. In recent years, generic patient advisory boards (PAB) have been increasingly established in Germany to involve patients across different projects in primary care research. One of those PABs is localized at Witten/Herdecke University as part of the North-Rhine Westphalian General Practice Research Network (NRW-GPRN). This manuscript evaluates the impact of involving the NRW-GPRN PAB into research projects, the patients' experiences with involvement activities, and conditions required for the work of the PAB.

Methods: The concept for the NRW-GPRN PAB was developed on the basis of the literature and expert discussions. PAB members were, inter alia, approached via local notices and directly by general practitioners. Since 2021 the PAB meetings have taken place twice a year and are evaluated using a short, written questionnaire. In addition, there is an oral feedback round and debriefings by the scientific coordinators. The scientists contributing their projects subsequently report on the changes that have been made due to the PABs' contributions. The findings from the written and oral evaluations are discussed together after analysis in order to draw implications for possible adjustments to PAB activities.

Results: The NRW-GPRN PAB comprises eleven persons; seven of them are female and most are 50 years or older. So far, six meetings have taken place with an average of six participants, where the contents of eight different projects have been discussed. During all sessions, patients were at least involved as advisors. The contributions of the PAB led to changes in all projects. Based on 38 written evaluations, the majority of the PAB members (n = 29) thoroughly enjoyed the meetings. The research topics, the diverse perspectives and the appreciative interaction were highlighted as particularly positive aspects.

Discussion: The involvement activities are experienced positively by both PAB members and scientists. By reflecting on the meetings together, it was possible to adapt the structure of the PAB meetings to accommodate the members' needs. This joint process may also have had a positive effect on their respectful cooperation.

Conclusion: Involving a generic PAB across projects is feasible. In the future, the impact of involvement activities on research processes will have to be examined even more closely. Also, there is a need to develop strategies to promote more diversity among PAB members.

Introduction: Traditional role models or scandalous reports revealing poor working conditions have left their mark on the nursing profession in Germany. In order to make nursing a more attractive profession to young people and to create a sense of professional pride for members of the nursing profession, we need to focus more on its positive aspects. Children with hospital experience were invited to participate in a painting competition to counter visual stereotypes. "Nursing through a child's eyes" can provide a subjective view of the nursing profession based on individual experiences.

Methods: The pictures that children created during the painting competition were analysed qualitatively. The paintings were described and interpreted by independent peer groups in a four-step procedure.

Results: A total of 42 paintings from five university hospitals were included in the analysis. Paediatric specialties with a focus on surgery, oncology and internal medicine participated. The pictures showed typical nursing activities in the areas of communication, support, organisation, technology and basic needs. Nurses were portrayed as technically experienced and pleasantly reserved. In addition, symbols such as hearts, smileys or rainbows suggest associations with attention, emotional support or hope.

Discussion: Children with hospital experience painted a positive and modern professional image of the nursing role. In some pictures, the typical visual features allowing a clear assignment to the nursing profession are missing.

Conclusion: The stereotypes of the nursing profession should be replaced with a modern and realistic, counter-stereotypical narrative in the visual presentation. The perspective of children with hospital experience demonstrates that there are numerous, often invisible aspects that give reason to be proud of being a nurse.

Introduction: The Evidence-Based Practice Confidence (EPIC) Scale measures health professionals' self-efficacy associated with evidence-based practice activities. The scale has been cross-culturally translated into German together with physical therapists. To support its use in German-speaking countries, the measurement properties of the scale need to be determined. Therefore, the primary objective of this study was to assess the measurement properties of the German EPIC scale. In a preparatory step, we aimed to evaluate the comprehensibility of the scale among German-speaking occupational therapists, speech and language therapists, and nurses.

Methods: First, semi-structured cognitive interviews were used to evaluate the comprehensibility of the EPIC scale. Second, a longitudinal online survey with repeated measures (baseline and retest survey) was conducted. The target group included physical therapists, occupational therapists, speech and language therapists, and nurses from Germany, Austria, and Switzerland. Reliability, responsiveness, and validity were evaluated using internal consistency, test-retest reliability, standard error of measurement, known-groups method, exploratory factor analysis and the minimal detectable change, respectively.

Results: Comprehensibility of the German EPIC scale was confirmed by eleven health care professionals (four occupational therapists, two speech and language therapists, five nurses). The baseline and the retest surveys were completed by 708 and 222 participants, respectively. The measure demonstrated an internal consistency of .930, with an intraclass correlation coefficient (ICC) for test-retest reliability of .936 (95% CI: .917 to .951). The standard error of measurement was 4.92, and the minimal detectable change at the 95% confidence level was 6.02. All hypotheses in the known-groups method were confirmed, and construct validity was acceptable. Factor analysis revealed two main factors affecting the results of the scale.

Conclusion: The findings provide evidence that supports the use of the German EPIC scale among health professionals. For instance, it can be used to evaluate self-efficacy during EBP training.

Background: Opioid substitution therapy (OST) is required for patients with opioid use disorder, but specialized addiction services do not reach all patients. General practitioners (GP) can fill this gap and provide a low-threshold, locally accessible offering for OST. This study aims to explore barriers that prevent GPs from offering OST.

Methods: In 2022, an online questionnaire with 31 items was sent to GPs in the federal state of Baden-Württemberg by e-mail. The items included demographic data, training and experience in addiction medicine, implementation of OST in practice and possible barriers and facilitators to OST in the primary care setting. The results were analysed using a quantitative and semi-qualitative approach.

Results: In total, 309 GPs participated (response rate = approx. 6.2 %). 26.2 % of participants had special training in addiction medicine (n = 81). 71.9 % of GPs with special training performed OST. 15.6 % of GPs without special training knew about reimbursement for and organization of OST (30/192). The barriers most frequently mentioned included: perceived lack of competencies, difficult patient clientele, and insufficient interdisciplinary communication. 22.4 % of GPs without training considered offering OST, provided that barriers are reduced.

Conclusions: GPs have little knowledge of OST but one out of four considers offering OST. Thus, low-threshold addiction medicine courses in medical training and in continuing medical education are required. Barriers, such as bureaucratic obstacles and knowledge deficits, need to be addressed to decrease the growing gap in the care for patients with opioid use disorder.