Pub Date : 2025-03-03DOI: 10.1016/j.zefq.2025.01.008
Malik Cakir , Paula Starke , Alexandra Nolting , Wendi Qu , Dawid Pieper , Tim Mathes
Using real-world data (RWD) for comparative effectiveness research has gained increasing attention. Real-world data is usually not collected with the primary aim of answering questions about the comparative effectiveness of medical interventions. Therefore, data collection is often not optimally designed for this purpose. For this reason, using it can be associated with several data-related or analysis-related problems.
This article has two aims: First of all, we will outline the basic requirements for comparative non-randomized studies based on RWD. In addition, the advantages and disadvantages of potentially eligible RWD in Germany will be considered. In particular, the use of registry data will be discussed, as these currently appear to be the most suitable for comparing the effectiveness of interventions.
There are now various databases in Germany that contain RWD and can potentially be used for comparative effectiveness research. If they contain all the necessary information and if the data are of sufficient quality, they could offer a timely and efficient way of determining the effectiveness of medical interventions. However, our analysis shows that the use of this data is sometimes associated with considerable limitations. RWD is often highly aggregated and thus may not be sufficiently detailed to select the subjects precisely or to emulate the intervention or control interventions satisfactorily. In addition, many data sources only encompass a limited set of variables and limited time horizons (e.g., only hospitalization) according to their intended purpose (e.g., billing). Therefore, it is often questionable whether this includes all endpoints on benefit and harm that are important for the assessment and whether sufficiently long observation horizons/follow-up periods are given. Similarly, it is often questionable whether all necessary data to avoid bias are included. Furthermore, it is often difficult to assess suitability in advance due to the lack of available information.
{"title":"Versorgungsnahe Daten zur Bewertung der vergleichenden Effektivität von medizinischen Behandlungen: eine Bestandsaufnahme der verfügbaren Datenquellen in Deutschland unter besonderer Berücksichtigung von Registern","authors":"Malik Cakir , Paula Starke , Alexandra Nolting , Wendi Qu , Dawid Pieper , Tim Mathes","doi":"10.1016/j.zefq.2025.01.008","DOIUrl":"10.1016/j.zefq.2025.01.008","url":null,"abstract":"<div><div>Using real-world data (RWD) for comparative effectiveness research has gained increasing attention. Real-world data is usually not collected with the primary aim of answering questions about the comparative effectiveness of medical interventions. Therefore, data collection is often not optimally designed for this purpose. For this reason, using it can be associated with several data-related or analysis-related problems.</div><div>This article has two aims: First of all, we will outline the basic requirements for comparative non-randomized studies based on RWD. In addition, the advantages and disadvantages of potentially eligible RWD in Germany will be considered. In particular, the use of registry data will be discussed, as these currently appear to be the most suitable for comparing the effectiveness of interventions.</div><div>There are now various databases in Germany that contain RWD and can potentially be used for comparative effectiveness research. If they contain all the necessary information and if the data are of sufficient quality, they could offer a timely and efficient way of determining the effectiveness of medical interventions. However, our analysis shows that the use of this data is sometimes associated with considerable limitations. RWD is often highly aggregated and thus may not be sufficiently detailed to select the subjects precisely or to emulate the intervention or control interventions satisfactorily. In addition, many data sources only encompass a limited set of variables and limited time horizons (e.g., only hospitalization) according to their intended purpose (e.g., billing). Therefore, it is often questionable whether this includes all endpoints on benefit and harm that are important for the assessment and whether sufficiently long observation horizons/follow-up periods are given. Similarly, it is often questionable whether all necessary data to avoid bias are included. Furthermore, it is often difficult to assess suitability in advance due to the lack of available information.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 1-7"},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Digital transformation in healthcare is both a unique opportunity to improve care services and a significant challenge for legislation, stakeholders and all citizens. eHealth literacy (eHL) describes an important set of competencies when dealing with digital health information. Therefore, health insurance funds in Germany received the mandate to promote eHL among their policy holders. However, to date little is known about eHL in the German population and its potential determinants. Therefore, the aim of this study was to assess eHL in a sample of patients after their hospital stay and to explore potential sociodemographic determinants.
Methods
A cross-sectional, self-report, online survey study was conducted with a subgroup of a nationally representative sample in Germany using the revised eHealth Literacy Scale (GR-eHEALS). Market research providers were commissioned with the recruitment and data collection of 1,000 participants. Descriptive and bivariate analyses were computed.
Results
Overall, comparatively high scores were reported for eHealth literacy. Significant differences in eHL were found regarding age, sex, and educational background. Participants aged between 38 and 67 years had significantly higher scores than the under 27-year-olds. Female participants reported higher levels of eHL than male participants. Further, a higher level of educational attainment was related to a higher level of eHL. The native language (German) and the actual employment status were unrelated to eHL.
Discussion
Previous studies showed inconsistent results regarding the potential determinants of eHL. Our results provide further data on eHL in the German population and underscore the importance of age, sex, and education for eHL. Stakeholders such as health insurance funds should therefore pay particular attention to these determinants in order to fulfil their legal mandate to promote eHealth literacy.
Conclusions
Our results provide an assessment of the status quo of eHealth literacy among a subgroup of the general population in Germany, which can inform both legislators and health insurers about important determinants affecting the development and design of technical health products.
{"title":"Digital health literacy: A cross-sectional survey study among patients after hospitalization in Germany","authors":"Matthias Marsall , Matthias Weigl , Dagmar Lüttel , Hardy Müller","doi":"10.1016/j.zefq.2025.01.004","DOIUrl":"10.1016/j.zefq.2025.01.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Digital transformation in healthcare is both a unique opportunity to improve care services and a significant challenge for legislation, stakeholders and all citizens. eHealth literacy (eHL) describes an important set of competencies when dealing with digital health information. Therefore, health insurance funds in Germany received the mandate to promote eHL among their policy holders. However, to date little is known about eHL in the German population and its potential determinants. Therefore, the aim of this study was to assess eHL in a sample of patients after their hospital stay and to explore potential sociodemographic determinants.</div></div><div><h3>Methods</h3><div>A cross-sectional, self-report, online survey study was conducted with a subgroup of a nationally representative sample in Germany using the revised eHealth Literacy Scale (GR-eHEALS). Market research providers were commissioned with the recruitment and data collection of 1,000 participants. Descriptive and bivariate analyses were computed.</div></div><div><h3>Results</h3><div>Overall, comparatively high scores were reported for eHealth literacy. Significant differences in eHL were found regarding age, sex, and educational background. Participants aged between 38 and 67 years had significantly higher scores than the under 27-year-olds. Female participants reported higher levels of eHL than male participants. Further, a higher level of educational attainment was related to a higher level of eHL. The native language (German) and the actual employment status were unrelated to eHL.</div></div><div><h3>Discussion</h3><div>Previous studies showed inconsistent results regarding the potential determinants of eHL. Our results provide further data on eHL in the German population and underscore the importance of age, sex, and education for eHL. Stakeholders such as health insurance funds should therefore pay particular attention to these determinants in order to fulfil their legal mandate to promote eHealth literacy.</div></div><div><h3>Conclusions</h3><div>Our results provide an assessment of the status quo of eHealth literacy among a subgroup of the general population in Germany, which can inform both legislators and health insurers about important determinants affecting the development and design of technical health products.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 18-25"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1016/j.zefq.2025.01.007
Elena Tsarouha , Daniel Großmann , Kristina Greißl , Antje Krause-Zenß , Bernd Reuschenbach , Markus Wochnik , Karin Reiber
Introduction
The new Nursing Professions Act has been in force in Germany since 2020. Since then, general nursing training has been implemented. The reform of nursing training was the subject of controversial debate beforehand. Concerns were raised about inadequate preparation for different care sectors and settings. As a result, it is possible to choose specialized vocational qualifications in addition to the general nurse training. The article addresses how trainees are currently trained to meet the requirements in nursing and whether specialized vocational qualifications are chosen.
Methods
The article presents the results of an accompanying scientific research project (2021–2024). In this mixed methods study, a convergent parallel design was applied. The article is based on 80 guideline-based interviews with vocational trainers. Additionally, trainees were surveyed online in a longitudinal cohort study with three survey waves.
Results
Few of the institutions represented in the sample offer the specialized vocational qualifications. Where an offer exists, trainees make little use of it. Trainees feel that the nursing training does not prepare them equally well for the different care areas.
Discussion
The qualitative and quantitative findings demonstrate that general nursing training and the general vocational qualification are the preferred choice. Many vocational trainers consider general nursing training to be appropriate in order to meet the complex care requirements.
Conclusion
In particular, the practical part of the general nursing training must provide a more appropriate representation of care-oriented pediatric care settings. In order to cope with the fundamental transformation associated with generalistics, further training programs need to be established that adequately qualify future nurses.
{"title":"Die Bedeutung des Wahlrechts gesonderter Berufsabschlüsse in der generalistischen Pflegeausbildung aus Sicht von ausbildenden Akteuren und Auszubildenden – Ergebnisse aus der Begleitforschung im Mixed-Methods-Design","authors":"Elena Tsarouha , Daniel Großmann , Kristina Greißl , Antje Krause-Zenß , Bernd Reuschenbach , Markus Wochnik , Karin Reiber","doi":"10.1016/j.zefq.2025.01.007","DOIUrl":"10.1016/j.zefq.2025.01.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The new Nursing Professions Act has been in force in Germany since 2020. Since then, general nursing training has been implemented. The reform of nursing training was the subject of controversial debate beforehand. Concerns were raised about inadequate preparation for different care sectors and settings. As a result, it is possible to choose specialized vocational qualifications in addition to the general nurse training. The article addresses how trainees are currently trained to meet the requirements in nursing and whether specialized vocational qualifications are chosen.</div></div><div><h3>Methods</h3><div>The article presents the results of an accompanying scientific research project (2021–2024). In this mixed methods study, a convergent parallel design was applied. The article is based on 80 guideline-based interviews with vocational trainers. Additionally, trainees were surveyed online in a longitudinal cohort study with three survey waves.</div></div><div><h3>Results</h3><div>Few of the institutions represented in the sample offer the specialized vocational qualifications. Where an offer exists, trainees make little use of it. Trainees feel that the nursing training does not prepare them equally well for the different care areas.</div></div><div><h3>Discussion</h3><div>The qualitative and quantitative findings demonstrate that general nursing training and the general vocational qualification are the preferred choice. Many vocational trainers consider general nursing training to be appropriate in order to meet the complex care requirements.</div></div><div><h3>Conclusion</h3><div>In particular, the practical part of the general nursing training must provide a more appropriate representation of care-oriented pediatric care settings. In order to cope with the fundamental transformation associated with generalistics, further training programs need to be established that adequately qualify future nurses.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 86-93"},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1016/j.zefq.2025.01.006
Sabine Hammer , Clara Monaca , Annika Hoelz , Markus Tannheimer , Saskia Huckels- Baumgart , Kathrin Dornieden , Dagmar Lüttel , Marcus Rall , Hardy Müller
<div><h3>Background</h3><div>About 5% of the population are affected by post-infectious symptoms after a Sars-CoV-2-infection. Long COVID or a post-COVID-19 condition can affect all organ systems and lead to a complete need for care. 10–50% of patients meet the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Treatment recommendations have so far been limited to stress management and symptomatic, psychological or activity-enhancing measures (physical or exercise therapy). Initial studies of patients’ perspectives indicate that both the recognition of the disease and the medical care for affected patients are insufficient.</div></div><div><h3>Method</h3><div>Since June 2023, patients with long COVID or their relatives have been able to report medical and social care experiences by telephone or using an online reporting form from the Techniker (TK) Health Insurance fund and the German Society for Patient Safety as part of a project funded by the German Federal Ministry of Health. From 1,216 reports received by December 2023, 264 representative cases were selected and evaluated using structuring and summarizing content analysis. The aim was to understand the experiences of those affected with barriers to health and social care and their consequences.</div></div><div><h3>Results</h3><div>In the fourth year after the start of the pandemic, there is a lack of care structures and competence on the part of all care service providers, according to those affected. Special outpatient clinics for post-viral syndromes are either not accessible for the majority of participants or do not accept new patients or have waiting times of up to two years. Aside from the fact that there are currently no causally effective treatments for post-viral syndromes, 85% of those surveyed report that medical or social contacts are not sufficiently informed about the clinical picture. 80% of participants report that their symptoms are not acknowledged by employees in the health and social care sector, or they are considered a psychological issue. As a result, patients receive no or incorrect treatment and/or do not receive appropriate social care. 56% report a deterioration in their health status caused by prescribed or recommended examinations or treatments. The psychologization of post-viral symptoms is described as stigmatizing and considered the main cause of the precarious care situation of those affected by long COVID.</div></div><div><h3>Discussion</h3><div>The study shows that there are currently no adequate care concepts and structures for post-infectious illnesses and that activating therapies, mostly in connection with the assumption of a psychosomatic origin, lead to significant malpractice. The finding that the majority of respondents feel weakened, ashamed or harmed by their physicians is particularly dramatic. The data also provide evidence of systematic stigmatization and discrimination against those affected. The generalizability of th
{"title":"„Im Endeffekt ist man auf sich allein gestellt.“ Eine qualitative Analyse von Versorgungsbarrieren aus der Sicht Long-COVID-Betroffener","authors":"Sabine Hammer , Clara Monaca , Annika Hoelz , Markus Tannheimer , Saskia Huckels- Baumgart , Kathrin Dornieden , Dagmar Lüttel , Marcus Rall , Hardy Müller","doi":"10.1016/j.zefq.2025.01.006","DOIUrl":"10.1016/j.zefq.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>About 5% of the population are affected by post-infectious symptoms after a Sars-CoV-2-infection. Long COVID or a post-COVID-19 condition can affect all organ systems and lead to a complete need for care. 10–50% of patients meet the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Treatment recommendations have so far been limited to stress management and symptomatic, psychological or activity-enhancing measures (physical or exercise therapy). Initial studies of patients’ perspectives indicate that both the recognition of the disease and the medical care for affected patients are insufficient.</div></div><div><h3>Method</h3><div>Since June 2023, patients with long COVID or their relatives have been able to report medical and social care experiences by telephone or using an online reporting form from the Techniker (TK) Health Insurance fund and the German Society for Patient Safety as part of a project funded by the German Federal Ministry of Health. From 1,216 reports received by December 2023, 264 representative cases were selected and evaluated using structuring and summarizing content analysis. The aim was to understand the experiences of those affected with barriers to health and social care and their consequences.</div></div><div><h3>Results</h3><div>In the fourth year after the start of the pandemic, there is a lack of care structures and competence on the part of all care service providers, according to those affected. Special outpatient clinics for post-viral syndromes are either not accessible for the majority of participants or do not accept new patients or have waiting times of up to two years. Aside from the fact that there are currently no causally effective treatments for post-viral syndromes, 85% of those surveyed report that medical or social contacts are not sufficiently informed about the clinical picture. 80% of participants report that their symptoms are not acknowledged by employees in the health and social care sector, or they are considered a psychological issue. As a result, patients receive no or incorrect treatment and/or do not receive appropriate social care. 56% report a deterioration in their health status caused by prescribed or recommended examinations or treatments. The psychologization of post-viral symptoms is described as stigmatizing and considered the main cause of the precarious care situation of those affected by long COVID.</div></div><div><h3>Discussion</h3><div>The study shows that there are currently no adequate care concepts and structures for post-infectious illnesses and that activating therapies, mostly in connection with the assumption of a psychosomatic origin, lead to significant malpractice. The finding that the majority of respondents feel weakened, ashamed or harmed by their physicians is particularly dramatic. The data also provide evidence of systematic stigmatization and discrimination against those affected. The generalizability of th","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 8-17"},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.zefq.2025.01.005
Julia Nothacker , Stefanie Butz , Dagmar Lühmann , Paula Duwe , Marjan van den Akker , Ulrich Thiem , Martin Scherer , Ingmar Schäfer
Background
Multimorbidity is a common health problem among patients treated in GP practices and often associated with an increased risk of hospitalization. The aim of this review was to identify GP-based interventions to reduce hospitalization in patients with multimorbidity who were evaluated in randomized controlled trials.
Methods
For the rapid review, the databases Medline and CENTRAL were systematically searched for randomized controlled trials evaluating an effect of GP-based interventions on the duration or frequency of hospitalization in adult patients with multimorbidity living at home. The interventions and their effects were described narratively.
Results
From 2,260 hits in the database searches, 15 studies could be included. The interventions identified included, amongst others, interdisciplinary cooperation, training of GPs and other practice staff, and increased patient centeredness. Hospital admissions were reported in 13 studies, and the number of days spent in hospital was reported in six studies. Two studies found a significant reduction in hospitalization.
Conclusions
While most interventions were not effective, there were also two GP-based interventions for patients with multimorbidity which focused on the patients’ individual situation and contributed to avoiding hospitalization. However, more studies are needed to make reliable statements on the effectiveness of various measures.
{"title":"General practitioner-based interventions to reduce hospital admissions in patients with multimorbidity living at home – A rapid review","authors":"Julia Nothacker , Stefanie Butz , Dagmar Lühmann , Paula Duwe , Marjan van den Akker , Ulrich Thiem , Martin Scherer , Ingmar Schäfer","doi":"10.1016/j.zefq.2025.01.005","DOIUrl":"10.1016/j.zefq.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity is a common health problem among patients treated in GP practices and often associated with an increased risk of hospitalization. The aim of this review was to identify GP-based interventions to reduce hospitalization in patients with multimorbidity who were evaluated in randomized controlled trials.</div></div><div><h3>Methods</h3><div>For the rapid review, the databases Medline and CENTRAL were systematically searched for randomized controlled trials evaluating an effect of GP-based interventions on the duration or frequency of hospitalization in adult patients with multimorbidity living at home. The interventions and their effects were described narratively.</div></div><div><h3>Results</h3><div>From 2,260 hits in the database searches, 15 studies could be included. The interventions identified included, amongst others, interdisciplinary cooperation, training of GPs and other practice staff, and increased patient centeredness. Hospital admissions were reported in 13 studies, and the number of days spent in hospital was reported in six studies. Two studies found a significant reduction in hospitalization.</div></div><div><h3>Conclusions</h3><div>While most interventions were not effective, there were also two GP-based interventions for patients with multimorbidity which focused on the patients’ individual situation and contributed to avoiding hospitalization. However, more studies are needed to make reliable statements on the effectiveness of various measures.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 74-85"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.zefq.2025.01.002
Stefan Scheydt , André Nienaber , Martin Holzke
Introduction
The integration of academically qualified nurses into psychiatric care is crucial to the quality of patient care and the professional satisfaction of nurses. Despite its increasing importance and political demand, the integration of academic nursing roles into (psychiatric) care practice appears to be progressing slowly. This study therefore examines how academically qualified nurses who work in direct psychiatric nursing practice, practice development or nursing research perceive the integration of their academic nursing role into psychiatric care practice and which contextual factors promote or inhibit the integration of academic nursing roles into psychiatric nursing and care practice.
Methods
Data collection for the nationwide AkaPP study took place between August and November 2020 using a specially developed online questionnaire. The target population of the study was academically qualified nurses working in psychiatric settings (n = 185). The subgroup of academically qualified nurses working in direct psychiatric nursing practice, practice development or nursing research (n = 100) was analyzed as part of this sub-study. Data analysis was performed using descriptive statistical methods as well as appropriate statistical procedures to test the correlation between certain variables of role development or role integration and the rating of role integration (Chi-square test, Cramer’s V, Spearman’s rank correlation). Qualitative data (free text data) were analyzed using qualitative content analysis. Reporting was based on the STROBE checklist.
Results
Overall, role integration is rated as less successful (MV = 2.62; SD = 1.309). The results show that time resources for extended tasks (V = .554, p < .000) and for exchange and networking (V = .570, p < .001) correlate significantly with satisfaction with role integration. A specific description of tasks and activities (V = .522, p < .000) and for research activities (V = .453, p < .001) are also moderately to strongly associated with a positive assessment of role integration. On the other hand, induction concepts, trainee programs, and specific training courses do not show a strong statistical correlation with role integration. The use of systematic concepts such as the PEPPA framework was described by only a small group but tended to show a higher level of satisfaction. The main obstacles to successful role integration were lack of acceptance by members of one’s own discipline (68.2%) or lack of appropriate differentiation of tasks and activities (60.5%).
Conclusion
In order to successfully integrate academically qualified nurses into psychiatric nursing practice, nursing management, educational institutions, and policy makers should pay more attention to the provision of
{"title":"Hemmende und fördernde Faktoren für die Integration akademischer Pflegerollen in die psychiatrische Versorgungspraxis: Teilergebnisse der AkaPP-Studie","authors":"Stefan Scheydt , André Nienaber , Martin Holzke","doi":"10.1016/j.zefq.2025.01.002","DOIUrl":"10.1016/j.zefq.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The integration of academically qualified nurses into psychiatric care is crucial to the quality of patient care and the professional satisfaction of nurses. Despite its increasing importance and political demand, the integration of academic nursing roles into (psychiatric) care practice appears to be progressing slowly. This study therefore examines how academically qualified nurses who work in direct psychiatric nursing practice, practice development or nursing research perceive the integration of their academic nursing role into psychiatric care practice and which contextual factors promote or inhibit the integration of academic nursing roles into psychiatric nursing and care practice.</div></div><div><h3>Methods</h3><div>Data collection for the nationwide AkaPP study took place between August and November 2020 using a specially developed online questionnaire. The target population of the study was academically qualified nurses working in psychiatric settings (n = 185). The subgroup of academically qualified nurses working in direct psychiatric nursing practice, practice development or nursing research (n = 100) was analyzed as part of this sub-study. Data analysis was performed using descriptive statistical methods as well as appropriate statistical procedures to test the correlation between certain variables of role development or role integration and the rating of role integration (Chi-square test, Cramer’s <em>V</em>, Spearman’s rank correlation). Qualitative data (free text data) were analyzed using qualitative content analysis. Reporting was based on the STROBE checklist.</div></div><div><h3>Results</h3><div>Overall, role integration is rated as less successful (<em>MV</em> = 2.62; <em>SD</em> = 1.309). The results show that time resources for extended tasks (<em>V</em> = .554, <em>p</em> < .000) and for exchange and networking (<em>V</em> = .570, <em>p</em> < .001) correlate significantly with satisfaction with role integration. A specific description of tasks and activities (<em>V</em> = .522, <em>p</em> < .000) and for research activities (<em>V</em> = .453, <em>p</em> < .001) are also moderately to strongly associated with a positive assessment of role integration. On the other hand, induction concepts, trainee programs, and specific training courses do not show a strong statistical correlation with role integration. The use of systematic concepts such as the PEPPA framework was described by only a small group but tended to show a higher level of satisfaction. The main obstacles to successful role integration were lack of acceptance by members of one’s own discipline (68.2%) or lack of appropriate differentiation of tasks and activities (60.5%).</div></div><div><h3>Conclusion</h3><div>In order to successfully integrate academically qualified nurses into psychiatric nursing practice, nursing management, educational institutions, and policy makers should pay more attention to the provision of ","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 64-73"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1016/j.zefq.2024.12.010
Bettina K. Doering , Christina Hanauer , Berit Telaar , Rita Rosner
Background
Stepped-care approaches can improve the support for the bereaved. This requires the selection of interventions according to individual support needs. Grief counsellors are in a position to identify bereaved persons possibly suffering from a psychological disorder and to refer them to psychotherapeutic or medical treatment. However, it remains unclear what knowledge regarding psychological disorders and which skills grief counsellors need for this task.
Method
We conducted an online Delphi consensus study with 17 experts of grief counselling in three consecutive survey rounds. The first round qualitatively identified the required knowledge regarding psychological disorders and the respective skills. In the subsequent rounds, the experts rated the topics concerning their relevance, whether they should be part of a training curriculum and whether they are adequately considered in current curricula. Descriptive analyses were applied. Consensus was reached if at least 50 % of the experts rated a topic as rather relevant, and 80 % endorsed the topic for a training curriculum. Expert comments were used to generate recommendations that were evaluated for consensus.
Results
The qualitative analysis identified 39 topics, and 26 reached a consensus. Of these, six referred to “knowledge about grief”, five to “knowledge about psychological disorders”, and 15 to professional, interpersonal, and relationship and communication skills. Experts’ opinions on whether sufficient consideration is given to these topics in current curricula varied greatly between the topics.
Discussion
The experts reached a consensus regarding the areas of knowledge about psychological disorders and the specific skills to be taught. At the same time, there appears to be a high degree of heterogeneity between the various training and continuing education programmes with regard to imparting knowledge to identify the need for therapeutic support.
Conclusion
The present recommendations can be used to inform and optimise the content of training curricula for grief counsellors with regard to the identification of bereaved persons with increased therapeutic support needs.
{"title":"Was sollten Trauerbegleitende über psychische Störungen wissen? Ergebnisse einer Delphi-Befragung von Expert:innen","authors":"Bettina K. Doering , Christina Hanauer , Berit Telaar , Rita Rosner","doi":"10.1016/j.zefq.2024.12.010","DOIUrl":"10.1016/j.zefq.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Stepped-care approaches can improve the support for the bereaved. This requires the selection of interventions according to individual support needs. Grief counsellors are in a position to identify bereaved persons possibly suffering from a psychological disorder and to refer them to psychotherapeutic or medical treatment. However, it remains unclear what knowledge regarding psychological disorders and which skills grief counsellors need for this task.</div></div><div><h3>Method</h3><div>We conducted an online Delphi consensus study with 17 experts of grief counselling in three consecutive survey rounds. The first round qualitatively identified the required knowledge regarding psychological disorders and the respective skills. In the subsequent rounds, the experts rated the topics concerning their relevance, whether they should be part of a training curriculum and whether they are adequately considered in current curricula. Descriptive analyses were applied. Consensus was reached if at least 50 % of the experts rated a topic as rather relevant, and 80 % endorsed the topic for a training curriculum. Expert comments were used to generate recommendations that were evaluated for consensus.</div></div><div><h3>Results</h3><div>The qualitative analysis identified 39 topics, and 26 reached a consensus. Of these, six referred to “knowledge about grief”, five to “knowledge about psychological disorders”, and 15 to professional, interpersonal, and relationship and communication skills. Experts’ opinions on whether sufficient consideration is given to these topics in current curricula varied greatly between the topics.</div></div><div><h3>Discussion</h3><div>The experts reached a consensus regarding the areas of knowledge about psychological disorders and the specific skills to be taught. At the same time, there appears to be a high degree of heterogeneity between the various training and continuing education programmes with regard to imparting knowledge to identify the need for therapeutic support.</div></div><div><h3>Conclusion</h3><div>The present recommendations can be used to inform and optimise the content of training curricula for grief counsellors with regard to the identification of bereaved persons with increased therapeutic support needs.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 93-101"},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Aktive Mitgestaltung der allgemeinmedizinischen Forschung durch Patient*innen: Evaluation des HAFO.NRW-Patient*innenbeirats","authors":"Susanne Kersten , Judith Tillmann , Julia Hülsmann , Natalie Seuken , Achim Mortsiefer , Christine Kersting","doi":"10.1016/j.zefq.2025.01.003","DOIUrl":"10.1016/j.zefq.2025.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 21-30"},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/j.zefq.2024.12.009
Tobias Mai , Nicole Feldmann , Jennifer Luboeinski , Antje Tannen , Andreas Kocks
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.
{"title":"Pflege in Kinderaugen — eine qualitative Bildanalyse von Kinderzeichnungen","authors":"Tobias Mai , Nicole Feldmann , Jennifer Luboeinski , Antje Tannen , Andreas Kocks","doi":"10.1016/j.zefq.2024.12.009","DOIUrl":"10.1016/j.zefq.2024.12.009","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 26-35"},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/j.zefq.2024.12.011
Anna-Maria von Oltersdorff-Kalettka , Meike Gerber , Jennifer Engler , Karola Mergenthal , Corina Güthlin , Karen Voigt
<div><h3>Background</h3><div>With the aim of increasingly integrating research into outpatient care and ensuring its quality, the Dresden/Frankfurt am Main General Practice Research Network (SaxoForN, information at www.saxoforn.de) has been qualifying GP practice teams for research in outpatient care since the beginning of 2021. SaxoForN offers four qualification modules for this purpose, including the course for members of the investigator group in accordance with the German Medicines Act (AMG, investigator course) in order to be trained for participation in clinical trials and to be introduced to the principles of good clinical practice (GCP) so that they can work together on research projects. This course is implemented in SaxoForN through cooperation with the Coordination Centre for Clinical Studies Dresden (KKS-Dresden) (KKS examiner course). An evaluation was to be conducted to examine how well the qualification concept works for general practitioners (GPs) and medical assistants (MFAs) in the research practice network and how they perceive the KKS examiner course.</div></div><div><h3>Methods</h3><div>The evaluation of the PPS examiner course for GP practice teams was planned for September 2021 using a qualitative design. The research interests focused on the participants’ subjective experiences and opinions. Due to the potential vagueness and complexity of the remembered course experiences, a qualitative study design was chosen to enable a differentiated and explorative analysis of these impressions. For the survey, telephone-based, guided interviews with 11 narrative-generating, open questions were agreed upon by a team of several researchers being familiar with qualitative methods from the social and health care sciences. The interviews were analyzed using Mayring’s qualitative content analysis. The methodology was documented according to the COREQ checklist.</div></div><div><h3>Results</h3><div>A total of eight participants of the KKS examiner course were interviewed in October 2021 (n = 8, interview duration 15–20 min). The focus was on three central topics: (1) the quality of the content of the PPS examiner course, (2) the framework conditions in terms of time management and implementation, and (3) the suitability of the course for clinical trials and GP practices. In particular, the organization and interactive design of the KKS examiner courses were rated positively. However, the need for improvement was identified with regard to the accuracy of the training for GP practice teams: above all, the participants felt that the adaptation to the GP setting through instructions for the concrete implementation of studies in GP practices was lacking.</div></div><div><h3>Conclusion</h3><div>The integration of the KKS examiner course into the SaxoForN research practice network has worked well to cover the necessary GCP basics in the outpatient setting. However, there is a need for further development in the practical implementation of the qua
{"title":"Der KKS-Prüferkurs als Qualifizierungsmaßnahme hausärztlicher Praxen zur Teilnahme an klinischer Forschung: eine qualitative Studie mit Teilnehmenden aus dem Forschungspraxennetz SaxoForN","authors":"Anna-Maria von Oltersdorff-Kalettka , Meike Gerber , Jennifer Engler , Karola Mergenthal , Corina Güthlin , Karen Voigt","doi":"10.1016/j.zefq.2024.12.011","DOIUrl":"10.1016/j.zefq.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>With the aim of increasingly integrating research into outpatient care and ensuring its quality, the Dresden/Frankfurt am Main General Practice Research Network (SaxoForN, information at www.saxoforn.de) has been qualifying GP practice teams for research in outpatient care since the beginning of 2021. SaxoForN offers four qualification modules for this purpose, including the course for members of the investigator group in accordance with the German Medicines Act (AMG, investigator course) in order to be trained for participation in clinical trials and to be introduced to the principles of good clinical practice (GCP) so that they can work together on research projects. This course is implemented in SaxoForN through cooperation with the Coordination Centre for Clinical Studies Dresden (KKS-Dresden) (KKS examiner course). An evaluation was to be conducted to examine how well the qualification concept works for general practitioners (GPs) and medical assistants (MFAs) in the research practice network and how they perceive the KKS examiner course.</div></div><div><h3>Methods</h3><div>The evaluation of the PPS examiner course for GP practice teams was planned for September 2021 using a qualitative design. The research interests focused on the participants’ subjective experiences and opinions. Due to the potential vagueness and complexity of the remembered course experiences, a qualitative study design was chosen to enable a differentiated and explorative analysis of these impressions. For the survey, telephone-based, guided interviews with 11 narrative-generating, open questions were agreed upon by a team of several researchers being familiar with qualitative methods from the social and health care sciences. The interviews were analyzed using Mayring’s qualitative content analysis. The methodology was documented according to the COREQ checklist.</div></div><div><h3>Results</h3><div>A total of eight participants of the KKS examiner course were interviewed in October 2021 (n = 8, interview duration 15–20 min). The focus was on three central topics: (1) the quality of the content of the PPS examiner course, (2) the framework conditions in terms of time management and implementation, and (3) the suitability of the course for clinical trials and GP practices. In particular, the organization and interactive design of the KKS examiner courses were rated positively. However, the need for improvement was identified with regard to the accuracy of the training for GP practice teams: above all, the participants felt that the adaptation to the GP setting through instructions for the concrete implementation of studies in GP practices was lacking.</div></div><div><h3>Conclusion</h3><div>The integration of the KKS examiner course into the SaxoForN research practice network has worked well to cover the necessary GCP basics in the outpatient setting. However, there is a need for further development in the practical implementation of the qua","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 54-63"},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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