Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Die Brücke zwischen Theorie und Praxis schlagen: Veranschaulichung von Implementierungsansätzen für komplexe Familieninterventionen","authors":"Saskia Oesch,&nbsp;Torsten Schwalbach,&nbsp;Lotte Verweij,&nbsp;Myrta Kohler,&nbsp;Simone Sutter,&nbsp;Marco Riguzzi,&nbsp;Rahel Naef","doi":"10.1016/j.zefq.2024.09.003","DOIUrl":"10.1016/j.zefq.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of complex family interventions poses a challenge since they consist of various interacting components which affect multiple players and often require changes in behaviour and work processes. Implementation success is strongly influenced by environmental factors. The comprehensive implementation of complex interventions therefore needs a deliberate and systematic implementation process, including its evaluation. Implementation science offers a variety of theories and methods to support the integration and evaluation of complex family health interventions in real-world settings, requiring a broad spectrum of knowledge and skills for clinicians and researchers alike. Hence, specific examples may be relevant to both clinicians and researchers who wish to systematically address know-do gaps in clinical practice.</div></div><div><h3>Aim</h3><div>The aim is to describe and illustrate how complex family interventions can be systematically designed, evaluated and implemented using implementation science frameworks and methods by drawing on two research projects – namely the <em>Family Support in Intensive Care Units</em> (FICUS) and <em>Bereavement Support for Families</em> (B4F).</div></div><div><h3>Methodical steps to implementation</h3><div>Five steps were used to implement and evaluate the interventions across both research projects: 1) engaging key persons and families, 2) identifying gaps in care and developing/adapting the intervention, 3) understanding the implementation context, 4) tailoring implementation approaches, and 5) evaluating implementation progress and success.</div></div><div><h3>Discussion and conclusion</h3><div>The five illustrated steps allow for a theory-guided but nevertheless pragmatic approach in the implementation of complex family interventions. This approach may serve as a guide to integrate complex interventions and evidence-based practices into routine care and to close know-do gaps.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 101-107"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689183","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}

{"title":"Informations- und Unterstützungsbedarfe von Frauen bei geplantem Schwangerschaftsabbruch nach Beratungsregelung in Deutschland – eine qualitative Studie","authors":"Caroline Jeltsch,&nbsp;Birte Berger-Höger","doi":"10.1016/j.zefq.2024.09.001","DOIUrl":"10.1016/j.zefq.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>For women seeking legal abortion care, access to information and care options is not transparent in Germany. This can affect health and complicate the decision-making process. In its guideline, the WHO recommends the use of evidence-based information to enable women to make informed decisions. This qualitative study aims to assess preferences and decisional needs of women in Germany.</div></div><div><h3>Method</h3><div>For the needs assessment, a qualitative study based on semi-structured guided interviews was conducted with pregnancy conflict counsellors and women who terminated a pregnancy in the past five years in Germany. These data were supplemented with social media group postings of women with pregnancy conflict experiences. All data were analysed using content-structuring analysis according to Kuckartz.</div></div><div><h3>Results</h3><div>Three women who had undergone an abortion and two pregnancy conflict counsellors were interviewed. In addition, 89 posts from a closed social media group were analysed. Three main categories were identified: women’s categorisation in value systems, factors influencing the experience of the care process and information needs of women facing conflict situations in connection with their pregnancy (“pregnancy conflict”). Abortion is considered to be stigmatised, so women rarely use existing counselling services. Overall, there is a high need for information and support among those seeking care. Concerns exist, especially with regard to the methods of abortion. The results of the study also indicate a burden caused by fragmented care, which requires a high degree of self-organisation of women.</div></div><div><h3>Discussion</h3><div>The care situation in Germany does not meet the recommendations of the WHO guideline on safe abortion. The results indicate that care close to home and with an abortion procedure that meets women’s individual preferences and thus complies with their self-determination has not yet been achieved in Germany.</div></div><div><h3>Conclusion</h3><div>Neutral and evidence-based information could be helpful to enable women to make informed decisions and reduce anxiety. It would also be desirable to increase the opportunities for women to talk about their experiences in a protected environment.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 44-52"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548141","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}

{"title":"Health issues of young adults with hearing loss or deafness: A basis for the development of a chatbot","authors":"Miriam Meng ,&nbsp;Hannele Hediger ,&nbsp;Alexandre de Spindler ,&nbsp;Daniela Händler-Schuster","doi":"10.1016/j.zefq.2024.09.002","DOIUrl":"10.1016/j.zefq.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>The loss of hearing and thus communication affects the well-being of millions of people worldwide. Digital tools for coping with everyday life are becoming increasingly important and can have a positive impact on health literacy, especially among young adults. This raises the question of which issues such apps should specifically address in order to meet the needs of young adults with hearing loss or deafness.</div></div><div><h3>Methods</h3><div>The aim was to identify the health issues of young adults (aged 18–28 years) with hearing loss or deafness in order to derive specific recommendations for a conversational agent (chatbot). A multiple embedded case study design consisting of chat interviews (n = 8) and an online-based expert survey (n = 14) was used.</div></div><div><h3>Results</h3><div>The central phenomenon focuses on “The sense of belonging and feeling well in spite of hearing loss”, which is influenced by two main categories: a. the ability to be oneself despite one’s vulnerability; b. the desire to be strong despite one’s vulnerability. Important health issues include depression, drug use, diet, exercise, isolation due to COVID measures and HIV prophylaxis.</div></div><div><h3>Conclusion</h3><div>Written information must be provided in simple and accessible language supported by images and symbols. Conversation agents developed to support people with hearing impairment should be easy to install and self-explanatory to use.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 20-28"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548142","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}

{"title":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(24)00251-4","DOIUrl":"10.1016/S1865-9217(24)00251-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages iv-v"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095931","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}

{"title":"Gesundheitliche Vorausplanung für die letzte Lebensphase: Wie sind Einrichtungen für erwachsene Menschen mit Behinderungen in Bayern hierauf vorbereitet?","authors":"Malte Klemmt ,&nbsp;Franziska Zehl ,&nbsp;Silke Neuderth ,&nbsp;Tanja Henking","doi":"10.1016/j.zefq.2024.09.004","DOIUrl":"10.1016/j.zefq.2024.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Autonomy at the end of life is associated with the ability to make self-determined decisions. The heterogeneous field of inpatient integration assistance poses particular challenges in this context. Advance care planning (ACP) is now available to people with disabilities. Nevertheless, little is known about the institution-related needs and the current status with regard to ACP in integration assistance homes.</div></div><div><h3>Methods</h3><div>A survey of all 850 inpatient homes providing integration assistance for adults in Bavaria was carried out. The survey was conducted online and addressed to home managers. In total, data of 96 homes (11.3% of all homes) was included in the descriptive and categorizing text analysis.</div></div><div><h3>Results</h3><div>Residents die in 60% of the homes surveyed. 73.7% of the homes offer ACP for their residents, with 62.9% of these homes using standardized procedures. One of the reasons given by the participants for not offering ACP is a better qualification of employees. Barriers include the residents’ lack of ability to participate in ACP meetings or relatives’ reluctant attitude towards ACP.</div></div><div><h3>Discussion</h3><div>End-of-life care is a relevant topic for inpatient homes providing integration assistance. Accordingly, ACP is already being addressed by a large proportion of homes. Here, special needs of residents due to existing impairments can pose challenges.</div></div><div><h3>Conclusion</h3><div>The study enables us to draw conclusions about the optimization of ACP from the perspective of care homes, which relate to structural (e.g., adaptation of existing concepts), personal (e.<!--> <!-->g., qualification) and emotional (e.g., de-tabooization) aspects.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 63-71"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629989","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}

{"title":"Nursing research at German university hospitals: A descriptive, cross-sectional study on the current status of nursing research activities and challenges for ethical approval","authors":"Anna-Henrikje Seidlein ,&nbsp;Helga E. Breimaier ,&nbsp;Franziska Wefer ,&nbsp;Jennifer Luboeinski ,&nbsp;Astrid Stephan ,&nbsp;Andreas Kocks ,&nbsp;Peter Nydahl","doi":"10.1016/j.zefq.2024.10.005","DOIUrl":"10.1016/j.zefq.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Nursing research is an integral part of nursing science and essential for evidence-based nursing practice. Research conducted by nursing scientists employed at university hospitals is shaped by the specific prevailing conditions. It is largely unclear to what extent these nursing scientists are engaged in research and which difficulties they have to face. The purpose of the study was to gain insight into nursing scientists’ research activities in German university hospitals and to assess the challenges they encounter in gaining ethical approval from institutional review boards.</div></div><div><h3>Methods</h3><div>We conducted a descriptive, cross-sectional study. Data was collected among nursing scientists at university hospitals in Germany with an online survey using closed and open questions.</div></div><div><h3>Results</h3><div>The response rate was 68 %. In total, the answers of n = 31 nursing researchers could be analysed. The majority of participants (58.1 %) stated that they worked as project leaders on several research projects and estimated the time they spent on research at up to 25 % of their working time. The most frequently used research methodology was qualitative research (45.2 %) with employees (54.8 %) and patients (22.6 %) as study participants. Prior to performing research projects, most of the respondents submitted their study protocols to the local institutional review board (35.5 %). Half of the nursing researchers (48.4 %) had been faced with challenges in this process which were mostly due to board members being unfamiliar with qualitative designs and nursing research.</div></div><div><h3>Discussion</h3><div>Nursing scientists employed at German university hospitals carry out a considerable number of research projects. However, time constraints and lack of funding in particular pose a challenge not only for productivity in the clinical setting, but also for the process of ethical clearance. The requirements of applying for ethical clearance at the local research ethics committees, the costs and the time required for gaining approval are very heterogeneous and thus lead to uncertainty and complicated processes.</div></div><div><h3>Conclusion</h3><div>A good cooperative relationship, the adaptation of structural requirements with regard to the assessment of nursing research projects in favour of increased transparency and, finally, better integration of nursing scientists in local research ethics committees should be established in order to better support nursing research activities.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 5-12"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689189","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}

{"title":"The SLIPPS Learning Event Recording Tool for students in Advanced Practice Nursing: A translation and content validation study","authors":"Lisa Pointner ,&nbsp;Alison Steven ,&nbsp;Piret Paal ,&nbsp;Manela Glarcher","doi":"10.1016/j.zefq.2024.11.001","DOIUrl":"10.1016/j.zefq.2024.11.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient safety is crucial in healthcare, yet over three million people die annually worldwide due to adverse events. To learn from adverse events and patient safety incidents, they need to be identified, examined, and reflected upon. Therefore, the SLIPPS Learning Event Recording Tool (SLERT) was developed to promote learning from patient safety events, both negative and positive. This study aimed to translate and validate the SLERT, which is already available in seven languages, for German-speaking countries.</div></div><div><h3>Methods</h3><div>The validation study involved a structured 4-phase blind-back translation to ensure cross-cultural equivalence of the translated tool. This was followed by a cognitive validation to determine content validity, a pilot survey with nursing students, and an evaluation of user-friendliness based on the System Usability Scale (SUS). Data was analysed qualitatively with Mayring’s method using MAXQDA and quantitatively with descriptive analysis in Excel.</div></div><div><h3>Results</h3><div>Five nurses participated in the group meeting on cognitive validation (Ø age = 28.8; Ø years of professional experience = 4.7). The German SLERT comprises sections underpinned by theory, which prompt students to describe, reflect upon, and learn from patient safety events. The pilot survey with 15 students (80 % women) indicated acceptable user-friendliness, with 50 % scoring between 80 and 100 on the SUS. The incidents described in the pilot exclusively indicated adverse events, near misses, or hazards from the sub-areas “medication management”, “using medical devices”, “confusion of patients”, “staff problems/errors” and “self-harm of patients”.</div></div><div><h3>Discussion</h3><div>For the first time, the German-language version of the SLERT was used to record and reflect on patient safety events among nursing students.</div></div><div><h3>Conclusion</h3><div>Standardised reporting and reflective practices are critical to improving patient safety. The SLERT provides a user-friendly way to contribute valuable data for targeted quality and risk management measures and prepare future healthcare professionals for advanced practice.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 37-43"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751611","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}

{"title":"Alternative Versorgungskonzepte für niedrigprioritäre Einsätze im deutschen Rettungsdienst – deskriptive Ergebnisse einer Online-Befragung","authors":"Johanna Sophie Lubasch ,&nbsp;Syrina Beierle ,&nbsp;Viktoria Sirkku Marewski ,&nbsp;Cassandra Rehbock ,&nbsp;Stefan Thate ,&nbsp;Hanna Schröder ,&nbsp;Stefan K. Beckers ,&nbsp;Anja Sommer ,&nbsp;Insa Seeger","doi":"10.1016/j.zefq.2024.07.008","DOIUrl":"10.1016/j.zefq.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>In Germany, the number of emergency missions has been rising for several years. At the same time, it can be observed that the amount of missions involving emergency physicians is decreasing, while the number of outpatient treatments without transport is increasing. To cope with this situation, different alternative care concepts have been developed as complementary resources throughout Germany. This study comprehensively compares these concepts, and it aims to highlight best-practice examples and stimulate a joint learning process.</div></div><div><h3>Methods</h3><div>As part of an online survey project leaders of various concepts were asked to take part in a standardized online survey. The survey comprised a total of 28 questions relating to various areas such as qualifications and training or resource equipment. The information was supplemented by documents, which were additionally submitted by the respondents.</div></div><div><h3>Results</h3><div>A total of seven concepts were examined. They all have in common that they are alerted by the dispatch centers to care mainly for low-code cases. Furthermore, the resources are staffed by trained paramedics, and patient transport is not possible. All resources are able to contact other medical facilities. Differences can be seen in the areas of funding, training, equipment, availability, and further areas of responsibility.</div></div><div><h3>Discussion</h3><div>The development of a large number of different care concepts in Germany has taken place in parallel with the development in other European countries, where different approaches have also been established for low-priority requests for assistance. In order to direct low-priority requests for assistance to a needs-based care unit in Germany as well, rescue dispatch centers should have a broader repertoire of care at their disposal. Implications for research arising from this lie in particular in evaluating the various concepts adequately, especially with regard to the quality of care, and thus ensuring needs-based and targeted care.</div></div><div><h3>Conclusion</h3><div>Widespread introduction of alternative care concepts might help relieve the burden on emergency medical care. This requires more research and evaluation as well as optimized data quality and standardization. In addition, it is desirable to enhance cooperation with the medical on-call service.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 92-100"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693748","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}

{"title":"Kinder und Jugendliche mit Post-COVID-Syndrom: eine qualitative Studie zu Erfahrungen und Zufriedenheit mit der Versorgung in einem Modellprojekt in Bayern (Post-COVID Kids Bavaria)","authors":"Susanne Brandstetter ,&nbsp;Maja Pawellek ,&nbsp;Chiara Rathgeb ,&nbsp;Martin Alberer ,&nbsp;Cordula Warlitz ,&nbsp;Uta Behrends ,&nbsp;Michael Kabesch ,&nbsp;Stephan Gerling ,&nbsp;Christian Apfelbacher","doi":"10.1016/j.zefq.2024.08.008","DOIUrl":"10.1016/j.zefq.2024.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Against the background of inadequate healthcare provision for children and adolescents with post-COVID-19 syndrome (PCS), a model project was initiated in Bavaria (PoCoKiBa: Post-COVID Kids Bavaria), offering specialized diagnostics and care. The aim of this study was to explore and describe the experiences and satisfaction of children and adolescents with PCS, as well as their parents, with the healthcare provided in the model project.</div></div><div><h3>Methods</h3><div>From October to December 2022, seven focus group discussions were conducted via video conference or in person with a total of 32 participants (19 children/adolescents, twelve mothers, one father). These represented 28 children and adolescents affected by PCS (aged 7 to 17 years). The focus group discussions were recorded, transcribed and analysed using qualitative content analysis.</div></div><div><h3>Results</h3><div>Study participants talked about their experiences with the care they received within and beyond the model project, continuity of care, communication between doctors and patients, patient information, and the accompanying study. At the sites of the model project, patients found physicians who spent more time with their patients and took them seriously. Following diagnosis, some patients have benefited from recommendations for therapeutic services or everyday behaviours, while others complained about a lack of treatment suggestions or support for dealing with PCS in their everyday life.</div></div><div><h3>Discussion</h3><div>The experiences of study participants with the medical care of their PCS symptoms within or beyond the model project mirror the well-known challenges of healthcare provision. There is considerable room for improvement in the care of children and adolescents with PCS, particularly in the organization of the complex diagnostic process, which involves several organ systems, and in the provision of targeted information to patients and families affected.</div></div><div><h3>Conclusion</h3><div>The supply of healthcare services, as established and offered in the PoCoKiBa model project, is crucial for families with a child affected by PCS, since it can offer expertise in diagnosis and treatment that is currently not available in routine health care.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 108-118"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548140","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}

{"title":"Dünn in der Fläche? Regionale Disparitäten in der Hospiz- und Palliativversorgung in Deutschland","authors":"Beate Apolinarski ,&nbsp;Stephanie Stiel ,&nbsp;Franziska A. Herbst ,&nbsp;Siegfried Geyer","doi":"10.1016/j.zefq.2024.07.007","DOIUrl":"10.1016/j.zefq.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Outpatient and inpatient hospice and palliative care services have been significantly expanded in Germany in recent decades and are increasingly being supplemented by day care services. However, the availability of these services varies greatly from region to region. The extent to which the availability of these care structures is matched by a regional need based on local population structures is as yet unknown.</div></div><div><h3>Methods</h3><div>In four Poisson regression models, the relationship between population indicators from the areas of demographics, employment, income, education and health and the number of offers of outpatient and inpatient hospice work and palliative care is exploratively examined. The cumulated data at district level is drawn from the INKAR database of the Federal Institute for Research on Building, Urban Affairs and Spatial Development on living conditions in Germany and from the guide of the German Association for Palliative Medicine. By means of logistic regression, factors influencing the establishment of day care services will also be identified.</div></div><div><h3>Results</h3><div>The analysis included 401 districts and cities in Germany. The number of inhabitants, settlement density, and the average age of inhabitants are the strongest predictors of the number of palliative care services. In metropolitan regions, both outpatient palliative care services and palliative care units tend to be more frequently available, while the number of outpatient hospice services and inpatient hospices increases in districts with a higher number of inhabitants regardless of settlement density. The regression model was unable to demonstrate a significant influence on the emergence of semi-inpatient care facilities, neither for the population indicators nor for the existing care structures.</div></div><div><h3>Discussion</h3><div>Regional population structures can only partially explain the geographically uneven distribution of hospice and palliative care services in districts and cities in Germany. Despite an increase in hospice and palliative care services, fewer hospice and palliative care structures are available in low population density regions that tend to have a higher share of older inhabitants.</div></div><div><h3>Conclusion</h3><div>Future health care planning should give more consideration to other population characteristics than to population size alone in order to improve care in regions with higher care needs that are, for example, due to a higher proportion of older residents. Subsequent studies should investigate which population characteristics can best describe the actual care needs.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"190 ","pages":"Pages 53-62"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606835","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}