Citizens can represent a relevant key resource in health care, for example by actively practicing preventive health care and managing their own health care needs. In Germany, the role of citizens in the health care system has not yet been defined. Therefore, the aim of this study is, as a first step, to determine what is meant by “citizen-centred healthcare”, since there is, as yet, no clear definition.
Methods
Between September and November 2022, semi-structured expert interviews were conducted with representatives from the fields of politics and self-administration and service providers and, with their consent, recorded and transcribed. A category system was developed inductively and deductively based on Mayring's content analysis. Using this, two members of the project team coded the interviews independently of each other using the QCAmap software. After a replication check of the deviations, the content could then be analyzed.
Results
A total of n = 10 interviews were conducted (n = 3 service providers, n = 2 self-administration, n = 5 politicians). The analysis revealed two different understandings of citizen-centred healthcare. Some of the experts understand citizen-centred healthcare as care that is provided close to home and easily accessible for citizens. The others interpret the term as care where citizens take on an active role. All interviewees saw the lack of health literacy among citizens as a key challenge. The social imbalance, which creates an inequality of opportunity in the involvement of citizens, was also mentioned several times. Opportunities were generally understood as the possibility of conserving resources and maintaining health. The analysis shows that there is still a lack of solutions that specifically address these challenges as well as the implementation of citizen-centred health care.
Discussion
The expert interviews demonstrate that there are two fundamentally different understandings of citizen-centred healthcare and how it should be established in Germany. Future research should therefore pursue the goal of developing a definition of “citizen-centred health care” by expert consensus. This can then form the basis for concrete, future goals for action. There was consensus among the experts regarding the problems that need to be considered in this context. Factors such as citizens' lack of health literacy and social imbalance should therefore be given more attention in the future.
{"title":"Bürgerzentrierte Gesundheitsversorgung in Deutschland – eine Analyse von ExpertInneninterviews","authors":"Eva Steinfeld , Katharina Schneegans , Carina Benstoem , Michaela Hesse , Sandra Dohmen","doi":"10.1016/j.zefq.2024.03.010","DOIUrl":"10.1016/j.zefq.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><p>Citizens can represent a relevant key resource in health care, for example by actively practicing preventive health care and managing their own health care needs. In Germany, the role of citizens in the health care system has not yet been defined. Therefore, the aim of this study is, as a first step, to determine what is meant by “citizen-centred healthcare”, since there is, as yet, no clear definition.</p></div><div><h3>Methods</h3><p>Between September and November 2022, semi-structured expert interviews were conducted with representatives from the fields of politics and self-administration and service providers and, with their consent, recorded and transcribed. A category system was developed inductively and deductively based on Mayring's content analysis. Using this, two members of the project team coded the interviews independently of each other using the QCAmap software. After a replication check of the deviations, the content could then be analyzed.</p></div><div><h3>Results</h3><p>A total of n = 10 interviews were conducted (n = 3 service providers, n = 2 self-administration, n = 5 politicians). The analysis revealed two different understandings of citizen-centred healthcare. Some of the experts understand citizen-centred healthcare as care that is provided close to home and easily accessible for citizens. The others interpret the term as care where citizens take on an active role. All interviewees saw the lack of health literacy among citizens as a key challenge. The social imbalance, which creates an inequality of opportunity in the involvement of citizens, was also mentioned several times. Opportunities were generally understood as the possibility of conserving resources and maintaining health. The analysis shows that there is still a lack of solutions that specifically address these challenges as well as the implementation of citizen-centred health care.</p></div><div><h3>Discussion</h3><p>The expert interviews demonstrate that there are two fundamentally different understandings of citizen-centred healthcare and how it should be established in Germany. Future research should therefore pursue the goal of developing a definition of “citizen-centred health care” by expert consensus. This can then form the basis for concrete, future goals for action. There was consensus among the experts regarding the problems that need to be considered in this context. Factors such as citizens' lack of health literacy and social imbalance should therefore be given more attention in the future.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000588/pdfft?md5=80676798968a4d6d7d649ae3b5cbfe0a&pid=1-s2.0-S1865921724000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912977","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.03.011
Roland Brian Büchter , Martina Albrecht , Michael Grimm , Markus Seelig , Anke Steckelberg , Anne Christin Rahn
Background
The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development.
Methods
In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively.
Results
Among the 41 participants, only 23 % considered the standards to be sufficient, and only 55 % found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n = 46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, “presenting benefits and harms” and “content beyond treatments (in particular, diagnostics and prognosis)” were considered to be the most important (n = 36).
Discussion
Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability – for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a li
{"title":"Inhaltliche Weiterentwicklung von Standards zur Erstellung evidenzbasierter Gesundheitsinformationen: Eine Bedarfserhebung und Priorisierung im EbM-Netzwerk","authors":"Roland Brian Büchter , Martina Albrecht , Michael Grimm , Markus Seelig , Anke Steckelberg , Anne Christin Rahn","doi":"10.1016/j.zefq.2024.03.011","DOIUrl":"10.1016/j.zefq.2024.03.011","url":null,"abstract":"<div><h3>Background</h3><p>The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development.</p></div><div><h3>Methods</h3><p>In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively.</p></div><div><h3>Results</h3><p>Among the 41 participants, only 23<!--> <!-->% considered the standards to be sufficient, and only 55<!--> <!-->% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n<!--> <!-->=<!--> <!-->46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, “presenting benefits and harms” and “content beyond treatments (in particular, diagnostics and prognosis)” were considered to be the most important (n<!--> <!-->=<!--> <!-->36).</p></div><div><h3>Discussion</h3><p>Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability – for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a li","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922706","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}
The recruitment of internationally educated nurses is gaining relevance in Germany in response to the growing shortage of nurses. Differences in nursing qualifications and practices between the country of origin and of destination can irritate the professional self-concept and hinder professional integration.
Purpose
The study objective was to examine the development of the professional scope of action to unfold the professional self-concept of academically qualified nurses in Germany.
Methods
In accordance with the episodic interview, eight guided interviews were conducted with Filipino nurses who had migrated to Germany. Data was analyzed by thematic coding.
Results
The analysis shows two dimensions that impact the professional scope of action: perceived systemic constraints in the transition process and perspectives on professional development. The recruitment and recognition process is associated with high financial and time-related uncertainties and professional devaluation experiences. Migrant nurses experience both a loss of competence and a sense of foreignness in their nursing role in Germany. In order to regain professional scope of action, strategies of continuing education and focusing on more technology-intensive nursing care areas are pursued; only a minority can adapt their self-concept to the circumstances of nursing practice in Germany.
Discussion
The study results demonstrate the importance of paying attention to both the competence profile and the professional self-concept of academically educated nurses in order to offer migrant nurses professional career prospects in Germany. Especially in long-term care, this has proved to be a structural problem.
Conclusion
To provide an attractive destination for international academically qualified nursing professionals in Germany, the ratification of international standards, the provision of transparent and independent information, utilization of existing nursing expertise as well as the establishment of career opportunities are recommended.
{"title":"Akademisiertes Pflegefachpersonal aus Drittstaaten: Professionelles Selbstverständnis vs. berufliche Realität in Deutschland? Eine qualitative Studie am Beispiel migrierter philippinischer Pflegefachpersonen","authors":"Maike Zwergel , Phillip Florian Schmidt , Kerstin Hämel","doi":"10.1016/j.zefq.2024.04.005","DOIUrl":"10.1016/j.zefq.2024.04.005","url":null,"abstract":"<div><h3>Background</h3><p>The recruitment of internationally educated nurses is gaining relevance in Germany in response to the growing shortage of nurses. Differences in nursing qualifications and practices between the country of origin and of destination can irritate the professional self-concept and hinder professional integration.</p></div><div><h3>Purpose</h3><p>The study objective was to examine the development of the professional scope of action to unfold the professional self-concept of academically qualified nurses in Germany.</p></div><div><h3>Methods</h3><p>In accordance with the episodic interview, eight guided interviews were conducted with Filipino nurses who had migrated to Germany. Data was analyzed by thematic coding.</p></div><div><h3>Results</h3><p>The analysis shows two dimensions that impact the professional scope of action: perceived systemic constraints in the transition process and perspectives on professional development. The recruitment and recognition process is associated with high financial and time-related uncertainties and professional devaluation experiences. Migrant nurses experience both a loss of competence and a sense of foreignness in their nursing role in Germany. In order to regain professional scope of action, strategies of continuing education and focusing on more technology-intensive nursing care areas are pursued; only a minority can adapt their self-concept to the circumstances of nursing practice in Germany.</p></div><div><h3>Discussion</h3><p>The study results demonstrate the importance of paying attention to both the competence profile and the professional self-concept of academically educated nurses in order to offer migrant nurses professional career prospects in Germany. Especially in long-term care, this has proved to be a structural problem.</p></div><div><h3>Conclusion</h3><p>To provide an attractive destination for international academically qualified nursing professionals in Germany, the ratification of international standards, the provision of transparent and independent information, utilization of existing nursing expertise as well as the establishment of career opportunities are recommended.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000837/pdfft?md5=98a7bf363b63d72b3a6613cefe42ee9c&pid=1-s2.0-S1865921724000837-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093438","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.04.002
Mirjam Garvelink , Atena Mahboubian , Okke de Weerdt , Paul van der Nat
Objective
As part of a quality improvement initiative in the context of value-based health care we aimed to optimize the shared decision-making (SDM) process in the care pathway for Multiple Myeloma as part of a digital care pathway (DCP). For this, more insight was needed in health care professionals’ (HCPs’) perspectives on SDM, and how SDM elements could be addressed in a DCP for MM to facilitate HCPs’ performance of SDM.
Methods
HCPs were interviewed as per the theory of planned behaviour and the model of organizational context and SDM (phase 1). Multidisciplinary development sessions were organized to discuss concepts of the solution with HCPs (phase 2). The solution was evaluated with two patients from the quality improvement team.
Results
In phase 1, ten interviews were held. HCPs’ attitudes and the subjective norm towards SDM were positive, and the intention to perform SDM was high. The clinical environment (physical context, disease characteristics, assumptions about patient characteristics, and workflows) for MM posed challenges on the actual SDM behavior. Education and use of the DCP to create awareness of SDM were seen as possible facilitators for SDM. A prepared and active patient would facilitate the SDM process. In phase 2, three concept solutions were developed before arriving at the final solution. The final solution consisted of three elements to incorporate SDM steps in the DCP: 1) creating patient awareness and activation with two questions about their preferences prior to a consultation, 2) visualisation of preferences centrally in the DCP to trigger HCP to discuss them, 3) monitoring and improving SDM with patient-questionnaires after decision-making. Patients and HCPs were willing to implement it.
Conclusion
HCPs intention to engage in SDM was high, but their actual behaviour was challenged by the clinical environment. A 3-element DCP-based intervention was developed to increase SDM.
Patient or public contribution
Input on the solution was obtained from end-users including two patients and ten healthcare professionals.
{"title":"MMpowerment: Empowering patients with multiple myeloma for shared decision-making by developing an intervention to integrate personal preferences into digital care pathways","authors":"Mirjam Garvelink , Atena Mahboubian , Okke de Weerdt , Paul van der Nat","doi":"10.1016/j.zefq.2024.04.002","DOIUrl":"10.1016/j.zefq.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>As part of a quality improvement initiative in the context of value-based health care we aimed to optimize the shared decision-making (SDM) process in the care pathway for Multiple Myeloma as part of a digital care pathway (DCP). For this, more insight was needed in health care professionals’ (HCPs’) perspectives on SDM, and how SDM elements could be addressed in a DCP for MM to facilitate HCPs’ performance of SDM.</p></div><div><h3>Methods</h3><p>HCPs were interviewed as per the theory of planned behaviour and the model of organizational context and SDM (phase 1). Multidisciplinary development sessions were organized to discuss concepts of the solution with HCPs (phase 2). The solution was evaluated with two patients from the quality improvement team.</p></div><div><h3>Results</h3><p>In phase 1, ten interviews were held. HCPs’ attitudes and the subjective norm towards SDM were positive, and the intention to perform SDM was high. The clinical environment (physical context, disease characteristics, assumptions about patient characteristics, and workflows) for MM posed challenges on the actual SDM behavior. Education and use of the DCP to create awareness of SDM were seen as possible facilitators for SDM. A prepared and active patient would facilitate the SDM process. In phase 2, three concept solutions were developed before arriving at the final solution. The final solution consisted of three elements to incorporate SDM steps in the DCP: 1) creating patient awareness and activation with two questions about their preferences prior to a consultation, 2) visualisation of preferences centrally in the DCP to trigger HCP to discuss them, 3) monitoring and improving SDM with patient-questionnaires after decision-making. Patients and HCPs were willing to implement it.</p></div><div><h3>Conclusion</h3><p>HCPs intention to engage in SDM was high, but their actual behaviour was challenged by the clinical environment. A 3-element DCP-based intervention was developed to increase SDM.</p></div><div><h3>Patient or public contribution</h3><p>Input on the solution was obtained from end-users including two patients and ten healthcare professionals.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093444","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 : 2024-06-01DOI: 10.1016/S1865-9217(24)00109-0
{"title":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(24)00109-0","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00109-0","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724001090/pdfft?md5=6bde23f1a84c1eaf1ad2b232eaf9da51&pid=1-s2.0-S1865921724001090-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540875","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.05.002
Hinpetch Daungsupawong , Viroj Wiwanitkit
{"title":"Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al.","authors":"Hinpetch Daungsupawong , Viroj Wiwanitkit","doi":"10.1016/j.zefq.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.05.002","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540876","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.05.001
Vanessa Piechotta, Wiebe Külper-Schiek
{"title":"Antwort auf Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al. von Hinpetch Daungsupawong (ZEFQ 187 (2024) 100)","authors":"Vanessa Piechotta, Wiebe Külper-Schiek","doi":"10.1016/j.zefq.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.05.001","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540877","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.05.006
Anna Levke Brütt , Anne Fahsold , Juliane Köberlein-Neu , Rebecca Palm , Nadine Janis Pohontsch , Lisa Tönnis
Background
Early career researchers in health services research work in an interdisciplinary field of research. So far, information on early career researchers in health services research has only been available from surveys of individual disciplines, which do not adequately reflect the concerns in the field of health services research. Therefore, a working group of the German Network for Health Services Research (DNVF) conducted a first survey. The following research questions can be answered on the basis of the data obtained: (1) Which socio-demographic aspects characterize early career researchers in health services research? (2) What is the professional biographical background of early career researchers in health services research? (3) What are the research fields of early career researchers? (4) What are the career perspectives of early career researchers?
Method
The survey among early career researchers was conducted as an online survey in January/February 2019. The study was addressed to individuals currently working as early career researchers in health services research in Germany. The online survey was conducted using a standardized questionnaire. Participants were recruited through the DNVF access points and by snowball sampling.
Results
336 early career researcher aged between 23 and 57 participated in the online survey study, 102 of whom held a doctorate. The majority were employed as scientific staff (58 %) and were in temporary employment (75 %); 69 % of them were emplyed at a university, followed by health care institutions (17 %) and non-university research institutions (16 %). About one-third of the respondents (36 %) completed a vocational training prior to their studies. Of the participants, 50 % said they were strongly or very strongly aspiring to a professional career in academia, 43 % at a non-university research institution, and 30 % at a university of applied sciences.
Discussion
The results of the online survey show the heterogeneity in terms of age and professional biography of early career researchers in health services research. Few researchers have permanent positions. However, the majority of respondents would like to have a professional future at a university, a research institute or a university of applied sciences. Further studies should be conducted to determine (possible) career paths taken by young scientists in health services research.
Conclusion
There is still scope for improvement in the promotion of early career researchers.
{"title":"Situation des wissenschaftlichen Nachwuchses in der Versorgungsforschung – eine Survey-Studie","authors":"Anna Levke Brütt , Anne Fahsold , Juliane Köberlein-Neu , Rebecca Palm , Nadine Janis Pohontsch , Lisa Tönnis","doi":"10.1016/j.zefq.2024.05.006","DOIUrl":"10.1016/j.zefq.2024.05.006","url":null,"abstract":"<div><h3>Background</h3><p>Early career researchers in health services research work in an interdisciplinary field of research. So far, information on early career researchers in health services research has only been available from surveys of individual disciplines, which do not adequately reflect the concerns in the field of health services research. Therefore, a working group of the German Network for Health Services Research (DNVF) conducted a first survey. The following research questions can be answered on the basis of the data obtained: (1) Which socio-demographic aspects characterize early career researchers in health services research? (2) What is the professional biographical background of early career researchers in health services research? (3) What are the research fields of early career researchers? (4) What are the career perspectives of early career researchers?</p></div><div><h3>Method</h3><p>The survey among early career researchers was conducted as an online survey in January/February 2019. The study was addressed to individuals currently working as early career researchers in health services research in Germany. The online survey was conducted using a standardized questionnaire. Participants were recruited through the DNVF access points and by snowball sampling.</p></div><div><h3>Results</h3><p>336 early career researcher aged between 23 and 57 participated in the online survey study, 102 of whom held a doctorate. The majority were employed as scientific staff (58<!--> <!-->%) and were in temporary employment (75<!--> <!-->%); 69<!--> <!-->% of them were emplyed at a university, followed by health care institutions (17<!--> <!-->%) and non-university research institutions (16<!--> <!-->%). About one-third of the respondents (36<!--> <!-->%) completed a vocational training prior to their studies. Of the participants, 50<!--> <!-->% said they were strongly or very strongly aspiring to a professional career in academia, 43<!--> <!-->% at a non-university research institution, and 30<!--> <!-->% at a university of applied sciences.</p></div><div><h3>Discussion</h3><p>The results of the online survey show the heterogeneity in terms of age and professional biography of early career researchers in health services research. Few researchers have permanent positions. However, the majority of respondents would like to have a professional future at a university, a research institute or a university of applied sciences. Further studies should be conducted to determine (possible) career paths taken by young scientists in health services research.</p></div><div><h3>Conclusion</h3><p>There is still scope for improvement in the promotion of early career researchers.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176448","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 : 2024-06-01DOI: 10.1016/j.zefq.2024.03.008
Juliane Andrea Duevel , Svenja Elkenkamp , Daniel Gensorowsky , Michael Brinkmeier , Georg Galle , Johannes Miethe , Wolfgang Greiner
Background
Patients with initial stroke or transient ischemic attack (TIA) are at high risk for further strokes, death or cardiovascular events. Even the first-ever stroke is associated with a high chance of disability and need for assistance. The risk of long-term health care demands increases with each subsequent event. Although the inpatient sector already provides a high standard of care in Germany, it can be difficult to obtain cross-sectoral aftercare. Thus, the study investigated whether a structured case management program can avoid stroke recurrences.
Methods
The study was conducted with a quasi-experimental study design in three regions in North Rhine-Westphalia. Patients with first-ever stroke or TIA were eligible to participate. The intervention group was prospectively recruited and supported by a case manager during a one-year follow-up. Optimal Full Matching was used to generate a control group based on statutory claims data. The primary outcome was the stroke recurrence. Recurrence and mortality were analysed by using Cox regression; other secondary outcomes were examined with test-based procedures and with logistic regressions. Additionally, subgroup analyses were performed.
Results
From June 2018 to March 2020, 1,512 patients were enrolled in the intervention group. Claims data from 19,104 patients have been transmitted for establishing the control group. After the matching process, 1,167 patients of each group were included in the analysis. 70 recurrences (6.0 %) occurred in the intervention group and 67 recurrences (5.7 %) in the control group. With a hazard ratio of 1.06 (95 % CI: [1.42-0.69]; p = 0.69), no significant effect was found for the primary outcome. With regard to the secondary outcome mortality, 36 patients in the intervention group and 46 in the control group died (3.1 % vs. 3.9 %). Again, there was no significant effect (HR: 0.86; 95 % CI: [0.58-1.28], p = 0.46).
Discussion
Based on the present findings, the case management approach for stroke patients evaluated here was unable to demonstrate an improvement in health care. Potential effects of case management might not be adequately depicted in short observation periods. Thus, future studies should consider longer observation periods.
Conclusion
A panel of experts should discuss whether the core approach of case management to support cost-intensive individual cases is contrary to a broad implementation with a one-size-fits-all intervention for stroke patients. In this case, further research should focus on more specific study populations.
{"title":"A case management intervention in stroke care: Evaluation of a quasi-experimental study","authors":"Juliane Andrea Duevel , Svenja Elkenkamp , Daniel Gensorowsky , Michael Brinkmeier , Georg Galle , Johannes Miethe , Wolfgang Greiner","doi":"10.1016/j.zefq.2024.03.008","DOIUrl":"10.1016/j.zefq.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Patients with initial stroke or transient ischemic attack (TIA) are at high risk for further strokes, death or cardiovascular events. Even the first-ever stroke is associated with a high chance of disability and need for assistance. The risk of long-term health care demands increases with each subsequent event. Although the inpatient sector already provides a high standard of care in Germany, it can be difficult to obtain cross-sectoral aftercare. Thus, the study investigated whether a structured case management program can avoid stroke recurrences.</p></div><div><h3>Methods</h3><p>The study was conducted with a quasi-experimental study design in three regions in North Rhine-Westphalia. Patients with first-ever stroke or TIA were eligible to participate. The intervention group was prospectively recruited and supported by a case manager during a one-year follow-up. Optimal Full Matching was used to generate a control group based on statutory claims data. The primary outcome was the stroke recurrence. Recurrence and mortality were analysed by using Cox regression; other secondary outcomes were examined with test-based procedures and with logistic regressions. Additionally, subgroup analyses were performed.</p></div><div><h3>Results</h3><p>From June 2018 to March 2020, 1,512 patients were enrolled in the intervention group. Claims data from 19,104 patients have been transmitted for establishing the control group. After the matching process, 1,167 patients of each group were included in the analysis. 70 recurrences (6.0<!--> <!-->%) occurred in the intervention group and 67 recurrences (5.7<!--> <!-->%) in the control group. With a hazard ratio of 1.06 (95<!--> <!-->% CI: [1.42-0.69]; p<!--> <!-->=<!--> <!-->0.69), no significant effect was found for the primary outcome. With regard to the secondary outcome mortality, 36 patients in the intervention group and 46 in the control group died (3.1<!--> <!-->% vs. 3.9<!--> <!-->%). Again, there was no significant effect (HR: 0.86; 95<!--> <!-->% CI: [0.58-1.28], p<!--> <!-->=<!--> <!-->0.46).</p></div><div><h3>Discussion</h3><p>Based on the present findings, the case management approach for stroke patients evaluated here was unable to demonstrate an improvement in health care. Potential effects of case management might not be adequately depicted in short observation periods. Thus, future studies should consider longer observation periods.</p></div><div><h3>Conclusion</h3><p>A panel of experts should discuss whether the core approach of case management to support cost-intensive individual cases is contrary to a broad implementation with a one-size-fits-all intervention for stroke patients. In this case, further research should focus on more specific study populations.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000564/pdfft?md5=05304c2f690a35c038c568a410e2ec44&pid=1-s2.0-S1865921724000564-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904937","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}
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