Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"[Planetary Health Diet in a hospital cafeteria: Increasing employee satisfaction and reducing greenhouse gas emissions and costs].","authors":"Laura Harrison, Emma Reynolds, Claudia Quitmann, Luisa Till, Bernd Franke, Christin Zeitz, Ina Danquah, Alina Herrmann","doi":"10.1016/j.zefq.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.003","url":null,"abstract":"<p><strong>Introduction: </strong>In order to ensure a healthy diet for the world's population within planetary boundaries, the EAT-Lancet Commission has made recommendations for a \"Planetary Health Diet\" (PHD). Due to the special responsibility of the health sector for healthy living conditions, offering food provision in line with the Planetary Health Diet is a sensible thing to do for health facilities. With this in mind, we evaluated the acceptance, costs and reduction of greenhouse gas (GHG) emissions through a correspondingly modified food offer in the cafeteria of a large university hospital.</p><p><strong>Methods: </strong>For three months, a lunch menu adapted to the recommendations of the PHD and information material on sustainable nutrition were offered in the hospital cafeteria. Customers in this cafeteria (intervention group) and in all other hospital cafeterias (control group) completed a questionnaire before (from 12/2022 to 01/2023) and after (from 03/2023 to 04/2023) the intervention period. In this questionnaire, customers were asked how satisfied they were with the sustainable food offer using German school grades (from 1 to 6). We calculated the difference-in-differences (DID), 95% confidence intervals (CIs) and p-values for the school grades. Open-ended questions were used to learn about customers' perception of health and sustainability aspects of the food supply and written feedback analysed qualitatively. We conducted a bottom-up analysis of the greenhouse gas emissions of the different lunch menu lines based on the main ingredients of the dishes and calculated cost differences between the vegan menu line and the conventional menu lines based on food costs.</p><p><strong>Results: </strong>In the intervention group, the ratings for the sustainability, health, diversity, and flavour of the food on offer improved significantly compared to the control group. The composition of the food (e. g., proportion of meat or vegetables), the product selection (regional, seasonal, organic) and the amount of waste produced were important to the employees when rating the sustainability and healthiness of the food. In the intervention cafeteria, GHG emissions fell by 27 % from 26.2 tonnes to 20.5 tonnes of GHG emissions (saving 5.6 tonnes of GHG emissions) in the second half of the intervention period compared to the previous year, despite a higher number of orders. During the entire intervention period, the intervention group saved about € 4,000 on ingredients.</p><p><strong>Discussion: </strong>Due to the robust quasi-experimental study design and in combination with the qualitative results, this study provides initial evidence that a PHD-oriented food offer can increase food-related employee satisfaction.</p><p><strong>Conclusion: </strong>Switching to sustainable food supply at hospitals is to be recommended due to its cost-effectiveness, positive feedback from employees and the reduction of GHG emissions.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075855","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":"Use and acceptance of video consultation among adults insured by statutory health insurance provider in Germany: A nationwide online survey.","authors":"Saskia Muellmann, Karina Karolina De Santis, Hermann Pohlabeln, Hajo Zeeb","doi":"10.1016/j.zefq.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.008","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing digitalization of the healthcare system makes it possible to provide medical services using digital technologies without direct patient-provider contact. This study aimed to investigate 1) the use and acceptance of video consultation and 2) factors associated with the use of video consultation.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted in February 2023. Overall, 20,000 adults insured at a statutory health insurance company in Germany (10,000 users and 10,000 non-users of video consultation) were invited by email to an online survey with 31 items. The items addressed use and acceptance of digital health services with a focus on video consultation, digital health literacy and sociodemographic characteristics. Data were analyzed using descriptive statistics and factors associated with video consultation use were assessed using binary logistic regression.</p><p><strong>Results: </strong>Among the 1657 participants, 686 were users and 971 were non-users of video consultation. The participants were aged between 18 and 80 years (M ± SD: 44 ± 13 years), 55% were female, 59% reported a medium subjective socioeconomic status, and 69% a good to very good health status. Video consultation were predominantly used following physician recommendations (71%) as part of general medical care (50%). The main reasons for using video consultation were time saving (93%) and flexibility in terms of location (87%). Most video consultation users felt well cared-for during video consulting (93%), would use it again (95%), and would recommend it to others (93%). Factors associated with video consultation use were age from 30 to 49 years, high subjective socioeconomic status, high digital health litercay, and very poor to moderate health status.</p><p><strong>Conclusion: </strong>The acceptance of video consultations in this study was high. Advantages and barriers to offering video consultations from a physician perspective should be investigated to incorporate video consultations in everyday medical practice.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029957","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":"[Small-area and socially differentiated analyses of the utilization of screening examinations in the city of Hamburg: a secondary data analysis].","authors":"Denise Kubat, Nele Meinert, Susanne Busch, Enno Swart","doi":"10.1016/j.zefq.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>Social reporting in Hamburg identifies existing inequalities at the urban area level. These social-contextual variations may potentially influence preventive health behaviors. The aim of this article is to examine correlations between the degree of social regional disadvantage of Hamburg's population and the utilization of regular screening examinations for children, adolescents, and adults through small-area analysis.</p><p><strong>Methods: </strong>The analyses are based on claims data from 2017 of insured individuals living in Hamburg from three cooperating statutory health insurance funds. A socially contextual indicator (1 = \"very low\" to 7 = \"high\") was assigned to the data at urban area level. Based on this, binary correlations between the social indicator and calculated utilization rates (stratified by gender and age) of early detection examinations were examined using Kendall's tau correlation analysis.</p><p><strong>Results: </strong>The study population included N = 433,053 individuals (53.7 % female) from the city of Hamburg. Strong positive associations were found between utilization rates and social contextual index classes for U7 to U9 examinations (r > 0.7; p-values < 0.05) as well as cervical cancer screening (r > 0.9; p-values = 0.002), indicating that utilization increases with the rising social status of the urban area level. Additionally, strong positive correlations can be observed in some subgroups for prostate cancer screening (> 59 years: r = 0.905, p-value = 0.004) and colorectal cancer screening (women aged 50-60 years: r = 0.905, p-value = 0.004). No significant correlations were found for other subgroups, as well as for skin cancer screening, breast cancer screening and the J1 examination (p-value > 0.05). Strong negative associations have only been detected for the general health check-up for individuals aged 35 to 59 (women: r = -0.810, p-value = 0.011; men: r = -0.714, p-value = 0.024).</p><p><strong>Discussion and conclusion: </strong>The results indicate inequalities in the use of early detection examinations provided by statutory health insurers for children and adults to the disadvantage of urban areas ranking lower in social status. This socially selective utilization may lead to an accumulation of health problems in urban areas that are already disadvantaged socially, which would result in an exacerbation of existing social and health inequalities. Small-scale and socially differentiated analyses of healthcare provision should be seen as a regular component of regional healthcare provision. They provide starting points for a more needs-oriented further development of the healthcare system and secondary prevention services.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025206","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":"[Content and quality of web-based health information for the prevention and prediction of food allergies in children: A systematic evaluation].","authors":"Madlen Hörold, Magdalena Rohr, Maja Beyer, Theresa Bauer, Mara König, Katharina Gerhardinger, Christian Apfelbacher, Susanne Brandstetter","doi":"10.1016/j.zefq.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.11.010","url":null,"abstract":"<p><strong>Introduction: </strong>Web-based health information can support health-related decisions if it is of high quality, i. e. accurate, understandable and barrier-free. Our study systematically searched for German-language, web-based health information on the prevention and prediction of food allergies in children and assessed their content and quality.</p><p><strong>Methods: </strong>In July 2022, four researchers conducted a systematic Google search for German-language web-based health information (HI) on the prediction and prevention of food allergies in children. They searched independently of each other with a predefined search algorithm. Two independent reviewers analyzed the data using qualitative and quantitative content analysis (step/analysis 1) and assessed the quality of HI (step/analysis 2) using a comprehensive criteria catalog (transparency, text design, content, language, presentation of frequencies and statistical information, visualization, and accessibility).</p><p><strong>Results: </strong>The systematic search yielded 59 websites, which were provided by nine sectors. The most frequent sectors were \"Health portals and expert opinions\" and \"Guidelines/scientific and medical specialized information\" (22 % each). The content analysis (step 1) showed, among other things, that the topic of prediction was only implicitly addressed. 49 materials (83 %) contained guideline-compliant information. However, there were also 26 materials (44 %) whose content was not in line with the current S3 guideline on allergy prevention. Quality assessment (step 2) revealed that only a small number of the 43 HI received good or very good ratings regarding the transparency (n = 3, 7 %) and content (n = 9, 21 %) criteria. The criterion concerning frequencies and statistical information was rated good or very good quality in only 11 HI (26 %). Almost all HI met the quality criteria for language (n = 38, 88 %), text design (n = 43, 100 %), and visualization (n = 43, 100 %). None of the evaluated HI was given a good or very good rating in terms of accessibility criteria. The analysis by sector revealed only minor differences (Mean of the seven criteria: 56-69 %).</p><p><strong>Conclusion: </strong>The quality of the available web-based health information on the prevention and prediction of food allergies in children is highly heterogeneous. There is need for improvement in terms of accessibility, content (e. g., selective presentation of prevention measures), and transparency (e. g., missing details of contacts). Further research is needed for expanding the user perspective and analyzing social media in the context of prediction and prevention of food allergies in children.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013014","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":"[Unmet health care needs of younger and older people with intellectual, mental and multiple disabilities: A pilot study in a facility in the Ruhr area].","authors":"Sarah Heidenreiter, Michael Lauerer, Eckhard Nagel","doi":"10.1016/j.zefq.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Unmet health care needs are seen as a key indicator of equity in access to health care. With younger people, they can lead to poorer health outcomes in adulthood, and in older people they can be associated with an increased risk of mortality. The presence of a disability is considered a risk factor for unmet needs. Against this background, unmet health care needs of younger and older people with intellectual, mental and multiple disabilities in Essen were examined as part of a qualitative pilot study in a facility in Essen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;The interview study includes the perspectives of adolescents and older people living in a residential facility for people with intellectual, mental and multiple disabilities, as well as assessments of their caregivers and managers of the institution. We conducted semi-structured guided interviews with clients and managers, and unstructured interviews with care assistants. After transcription, a qualitative content analysis and a supplementary frequency analysis were carried out. The reporting is based on the Standards for Qualitative Research (SRQR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of eleven interviews - five with people with intellectual, mental and multiple disabilities, four with care assistants, and two with managers - were subjected to analysis. Fourteen interviews conducted with people with intellectual, mental and multiple disabilities and one interview with a care assistant had to be excluded due to high cognitive impairment or lack of insight, amongst other reasons. The clients reported unmet needs, particularly in outpatient care: waiting times, shortcomings in both treatment and doctor-patient interaction play a decisive role. The latter manifests itself in disregarding the patients' wishes and the patients' feeling of not being taken seriously. The most frequently cited consequence of unmet needs is a change of physician. Care assistants and managers unanimously confirmed their clients' experiences in the areas mentioned and added: lack of opportunities for their clients to participate in medical consultations and lack of medical information. In addition, their clients' problems often start with accessing health care since their ability to identify and articulate complaints or treatment requests is often limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Using one residential facility in the Ruhr region as an example, the results provide indications of deficits in the health care of younger and older people with intellectual, mental and multiple disabilities as well as priorities for a sustainable improvement in their health-related living situation. One specific field of action is to increase the competencies of service providers regarding the care of people with intellectual, mental and multiple disabilities and their specific needs. In addition, doctor-patient interaction must be adapted and target group-specific communication introduced into pra","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013619","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":"Abschlusseditorial.","authors":"Beate Müller","doi":"10.1016/j.zefq.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.005","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967202","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":"Digital health technologies enabling the transition from pregnancy to early parenthood: A scoping review.","authors":"Alexander Hochmuth, Alisa M Hochmuth, Christoph Dockweiler","doi":"10.1016/j.zefq.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.11.013","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women and their families, especially those navigating chronic illness or challenging life situations, often seek information and counseling. The pregnancy period and the transition to parenthood can exacerbate these circumstances, leaving families particularly vulnerable. Addressing stressful situations becomes a hurdle in this context. Digital health technologies (DHTs), encompassing mobile apps, wearable devices and online platforms, present a valuable avenue for pregnant women and their families to access health information, educational parenting resources and personalized recommendations. The aim is to analyze the current research of digital health interventions designed to support parents throughout the transition from pregnancy to parenthood.</p><p><strong>Methods: </strong>We conducted a scoping review and analyzed MEDLINE via PubMed, CINAHL, Cochrane Library, IEEE Xplore Digital Library, ScienceDirect and PsycINFO. Relevant German and English articles from 2004 to 2023 referring to DHTs to improve the time before and after birth were included.</p><p><strong>Results: </strong>In 78 articles, pregnant women and parents utilized various DHTs such as mobile applications, multi-functional digital platforms, social media, videos and health websites during the transition from pregnancy to parenthood. Mobile apps and multi-component digital interventions were most frequently used in these studies. A large proportion of the studies employed experimental designs such as randomized controlled trials (RCTs) and quasi-experimental methods. DHTs empower healthcare professionals to enhance parental health education for expecting and new parents in areas such as breastfeeding, preterm birth risks and mental health. DHTs provide accessible support, instruction, counseling and health services, including care for premature infants and guidance on baby-care practices. These DHTs also enable innovative monitoring of pregnancy progress, women's health, breastfeeding and mental wellbeing, thereby revolutionizing healthcare support for pregnant individuals and young families.</p><p><strong>Conclusion: </strong>DHTs allow pregnant women and their families to access health information, participate in parenting training, and receive personalized recommendations. This can contribute to increased self-care and a sense of control over the pregnancy journey. There is also a need for research to understand the effectiveness and feasibility of implementing and evaluation existing digital health interventions.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928280","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":"\"We are doing it together, don't worry\" - A qualitative study on the implementation of electronic medical records in German hospitals.","authors":"Kerstin Dittmer, Mi-Ran Okumu, Marina Beckmann, Natalia Cecon-Stabel, Paola Di Gion, Till Jes Hansen, Julia Jaschke, Ute Karbach, Juliane Köberlein-Neu, Maya Nocon, Carsten Rusniok, Jessica Schmara, Florian Wurster, Holger Pfaff","doi":"10.1016/j.zefq.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>The ongoing implementation of electronic medical records (EMRs) in German hospitals is currently slow. Implementation science widely acknowledges the barriers and facilitators to implementation. Thus, specific preconditions are necessary to address the former and to support an effective EMR implementation. However, a lack of knowledge exists about these necessary preconditions in Germany. This study aims to gain insight into key stakeholders' experiences with implementing EMR systems in German hospitals to identify preconditions for embedding EMRs in this social context.</p><p><strong>Methods: </strong>Expert interviews were conducted with members of hospital-wide implementation teams concerning EMR implementation. The interviewees belonged to the nursing, IT, medical, and pharmaceutical professions and worked in hospitals with different contextual characteristics. The interview guideline was based on the practical Consolidated Framework for Implementation, which supports the systematic assessment of potential barriers and facilitators to identify implementation strategies and necessary adaptations. Data was collected between May 2021 and September 2022, and the interviews were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>Thirteen interviews were conducted with employees from eleven hospitals. Five critical preconditions emerged for EMR implementation based on our analysis: 1) adaptation, where the clinical context and EMRs are aligned; 2) stakeholder co-production, where all relevant stakeholders (e. g., professional groups, departments, and hierarchical levels) are involved in planning, implementing, and evaluating; 3) end-user participation, where end-users are involved in the implementation through close support and training; 4) integration into daily routines, where EMRs are integrated into daily work, including work processes that initially require additional effort but are necessary to experience the relative advantages; and 5) the continuous Plan-Do-Check-Act cycle, where the EMR implementation process is continuously reviewed and adjusted. In addition, activities to enact these preconditions were derived based on the interview data.</p><p><strong>Discussion: </strong>Our findings indicate that overall contextual adaptation is required. The five preconditions include essential activities to facilitate the integration of the EMR into daily routines. Participation, communication, and support are fundamental, as described in the international literature. Failure to comply with these preconditions can lead to challenges during implementation, such as end-user resistance.</p><p><strong>Conclusion: </strong>Considering social and technical aspects is paramount in implementing EMRs, which may also apply to future digital innovations' change management processes.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928276","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":"[Live-in care in Germany: A qualitative content analysis of social and political discourses].","authors":"Adele Grenz, Mark Schweda, Milena von Kutzleben","doi":"10.1016/j.zefq.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>In Germany, Eastern European live-in carers are filling a gap in home-based long-term care for older persons. As a care reality fraught with diverse problems, live-in care is an unregulated care format bordering between formal and informal structures and has so far received little attention from health services research. The aim of the qualitative study described here was to analyze the current discourses among stakeholders from care practice, politics, and associations, as well as the arguments contained therein regarding the status quo and future of live-in care.</p><p><strong>Methods: </strong>We analyzed 22 online available documents from stakeholders, such as statements and contributions to the discussion, as well as ten expert interviews. Within the scope of a qualitative content analysis, triangulation of the two data corpora was conducted. Using a deductive-inductively developed system of categories, viewpoints and arguments were analyzed on this basis.</p><p><strong>Results: </strong>Three arguments regarding the future regulation of live-in care were identified in current socio-political discourses: 1) Maintain: professionalization of live-in care, 2) Supplement: integrating live-in care into the care mix, 3) Abolish: alternatives to the live-in care model. Despite different perspectives regarding the implementation of live-in care in the long-term care system, there is consensus that political measures must move beyond purely legal solutions. Regulation of framework conditions, mediation, and care practices is necessary.</p><p><strong>Discussion and conclusion: </strong>Regarding the future design of live-in care, particular emphasis is placed on adjusted financial incentives, professionalized live-in and live-out services, as well as the organization and promotion of informal care networks and collaborations with formal providers like outpatient services as key levers. In a broader discourse on the regulation of live-in care, it should be clarified how requirements for quality-assured long-term care can be applied, taking into account the needs of care arrangements.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915915","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":"[Dermatological diagnostics in patients with \"skin of color\"- How confident are German dermatologists?]","authors":"Can Alpagut, Christian Volberg, Michael Hertl, Lisa Krönig, Martin Gschnell","doi":"10.1016/j.zefq.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.11.011","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosis in dermatology is primarily based on the assessment and description of the clinical appearance of the skin. The German medical literature focuses almost exclusively on white skin, so it is questionable whether this one-sided training is sufficient to do justice to all patients since the diversity of skin types increases.</p><p><strong>Methods: </strong>Online survey among German dermatologists regarding training and experience in the diagnosis of dark skin, difficulties in recognizing dermatoses and the desire for training and further education in skin diseases of \"skin of color\".</p><p><strong>Results: </strong>A total of 236 responses were received. 65 % of participants felt unsure to very unsure about recognizing skin conditions in people with dark skin. Training in the recognition of skin types IV-VI was rated as poor to very poor by 76 %, and 73 % rated the current literature on the diagnosis of dark skin as poor to very poor. 89 % reported that they have difficulties in diagnosing skin diseases in dark skin in their daily practice.</p><p><strong>Conclusion: </strong>There is uncertainty among German dermatologists in the diagnosis of skin diseases in people with dark skin. This diagnostic uncertainty may lead to poorer treatment outcomes. More training opportunities should be offered to improve skills in the diagnosis and treatment of skin diseases in skin of color and the associated care.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915910","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}