Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Psychometric properties of the German Self-efficacy Expectation Scale (SES-G) in patients undergoing primary total hip arthroplasty: A validation study.","authors":"Yvet Mooiweer, Lena D Danner, Inge van den Akker-Scheek, Laura-Lee Linngrön, Gesine H Seeber, Martin Stevens","doi":"10.1016/j.zefq.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.08.004","url":null,"abstract":"<p><strong>Objectives: </strong>To translate and culturally adapt the Self-efficacy Expectation Scale (SES) into German and examine its psychometric properties for total hip arthroplasty (THA) patients.</p><p><strong>Methods: </strong>The English-language SES was translated into German (SES-G). 116 patients completed the SES-G together with the Self-Efficacy for Rehabilitation Outcome Scale-German version (SER-G), Hip Disability and Osteoarthritis Outcome Scale (HOOS), and Hospital for Special Surgery Hip Expectation Survey (HSS-HRES). Structural validity was assessed using an exploratory factor analysis (EFA). Construct validity was examined by testing predefined hypotheses on relationships between the SES-G and total- and subscores of the SER-G, HOOS, HSS-HRES. The SES-G was readministered after two weeks to assess test-retest reliability. To evaluate test-retest reliability 2-way random-effects absolute agreement intraclass correlation coefficients and Bland-Altman analysis were calculated. MacDonald's Omega was used to evaluate internal consistency. Standard error of measurement (SEM) and minimal detectable change (MDC) were explored.</p><p><strong>Results: </strong>EFA revealed three components explaining 75% of the total variance. For construct validity, 80% of the hypotheses were confirmed. Internal consistency was good (MacDonald's Omega = 0.81), as was test-retest reliability (ICC 0.71). Mean difference between the first and second administrations was -1.6 ± 4.2. The corresponding 95% CI did not contain zero [-2.4, -0.8], indicating systematic bias. Limits of agreement were 6.7 and 9.8. Proportional bias can be ruled out (B = 0.187, p = 0.05). SEM was 3.08, MDC_ind and MDC_group were 5.95 and 0.55, respectively.</p><p><strong>Conclusion: </strong>The psychometric analysis provides preliminary evidence that the SES-G is a valid and reliable instrument to measure self-efficacy in THA patients.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116594","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":"[In Monitoring we trust? The role of imaging-based monitoring examinations using echocardiography and carotid duplex sonography as examples - A qualitative interview study with patients and physicians].","authors":"Ciara Elisa Fink, Julia Heisig, Carolin Gonschorek, Victoria Koschemann, Veronika van der Wardt, Annika Viniol, Thomas Kühlein, Susann Hueber, Felix Werner, Laura Rink","doi":"10.1016/j.zefq.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.08.002","url":null,"abstract":"<p><strong>Background: </strong>Regular examinations, including imaging procedures (known as monitoring), have become an established component in the management of chronically ill patients. At the same time, guideline recommendations for monitoring chronic diseases are often based on low-level evidence. Nevertheless, doctors routinely carry out monitoring measures that go beyond the guideline recommendations. Monitoring also appears to be highly valued by patients. This study asks what emotional value monitoring examinations have from the perspective of patients and physicians, respectively, and why.</p><p><strong>Method: </strong>As part of a qualitative interview study, a secondary analysis of semi-structured interviews with patients and physicians was conducted. The patients had undergone echocardiography or carotid duplex sonography as part of their regular monitoring over the past three years due to CAD or cerebral infarction. The physicians involved in the study provided outpatient care for patients with these conditions. Participants were recruited in Hesse and Bavaria. The interviews were transcribed and then evaluated using Braun and Clarke's reflexive thematic analysis.</p><p><strong>Results: </strong>Fourteen patients (two women and 12 men aged between 51 and 90) and 22 physicians (five women and 17 men aged between 37 and 86) took part in qualitative interviews. The physicians worked in the fields of cardiology, neurology, and primary care. The physicians surveyed perceived that regular check-ups gave patients a feeling of security. Specialized physicians considered regular ultrasound examinations to be an integral part of their monitoring routine in order to detect relevant findings at an early stage. Monitoring using imaging techniques instills confidence in patients regarding the high quality of their medical care and a feeling of security. The prospect of a reduction in current monitoring routines caused uncertainty among the respondents.</p><p><strong>Discussion: </strong>The perceived benefits of monitoring routines are primarily shaped by emotional considerations, regardless of the presence or absence of evidence of their effectiveness. Established monitoring routines, such as echocardiography or carotid duplex sonography, provide patients with a strong sense of trust and control, which is why their reduction is often perceived as a loss. In doctor-patient consultations, risks, benefits, and gaps in the evidence should be communicated transparently and discussed in a reflective manner.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041231","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 relationship between area deprivation and the accessibility of general practices in Germany: An ecological study using the German Index of Multiple Deprivation 2015].","authors":"Christian Hans, Werner Maier, Sebastian Specht, Lars Schwettmann","doi":"10.1016/j.zefq.2026.07.007","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.07.007","url":null,"abstract":"<p><strong>Background: </strong>Higher area deprivation leads to higher morbidity and demand for health services. A negative association between area deprivation and spatial accessibility of general practices could lead to gaps in health services supply. Previous studies found different associations of deprivation and accessibility, along with accessibility differences due to settlement structure.</p><p><strong>Methods: </strong>We investigated the population-weighted straight-line distance to the next general practice for 11,085 municipalities in Germany (borders on Dec. 31, 2015) using multiple OLS regression models. Independent variables were the German Index of Multiple Deprivation (GIMD) 2015, centrality, and urbanity (Raumtyp 2010). We also modelled interaction effects of GIMD with centrality and urbanity.</p><p><strong>Results: </strong>We found statistically significant longer distances to the next practice (402-433 m, or 5-9 %) in municipalities with the highest deprivation (GIMD quintile 5) compared to municipalities in GIMD quintiles 1-4. In models with interaction effects, we obtained two results: in GIMD quintile 5, distances were longer in rural areas (444-1343 m, or 3-34 % longer), but generally shorter in urban areas (299 m longer to 731 m shorter, or 5-37 % shorter).</p><p><strong>Discussion: </strong>Our results for rural areas confirm studies from Germany and Poland, those for urban areas confirm results from England. The diverging interaction effects might be due to locational advantages of urban areas.</p><p><strong>Conclusion: </strong>The spatial accessibility of general practices was worst for rural municipalities in GIMD quintile 5. It should be evaluated whether the General Practice Planning Reform of 2019 and incentive programmes are able to attenuate this twofold disadvantage.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026470","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":"[Physiotherapeutic physical activity counselling in hospitals - A qualitative interview study of physical therapists' perspectives on their role as health advocates].","authors":"Lena Frenz, Ina Lesmann, Annalena Paus, Isabelle Stickdorn","doi":"10.1016/j.zefq.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>Physical activity counselling may be an effective approach to counteract physical inactivity among hospitalized patients. However, it remains unclear whether and to what extent physiotherapists provide such counselling as part of their role as health advocates in a hospital setting. Therefore, this study aimed to explore physiotherapists' perspectives on their role as health advocates in acute care.</p><p><strong>Methods: </strong>Semi-structured interviews with nine physiotherapists in a German university hospital were conducted and analysed using structured qualitative content analysis according to Kuckartz.</p><p><strong>Results: </strong>Participants' perspectives on their role as health advocates were shaped by various individual and contextual factors, which can be categorized along the domains of the Consolidated Framework for Implementation Research. These include personal attitudes and competencies, characteristics of the acute care setting, and organizational conditions.</p><p><strong>Discussion: </strong>The findings reveal a tension between function-oriented acute care and a health-promoting approach, with physical activity promotion often remaining secondary and opportunities for sustainable behaviour change being underutilized. In addition, the applicability of international health advocate role profiles to the German healthcare system should be considered with caution.</p><p><strong>Conclusion: </strong>The results indicate that physiotherapists partly assume the health advocate role in acute care, but it often remains implicit and is limited by a lack of structural support. This study provides starting points for a targeted promotion of this role through training, concept development, and stronger organizational integration, which could help address physical inactivity in hospitals more effectively in the future.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026381","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":"[Delays on the day of hospital discharge: An exploratory analysis of retrospective and prospective data on patient-related and process-related factors].","authors":"Simon Rieder, Johannes Serk, Jonas Rosendahl, Johannes Klose, Ulrich Ronellenfitsch, Jessica Döbereiner, Carsten Sekulla, Jörg Kleeff, Artur Rebelo","doi":"10.1016/j.zefq.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.08.005","url":null,"abstract":"<p><strong>Background: </strong>Delays on the day of hospital discharge place a significant burden on hospital resources, disrupt patient flow, and delay the release of bed capacity. The aim of this study was to identify the main causes and risk factors for delayed discharges, considering patient characteristics and discharge processes.</p><p><strong>Methods: </strong>The exploratory study is based on a retrospective and prospective survey conducted on a surgical and an internal medicine ward of a university hospital. In the retrospective survey, discharge dates, demographic and clinical data, discharge type, comorbidities, and discharge destination were recorded. The prospective survey was conducted over four weeks. All patients undergoing full inpatient treatment were analyzed consecutively, and a questionnaire was used as a tool.</p><p><strong>Results: </strong>A total of 12,634 patients were regularly discharged from both wards between 2019 and 2021. Of these, 946 patients (7.5%) were discharged on time (before 10:00 a.m.), 5,003 patients (39.6%) were discharged slightly delayed, and 6,685 patients (52.9%) were discharged very late (after 12:00 p.m.). The identified risk factors for delayed discharge included short-notice discharge decisions, advanced age, multimorbidity, prolonged hospital stays, and time-consuming diagnostic procedures on the day of discharge. In the prospective part of the study (n = 264), discharge was on time in 5.3% of patients, slightly delayed in 49.2%, and very late in 45.4% of patients. The main factors contributing to delayed discharges were delayed preparation of medical documentation, patients not being ready to leave, late scheduling of transportation, and discharge to home.</p><p><strong>Conclusion: </strong>These results emphasize the need for structured discharge planning and individual, risk-based assessment of each patient's readiness for discharge (e.g., based on age, multimorbidity, PCCL, and level of care) to minimize delays in the discharge process.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026441","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":"[Making financial distress visible: Development and piloting of guidelines for psychosocial counseling in oncology].","authors":"Sophie Pauge, Katja Mehlis, Andrea Zueger, Luise Richter, Bastian Surmann, Viktoria Mathies, Thomas Ernst, Natalja Menold, Wolfgang Greiner, Eva C Winkler","doi":"10.1016/j.zefq.2026.07.009","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.07.009","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients in Germany are often faced with financial distress associated with their illness, which can impair their quality of life and cause additional distress. Psychosocial counseling centers perceive an increasing demand for counseling, but do not have standardized guidelines for the structuring of counseling on this topic. The aim of the study is to develop a guideline for assessing financial distress and to conduct a pilot in a social services setting.</p><p><strong>Methods: </strong>Requirements for the guideline were identified in a focus group with social work professionals. The counseling guideline was then developed and tested in a social service facility. The guideline was evaluated using n = 7 semi-structured interviews and finalized based on the feedback.</p><p><strong>Results: </strong>The focus group confirmed the need for a short, practical tool for structuring counseling sessions on financial distress. A flexible guideline was then developed that considers the professionals' discretion. The guideline was rated positively in the evaluative interviews, particularly regarding its practicality and conversation structure. Criticism mainly focused on its length, which led to a further revision and shortening of the guideline.</p><p><strong>Discussion: </strong>The usability of the interview guide depends on its acceptance by counselors and a clear definition of its scope of application, taking into account the course of illness and social benefits. Using it early on after diagnosis and during relevant transitions will help with the identification of financial distress. Addressing both objective and subjective financial distress makes it possible to identify specific support needs during counseling.</p><p><strong>Conclusion: </strong>The guideline can contribute to structured counseling for cancer patients experiencing financial distress, improve the quality of care, and raise social awareness of the issue.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026449","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":"[Participatory research with personas - An empirical method for practice-oriented health research].","authors":"Kerstin Dittmer, Sandra Salm, Helen Strebel, Stefanie Houwaart, Theresia Krieger","doi":"10.1016/j.zefq.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.08.003","url":null,"abstract":"<p><p>Participation is a key element of practice-oriented innovation projects. At the same time, there is a growing interest among researchers, healthcare providers, and experts by experience in acquiring the relevant methodological skills. However, there is a lack of specific scientific descriptions, for example regarding a systematic presentation of the persona method in participatory contexts. The persona method offers a fictional, evidence-based representation of user perspectives and illustrates their needs, expectations, and contexts. It promotes transparency and a shared understanding within teams through narrative, creative, and visual elements. Personas integrate the collective experiential knowledge of experts without requiring individuals to disclose their personal experience, which is a particular advantage when working with vulnerable groups. This allows needs to be captured in a context-specific and comprehensive manner without compromising the anonymity of those involved. The persona method therefore holds potential for participatory research in healthcare but is susceptible to biases, particularly through stereotypical simplifications. A participatory, reflective development process can counteract these risks, but it requires methodological expertise, sufficient resources, and a critical examination of the underlying assumptions. The reflection questions presented in this article can assist research teams with the development and use of personas.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026452","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":"[Allergy Prevention L·OVE: Development of a structured, publicly accessible evidence repository for allergy prevention].","authors":"Robert Nunner, Valentina Veloso, José Ramos-Rojas, Sudip Karki, Michelle Wollmann, Jaekyung Shin, Antonia Sprenger, Paula Kuper, Claudia Hasenpusch, Eva-Maria Skiba, Katharina Sieferle, Camila Ávila-Oliver, Gabriel Rada, Christian Apfelbacher","doi":"10.1016/j.zefq.2026.07.006","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.07.006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The prevention of allergic diseases has been addressed by numerous systematic reviews. However, the evidence landscape is fragmented due to heterogeneous populations, interventions, outcomes, and dynamically evolving research approaches. Structured and continuously updated evidence resources are therefore needed to support guideline development, healthcare decision-making, and public health. Against this background, the Allergy Prevention Living Overview of Evidence (L·OVE) was developed as a freely accessible, continuously updated evidence repository for allergy prevention. The aim of this study is to describe the conceptual and methodological development of the repository as well as selected preliminary findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search was conducted in the Epistemonikos database for systematic reviews. In order to structure the evidence, a hierarchical taxonomy was developed covering the dimensions population, intervention, contextual dimensions, and outcome. Systematic reviews on primary preventive interventions aiming to prevent the development of allergic diseases or allergic sensitization were included. Relevant evidence was identified using an automated, platform-supported classification and identification workflow validated through a relative recall approach; included reviews were subsequently screened and taxonomically classified manually by two independent reviewers. Disagreements were resolved through discussion and, if necessary, by consultation with a third reviewer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As of 18 November 2025, the repository included 245 systematic reviews that met the inclusion criteria after a systematic search and multi-stage selection process. Nutrition- and microbiome-related interventions dominated the available evidence base, whereas nature-based, behavioral, and environmentally oriented prevention strategies were comparatively rarely addressed in systematic reviews. The automated, platform-supported identification strategy achieved a sensitivity of 96.49% compared with 92.98% for a Boolean search strategy, while also reducing the manual screening workload.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The findings indicate an uneven distribution of systematically synthesized evidence across different prevention domains and highlight potential research gaps. At the same time, the approach shows that systematic reviews in allergy prevention can be organized and continuously updated using structured taxonomies and automated, platform-supported identification procedures. The repository does not perform evidence synthesis itself, but rather supports the structured retrieval, classification, and contextualization of existing evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The Allergy Prevention L·OVE provides a structured, freely accessible, and continuously updatable evidence repository for allergy prevention. By combining automated evidence identification, a structured ta","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026476","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":"[Addressing racism-related discrimination against employees in German hospitals: Results of an organizational survey].","authors":"Tuğba Aksakal, Philipp Ostermann, Kübra Annac, Fabian Erdsiek, Yüce Yilmaz-Aslan, Patrick Brzoska","doi":"10.1016/j.zefq.2026.07.008","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.07.008","url":null,"abstract":"<p><strong>Introduction: </strong>Racial discrimination against healthcare staff may pose a burden for working conditions, team climate, and the quality of care in hospitals. In Germany, there is limited empirical evidence on how such incidents are addressed organizationally and what complaint and support structures have been implemented. The aim of this study was to describe the handling of racial discrimination against staff in German hospitals from an organizational perspective.</p><p><strong>Methods: </strong>A nationwide online cross-sectional survey of hospitals in Germany was conducted between October and November 2024. Respondents primarily included quality managers, complaint managers, and individuals in leadership or administrative roles. The survey examined the frequency of reported incidents of racial discrimination, their proportion of the total number of complaints, and the availability of complaint, support, and preventive structures.</p><p><strong>Results: </strong>Representatives from 211 hospitals participated in the survey (response rate: 15.5%). Racial discrimination was reported most frequently in connection with patients (38.4% reported such incidents to occur several times per year or more often) and relatives (26.2%), and less frequently in the context of colleagues (16.2%) and supervisors (6.0%). The proportion of such cases among all complaints was generally estimated to be about 10%. Nearly all institutions reported having formal complaint procedures in place (92.9%), but specialized support services for cases of discrimination were rare (3.0%). While 82.5% of respondents considered preventive measures to be important, only 16.7% perceived racial discrimination as a significant problem for staff.</p><p><strong>Discussion: </strong>The findings suggest that racial discrimination is only partially reflected in existing complaint-handling structures. Beyond formal systems, organizational definitions of the problem and structural conditions appear to influence how such incidents are perceived and addressed.</p><p><strong>Conclusions: </strong>To improve quality, it appears necessary to better align existing complaint and support structures with cases of discrimination and to strengthen the systematic implementation of preventive approaches. The findings provide a basis for the development of practice-oriented recommendations.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931605","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":"[From an attractive training site to a dream workplace? Fostering potential and retaining staff - Insights from a cross-sectional descriptive survey study in home-based long-term care].","authors":"Elisabeth Hahnel, Esther Schwanemann, Freja Engelmann, Ulrike Pörschmann-Schreiber","doi":"10.1016/j.zefq.2026.07.010","DOIUrl":"https://doi.org/10.1016/j.zefq.2026.07.010","url":null,"abstract":"<p><strong>Introduction: </strong>The growing demand for home care due to demographic changes and the preference of older people to remain at home presents new challenges for nursing professionals. Despite positive practical experiences, only a few trainees currently choose to start their professional career in the home care sector, indicating structural deficits and specific demands in this setting. The aim of the study was to identify factors influencing entry and retention of nursing professionals in ambulatory care, and to highlight actionable features for increasing attachment to the home care sector.</p><p><strong>Methods: </strong>The study, which was conducted from May to June 2024, is based on a nationwide, standardized online cross-sectional survey among nursing trainees, educators, and nursing professionals in home care services in Germany. To ensure data protection and quality, a modular, anonymized survey process with target group-specific modules and comprehensive technical safeguards was implemented. Data analysis included descriptive and inferential statistics (χ²-Test, logistic regression, Mantel-Haenszel test), with potential confounders controlled by stratified analyses.</p><p><strong>Results: </strong>A total of 1,603 questionnaires completed by nursing professionals, educators, and trainees were analyzed. Relevant differences were observed regarding the importance of working conditions and competencies: while educators emphasize social skills, practical experience is crucial for nursing professionals. Trainees rated digital, self-management, and improvisational competencies as significantly more important than the other groups. The results show that both personal and organizational factors influence the perceived attractiveness and competence profile in home care in different ways.</p><p><strong>Discussion: </strong>The study indicates that team atmosphere, appreciative organizational culture, innovative working models, and targeted preparation are key levers for the attractiveness and retention in home care. Divergent priorities among educators, nursing professionals, and trainees underscore the need for closer integration of education, onboarding, and competency development. Structural deficits and mismatched expectations in the home care setting hinder sustainable recruitment, making targeted promotion of personal and digital skills as well as improved working conditions necessary.</p><p><strong>Conclusion: </strong>Sustainable retention of nursing professionals in the home care setting requires a combination of structural improvements, targeted competency development, and attractive working conditions. Reforms should address the distinct needs of trainees, educators, and professionals in order to make careers in the home care sector a more attractive and sustainable choice.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907544","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}