Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"17 Jahre hausärztliches Fehlerberichts- und Lernsystem „jeder-fehler-zaehlt.de” – Analyse des Berichtsbestandes","authors":"Anna Kowalski ,&nbsp;Tatjana Blazejewski ,&nbsp;Lion Lehmann ,&nbsp;Dania Schütze ,&nbsp;Svea Holtz ,&nbsp;Johanna Römer ,&nbsp;Ferdinand M. Gerlach ,&nbsp;Beate S. Müller","doi":"10.1016/j.zefq.2023.12.007","DOIUrl":"10.1016/j.zefq.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><p>The topic of patient safety has been a subject of much discussion since the end of the last millennium. Ensuring patient safety is a central challenge in health care. An important tool to raise awareness for and learn from adverse events and thus promote patient safety are error-reporting and learning systems (Critical Incident Reporting System = CIRS).</p></div><div><h3>Methods</h3><p>More than 17 years after its establishment, the CIRS “jeder-fehler-zaehlt.de” (JFZ) for German primary care has undergone a revision in terms of content and technology. The revised web-based system can be used for reporting as well as for classifying and analyzing incident reports. During this process, a descriptive analysis of the current report inventory was carried out, with a focus on serious medication errors. This included all 781 valid incident reports received between September 2004 and December 2021.</p></div><div><h3>Results</h3><p>In 576 of the 781 reports (73.8%), the GP practice was directly involved in the critical incident. Among error types, process errors predominated (79.8% of the classifications, 99.1% of the reports) compared with knowledge and skills errors (20.2% of the classifications, 39.7% of the reports). Communication errors (63.0%) were the most common contributing factor to critical incidents, followed by flaws in tasks and measures (39.7%). Serious and permanent patient harm was rarely reported (8.3% of the reports), whereas temporary patient harm was more common (40.3% of the reports). Incident reports about medication errors with at least serious patient harm included, in particular, substances that affected blood clotting, corticosteroids, and opiates.</p></div><div><h3>Discussion</h3><p>Our results complement the rates that are reported internationally for error types, patient harm, and contributing factors. Serious but preventable adverse events, so-called never events, are frequently associated with the medication process in both JFZ reports and the literature.</p></div><div><h3>Conclusion</h3><p>Critical incident reporting systems cannot provide accurate information about the frequency of errors in health care, but they can offer important insights into, for example, serious medication errors. Therefore, they offer both employees and healthcare institutions an opportunity for individual and institutional learning.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 10-16"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000059/pdfft?md5=ae269d2743daa146bbb507f6787031b5&pid=1-s2.0-S1865921724000059-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementierung einer neuen Versorgungsform zur Früherkennung und Prävention emotionaler und Verhaltensauffälligkeiten bei Kindern im kinderärztlichen Setting: Qualitative Interviews mit Kinderärzt*innen, Praxispersonal und Sorgeberechtigten","authors":"Helene Hense ,&nbsp;Sophia Ernst ,&nbsp;Anja Zscheppang ,&nbsp;Jochen Schmitt ,&nbsp;Veit Roessner ,&nbsp;Max Weniger ,&nbsp;Katja Beesdo-Baum ,&nbsp;Susanne Knappe","doi":"10.1016/j.zefq.2023.12.004","DOIUrl":"10.1016/j.zefq.2023.12.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aim of the study&lt;/h3&gt;&lt;p&gt;Evaluation of the implementation of a standardized screening using the &lt;em&gt;Strengths and Difficulties Questionnaire&lt;/em&gt; (SDQ) as part of the routine pediatric health check-ups in the Dresden area (Germany) in order to detect emotional and behavioral problems (EBPs) in children early and allocate them to indicated preventive programs and&lt;!--&gt; &lt;!--&gt;/&lt;!--&gt; &lt;!--&gt;or to further counselling and treatment services.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;1.) Semi-structured interviews were performed with participating pediatricians (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;4), practice staff (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;4) and custodians of screened children (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;17) and subjected to content analysis regarding feasibility, advantages and disadvantages of the screening and the targeted allocation, as well as barriers and facilitators of using the screening and the preventive programs and further services. 2.) A self-developed questionnaire survey (descriptive analysis: means and frequencies) was conducted among pediatricians (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;34/99) to inquire about the implementation of the SDQ screening regarding feasibility, advantages, disadvantages and necessary conditions for a potential adoption of the screening to standard health services.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In the interviews, the pediatricians and practice staff reported that the SDQ screening embedded in routine pediatric health check-ups was simple and could be carried out in a few minutes. The screening helped to identify and address possible EBPs in children and to recommend a targeted service. Apart from the expenditure of time, no disadvantages were mentioned. As expected, parent-related (e.&lt;!--&gt; &lt;!--&gt;g. fears, attitudes and trust in the pediatrician), child-related (does not want to reveal any information about him- or herself , attitude and motivation), service provider-related (presentation of services), organizational (necessary signatures, financing, waiting time) and service-related (duration, costs, venue, designation) factors influenced the families’ use of the screening and further services. Interviewed custodians whose child participated in an indicated preventive program within the project (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;11) would recommend the SDQ screening and preventive program to other families. In the questionnaire survey 28/31 pediatricians “completely” or “rather” agreed on a 5-point Likert scale that the SDQ screening and targeted allocation should be included in standard pediatric care.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;The use of the SDQ, which is one of the most widely used and, despite its brevity, most valid screening instruments for the early detection of EBPs, in routine pediatric health check-ups and the targeted allocation of further health services represent a feasible approach to the early identification and clarification of EBPs in children as well as their allocation to indicated preventive services.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 92-107"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000023/pdfft?md5=dfb908e2297f41217e34397d8f5777cd&pid=1-s2.0-S1865921724000023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visions for planetary health: Results from open-ended questions of survey participants after a virtual planetary health lecture series","authors":"Katharina Wabnitz ,&nbsp;Friederike von Gierke ,&nbsp;Sophie Gepp ,&nbsp;Laura Jung ,&nbsp;Frederick Schneider ,&nbsp;Eva-Maria Schwienhorst-Stich ,&nbsp;Marischa Fast","doi":"10.1016/j.zefq.2023.12.002","DOIUrl":"10.1016/j.zefq.2023.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>A profound transformation of all areas of human activities is urgently needed for planetary health. Developing a shared vision of the future that is grounded in values aligned with planetary health is indispensable in this regard. The Planetary Health Academy is the first open online lecture series in Germany aiming for transformative planetary health education. As part of a recent evaluation of the impact of the lecture series, participants’ visions for planetary health were also examined.</p></div><div><h3>Methods</h3><p>As part of a retrospective, cross-sectional, self-administered online survey, participants were asked to respond to an open-ended question on their visions for planetary health. Results were analysed using summarising qualitative content analysis according to Mayring. Sociodemographic details of those participants who provided a valid answer (<em>n</em> = 197) were calculated.</p></div><div><h3>Results</h3><p>Eight main categories were developed to summarise participants’ visions for planetary health. These were: Awareness for planetary health – Planetary health integrated in all types of education – Establishment and development of the concept – A different understanding of health (care) – A transformative movement and global community – Transforming human activities – Planetary health as a guiding principle – The future state of planetary health.</p></div><div><h3>Discussion</h3><p>Broadly, the participants’ visions were about planetary health as a goal and the means necessary to achieve this goal. Our findings can only be seen as a first explorative step in eliciting aspects of a common vision for planetary health, as our study design did not include a mechanism of building consensus towards one common vision. Besides the field of planetary health, similar concepts and associated movements exist or are emerging. Facilitating dialogue and exchange across disciplines and narratives about the prevailing future visions will be key to achieving what we call planetary health and what others might call <em>Ubuntu</em> or <em>buen vivir</em>.</p></div><div><h3>Conclusion</h3><p>The results of this study provide first insights into the planetary health visions of those whom we would consider members of a movement aligned behind the idea of planetary health. In future editions, the Planetary Health Academy could integrate more discursive elements with a particular focus on negotiating future visions to support the creation of a critical mass of change agents within the health community and beyond.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 108-114"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921723002210/pdfft?md5=ccdf0913070466bb93b9983f2448c0c6&pid=1-s2.0-S1865921723002210-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dank an die Gutachter*innen des Jahres 2023","authors":"","doi":"10.1016/j.zefq.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.02.001","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 115-116"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618255","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":"Flächendeckende Ernährungstherapie – Wunsch oder Wirklichkeit? Eine fragebogengestützte Querschnittsstudie zur ernährungstherapeutischen Versorgung in baden-württembergischen Krankenhäusern","authors":"Michael Adolph ,&nbsp;Daniela Schweikert ,&nbsp;Annalena Wehner ,&nbsp;Andreas Fritsche ,&nbsp;Michael Bamberg ,&nbsp;Klaus Tischler ,&nbsp;Britta Wessels","doi":"10.1016/j.zefq.2024.01.004","DOIUrl":"10.1016/j.zefq.2024.01.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Malnutrition is widespread in German hospitals, has a negative impact on therapeutic success and quality of life, and it leads to increasing costs. An individualized nutritional support by nutritional professionals in accordance with current guidelines was shown to reduce mortality of malnourished inpatients. Ideally, nutritional support is conducted by an interdisciplinary nutrition support team. Current data on the nutritional therapy in German hospitals is missing.</p></div><div><h3>Methods</h3><p>In order to ascertain the current status of nutritional support in hospitals in the federal state of Baden-Württemberg, clinic managements of all hospitals in Baden-Württemberg received an online questionnaire. Affiliated hospitals, specialist hospitals, as well as hospitals with less than 50 beds were excluded from the analysis.</p></div><div><h3>Results</h3><p>The response rate was 84<!--> <!-->% (n = 94). The presence of a nutrition support team was reported by 34<!--> <!-->% of the hospitals. Twelve percent of the hospitals meet the structural characteristic of the OPS Code 8-98j <em>Ernährungsmedizinische Komplexbehandlung</em>, which means that their nutrition support team includes a physician. A validated nutritional risk screening is performed in 72<!--> <!-->% of the hospitals. Only 40<!--> <!-->% of the hospitals report that this is performed throughout every department. Nutrition support teams are more often concerned with malnutrition, enteral and parenteral nutrition as compared to nutritionists who are not organized in a team. Moreover, nutrition support teams have a wider range of tasks and more often a physician as a team member. Also, nutritional risk screenings are more often applied in hospitals with nutrition support teams.</p></div><div><h3>Discussion</h3><p>Compared with a nationwide survey from 2004, there are markedly more nutrition support teams available in hospitals in Baden-Württemberg. When compared internationally, however, the rate of nutrition support teams is still low. In addition, there is no comprehensive nutritional care available. High-quality nutritional support is more often found in hospitals with nutrition support teams.</p></div><div><h3>Conclusion</h3><p>There is still a great potential of improving clinical nutritional care in hospitals in Baden-Württemberg. Moreover, an increase in nutrition support teams, also comprising medical members, should be achieved. Therefore, legal regulations and a sufficient refinancing are indispensable.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 17-26"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000096/pdfft?md5=e9bec1f72849ad788e705cb6590200c5&pid=1-s2.0-S1865921724000096-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hausärztliche Versorgung von Patient:innen mit chronischen nicht-tumorbedingten Schmerzen: ein Rapid Review im Rahmen des RELIEF-Projekts","authors":"Regina Poß-Doering ,&nbsp;Sabrina Keller ,&nbsp;Marco Zugaj ,&nbsp;Hanna Seidling ,&nbsp;Cinara Paul ,&nbsp;Regina Stolz ,&nbsp;Petra Kaufmann-Kolle ,&nbsp;Cornelia Straßner","doi":"10.1016/j.zefq.2024.01.005","DOIUrl":"10.1016/j.zefq.2024.01.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;Approximately one fifth of the German population suffers from chronic pain, which is often associated with limitations in coping with everyday life, social isolation and psychological comorbidities such as anxiety and depression. The importance of a treatment approach that considers biological, psychological, and social factors (bio-psycho-social model) as well as non-drug interventions is emphasized in current guidelines, but presents challenges for primary care practices. To support the implementation of evidence-based best practice recommendations, the RELIEF project (Resource-oriented case management to implement recommendations for patients with chronic pain and frequent use of analgesics in general practices) aims to develop a case management program for the primary care of patients with chronic non-tumor pain.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Prior to intervention development, a rapid review was conducted to identify best practice recommendations for the care of patients with chronic non-tumor pain, barriers and strategies to their implementation, and gaps in care in current guidelines and literature. Selective searches of guidelines, PubMed, the Cochrane Library, bibliographies of relevant publications, and the gray literature focused on assessment and monitoring, education, promotion of self-care, and rational pharmacotherapy.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Numerous recommendations on assessment and monitoring were identified, but only a few studies examined their feasibility in primary care practices. Guidelines contained few specific recommendations on content and format of patient education on chronic pain. Recommendations for non-drug self-care measures were mainly related to physical activity, relaxation techniques, behavioral therapy techniques and external applications. Especially for the area of physical activity, numerous barriers but also strategies for a successful implementation could be identified.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;In a potential primary care model for patients with chronic non-tumor pain, pain assessment should aim to identify patients who need support in implementing medication and non-medication interventions in the primary care setting and/or could benefit from specialized care. To implement recommendations for pain education, primary care physicians need educational materials in a variety of formats and levels of detail that ideally could be processed by patients at home and then get addressed in practices using simple key questions. Non-drug measures should be an explicit part of the treatment plan.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Many of the identified recommendations for the treatment of patients with chronic non-tumor pain can also be considered relevant for the primary care setting. Specific guidelines and concepts for primary care physicians that include setting-specific characteristics at the physician, patient, and system levels would be desirable for a succe","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 1-9"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000114/pdfft?md5=3db9697b864b3a8f1b716a27e4f4a6be&pid=1-s2.0-S1865921724000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(24)00040-0","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00040-0","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Page OBC"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000400/pdfft?md5=74e2ca1df2bd078d44e75f9458a57f8b&pid=1-s2.0-S1865921724000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(24)00038-2","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00038-2","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Page iii"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000382/pdfft?md5=d60d52ffc789e51c6a9268e20407cf9b&pid=1-s2.0-S1865921724000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primärqualifizierende Studiengänge in der Pflege: Gemeinsamkeiten und Unterschiede im formalen Aufbau","authors":"Kai Knapp ,&nbsp;Ingrid Darmann-Finck","doi":"10.1016/j.zefq.2023.12.006","DOIUrl":"10.1016/j.zefq.2023.12.006","url":null,"abstract":"<div><h3>Background</h3><p>The German Nursing Professions Act establishes a primary qualifying course of studies at universities, which is completed with a bachelor's degree and a vocational qualification as a nurse. The Nursing Professions Act and the Nursing Training and Examination Ordinance open up some possibilities with regard to the study program concept. The present paper examines the question of how the degree programs are formally structured.</p></div><div><h3>Methodology</h3><p>A document analysis of the curricula or module manuals of the degree programs existing in December 2022 was conducted, which ultimately included 26 degree programs in the analysis. The module handbooks were analyzed and compared in terms of content using an inductively developed analysis grid.</p></div><div><h3>Results</h3><p>There are considerable differences between the programs in terms of total duration/total workload, length and rhythm of practical study phase, composition of workload of practical study phase, as well as the extent of university study and the ratio of classroom to self-study.</p></div><div><h3>Discussion</h3><p>Due to the high number of validations (20 from 26), the results are meaningful. The findings suggest that it is often less content-related than pragmatic reasons or external constraints that guide the design of the degree programs. From a vocational education and training perspective, too few alternations between practical and academic study phases or very extensive self-study phases could be disadvantageous for the students' acquisition of competencies.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 83-91"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000047/pdfft?md5=34adfa995262a207abaf4455e366a0b2&pid=1-s2.0-S1865921724000047-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die wahrgenommene Effektivität der Disease Management Programme für Diabetes mellitus Typ 2 und Koronare Herzkrankheit aus Sicht von Hausärzt*innen – Ergebnisse einer Fokusgruppenstudie","authors":"Larisa Pilic ,&nbsp;Kira Molkentin ,&nbsp;Lion Lehmann ,&nbsp;Alina Herrmann ,&nbsp;Christian Funke ,&nbsp;Beate Sigrid Müller ,&nbsp;August-Wilhelm Bödecker ,&nbsp;Marcus Redaèlli ,&nbsp;Stefan Wilm","doi":"10.1016/j.zefq.2023.12.003","DOIUrl":"10.1016/j.zefq.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>The majority of patients in disease management programs (DMPs) for type 2 diabetes (T2DM) and coronary heart disease (CHD) in Germany are enrolled by their general practitioner (GP). The aim of this study was, in the context of upcoming DMP expansions, to elicit GPs' current experiences and opinions regarding the perceived effectiveness and acceptance of the DMPs T2DM and CHD, as well as to determine beneficial and hindering aspects of the implementation of these programs from a GP's perspective.</p></div><div><h3>Methods</h3><p>In August and September 2020, 20 GPs of teaching practices of the University Hospital Cologne with experiences in DMPs were interviewed in semi-structured focus group discussions. Their expectations, attitudes and opinions regarding the DMPs T2DM and CHD were evaluated and analyzed according to the content-structuring qualitative content analysis by Kuckartz.</p></div><div><h3>Results</h3><p>The DMP T2DM was rated as generally positive by the respondents due to the structured treatment including regular foot and eye examinations, close patient contacts and perceptions of improved health outcomes. The DMP CHD was rated more negatively by the respondents because of a high and partly unnecessary documentation workload and limited therapeutic freedom, leading to a perceived ineffectiveness for patients’ health outcomes. Thus, there was a discrepancy in the perceived effectiveness of the examined DMPs, causing a lower acceptance of the DMP CHD. Therefore, some of the respondents tended to enroll fewer patients into the DMP CHD or to drop out of the DMP CHD.</p></div><div><h3>Discussion</h3><p>In order to increase the acceptance and sustainability of DMPs some elements of the DMP CHD as well as the remuneration and the documentation need to be reconsidered. Additionally, future studies on the acceptance of DMPs should differentiate between different DMPs in order to generate valid results.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"185 ","pages":"Pages 45-53"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000011/pdfft?md5=56af012b43e213803967ca394a1e3784&pid=1-s2.0-S1865921724000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991417","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}