Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Herausforderungen in der Versorgung außerklinischer Intensivpflegepatient*innen – eine Beobachtungsstudie zur Perspektive von Pflegepersonen","authors":"Alena Lübben ,&nbsp;Nathalie Englert ,&nbsp;Andreas Büscher","doi":"10.1016/j.zefq.2025.02.008","DOIUrl":"10.1016/j.zefq.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital intensive care (AKI) is a growing sector and is gaining increasing attention in research. In addition, the GKV-Intensive Care and Rehabilitation Strengthening Act (GKV-IPReG) influences the organization of care for people with AKI as well as the implementation and obligations of service providers. The aim is to promote decannulation and weaning from mechanical ventilation through surveys of potential. However, there is still a lack of scientifically sound evidence on care structures and care processes in AKI and the effects of the GKV-IPReG. These care structures were analyzed in the innovation fund project ATME (“Needs, requirements and cross-sectoral care pathways of out-of-hospital ventilated intensive care patients”).</div></div><div><h3>Methods</h3><div>As part of a mixed-methods approach, a quantitative online survey was conducted as part of the ATME project using a literature-based and interview-based questionnaire. Nurses in the AKI were surveyed from August to November 2023 on the care and care processes of patients in the AKI. Data was analyzed descriptively using SPSS. Critical care points and challenges of AKI were derived.</div></div><div><h3>Results</h3><div>There is a lack of both supply and personal capacities in the out-of-hospital intensive care setting. Hospital care is seen as critical and can lead to discontinuity of care. 308 nurses perceive themselves to be playing a central role in the coordination of care and everyday life, but at the same time they deplore the lack of recognition and want more room for autonomous care decisions. The primary therapeutic goal is not to wean patients from ventilation or decannulation, but to maintain their current health status. There is concern that the new legislation (GKV-IPReG) will lead to increased disruptions in care and additional bureaucracy.</div></div><div><h3>Conclusion</h3><div>The findings serve as a basis for further research and the optimization of interfaces and the solution to care issues. New care concepts need to be developed, in particular regarding the lack of personal and structural capacities. Greater cooperation across settings can prevent discontinuities in care and improve the perception of the care experienced. Also, there is a need for further monitoring of the effects of the GKV-IPReG and the implementation of the necessary conditions in patient care.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 60-67"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789174","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":"Angelina Müller,&nbsp;Olga A. Amberger,&nbsp;Kateryna Karimova","doi":"10.1016/j.zefq.2025.03.008","DOIUrl":"10.1016/j.zefq.2025.03.008","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 101-102"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054354","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":"Wie können stationär tätige Ärzt*innen in Weiterbildung und Quereinsteiger*innen in die Allgemeinmedizin in der Phase des Übergangs aus der Klinik in die Praxis unterstützt werden? Eine qualitative Interviewstudie","authors":"Maria Farquharson ,&nbsp;Ida Lotter ,&nbsp;Martin Fink,&nbsp;Armin Wunder","doi":"10.1016/j.zefq.2025.02.001","DOIUrl":"10.1016/j.zefq.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>In the context of specialist training and lateral entry into general practice (GP), the transition from inpatient to outpatient work can be associated with challenges and uncertainty. In view of the GP shortages, it is particularly important to promote both the entry into primary care and the quality of postgraduate training.</div></div><div><h3>Methods</h3><div>In a qualitative interview study, 15 lateral entrants into GP and resident doctors (“residents”) were asked about challenges and needs, and the results were analyzed using content analysis.</div></div><div><h3>Results</h3><div>Lateral entrants and residents are characterized by their hospital-oriented approach. In addition, lateral entrants have to (re-)familiarize themselves with being a doctor in training. The heavy workload is a key challenge for residents. Different structures and requirements of the inpatient and outpatient setting are challenging for both groups. Both groups see a need for support in areas such as adapted specialist knowledge, GP vocabulary and outpatient work processes, and they benefit from educational programs in heterogeneous groups including both lateral entrants and doctors in training in the outpatient setting, e.g., through networking.</div></div><div><h3>Discussion</h3><div>The common needs identified provide information for educational program planning. Irrespective of heterogeneous life circumstances, joint support programs can be both useful and resource-sparing, as existing programs are often suitable for covering the identified needs. The qualitative findings of this study provide insight into the (professional) biographical context of the interviewees and should be quantitatively verified in further research.</div></div><div><h3>Conclusion</h3><div>In order to facilitate the transition from inpatient to outpatient care for both lateral entrants and residents, existing seminar and mentoring programs of the Competence Centers for Postgraduate Education can meet, with a few minor adjustments, the needs of both groups. However, it is important to find unique ways to address these groups and to identify and remove barriers to participation at an organizational level.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 93-100"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573986","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":"Wie gehen Menschen mit Long COVID mit ihren Symptomen und Alltagseinschränkungen um? Eine qualitative Studie mit vier Fokusgruppen","authors":"Katharina Vieth ,&nbsp;Eva Hummers ,&nbsp;Sascha Roder ,&nbsp;Frank Müller ,&nbsp;Greta S. Wegener ,&nbsp;Christina Müllenmeister ,&nbsp;Iman El-Sayed ,&nbsp;Gloria Königs ,&nbsp;Dominik Schröder ,&nbsp;Tim Schmachtenberg","doi":"10.1016/j.zefq.2025.03.005","DOIUrl":"10.1016/j.zefq.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>The heterogenous and fluctuating intensity of long COVID symptoms poses a challenge to both patients and healthcare providers due to a lack of causal treatment options. The aim of supportive therapies is to help individuals cope with symptoms in daily life and maintain functionality. This study aims to identify coping strategies employed by those affected by long COVID and their perceived benefits.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted with four focus groups comprising 23 adult patients suffering from long COVID. The recorded and transcribed group discussions were analyzed using content-structuring content analysis according to Kuckartz. The results were then systematically analyzed, interpreted, and put in a theoretical context.</div></div><div><h3>Results</h3><div>Participants utilized healthcare resources but developed their own strategies for dealing with long COVID because of their dissatisfaction with medical care. These strategies included energy and resource management, physical activity, enhancing health literacy, changing mindset and lifestyle, infection prevention, using medical aids, and dietary changes.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that people with long COVID employ a variety of strategies to cope with impairments in everyday life. According to the interviewees, integrating these approaches into the treatment of long COVID can help to reduce the burden of symptoms on those affected, restore their everyday functionality, and improve their self-efficacy and quality of life. Established concepts like “pacing” or “shared-decision making” can serve as a starting point for developing individualized coping strategies and treatment concepts together with patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 68-77"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045932","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":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(25)00142-4","DOIUrl":"10.1016/S1865-9217(25)00142-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177908","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":"Analyse der Implementierung und Nutzung von Fehlermeldesystemen in deutschen Universitätskliniken: Ergebnisse einer querschnittlichen Online-Befragung","authors":"Carlos Ramon Hölzing,&nbsp;Charlotte Meynhardt,&nbsp;Patrick Meybohm,&nbsp;Oliver Happel","doi":"10.1016/j.zefq.2025.03.010","DOIUrl":"10.1016/j.zefq.2025.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Critical incident reporting systems (CIRS) are a central component for ensuring patient safety and an essential tool in risk management at German university hospitals. Despite their widespread use, there are still considerable challenges with regard to their practical application and effectiveness. The aim of this study is to analyze the dissemination and use of such systems and the associated barriers in order to identify potential for optimization.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted among all German university hospitals (n = 38) between August and September 2024. Both structural and process-related variables were recorded, supplemented by selected aspects of the WHO CIRS self-assessment. The data was analyzed descriptively using SPSS® Statistics Version 29, supported by graphical representation using GrapPad Prism 9®.</div></div><div><h3>Results</h3><div>Of the 38 university hospitals contacted, 14 participated (36.8%). All participating university hospitals use internal critical incident reporting systems. 92.9% forward reports to cross-institutional systems, with 92.3% of the university hospitals forwarding less than 10% of the reports. Most university hospitals (11) evaluate ≥ 90% of incoming reports, ten hospitals do not use standardized analysis specifications. Feedback to reporting persons is provided in eight out of 14 university hospitals. The WHO self-assessment showed deficits in the implementation of personalized feedback and clear criteria.</div></div><div><h3>Conclusion</h3><div>Despite the widespread use of critical incident reporting systems, the results reveal a clear optimization potential in the standardization of analysis processes, the prompt processing of reports and feedback mechanisms. The low transfer of reports to cross-institutional systems indicates structural and organizational barriers that need to be addressed. These findings provide important insights to support the further development of incident reporting systems and thus improve both patient safety and risk management.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 28-35"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051800","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":"[Outpatient forms of palliative care as predictors of outcome quality and costs of regional end-of-life care: a claims data-based cost-consequence analysis].","authors":"Antje Freytag, Markus Krause, Andreas Schmid, Bianka Ditscheid, Ursula Marschall, Ulrich Wedding, Franziska Meissner","doi":"10.1016/j.zefq.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>The quality of outcomes and cost-effectiveness of regional hospice and palliative care (PC) services vary greatly. This study examines the relationship between the different regional outpatient forms of PC and these two dimensions.</p><p><strong>Methods: </strong>The retrospective analysis is based on the study population of 145,372 persons who were insured with the BARMER health insurance fund, who died between 2016 and 2019 and received PC in the last year of their life. The association of primary palliative care (AAPV), specially qualified and coordinated PC (BQKPmV), and specialist palliative homecare (SAPV) with quality- and cost-related outcomes was determined through multiple regression analyses, taking into account regional variability of these associations and controlling for other forms of PC as well as patient and residential district characteristics.</p><p><strong>Results: </strong>AAPV in Rhineland-Palatinate, BQKPmV in Thuringia, and SAPV in Saxony-Anhalt and Berlin achieve an above-average impact on the quality of outcomes compared to the national average. The total costs of care in the last three months of life (except for the costs of ambulatory palliative care) are significantly reduced by AAPV. For SAPV, costs usually exceed potential savings, especially in North Rhine-Westphalia, with Berlin and Westphalia-Lippe being counter-examples. Whilst Westphalia-Lippe relies on a solidly effective, integrated, low-cost AAPV-SAPV model that benefits many people, Berlin represents a highly effective, low-cost SAPV model which, however, reaches fewer people.</p><p><strong>Conclusion: </strong>New evidence of good practice regions offers starting points for tackling the challenge of quality-of-life-oriented, resource-efficient palliative care for a demographically growing number of people in need. Approaches that result in fewer people receiving care and higher costs and at best increase the quality of care for a few, should be critically scrutinized.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132023","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":"[Communication, cooperation, and exchange with psychotherapists from the perspective of primary care providers - Results of a survey conducted as part of the project \"Evaluation der Psychotherapie-Richtlinie\"].","authors":"Pauline Birte Schlesiger, Jürgen Wasem, Luisa Friedrich, Sandra Werner, Sarah Schlierenkamp, Gerald Lux, Anke Walendzik, Carina Abels, Klemens Höfer, Kathrin Klipker, Ursula Marschall, Dieter Best, Christa Schaff, Helene Timmermann, Silke Neusser","doi":"10.1016/j.zefq.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.04.005","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) and psychotherapists fulfill a variety of functions in the care for individuals with mental illness. However, little is currently known about the exchange and communication between these two groups. To address this gap, an exploratory study has been conducted from the perspective of primary care providers to analyze the nature of exchange and communication with psychotherapists.</p><p><strong>Methodology: </strong>A standardized cross-sectional survey was conducted among primary care providers for adults (PEW) and children/adolescents (PKJ) as part of the 'Evaluation of the Psychotherapy Guideline' project. In July 2021, a random sample from the pool of a target group of specialists with N = 1,700 people from each group were contacted by mail. Another random sample of N = 1,700 from each group was contacted in November 2021. The survey questionnaire included, among other things, questions about the exchange with psychotherapists. The exploratory analysis was descriptive.</p><p><strong>Results: </strong>A total of N = 255 and N = 444 valid survey questionnaires from PEW and PKJ was analyzed. The majority of primary care providers are over 50 years old (PEW 72.8%; PKJ 62.0%), and more than half are female (PEW 53.8%; PKJ 53.7%). As reported by PEW, the primary modes of communication and exchange with psychotherapists are via written correspondence (20.4%) and telephone (18.0%). For PKJ, the predominant mode of communication is by phone (22.6%). The majority of primary care providers expressed their dissatisfaction with the exchange with psychotherapists, with the highest rates being observed during (PEW 60.8%; PKJ 47.4%) and after referral (PEW 57.4%; PKJ 49.2%). Satisfaction is influenced by a number of factors, including integration into networks, which has been shown to have a positive effect.</p><p><strong>Conclusion: </strong>The cross-sectional survey provides insight into the communication and collaboration between primary care providers and psychotherapists. To facilitate improvements, further research is needed on the barriers to interdisciplinary cooperation and communication.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121140","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":"Taking a look behind the scenes: Updating health information on Gesundheitsinformation.de.","authors":"Milly Schröer-Günther, Klaus Koch, Inger Scheike","doi":"10.1016/j.zefq.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.04.002","url":null,"abstract":"<p><p>The website Gesundheitsinformation.de and its English sister website InformedHealth.org are a service of the Institute for Quality and Efficiency in Health Care (IQWiG). IQWiG has the legal mandate to provide all citizens with independent and scientifically proven free health information. The website currently comprises information on more than 300 diseases and health issues (\"topics\"). Evidence-based medicine (EBM) forms the base of Gesundheitsinformation.de. Regular updates are therefore an important quality criterion. Usually, the information is updated every three years. The paper will describe a major update process of the individual topics on Gesundheitsinformation.de. The major process includes 10 steps (e.g., evidence search, medical writing, editorial revisions, and translation). However, many updates are minor in reason or scope. For those minor updates certain steps can be omitted to limit resources and time.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080278","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":"[User experience with plain language summaries of psychological systematic reviews with meta-analysis (\"KLARpsy\" texts) - A qualitative study using the think aloud method].","authors":"Marwin Weber, Marlene Stoll, Anita Chasiotis, Claudia Breuer, Joerg J Meerpohl, Angela M Kunzler","doi":"10.1016/j.zefq.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Science communication can support informed decision-making. As part of the \"PLan Psy\" project, a guideline for producing plain language summaries of systematic reviews with meta-analysis on psychological topics (\"KLARpsy\" texts), was developed. This study aims to investigate the similarities and differences in the user experience with \"KLARpsy texts\" between laypersons and professionals (science communicators and psychologists).</p><p><strong>Methods: </strong>We conducted a qualitative online interview study. Participants read two \"KLARpsy\" texts presented on a mock-up website and verbalized their impressions and experiences using the think aloud method. The interviews were transcribed verbatim and analyzed with a deductive approach using content analysis.</p><p><strong>Results: </strong>The study was completed by twelve participants (nine female, three male), including six laypersons, three science communicators, and three psychologists. Both groups found the \"KLARpsy\" texts to be mainly useful, user-friendly, and trustworthy. Nevertheless, professional users preferred the original studies. Both groups emphasized the need for more detailed descriptions regarding methodology and result presentation. The \"KLARsaurus\" glossary promoted comprehensibility. The text structure supported usability. However, the structure and transitions between study-specific and general information as well as sentence structure were sometimes seen as non-intuitive. Some opinions on comprehensibility and information density were not consistent within the two groups.</p><p><strong>Discussion: </strong>The plain language summaries in the form of 'KLARpsy' texts were perceived by interested participants as added value for laypersons. Both laypersons and professionals attach particular importance to a transparent and critical, but also understandable and clear presentation of study results. Individual preferences and differences in the perspectives of both user groups highlight challenges of standardizing such a science communication format.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079753","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}