Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Pflege in Kinderaugen — eine qualitative Bildanalyse von Kinderzeichnungen","authors":"Tobias Mai ,&nbsp;Nicole Feldmann ,&nbsp;Jennifer Luboeinski ,&nbsp;Antje Tannen ,&nbsp;Andreas Kocks","doi":"10.1016/j.zefq.2024.12.009","DOIUrl":"10.1016/j.zefq.2024.12.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Traditional role models or scandalous reports revealing poor working conditions have left their mark on the nursing profession in Germany. In order to make nursing a more attractive profession to young people and to create a sense of professional pride for members of the nursing profession, we need to focus more on its positive aspects. Children with hospital experience were invited to participate in a painting competition to counter visual stereotypes. “Nursing through a child’s eyes” can provide a subjective view of the nursing profession based on individual experiences.</div></div><div><h3>Methods</h3><div>The pictures that children created during the painting competition were analysed qualitatively. The paintings were described and interpreted by independent peer groups in a four-step procedure.</div></div><div><h3>Results</h3><div>A total of 42 paintings from five university hospitals were included in the analysis. Paediatric specialties with a focus on surgery, oncology and internal medicine participated. The pictures showed typical nursing activities in the areas of communication, support, organisation, technology and basic needs. Nurses were portrayed as technically experienced and pleasantly reserved. In addition, symbols such as hearts, smileys or rainbows suggest associations with attention, emotional support or hope.</div></div><div><h3>Discussion</h3><div>Children with hospital experience painted a positive and modern professional image of the nursing role. In some pictures, the typical visual features allowing a clear assignment to the nursing profession are missing.</div></div><div><h3>Conclusion</h3><div>The stereotypes of the nursing profession should be replaced with a modern and realistic, counter-stereotypical narrative in the visual presentation. The perspective of children with hospital experience demonstrates that there are numerous, often invisible aspects that give reason to be proud of being a nurse.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 26-35"},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426314","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":"Reliability and validity of the German “Evidence-Based Practice Confidence (EPIC) Scale” for allied health professionals","authors":"Alexander Elser ,&nbsp;Moritz Scherer ,&nbsp;Maria Stadel ,&nbsp;Sven F. Garbade ,&nbsp;Gudrun Diermayr","doi":"10.1016/j.zefq.2024.12.006","DOIUrl":"10.1016/j.zefq.2024.12.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The Evidence-Based Practice Confidence (EPIC) Scale measures health professionals’ self-efficacy associated with evidence-based practice activities. The scale has been cross-culturally translated into German together with physical therapists. To support its use in German-speaking countries, the measurement properties of the scale need to be determined. Therefore, the primary objective of this study was to assess the measurement properties of the German EPIC scale. In a preparatory step, we aimed to evaluate the comprehensibility of the scale among German-speaking occupational therapists, speech and language therapists, and nurses.</div></div><div><h3>Methods</h3><div>First, semi-structured cognitive interviews were used to evaluate the comprehensibility of the EPIC scale. Second, a longitudinal online survey with repeated measures (baseline and retest survey) was conducted. The target group included physical therapists, occupational therapists, speech and language therapists, and nurses from Germany, Austria, and Switzerland. Reliability, responsiveness, and validity were evaluated using internal consistency, test-retest reliability, standard error of measurement, known-groups method, exploratory factor analysis and the minimal detectable change, respectively.</div></div><div><h3>Results</h3><div>Comprehensibility of the German EPIC scale was confirmed by eleven health care professionals (four occupational therapists, two speech and language therapists, five nurses). The baseline and the retest surveys were completed by 708 and 222 participants, respectively. The measure demonstrated an internal consistency of .930, with an intraclass correlation coefficient (ICC) for test-retest reliability of .936 (95% CI: .917 to .951). The standard error of measurement was 4.92, and the minimal detectable change at the 95% confidence level was 6.02. All hypotheses in the known-groups method were confirmed, and construct validity was acceptable. Factor analysis revealed two main factors affecting the results of the scale.</div></div><div><h3>Conclusion</h3><div>The findings provide evidence that supports the use of the German EPIC scale among health professionals. For instance, it can be used to evaluate self-efficacy during EBP training.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 1-7"},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415735","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":"[The KKS examiner course as a qualification measure for GP practices to participate in clinical research: A qualitative study with participants from the SaxoForN research practice network].","authors":"Anna-Maria von Oltersdorff-Kalettka, Meike Gerber, Jennifer Engler, Karola Mergenthal, Corina Güthlin, Karen Voigt","doi":"10.1016/j.zefq.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With the aim of increasingly integrating research into outpatient care and ensuring its quality, the Dresden/Frankfurt am Main General Practice Research Network (SaxoForN, information at www.saxoforn.de) has been qualifying GP practice teams for research in outpatient care since the beginning of 2021. SaxoForN offers four qualification modules for this purpose, including the course for members of the investigator group in accordance with the German Medicines Act (AMG, investigator course) in order to be trained for participation in clinical trials and to be introduced to the principles of good clinical practice (GCP) so that they can work together on research projects. This course is implemented in SaxoForN through cooperation with the Coordination Centre for Clinical Studies Dresden (KKS-Dresden) (KKS examiner course). An evaluation was to be conducted to examine how well the qualification concept works for general practitioners (GPs) and medical assistants (MFAs) in the research practice network and how they perceive the KKS examiner course.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The evaluation of the PPS examiner course for GP practice teams was planned for September 2021 using a qualitative design. The research interests focused on the participants' subjective experiences and opinions. Due to the potential vagueness and complexity of the remembered course experiences, a qualitative study design was chosen to enable a differentiated and explorative analysis of these impressions. For the survey, telephone-based, guided interviews with 11 narrative-generating, open questions were agreed upon by a team of several researchers being familiar with qualitative methods from the social and health care sciences. The interviews were analyzed using Mayring's qualitative content analysis. The methodology was documented according to the COREQ checklist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of eight participants of the KKS examiner course were interviewed in October 2021 (n = 8, interview duration 15-20 min). The focus was on three central topics: (1) the quality of the content of the PPS examiner course, (2) the framework conditions in terms of time management and implementation, and (3) the suitability of the course for clinical trials and GP practices. In particular, the organization and interactive design of the KKS examiner courses were rated positively. However, the need for improvement was identified with regard to the accuracy of the training for GP practice teams: above all, the participants felt that the adaptation to the GP setting through instructions for the concrete implementation of studies in GP practices was lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The integration of the KKS examiner course into the SaxoForN research practice network has worked well to cover the necessary GCP basics in the outpatient setting. However, there is a need for further development in the practical implementation of the qualification c","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415706","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":"Barriers to opioid substitution therapy in primary care: A survey among general practitioners in Germany.","authors":"Benedikt Sonnek, Jan Koetsenruijter, Cornelia Straßner, Andreas C Dreher, Michel Wensing, Simon Schwill","doi":"10.1016/j.zefq.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>Opioid substitution therapy (OST) is required for patients with opioid use disorder, but specialized addiction services do not reach all patients. General practitioners (GP) can fill this gap and provide a low-threshold, locally accessible offering for OST. This study aims to explore barriers that prevent GPs from offering OST.</p><p><strong>Methods: </strong>In 2022, an online questionnaire with 31 items was sent to GPs in the federal state of Baden-Württemberg by e-mail. The items included demographic data, training and experience in addiction medicine, implementation of OST in practice and possible barriers and facilitators to OST in the primary care setting. The results were analysed using a quantitative and semi-qualitative approach.</p><p><strong>Results: </strong>In total, 309 GPs participated (response rate = approx. 6.2 %). 26.2 % of participants had special training in addiction medicine (n = 81). 71.9 % of GPs with special training performed OST. 15.6 % of GPs without special training knew about reimbursement for and organization of OST (30/192). The barriers most frequently mentioned included: perceived lack of competencies, difficult patient clientele, and insufficient interdisciplinary communication. 22.4 % of GPs without training considered offering OST, provided that barriers are reduced.</p><p><strong>Conclusions: </strong>GPs have little knowledge of OST but one out of four considers offering OST. Thus, low-threshold addiction medicine courses in medical training and in continuing medical education are required. Barriers, such as bureaucratic obstacles and knowledge deficits, need to be addressed to decrease the growing gap in the care for patients with opioid use disorder.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415650","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-Versorgung in Deutschland: eine qualitative Inhaltsanalyse gesellschaftlicher und politischer Diskurse","authors":"Adele Grenz ,&nbsp;Mark Schweda ,&nbsp;Milena von Kutzleben","doi":"10.1016/j.zefq.2024.10.007","DOIUrl":"10.1016/j.zefq.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion and Conclusion</h3><div>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.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 57-65"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planetary Health Diet in einer Klinikumscafeteria: Steigerung der Mitarbeitendenzufriedenheit und Reduktion von Treibhausgasemissionen und Kosten","authors":"Laura Harrison ,&nbsp;Emma Reynolds ,&nbsp;Claudia Quitmann ,&nbsp;Luisa Till ,&nbsp;Bernd Franke ,&nbsp;Christin Zeitz ,&nbsp;Ina Danquah ,&nbsp;Alina Herrmann","doi":"10.1016/j.zefq.2024.12.003","DOIUrl":"10.1016/j.zefq.2024.12.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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 &lt;em&gt;p&lt;/em&gt;-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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;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.&lt;/div","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 77-87"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dank an die Gutachter*innen des Jahres 2024","authors":"","doi":"10.1016/j.zefq.2024.12.002","DOIUrl":"10.1016/j.zefq.2024.12.002","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 94-96"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436949","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":"Struktur- und Verfahrensverbesserungen auf Rezept? Eine qualitative Analyse der Potenziale und Herausforderungen des pSVV-Konzepts bei Digitalen Gesundheitsanwendungen (DiGA)","authors":"Sara Gehder,&nbsp;Moritz Goeldner","doi":"10.1016/j.zefq.2024.11.003","DOIUrl":"10.1016/j.zefq.2024.11.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;With the introduction of the Digital Healthcare Act (DVG) at the end of 2019, digital health applications (DiGA) were included in the statutory health insurance in Germany. DiGA are digital medical products whose primary function is based on digital technologies. In the definition of the approval process, the term “therapeutic benefit”, which is crucial to the evaluation of pharmaceuticals, was expanded to include the broader concept of “positive healthcare effect” (“pVE”). In particular, the concept of “patient-relevant structural and procedural improvements” (pSVV) has been introduced alongside the well-known “medical benefit” to facilitate market access for applications that specifically aim to strengthen the role of the patient in healthcare. Three and a half years after the implementation of DiGA, it has become evident that the concept of pSVV has not yet been adopted in the healthcare system to the extent intended by the legislation. As of July 1&lt;sup&gt;st&lt;/sup&gt; 2024, only one of the 56 listed DiGA uses pSVV as a primary endpoint, with ten others using pSVV as a secondary endpoint.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A qualitative approach was chosen to explore the new and under-researched topic of DiGA and, in particular, pSVV. The Grounded Theory method was applied in combination with the Gioia method, which is particularly suitable for analyzing innovative subject areas. The inductive approach allows for new concepts to be developed from the data of the study participants, thus supporting flexible and dynamic theory building. Decision-makers from groups including DiGA manufacturers with and without pSVV, manufacturers of digital medical products without DiGA approval, consultancies, and institutions involved in the DiGA approval process were included in the study by conducting semi-structured interviews. The evaluation was conducted through a multi-step analysis leading to the identification of first-order concepts, second-order themes, and aggregated dimensions. The developed data structure was supported by the presentation of relevant quotes as part of the &lt;span&gt;&lt;span&gt;Anhang A&lt;/span&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The analysis indicates that refining the benefit definition for the pSVV categories defined in the DiGA guidelines is critical to the successful establishment of the pSVV concept. Additionally, further analysis of potential methods for demonstrating pSVV, suitable measurement tools, and the general inclusion of economic considerations in the benefit analysis appear sensible.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The qualitative analysis demonstrates that refining the pSVV concept and defining appropriate measurement methods are essential for a successful implementation in the German healthcare system. An economic evaluation could bring objectivity to the debate on DiGA costs and contribute to transparency in the approval process. Further research and the involvement of key stakeholder","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 1-10"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848014","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":"Arbeitssituation von angestellten Hebammen in deutschen Kreißsälen – Implikationen für die Qualität und Sicherheit der Versorgung","authors":"Katja Stahl","doi":"10.1016/j.zefq.2024.11.007","DOIUrl":"10.1016/j.zefq.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Nursing research indicates a correlation between work environment and the quality and safety of nursing care. For intrapartum care there is evidence that continuous one-to-one support is associated with better perinatal outcomes and fewer interventions. Little is known about the work environment of midwives working in German maternity theatres.</div></div><div><h3>Aim</h3><div>To analyse the work environment in German maternity theatres from the midwife’s perspective.</div></div><div><h3>Methods</h3><div>Online survey among 1,599 midwives using a validated instrument adapted to the specific characteristics of midwifery care.</div></div><div><h3>Results</h3><div>The response rate for the survey was 44<!--> <!-->%. The number of patients has risen substantially over the last three years without an equivalent increase in staff numbers. Nearly two thirds of the midwives (65<!--> <!-->%) are responsible for three or more women simultaneously, most of the time; 35<!--> <!-->% are normally providing care for two women at the same time. There are significant differences between these two groups with regard to nearly all the work environment aspects analysed. The most pronounced differences were found with regard to not being able to accomplish tasks during regular working hours (64<!--> <!-->% vs. 33<!--> <!-->%; OR 3.7, 95% CI 3.0 to 4.6; <em>p</em> <!-->&lt;<!--> <!-->0.001), taking legally required breaks (5<!--> <!-->% vs. 19<!--> <!-->%; OR 4.2, 95% CI 2.9 to 5.9; <em>p</em> <!-->&lt;<!--> <!-->0.001), frequency of interruptions (96<!--> <!-->% vs. 88<!--> <!-->%; OR 3.5, 95% CI 2.3 to 5.4; <em>p</em> <!-->&lt;<!--> <!-->0.001), lack of time for individual care (90<!--> <!-->% vs. 63<!--> <!-->%; OR 5.6, 95% CI 4.2 to 7.4; <em>p</em> <!-->&lt;<!--> <!-->0.001), need for improving the personal interaction between midwives and obstetricians (28<!--> <!-->% vs. 20<!--> <!-->%; OR 1.6, 95% CI 1.2 to 2.0; <em>p</em> <!-->=<!--> <!-->0.001), lack of support from hospital management (92<!--> <!-->% vs. 83<!--> <!-->%; OR 2.2, 95% CI 1.6 to 3.1; <em>p</em> <!-->&lt;<!--> <!-->0.001) and the intention to leave the employer (60% vs. 40%; OR 2.2, 95% CI 1.8 to 2.7; <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>The current work environment of midwives in German maternity theatres does not allow for one-to-one-care during labour. If the necessary increase in midwifery staff is to be effective, it needs to be accompanied by an improved work environment. Further research into the work environment of midwives, likely predictors and associations with perinatal outcomes is urgently needed.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 19-27"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822738","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":"Dermatologische Diagnostik bei Patient*innen mit „skin of color“ – Wie sicher fühlen sich deutsche Dermatolog*innen?","authors":"Can Alpagut ,&nbsp;Christian Volberg ,&nbsp;Michael Hertl ,&nbsp;Lisa Krönig ,&nbsp;Martin Gschnell","doi":"10.1016/j.zefq.2024.11.011","DOIUrl":"10.1016/j.zefq.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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”.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 28-35"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}