Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Physiotherapeutic care for urinary incontinence in the context of age, sex, care situation, and informal provider networks – A longitudinal German claims data analysis","authors":"Dirk Peschke ,&nbsp;Kathrin Seibert ,&nbsp;Susanne Stiefler ,&nbsp;Dominik Domhoff ,&nbsp;Karin Wolf-Ostermann","doi":"10.1016/j.zefq.2025.05.001","DOIUrl":"10.1016/j.zefq.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence affects 5% to 35% of the older adult population. Untreated urinary incontinence is associated with reduced quality of life, amongst others. Pelvic floor muscle training is the first-line treatment. Existing evidence on the proportion of physiotherapy care remains limited, particularly regarding men with urinary incontinence, and insufficiently accounts for care situation- or age-specific disparities. This study investigated the proportion of physiotherapy care, differentiated by age, sex, care situation, informal provider networks, and temporal trends, to address these evidence gaps.</div></div><div><h3>Method</h3><div>We analysed health insurance fund claims data covering a period of 9 years (2008–2016), from up to 6,433,070 individuals aged 65+, and applied a network approach to identify patient sharing networks. We calculated the proportion of physiotherapy care on a quarterly basis.</div></div><div><h3>Results</h3><div>The proportion of physiotherapy care remained relatively stable over time. In the first quarter of 2016, it was 10.5% for people with incident urinary incontinence in total, 7.9% for those without care, 11.9% for people with home care, and 14.0% for nursing home residents. The lowest proportion of physiotherapy care (3.5%) was found among men with incident urinary incontinence in the 85 to 89 age group receiving no care, and the highest proportion (19.3%) among women with incident urinary incontinence in the age group 70 to 74 years living in a nursing home. The variation in the proportion of physiotherapy care between patient sharing networks was the highest for women and men in nursing homes (SD 9.7% and 9.2%, respectively).</div></div><div><h3>Conclusions</h3><div>These findings indicate a systematic underuse of physiotherapy services for both sexes across all age groups and care situations. Older men without care needs are particularly at risk for underuse.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"196 ","pages":"Pages 65-71"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235528","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":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(25)00161-8","DOIUrl":"10.1016/S1865-9217(25)00161-8","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"196 ","pages":"Page iii"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588084","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 social delegitimization of individualism: Exploring potential drivers during the COVID-19 pandemic","authors":"Pascal René Marcel Kubin","doi":"10.1016/j.zefq.2025.03.001","DOIUrl":"10.1016/j.zefq.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic many people supported compulsory vaccination and other far-reaching restrictions for unvaccinated individuals. This indicates that the COVID-19 pandemic was accompanied by a social delegitimization of individualism, which undermined personal autonomy and informed consent.</div></div><div><h3>Purpose &amp; Method</h3><div>Against this background, I intend to identify conceptual notions that can help to explain the drivers of the social delegitimization of individualism during the COVID-19 pandemic. For this purpose, I conceptually analyzed theories from social science research on vaccination behavior by applying the technique of concept mapping.</div></div><div><h3>Results</h3><div>The theoretical analysis reveals that (1) the essential need for health protection, (2) the demand for complexity reduction, (3) the optimization of social identity, (4) the reassurance of previous decisions, as well as (5) the feeling of being socially underprivileged may have contributed to the social delegitimization of individualism during the COVID-19 pandemic.</div></div><div><h3>Conclusions</h3><div>The five identified conceptual notions can explain the drivers behind the collective support for compulsory vaccination and other far-reaching restrictions against unvaccinated individuals. From a conceptual perspective, dynamic interactions between these drivers are likely. In the future, the identified notions may become relevant beyond COVID-19 if the social delegitimization of individualism continues to evolve into a ubiquitous phenomenon.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 42-50"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789180","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":"SHOW ME – Zeig mir die Evidenz: Merkmale eines Ansatzes, um Evidenz aus der Forschung zuverlässig denjenigen bereitzustellen, die sie benötigen","authors":"John N. Lavis ,&nbsp;Jeremy M. Grimshaw ,&nbsp;Ruth Stewart ,&nbsp;Julian Elliott ,&nbsp;Will Moy ,&nbsp;Joerg J. Meerpohl","doi":"10.1016/j.zefq.2025.03.002","DOIUrl":"10.1016/j.zefq.2025.03.002","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 1-5"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006732","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":"Digitale Teilhabe mithilfe partizipativ entwickelter Informations- und Beratungskonzepte – eine qualitative Studie mit Senior:innen","authors":"Marielle Schirmer ,&nbsp;Denny Paulicke ,&nbsp;Dietrich Stoevesandt ,&nbsp;Patrick Jahn","doi":"10.1016/j.zefq.2025.03.004","DOIUrl":"10.1016/j.zefq.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>With the increasing digitalization of rural care structures, teaching digital skills to senior citizens is becoming more important. Telemedicine services, for example, offer the potential to compensate for a lack of access to specialist medical care. On the other hand, there is a lack of information services that enable access and support older people’s digital application skills. The aim of the study is to explore the perspectives of senior citizens on information and advice services on the topic of digitalization in health and care provision and thus to initiate a starting point for a participatory research project.</div></div><div><h3>Methods</h3><div>Exploratory, guideline-based focus groups were conducted with senior citizens in selected rural communities. The evaluation was carried out using content analysis according to Gläser and Laudel (2010) as part of an iterative data collection process.</div></div><div><h3>Results</h3><div>N = 21 people took part in the focus groups. Senior citizens perceive a clear decline in the municipal infrastructure, which affects the security of health care provision. They perceive digitalization in health and care provision as problematic and are concerned about being digitally disconnected. There is a lack of practical experience in everyday life and a lack of access to information. Gaining information on care-related topics should be made possible in a directional form through personal encounters.</div></div><div><h3>Conclusions</h3><div>There is a lack of tangible access to digitalization in health and care provision for senior citizens in rural regions. This means that aspects of the digital transformation are often negatively connoted due to a lack of exchange formats. Positive everyday experiences and continuous offers for digitally supported health care could broaden the general interest that exists.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 78-84"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054140","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":"National improvements in falls and pressure injuries in Swiss hospitals from 2011 to 2022: A secondary data analysis of national quality monitoring data","authors":"Silvia Thomann,&nbsp;Raya Zimmermann,&nbsp;Joëlle Sina Riedweg,&nbsp;Niklaus Stefan Bernet","doi":"10.1016/j.zefq.2025.03.006","DOIUrl":"10.1016/j.zefq.2025.03.006","url":null,"abstract":"<div><h3>Introduction</h3><div>National quality monitoring in healthcare and, in particular, the (transparent) comparison of results can trigger improvements at the structural and procedural levels and, thus, improve the outcome. In Switzerland, this kind of monitoring was conducted between 2011 and 2022 (except 2020 and 2021 due to the COVID-19 pandemic) for falls and pressure injuries in the hospital setting. The aim of this study was to examine the improvements in the quality of care for falls and pressure injuries in Swiss hospitals during the monitoring period.</div></div><div><h3>Method</h3><div>A secondary data analysis was conducted of the Swiss national quality monitoring data on falls and pressure injuries based on a multicenter cross-sectional design. Descriptive data analysis was performed.</div></div><div><h3>Results</h3><div>The hospital-acquired pressure injury prevalence rate varied between 3.6% and 5.8%, and the in-hospital fall rate was between 3.0% and 4.6%. The prevalence rates showed their greatest decrease after the first monitoring, with only a slight decrease/stagnation observed thereafter. An increase in prevalence rates was revealed after the two-year monitoring break due to the COVID-19 pandemic. The structural conditions improved (e.g., implementation of guidelines) and more processes were implemented at the patient level (e.g., use of preventive measures) over the monitoring period. At the same time, patients tended to be older, more multimorbid, and more at risk of pressure injuries.</div></div><div><h3>Conclusion</h3><div>Considering the change in the patient population (higher risk) and the findings on the structure and process indicators, the improvement in quality of care is likely to be more pronounced than the prevalence rates suggest.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 6-14"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040021","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":"Kernkompetenzen von Physiotherapeut*innen für den Direktzugang von Patient*innen bei muskuloskelettalen Erkrankungen im deutschen Gesundheitssystem – ein Scoping Review","authors":"Jan Paul Iske ,&nbsp;Pia Herz ,&nbsp;Kerstin Lüdtke ,&nbsp;Phillip Thies ,&nbsp;Annika Schwarz","doi":"10.1016/j.zefq.2025.03.011","DOIUrl":"10.1016/j.zefq.2025.03.011","url":null,"abstract":"<div><h3>Introduction</h3><div>In many countries, direct access to physiotherapy for patients with musculoskeletal disorders (MSKDs) has already been established. It presents an opportunity to optimize healthcare delivery within the German healthcare system, addressing the challenges of demographic changes and staff shortages. This study aims to identify the necessary competencies of physiotherapists for direct access practice, describes them, and compares them with the German Training and Examination Order for Physiotherapy (PhysTh-APrV) and the German Qualifications Framework for Lifelong Learning (DQR).</div></div><div><h3>Method</h3><div>A scoping review was conducted, including a systematic literature review in five databases (Medline, CINAHL, Cochrane Library, PEDro and ScienceDirect), supplemented by a non-systematic search in both Google Scholar and the gray literature. Publications were included if they described the necessary competencies for direct access to physiotherapy for patients with MSKDs in primary or emergency care. Non-German or non-English publications were excluded. Subsequently, content analysis of all included publications was performed. The competencies were analyzed, clustered into five categories, and compared to DQR and PhysTh-APrV.</div></div><div><h3>Results</h3><div>The literature search yielded 1,283 publications, 61 of which were included. A total of 24 competencies were identified and categorized into five domains: Assessment and Evaluation, Management and Interventions, Communication, Cooperation and Collaboration, Professionalism and Leadership. These competencies are covered by the DQR Level 6 competencies. The PhysTh-APrV does not provide sufficient qualifications for direct access practice.</div></div><div><h3>Discussion and conclusion</h3><div>The results highlight the required level of qualification for implementing direct access in the German healthcare system and define the competencies that physiotherapists need in this setting.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 15-27"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054353","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":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(25)00139-4","DOIUrl":"10.1016/S1865-9217(25)00139-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages iii-iv"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178018","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":"Autofahren bei kognitiven Beeinträchtigungen: Ergebnisse des bevölkerungsbasierten Digitalen Demenzregisters Bayern (digiDEM Bayern)","authors":"Anne Keefer ,&nbsp;Maren Dehler ,&nbsp;Peter L. Kolominsky-Rabas ,&nbsp;Elmar Gräßel ,&nbsp;Nicole J. Saam ,&nbsp;Katrin Drasch","doi":"10.1016/j.zefq.2025.03.007","DOIUrl":"10.1016/j.zefq.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>In Germany, the number of drivers aged 65 and over is increasing. However, the risk of physical and cognitive impairments that affect the ability to drive rises with increasing age. Those who give up driving are often confronted with constraints of their autonomy and quality of life. The study aims to identify socio-demographic and health-related determinants of non-driving in people with mild cognitive impairment (MCI) or mild to moderate dementia.</div></div><div><h3>Methods</h3><div>The data basis is the baseline survey of the multicentre, prospective registry study „Digital Dementia Register Bavaria – digiDEM Bayern“. The categorisation of people with MCI and people with mild to moderate dementia is based on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). A diagnosis may exist but is not a requirement. In addition to descriptive analyses, a binary logistic regression was conducted, and average marginal effects (AMEs) were interpreted.</div></div><div><h3>Results</h3><div>Out of 1,005 participants with a valid driving license, 410 people (40.8%) participate in road traffic as drivers. The probability that people use a car increases with age, peaking at around 70 years and then decreasing. Being female, living in an urban environment, and having a care degree are associated with a lower probability of driving a car, whilst no existing MCI or dementia diagnosis, higher cognitive abilities, and better independence in everyday life (ADLs) are associated with a higher probability.</div></div><div><h3>Conclusion</h3><div>The decision to continue driving a car depends on several factors, including age, sex, place of residence, and cognitive and physical abilities. Regular assessments of the fitness to drive should take place, and alternative mobility options should be offered to ensure road safety and maintain the quality of life of people with cognitive impairments for as long as possible. The professional and private environment of people with cognitive impairments plays a crucial role in dealing appropriately with these issues.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 85-92"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021537","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":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(25)00138-2","DOIUrl":"10.1016/S1865-9217(25)00138-2","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Page ii"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178017","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}