Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Abschlusseditorial","authors":"Beate Müller","doi":"10.1016/j.zefq.2024.12.005","DOIUrl":"10.1016/j.zefq.2024.12.005","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 88-89"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967202","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":"Advances in Shared Decision Making in Brazil: The role of patient autonomy in curriculum reform, health system and clinical care","authors":"Mirhelen Mendes de Abreu ,&nbsp;Melanie Noël Maia ,&nbsp;Alexandre Oliveira Telles ,&nbsp;Renata Oliveira Maciel dos Santos ,&nbsp;Maria Katia Gomes ,&nbsp;Ana Luisa Rocha Mallet ,&nbsp;Lúcia Maria Soares de Azevedo","doi":"10.1016/j.zefq.2024.11.006","DOIUrl":"10.1016/j.zefq.2024.11.006","url":null,"abstract":"<div><div>Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian <em>status quo</em> of decision support tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 90-93"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819420","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":"Measurement of non-invasive rectal and ear temperature in inpatients ≥ 18 years old: A cross-sectional comparative study","authors":"Lone Jørgensen ,&nbsp;Birgitte Boll ,&nbsp;Kristina Fischer Rosenkilde ,&nbsp;Niels Henrik Bruun ,&nbsp;Preben Ulrich Pedersen ,&nbsp;Marianne Wetendorff Nørgaard","doi":"10.1016/j.zefq.2024.11.005","DOIUrl":"10.1016/j.zefq.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Body temperature measurement is a fundamental requirement for clinical decisions in nursing care, medical diagnosis, and treatment. Therefore, it is pivotal that body temperature measurements are accurate and precise.</div></div><div><h3>Aims</h3><div>To test the diagnostic accuracy of an ear temperature screening procedure among adult hospitalized patients. Further aims were to test the precision of the measurements being carried out by trained registered nurses compared with daily routine practice and to investigate patients’ preferences for different measurement methods.</div></div><div><h3>Methods</h3><div>In Aalborg University Hospital, 274 patients were included in a cross-sectional comparative study. Each patient had four temperature measurements and responded to a survey regarding their preference for measurement. Bland–Altman analysis was used to evaluate the difference between ear- and rectal measurements. Sensitivity and specificity were evaluated at different cut-off points.</div></div><div><h3>Results</h3><div>The ear temperature was 0.1 to 0.2 °C lower than rectal temperature. At a cut-off point at 37.5 °C an ear thermometer is accurate and can be used for screening, while higher cut-off points risk missing patients with fever. There was no significant difference in the mean temperature measured by a trained registered nurse or other staff members and patients. Patients preferred ear measurements to rectal measurements.</div></div><div><h3>Conclusion</h3><div>The tested ear thermometer is accurate for screening fever in an adult population during hospital admission. Using ear measurement as a screening tool can contribute to a less resource-demanding care activity and a more convenient alternative to rectal measurements in hospitalised patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 36-41"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824691","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":"Potenzial telemedizinischer Anwendungen zur Verbesserung einer flächendeckenden Gesundheitsversorgung am Beispiel der Teledermatologie","authors":"Anne Kis,&nbsp;Christina Sorbe,&nbsp;Matthias Augustin,&nbsp;Marina Otten,&nbsp;Jobst Augustin","doi":"10.1016/j.zefq.2024.11.012","DOIUrl":"10.1016/j.zefq.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine applications are perceived as having great potential to address regional health service deficits. However, it is unclear to what extent telemedicine can actually contribute to ensuring care in medically underserved regions. The aim of this study is to prospectively identify underserved regions and to investigate the potential of telemedicine applications using teledermatology as an example.</div></div><div><h3>Methods</h3><div>Well-served regions were identified using selected indicators. Points were awarded for each indicator and added up to form two scores. The results were analyzed for spatial autocorrelation (Moran’s I), and visualized as a bivariate choropleth map. Data on broadband availability (BMVI) and descriptive statistics (Spearman’s Rho, Beeswarm plots) were used to analyze the potential for telemedicine applications. All analyses were carried out at county level.</div></div><div><h3>Results</h3><div>Out of 401 counties, 159 can be classified as vulnerable because of their supply situation. They are mainly located in the north-west part of Germany. Locally, there are infrastructure deficits, i. e. insufficient bandwidth for telemedicine applications. Spearman’s Rho shows negative correlations between broadband availability and the scores obtained (ρ: –0.654/–0.229, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The results indicate a consolidation of regional disparities. If the identified regions are inhabited by patients with limited mobility and by socially disadvantaged patients, there is a risk of “double gaps in care”. In the context of an increasing demand and workload, barriers to telemedicine should be removed, especially in the identified areas, and alternative care models should be implemented.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 11-18"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915883","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(25)00040-6","DOIUrl":"10.1016/S1865-9217(25)00040-6","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436950","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)00037-6","DOIUrl":"10.1016/S1865-9217(25)00037-6","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages iii-iv"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437067","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":"Integration von Physician Assistants in die hausärztliche Versorgung: Akzeptanz und Bedenken von Hausärzt*innen","authors":"Alessia Dehnen ,&nbsp;Benjamin Borchardt ,&nbsp;Philip Schillen ,&nbsp;Jürgen in der Schmitten ,&nbsp;Christine Kersting ,&nbsp;Angela Fuchs ,&nbsp;Nino Chikhradze ,&nbsp;Dorothea Dehnen","doi":"10.1016/j.zefq.2024.11.008","DOIUrl":"10.1016/j.zefq.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Strategies to counteract the impending and in some places already existing shortage of general practitioners (GPs) are being discussed in Germany. One approach could be to establish interprofessional teams in GP practices by integrating physician assistants (PAs).</div></div><div><h3>Question</h3><div>Can GPs imagine employing a PA in their practice and if so, under what conditions?</div></div><div><h3>Methods</h3><div>In March/April 2023, about 5,000 GPs in North Rhine-Westphalia (NRW), who work in a region with a care level of &lt; 100 %, and about 1,000 GPs from Saxony-Anhalt were asked to take part in an online-based survey. Simultaneously, semi-structured preliminary interviews (one online focus group with four participants, seven individual interviews) were conducted with GPs from NRW.</div></div><div><h3>Results</h3><div>290 GPs participated in the survey (response rate approx. 5 %). Of these, 46.3 % expressed interest in employing a PA in their practice. A majority of 60 % considered assignments such as conducting an open consultation for uncomplicated respiratory tract infections or vaccination consultations to be delegable. As many as 21.9 % would be willing to pay a PA more than 3,500 euro gross monthly salary (based on a full-time position) (8.7 % more than 4,000 euro), while 38.4 % stated that they could not currently afford the cost of employing a PA. The qualitative results underline these findings. One of the respondents’ conditions for the employment of a PA was to abolish the quarterly budget limits for GPs.</div></div><div><h3>Discussion</h3><div>Many GPs already express their interest and willingness to both employ PAs and to delegate medical tasks to them – in spite of unanswered questions and, possibly, by necessity. About a fifth of the participants can even imagine paying from their own budget the same gross salary that PAs employed by hospitals are paid. Reliable clarification of feasibility, safety and cost-effectiveness of the use of PAs as well as effects on the quality of treatment in primary care should be a priority for health policy actors.</div></div><div><h3>Take-home message</h3><div>From the GP’s point of view, the integration of PAs into GP-centred care in terms of an interprofessional team practice has got potential. At the same time, the question of financial feasibility is still unsettled.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 66-76"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915913","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":"Patient*innenbeteiligung am Beispiel des Innovationsfondsprojekts „integrierte, sektorenübergreifende Psychoonkologie“ (isPO)","authors":"Vera Schiewer ,&nbsp;Anne Klein ,&nbsp;Thilo Dietz ,&nbsp;Hildegard Labouvie ,&nbsp;Michael Kusch ,&nbsp;Hedy Kerek-Bodden ,&nbsp;Michael Hallek","doi":"10.1016/j.zefq.2024.11.004","DOIUrl":"10.1016/j.zefq.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>In the German health care system, the participation of patients (patient representatives) and the consideration of their perspectives in all phases of research and care are being increasingly demanded. How appropriate patient participation (participation of patient representatives) can be designed is illustrated by the example of the project on the new form of care titled “<em>Integrated, cross-sectoral psychooncology</em> nVF-isPO” and funded by the Innovation Fund at the Federal Joint Committee.</div></div><div><h3>Method</h3><div>The realization of patient (representative) participation is presented by the example of the isPO project, taking into account the short form of the Guidance for Reporting Involvement of Patients and the Public (GRIPP2). This is done on the basis of the involvement and participation of patients (patient representatives) in research, care and care evaluation, as well as quality development (1) through the Haus der Krebs-Selbsthilfe – Bundesverband e. V. (HKSH-BV), as the consortium and contract partner in conceptual project work, (2) through the participation of cancer survivors in the role of isPO oncoguides, and (3) through the involvement of cancer patients in the evaluation of the nVF-isPO.</div></div><div><h3>Results</h3><div>Through the constant involvement of the HKSH-BV as a consortium partner, the patients’ perspective informed the development and implementation of the nVF-isPO at an early stage. The nVF-isPO’s isPO-Oncoguide concept, developed in collaboration with the HKSH-BV, made it possible to involve cancer survivors as isPO-Oncoguides in health care. In addition, oncological patients, who are regarded as health benefit recipients in the health care evaluation, were involved in the further development of the quality of care of the nVF-isPO.</div></div><div><h3>Conclusion</h3><div>The involvement and consideration of the expertise of patients (patient representatives) in all phases of development, implementation and evaluation have been realized in the isPO project. The isPO project has been recognized by the HKSH-BV as having a high degree of patient participation; and the nVF-isPO and the concept of the isPO-oncoguide are recognized as relevant, acceptable and of high quality from the perspective of both cancer survivors and cancer patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 42-48"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822684","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(25)00036-4","DOIUrl":"10.1016/S1865-9217(25)00036-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Page ii"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437070","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":"Use and acceptance of video consultation among adults insured by statutory health insurance providers in Germany: A nationwide online survey","authors":"Saskia Muellmann ,&nbsp;Karina Karolina De Santis ,&nbsp;Hermann Pohlabeln ,&nbsp;Hajo Zeeb","doi":"10.1016/j.zefq.2024.12.008","DOIUrl":"10.1016/j.zefq.2024.12.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing digitalization of the healthcare system makes it possible to provide medical services using digital technologies without direct patient–provider contact. This study aimed to investigate 1) the use and acceptance of video consultation and 2) factors associated with the use of video consultation.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted in February 2023. Overall, 20,000 adults insured at a statutory health insurance company in Germany (10,000 users and 10,000 non-users of video consultation) were invited by email to an online survey with 31 items. The items addressed use and acceptance of digital health services with a focus on video consultation, digital health literacy, and sociodemographic characteristics. Data were analyzed using descriptive statistics and factors associated with video consultation use were assessed using binary logistic regression.</div></div><div><h3>Results</h3><div>Among the 1,657 participants, 686 were users and 971 were non-users of video consultation. The participants were aged between 18 and 80 years (M ± SD: 44 ± 13 years), 55% were female, 59% reported a medium subjective socioeconomic status and 69% a good to very good health status. Video consultation was predominantly used following physician recommendations (71%) as part of general medical care (50%). The main reasons for using video consultation were time saving (93%) and flexibility in terms of location (87%). Most video consultation users felt well cared-for during video consulting (93%), would use it again (95%), and would recommend it to others (93%). Factors associated with video consultation use were age from 30 to 49 years, high subjective socioeconomic status, high digital health litercay, and very poor to moderate health status.</div></div><div><h3>Conclusion</h3><div>The acceptance of video consultations in this study was high. Advantages and barriers to offering video consultations from a physician perspective should be investigated to incorporate video consultations in everyday medical practice.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 36-44"},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029957","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}