Gesundheitswesen最新文献

{"title":"[Psychosocial and Practical Burdens Faced by Families with (Seriously) Ill Children and Adolescents in Lower Saxony: An Analysis of their Current Life Situation].","authors":"Rebecca Toenne, Imke Meißner, Melissa Hemmerling, Sabrina Schütte, Jona T Stahmeyer, Anika Koch, Felix Reschke","doi":"10.1055/a-2939-7368","DOIUrl":"10.1055/a-2939-7368","url":null,"abstract":"<p><strong>Introduction: </strong>Families with chronically ill or care-dependent children often face considerable organizational, psychosocial, and health-related burdens. At the same time, complex care structures and unclear responsibilities can hinder access to support services. This study aimed to describe the burden experienced by families with care-dependent children in Lower Saxony and to identify factors associated with key dimensions of parents' living situation.</p><p><strong>Methods: </strong>In September 2024, postal questionnaires were sent to 600 families with care-dependent children (0-18 years) insured by AOK Lower Saxony. The questionnaire was based on a preceding qualitative interview study and included sociodemographic characteristics, disease-related information, and 26 burden indicators. Four dimensions of the parents' living situation were assessed: coping with everyday life, adequacy of care provision, availability of support services, and parents' self-reported health status. Data were analyzed descriptively, and associations were examined using Spearman rank correlations.</p><p><strong>Results: </strong>111 families participated in the survey (response rate: 19%). Care for the children is primarily provided by the parents themselves; only 12.6% use a care service for support. Frequently reported burdens include concerns about the child (95%), the significant time commitment required for care (91%), and a lack of time as a couple (83%). At the same time, 73% of respondents reported unclear responsibilities among social service providers, and 54% reported insufficient support services. Social factors-particularly the impact on siblings, social isolation, and a lack of support-are associated with all dimensions of living conditions examined.</p><p><strong>Conclusion: </strong>The findings indicate a high multidimensional burden among families with care-dependent children. In addition to structural gaps in care provision, psychosocial factors and parental health play a central role. Improved care coordination and low-threshold information and support services may help reduce the burden on affected families.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cancer Patients' Preferences for Quality Information in Hospital Choice].","authors":"David Weber, Stephanie Schmid, Martin Emmert","doi":"10.1055/a-2939-9286","DOIUrl":"10.1055/a-2939-9286","url":null,"abstract":"<p><strong>Background: </strong>In Germany, approximately 500,000 people are diagnosed with cancer each year, and about 1.40 million cancer patients receive inpatient care. Public quality reports are intended to support patients' freedom to choose a hospital, but they are rarely used. Against this background, this study investigates which (quality-related) information cancer patients consider relevant when choosing a hospital and whether the importance of these criteria changes over time.</p><p><strong>Methods: </strong>First, a literature review was conducted to identify relevant criteria for hospital choice. Subsequently, 15 cancer patients were interviewed using a qualitative design (quantitative pre-survey, semi-structured interviews). Findings from both study components were integrated to determine the overall importance of the criteria.</p><p><strong>Results: </strong>Of 4,470 screened studies, 20 met the inclusion criteria. In total, 56 criteria were identified; the 20 most relevant were included in the patient interviews. Physician recommendation was rated as most important, followed by waiting time, treatment volume, distance to the hospital, and physician communication. Patients' own hospital experience had only a minor influence on preferences over time: 16 of 20 criteria increased in importance (mostly slightly), while 3 decreased slightly. The largest change was observed for personal prior experience with the hospital.</p><p><strong>Conclusion: </strong>Although patients show interest in quality-related information, hospital choice is predominantly a socially embedded decision shaped by the emotional burden of the disease; counselling by the primary care physician plays a key role. More patient-centred quality reports and their integration into physician counselling may improve informed hospital choice.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How can clinical trials be successfully conducted in primary care settings? - Challenges and solution strategies: a survey of research-active general practices].","authors":"Hanna Schrader, David Müller, Christian Förster, Lia Heyl, Leonor Heinz, Hannah Haumann, Sabine Blaschke, Patrick Meybohm, Stefanie Joos, Ildikó Gágyor","doi":"10.1055/a-2939-7615","DOIUrl":"10.1055/a-2939-7615","url":null,"abstract":"<p><strong>Background: </strong>Patients in general practices are often insufficiently reached for clinical trial participation. Since much care is delivered in the outpatient sector, this sector, particularly general practice, should be central to future research infrastructures. The NAPKON Therapeutic Intervention Platform (NAPKON-TIP), a project of the Network University Medicine, provides infrastructure for clinical trials involving the outpatient sector.</p><p><strong>Research question: </strong>The study aimed to identify barriers to patient recruitment in general practices and strategies to overcome them.</p><p><strong>Methods: </strong>From 12/2024 to 02/2025, an online survey assessed recruitment barriers perceived by general practitioners and medical assistants (MFA) in clinical trials. The survey was emailed to DEGAM-ForNet general practice research practices. Reminder emails were used. Questionnaire data were analysed descriptively in SPSS, and free-text responses by qualitative content analysis in MAXQDA.</p><p><strong>Results: </strong>A total of 62 persons participated; the response rate was 7.2%. Most participants were general practitioners (83.9%); 16.1% were MFA. The most common barriers were high administrative and time burden (88.7%), insufficient remuneration (58.1%), and staff shortages (56.4%). Qualitative content analysis identified barriers in study design, such as complex inclusion criteria; practice-team barriers such as staff shortages; difficult-to-integrate processes in everyday practice; and patient-related difficulties such as being overwhelmed by study demands. Proposed solutions included strengthening practice teams and patients as active research partners in genuine participation, financial and non-material incentives, and simplified digital study logistics.</p><p><strong>Conclusion: </strong>Studies should be adapted to outpatient care needs and planned with existing research practices. This may facilitate study participation for general practices and support a cross-sectoral research infrastructure in which the outpatient sector is equally represented. In this survey, physicians and MFA may have partly worked in the same practice, so participation may not have been evenly distributed across practices.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Perceived support for autonomy in general practice: a multicenter cross-sectional study].","authors":"Tim Netzer, Sarah-Christine Arndt, Sarah Bebermeier, Stephanie Stiel, Malte Klemmt","doi":"10.1055/a-2918-6420","DOIUrl":"https://doi.org/10.1055/a-2918-6420","url":null,"abstract":"<p><strong>Introduction: </strong>Respecting patient autonomy is one of the guiding principles of contemporary medical ethics. Supporting autonomy can improve patients' health literacy and promote their adherence to and the outcomes of medical treatments. Quantitative studies on the extent of patients' experience of autonomy and the predictors of this experience are lacking in general practice.</p><p><strong>Methods: </strong>In a multicenter cross-sectional study, patients in three general practices in Lower Saxony were surveyed in 2024. Via a paper-pencil questionnaire, patient characteristics and perceived autonomy were assessed using the German version of the Health Care Climate Questionnaire (HCCQ).</p><p><strong>Results: </strong>The study included n=637 participants. Participants demonstrated a high level of perceived autonomy on a scale of 1-7 (M=6.1, SD=1.1). In the multi-regression analysis, age (ß=0.127; T=2.609; p=0.009), partnership (ß=0.101; T=2.421; p=0.016), and education level (ß=-0.112; T=-2.518; p=0.012) emerged as statistically significant predictors.</p><p><strong>Conclusion: </strong>This study was the first to quantitatively assess patients' experience of autonomy in a general practice setting in Germany. Overall, a higher level of autonomy was observed than in studies in inpatient settings. This might indicate an egalitarian doctor-patient relationship and a situation in which patients already feel that their individual autonomy is recognized. The analysis of predictors provides evidence that specific groups, such as those with low levels of education, should be specifically helped in the promotion of autonomy.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[WHO Guideline for the prevention, diagnosis and treatment of infertility].","authors":"Brigitte Piso, Isolde Sommer, Gerald Gartlehner","doi":"10.1055/a-2923-8257","DOIUrl":"https://doi.org/10.1055/a-2923-8257","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects approximately one in six people of reproductive age worldwide and represents a major global health issue, regardless of world region or income level. It limits the realization of individuals' desire to have children, thereby underscoring the importance of high-quality fertility care.</p><p><strong>Method: </strong>The guideline was developed by WHO in accordance with WHO standards. It. The executive summary was translated into German by the WHO Collaborating Centre for Evidence-based Medicine at the University of Continuing Education Krems (Austria).</p><p><strong>Results: </strong>In addition to general good practice recommendations for the management of infertility, the guideline includes four recommendations on prevention, eleven on diagnosis, and 24 on the treatment of infertility. The diagnostic and treatment recommendations further distinguish between female, male, and unexplained infertility.</p><p><strong>Conclusions: </strong>This guideline is the first WHO guideline on the prevention, diagnosis, and treatment of infertility. It aims to improve the implementation of evidence-based interventions related to infertility.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Is a Time Lag Between Diagnostic Information from Different Data Sources in Data Linkage Projects a Problem? An Empirical Evaluation Using ADHD Diagnosis Data from the INTEGRATE-ADHD Project].","authors":"Lilian Beck, Ann-Kristin Beyer, Heike Hölling, Marcel Romanos, Thomas Jans, Sophia Weyrich, Anne Kaman, Ulrike Ravens-Sieberer, Julian Witte, Katharina Weinert, Cornelia Fiessler, Peter Heuschmann, Cordula Riederer","doi":"10.1055/a-2918-2975","DOIUrl":"10.1055/a-2918-2975","url":null,"abstract":"<p><strong>Abstract: </strong>In the project INTEGRATE-ADHD, routine data from a German statutory health insurance company (DAK-Gesundheit) was linked with data from an online survey and clinical online diagnostics. The period between the documentation of a child's ADHD diagnosis in the routine data and the parent report of the diagnosis in the survey was at least nine and at most 32 months. Clinical online diagnostics according to the German AWMF-S3 guideline took place between three and five months after the survey. Only about two-thirds of the parents reported the ADHD diagnosis of their child in the survey and only just under two-thirds of the administrative ADHD diagnoses were clinically confirmed. Based on data from 1,355 children and adolescents with incident ADHD diagnosis, this study used descriptive statistics and logistic regression to examine whether the time lag between the date of diagnosis documentation and the parent report in the survey or the diagnosis in the clinical examination could explain the discrepancies between the different diagnosis data, for example, due to parents' recall bias or changes in in the children's symptom presentation. The date when the diagnosis was coded could be approximated with the start and end date of the treatment period in which the diagnosis was coded. Subsequently, the effect of the time lag was analyzed using descriptive and multivariate statistics. Even when the date of diagnostic coding was differently approximated, no statistically significant association was observed between the time lag and discrepancies between the diagnosis data. Accordingly, the present analyses did not provide evidence that a time-dependent recall bias of the parents or changes in the presentation of symptoms were associated with unreported or clinically unconfirmed ADHD diagnoses.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tension between being a Physician and Mother: A Qualitative Interview Study on Structural Barriers to Re-entry into Medical Practice].","authors":"Sandra Decker, Jan Gehrmann, Frederike Kneissl, Klaus Linde, Antonius Schneider","doi":"10.1055/a-2910-4310","DOIUrl":"https://doi.org/10.1055/a-2910-4310","url":null,"abstract":"<p><strong>Background: </strong>The increasing proportion of female physicians, combined with the emerging shortage of medical professionals, makes the reconciliation of family responsibilities and medical work a central issue for healthcare systems. Returning to work after maternity leave poses substantial structural and organisational challenges for female physicians.</p><p><strong>Objective: </strong>This study examines factors that facilitate or hinder the return to clinical work of female physicians with children, as well as existing opportunities to improve compatibility of family and professional life.</p><p><strong>Methods: </strong>Twenty semi-structured, guideline-based interviews were conducted with female physicians working in inpatient and outpatient settings. Data were analysed using Mayring's structuring content analysis.</p><p><strong>Results: </strong>Four key factors were found to shape the re-entry experience: (1) institutional conditions, such as the availability and suitability of childcare; (2) organisational structures, particularly flexible working hours and duty schedules; (3) team and leadership culture, including appreciation, integration, and understanding of family responsibilities; and (4) regulations governing residency training, especially regarding crediting of training periods, duration of training, and disadvantages in rotation or position allocation. A lack of structured re-entry processes and uncertainties regarding legal frameworks further increase the burden. Many physicians report role conflicts, mental strain, and doubts about long-term compatibility, which may lead to delayed re-entry, changes in specialty, or considerations of leaving clinical practice.</p><p><strong>Conclusion: </strong>The findings demonstrate that work-family compatibility in medicine is primarily a structural challenge that requires structural solutions. Family-friendly working models, reliable childcare, supportive leadership cultures, and flexible training regulations are essential levers to facilitate re-entry and sustainably counteract the shortage of physicians.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Digital Physical Activity-related Health Services: Effects, Quality, and Research Implications - An Interdisciplinary Discussion Paper].","authors":"Martin Lange, Bettina Barisch-Fritz, Hannes Baumann, Katharina Eckert, Lars Gabrys, Angelina Heub, Sven Kernebeck, Laura Maaß, Harriet Morf, Jutta G Richter, Andrea Schaller, René Streber, Gorden Sudeck, Alexander Tallner, Christian Thiel, Claudia Voelcker-Rehage, Bettina Wollesen, Stefan Peters","doi":"10.1055/a-2930-2321","DOIUrl":"https://doi.org/10.1055/a-2930-2321","url":null,"abstract":"<p><strong>Background: </strong>Digital physical activity-related health care services (dbVL) are becoming increasingly important in the German healthcare system, whilst quality requirements and criteria regarding efficacy are still undergoing a dynamic development process. The aim of this article is to provide a conceptual classification for dbVL and a systematic overview of the current state of their potential usage and quality requirements in healthcare practice.</p><p><strong>Methods: </strong>To establish a conceptual classification, existing perspectives on physical activity-related health care and international classification systems for digital health interventions were taken into account. Legal frameworks and specific quality and effectiveness requirements for dbVL were systematically synthesized from available healthcare-related documents.</p><p><strong>Results: </strong>In all healthcare settings, the legal framework generally permits the use of dbVL. However, in some cases the analysis reveals significant healthcare sector-specific heterogeneity and fragmentation regarding quality and effectiveness requirements.</p><p><strong>Discussion: </strong>The analysis highlights the need for consistent, cross-contextual systematization, quality requirements, and evaluation criteria for dbVL. Key implications include the integration of physical activity-related expertise, user-centered development, and technology-appropriate evaluation approaches. The current sectoral fragmentation calls for consensus-based, cross-contextual concepts of evidence and benefits, as well as, a more coherent regulatory restructuring in the long term.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leaving no one behind in the era of climate change and digitalisation? Barriers to healthy and climate-friendly living among informal caregivers.","authors":"Andrea E Schmidt, Gerhard Paulinger, Sandra Dohr, Sophie Kellerberger, Martin Ernst, Judith Goldgruber, Wolfgang Kratky, Christina Lampl, Doris Maurer, Johannes Pflegerl, Petra Plunger, Eva Turk, Thomas Ernst Dorner, Vera Gallistl-Kassing","doi":"10.1055/a-2898-4159","DOIUrl":"10.1055/a-2898-4159","url":null,"abstract":"<p><strong>Background: </strong>Informal caregivers play a crucial role in supporting older adults, yet they often face challenges that compromise their own health and well-being, particularly in family-based care regimes like Austria. These challenges leave little room for adopting ecologically sustainable behaviours, calling for societal strategies to address climate change without adding pressure. We examined barriers in areas linked to the \"triple win\" of health promotion, climate mitigation, and social inclusion, and explored the role of Information and Communication Technologies (ICTs).</p><p><strong>Methods: </strong>Data were collected in 2024 from a non-probability sample of Austrian caregivers on social contacts, mobility, nutrition, and digital device use. We present descriptive results.</p><p><strong>Results: </strong>Unpaid caregiving responsibilities reshaped daily routines and challenged health and sustainability (N=204, 81% females; mean age 58±13 years): 15-20% of participants were at risk of social isolation, 54% reported fewer social interactions. Awareness of healthy diets increased partially, but 26% had less time to eat. Mobility patterns showed strong car reliance with higher weekly travel demands (69%). Internet and ICT were used for communication daily (72%).</p><p><strong>Conclusions: </strong>Mobility and nutrition offer high co-benefit potential, but structural changes, not individual responsibility, are key. ICT tools should complement in person engagement to leverage positive aspects of caregiving for climate-health co-benefits.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Memorandum: Conceptual, Methodological, and Structural Aspects for Strengthening Health Services Research in Dentistry].","authors":"Falk Schwendicke, Ghazal Aarabi, Anna Greta Barbe, Renate Deinzer, Katrin Hertrampf, Michael Raedel, Prof Dr Rainer Jordan","doi":"10.1055/a-2948-6942","DOIUrl":"10.1055/a-2948-6942","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}