Gesundheitswesen最新文献

{"title":"[Weaning in the out-of-hospital setting: a Scoping Review].","authors":"Corina Schiegl, Irmgard Schroll-Decker","doi":"10.1055/a-2504-0195","DOIUrl":"10.1055/a-2504-0195","url":null,"abstract":"<p><p>In 2021, a transitional form of housing for outpatient weaning was certified based on paragraph 17 of the Bavarian Law on Quality Assurance of Care and Housing. In order to get an overview over the research field, we carried out a scoping review. In particular, we focussed on two research questions: 1. What are the factors that contribute to the quality of life of people receiving artificial respiration in an outpatient setting? 2. Which factors necessitate weaning in an outpatient setting and what are the conditions that facilitate weaning?Seven data bases were searched with defined search terms. After two extractions, 401 matches were found. On the basis of an analysis of these abstracts, the results were systematically categorized. In order to answer the research questions, the topic \"intensive and respiration care\" was chosen for closer analysis; 120 texts were analysed more thoroughly.Results showed that we do not have sufficient data to answer the research questions in a satisfactory manner. The quality of life of ventilated people was found to be heterogenous, but self-determination and empathetic communication between the relevant institutions, on the one hand, and patients, on the other, clearly enhanced it. What was also beneficial was the inclusion of patients in social networks. What was obviously negative was the lack of competent personnel. It was also observed that the weaning potentials in outpatient care were not sufficiently made use of. Intersectoral care concepts are being discussed.The issues of intensive outpatient care as well as weaning and the question of how a self-determined and satisfactory life can be achieved have hardly been evaluated. Moreover, the terms quality of life and self-determination in this setting have hardly been operationalized. Further research is necessary. Nonetheless, self-determination appears to contribute to the life quality of seriously ill patients.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840005","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":"[Medication safety in German hospitals: An analysis of structured quality reports].","authors":"Nadin Kastirke, Beatrice Groß","doi":"10.1055/a-2501-0241","DOIUrl":"10.1055/a-2501-0241","url":null,"abstract":"<p><p>Medication safety represents an increasingly pertinent aspect of quality and risk management in hospitals. However, little is known about the relevance of specific methods in controlling medication safety with respect to medical care processes. The aim of this study, therefore, is to assess the implementation of medication safety measures and the significance of specific hospital characteristics.We analyzed data from 2018, comprising structured quality reports of 1987 sites that were the first to contain information on 13 medication safety tools and measures. Relative implementation rates were assessed both in general and for subgroups. The latter were formed based on site size, presence of specialized departments as well as university hospital affiliation. The relevance of corresponding differences between subgroups was examined using threshold analysis.Across all 13 medication safety measures, implementation rates varied highly (gapless medication safety after hospital release: 71.4%; SOP for good prescription practice: 23.5%). Rates also increased in relation to site size from 31.5% (<50 hospital beds) to 61.5% (>500 hospital beds). This pattern was especially prevalent for medication safety measures pertaining to electronics and IT. There were significant differences between eight measures based on the presence of specialized departments as well as university hospital affiliation. Two measures (medication safety training, description of optimal medication processes) did not vary with the hospital characteristics.Our results highlight the importance of standardized assessments of quality assurance data in hospital settings. The present data analysis enables the identification of those measures that have already been implemented. Implementation seems to be associated with hospital characteristics as well as regulatory guidelines. However, it is noteworthy that medication safety measures are not being implemented across the board. This might be explained by economic, social and technological barriers. These hurdles should be dealt with on a long-term basis and via adequate incentives.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"193-201"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411259","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":"[Can SARS-CoV-2 Infection Status in Preschool Children be Predicted by Pandemic-related Attitudes and Concerns of their Parents? Data from the Würzburg Daycare Centre Studies (Wü-KiTa-CoV, 2020-2022)].","authors":"Thomas Jans, Maike Krauthausen, Carsten Bauer, Johannes Forster, Geraldine Engels, Franziska Pietsch, Julia Wallstabe, Victoria Rücker, Julia Wendel, Benedikt Weissbrich, Peter Heuschmann, Christoph Härtel, Lars Dölken, Oliver Kurzai, Ildikó Gágyor, Johannes G Liese, Marcel Romanos, Andrea Streng","doi":"10.1055/a-2386-4490","DOIUrl":"10.1055/a-2386-4490","url":null,"abstract":"<p><p>As part of the Würzburg KiTa-CoV study series, SARS-CoV-2 pandemic-related attitudes/concerns of parents of preschool children attending day care centres were surveyed over a 21-month period. We expected associations between these parental attitudes/concerns and their change over the course of the pandemic, on the one hand, and the SARS-CoV-2 infection status of the children, on the other. Parents of children from nine day-care centres who completed a survey on pandemic-related attitudes/concerns in October 2020, July 2021 and July 2022, were included in the analysis. In July 2022, the children's infection status was determined by measuring nucleocapsid protein antibodies (N-AK) and, in the case of N-AK negative, unvaccinated children, the measurement results of spike protein antibodies (S-AK) against SARS-CoV-2 as indicators of previous infection were also taken into account. Changes in parental attitudes/concerns were analysed using trend tests, and their significance in predicting the child's infection status was analysed using multiple binomial regression analyses. Data were available from parents of 159 children (mean age 3.2 years). The overall group of parents showed an increasingly relaxed attitude towards the pandemic over the study period, although the parents' concerns towards a possible infection of their own increased. The infection status of the children could not be predicted from the initial attitudes and concerns of the parents. However, the subgroup of parents with an uninfected child tended to have a higher level of concerns over the course of the pandemic than the parents with an infected child and did not show the same increasing composure towards the pandemic event. The parents' increasing composure is understandable in the context of the reduced virulence of the virus variants prevailing over time, the increasing availability of testing strategies and vaccinations, and the withdrawal of pandemic-related restrictions. In addition, the mildness of most children's infections may have contributed to their parents' sense of security. The seemingly contradictory increase in parental concerns about infection may be related to the strong increase in the incidence due to omicron variant infections in the population since January 2022. It is possible that the higher level of concerns among parents of uninfected children had a protective effect behaviourally.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"216-226"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976928","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":"[Socio-Cultural and Professional Integration of Foreign-Born and Foreign-Educated Physicians in German Outpatient Care: an Interview-Based Study in Baden-Württemberg and Hessen].","authors":"Angelina Gresser, Stefanie Joos, Heidrun Sturm","doi":"10.1055/a-2319-3160","DOIUrl":"10.1055/a-2319-3160","url":null,"abstract":"<p><p>Introduction In recent years, it has become increasingly hard to fill outpatient physician vacancies in all parts of Germany. This development is particularly pronounced in general practice. At the same time, the number of doctors trained abroad is increasing, predominantly in the inpatient sector. In the next few years, foreign-born and -trained physicians will presumably be increasingly active also in the field of family medicine. The aim of this study was to explore experiences, support needs and possible improvements from the perspective of such physicians in the outpatient sector with a focus on primary care.Method In this qualitative study, semi-structured interviews were conducted with physicians not raised and trained in Germany and working in the outpatient setting in Germany. The evaluation was carried out by means of qualitative content analysis. Categories were derived in a deductive-inductive manner.Results Thirteen physicians (of which nine were primary care physicians) were interviewed. Next to the deductively derived main categories (departure, des-orientation, adaptation) four subcategories as overarching problems emerged in the interviews: Administrative tasks, communication and professional as well as social adaptation / integration in Germany. Proposed solutions were categorized in structuring measures (official, easily accessible guidelines for physician migration, paid qualification period), specific preparatory courses for the outpatient sector, and personal support such as mentoring and networking of outpatient physicians in training.Conclusions Some of the problem areas mentioned were similar to those known from the inpatient setting. To support sustainable recruitment in the outpatient sector, specific preparatory courses and the promotion of networking among physicians appeared to be additional measures that would benefit physicians applying for positions in the outpatient sector and also easy to implement.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"174-178"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856794","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":"[Allocation principles and the organization of tissue donation: ethical challenges and possible influence on the willingness to donate from the perspective of multidisciplinary experts].","authors":"Katja Kirchner, Michael Lauerer, Eckhard Nagel","doi":"10.1055/a-2508-4769","DOIUrl":"10.1055/a-2508-4769","url":null,"abstract":"<p><p>Due to the shortage of tissues and organs, numerous patients suffer from a reduced quality of life or even die. In political measures to increase the donation rate, tissue donation is often subsumed to organ donation, despite considerable differences: For example, unlike organs, tissue transplants can be stored for up to five years and allocated internationally. Similarly, industrially processed tissue preparations can be sold commercially, whereas organs are subject to a trade ban. Tissue donation also differs from centrally organized organ donation in terms of decentralized organization. As the associated ethical challenges and possible influence on the willingness to donate have only been insufficiently investigated to date, these are the focus of this exploratory expert survey.We conducted qualitative interviews with 14 experts who are involved in the tissue donation process in different positions. In addition, we interviewed medical ethicists, lawyers and scientists. We evaluated the interviews with a structuring content analysis according to Mayring and performed a frequency analysis. In reporting, we followed the standards for qualitative studies.Altruism and the medical necessity of transplantation were cited as legitimation of tissue donation. Therefore, most experts were in favor of a commercial ban for all tissues. In case of a commercial use of tissues, a negative effect on the donation rate was feared. According to most experts, neither the possible commercial use of tissue transplants nor the decentralized organization of tissue donation or the international allocation of transplants are discussed in conversations with relatives, although some experts assume that they could have an impact on the willingness to donate. Furthermore, the general population is not sufficiently informed about the characteristics of tissue donation.The characteristics of tissue donation can influence the willingness to donate. At the same time, they are discussed neither in conversations with relatives nor in public communication. If the present results are confirmed in further studies, in the sense of an informed decision both in in discussions with relatives as well as in public communication, transparency must be created about the decision-relevant aspects.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"87 3","pages":"202-207"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574272","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":"[Subjective Health Impairment And Associated Factors In The Heatwave Of Summer 2022: An Online Survey].","authors":"Christian Buhtz, Thomas Frese, Patrick Jahn, Eva Kantelhardt, Alexander Kuhlmann, Sara Lena Lückmann, Gabriele Meyer, Thorsten Meyer-Feil, Jan Schildmann, Anke Steckelberg, Anja Knöchelmann","doi":"10.1055/a-2332-0059","DOIUrl":"10.1055/a-2332-0059","url":null,"abstract":"<p><strong>Background: </strong>Heatwaves might diminish the sense of well-being and are associated with increased mortality. Individual measures to protect against heat are often insufficient, with the perception of one's own risk playing a crucial role. Due to varying levels of vulnerability, it is expected that the perception differs among populations. Presumably, symptom awareness is higher when people are concerned with and inform themselves about the topic of heat. Our study examined subjective health impairment during the heatwave in 2022, its association with socio-demographic and economic factors, as well as perceived heat stress and individual engagement with the issue.</p><p><strong>Method: </strong>An online survey of a population-based sample from five federal states of Germany was carried out. Multivariable regression analyses were conducted to explore the relationship between subjective health impairment due to heat and potential risk indicators.</p><p><strong>Results: </strong>Out of 3,111 people contacted, 1,522 responded, with 649 (20.9%) included in the analysis as they were affected by heat in their region of residence during the summer of 2022. The average subjective health impairment was 9.29 (SD: 5.25) out of 29 possible points. Higher age was associated with lower impairment; -1.36 points (95%-CI: -4.10; 1.38) in the group of those aged 80 and compared with the reference group of 60 to 69-year-old people. Furthermore, higher impairment was reported more by women and individuals with lower educational levels. Low impairment was associated with a high perceived level of information.</p><p><strong>Conclusion: </strong>Interventions aimed at reducing heat-related health problems should target a broader audience, particularly young people, women, individuals with lower education, and working people.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"208-215"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074171","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":"[Analysis of the types of death before and after public prosecutor's investigations in Baden-Württemberg].","authors":"Theodor Gonser, Monika Spannenkrebs, Michael Foell","doi":"10.1055/a-2406-5457","DOIUrl":"10.1055/a-2406-5457","url":null,"abstract":"<p><p>Difficulties in diagnosing the cause of death have been widely discussed in the literature. However, studies on the quality assurance of the determination of the manner of death and the results of public prosecutor investigations are rare. In this study, data from six public health departments in Baden-Württemberg on all deaths from 2016-2018 were analyzed. Significant differences were found between the individual public prosecutor's districts with regard to the type of death determined during the medical post-mortem examination. In 6.3 [4.5-7.4]% of all deaths, the public prosecutor's offices initiated investigations. In 6.0 [4.3-8.5]% of these investigations, an autopsy was performed. A significant difference between the public prosecutor's districts could not be demonstrated in this regard.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"227-232"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523331","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":"[Patient safety in the Innovation Fund - Characterization, results and evaluation of completed projects: Results of a scoping review].","authors":"Lorenz Harst, Felix Walther, Lilly Rüthrich, Laura Keßler, Christina Lindemann, Martin Härter, Erik Farin-Glattacker, Max Geraedts, Jochen Schmitt","doi":"10.1055/a-2309-8968","DOIUrl":"10.1055/a-2309-8968","url":null,"abstract":"<p><p>The German Innovation Fund has funded various studies on patient safety. Their thematic spectrum, methodological quality, results and recommendations of the Innovation committee were to be systematically investigated in order to derive proposals for optimizing transfer success. As part of a scoping review, all Innovation Fund projects funded in the period 2016-02/2023 with a focus on patient safety were analyzed. Each included study document was critically reviewed by two independent persons. The 16 included projects addressed a wide range of populations, indications and interventions. The study quality was mostly good. The results ranged from feasible indicator sets and the prevention of adverse drug reactions to the optimization of error management. For seven projects, the Innovation Committee recommended forwarding the results to healthcare institutions with the request that they take note and/or examine the feasibility of implementation in standard care. Implementation, however, has not yet taken place. In order to facilitate implementation, the joint development of an implementation strategy by the recipients of the Innovation Committee's recommendations is necessary.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"179-192"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989151","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":"[In times of crisis, utilization of medical services by mothers decreases - Are single mothers affected more?]","authors":"Michael Erhart, Doreen Müller, Julie Lorraine O'Sullivan","doi":"10.1055/a-2508-1329","DOIUrl":"https://doi.org/10.1055/a-2508-1329","url":null,"abstract":"<p><p>Accessing medical services requires resources, which can be particularly scarce for single parents. During times of crisis and the associated daily challenges, the threshold for seeking out medical care increases further. This study is based on data on 6,155 mothers from the Socioeconomic panel (SOEP) survey waves of 2019 and 2021. The COVID-19 pandemic is used here as an example of a crisis. The results suggest that single parents have an overall higher need for medical care, reflected by poorer health and more medical diagnoses. During the COVID-19 pandemic, a decline in the utilization of healthcare services was observed, especially among single mothers. It is important to create support opportunities for (single) mothers to improve and maintain their health during times of crisis.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411258","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":"[Determinants of the utilization of general health check-up among older adults in Saxony-Anhalt: What is the influence of access to health services?]","authors":"Denise Kubat, Jelena Epping, Christoph Stallmann, Stefanie March, Enno Swart","doi":"10.1055/a-2446-6583","DOIUrl":"https://doi.org/10.1055/a-2446-6583","url":null,"abstract":"<p><p>Due to the nature of demographic developmens, there is an increasing need for prevention measures in healthcare. In Germany, people with statutory health insurance have a legal right to general health check-ups for early detection of diseases that are significant in terms of population medicine. However, the older population has thus far made inadequate use of these services, resulting in significant losses of prevention potential. This paper examines the impact of objective and subjectively perceived access to health services on the use of general health check-up among citizens aged 55 years and older in the state of Saxony-Anhalt, Germany.The study uses data from a written cross-sectional survey of residents from four major and minor cities in Saxony-Anhalt. Bivariate logistic regression models were used for the statistical analysis of data to evaluate the relation between access parameters to health services and utilization.In all, 953 questionnaires were included in the analyses; 59.7% of the respondents used the general health check-up in the recommended time interval. In the multivariate analyses, the study showed that neither subjective satisfaction with access nor self-reported travel times to family doctors were significant factors affecting the utilization. On the other hand, being a member of statutory health insurance funds and the use of a private car increased the likelihood of utilization. Other determinants that had an influence on the use of general health checks were net household income and need for long-term care.The results of this study indicate potential for increasing utilization of general health check-up among older people. However, increased use of free health check-ups by this section of the population cannot be achieved primarily by improving accessibility, but must be addressed by other factors, such as attitudes towards health checks, which requires further analysis.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371306","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}