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Background: Attention to the healthcare workforce has increased, yet comprehensive information on migrant healthcare workers is missing. This study focuses on migrant healthcare workers' experiences and mobility patterns in the middle of a global health crisis, aiming to explore the capacity for circular migration and support effective and equitable healthcare workforce policy., Methods: Romanian physicians working in Germany during the COVID-19 pandemic served as an empirical case study. We applied a qualitative explorative approach; interviews (n = 21) were collected from mid of September to early November 2022 and content analysis was performed., Results and Discussion: Migrant physicians showed strong resilience during the COVID-19 crisis and rarely complained. Commitment to high professional standards and career development were major pull factors towards Germany, while perceptions of limited career choices, nepotism and corruption in Romania caused strong push mechanisms. We identified two major mobility patterns that may support circular migration policies: well-integrated physicians with a wish to give something back to their home country, and mobile cosmopolitan physicians who flexibly balance career opportunities and personal/family interests. Health policy must establish systematic monitoring of the migrant healthcare workforce including actor-centred approaches, support integration in destination countries as well as health system development in sending countries, and invest in evidence-based circular migration policy., (© 2024 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

This paper discusses the conception of a joint intercultural students' research program of one German and two Kyrgyzstani teachers and students from the Otto-von-Guericke University of Magdeburg (Germany) and the American University of Central Asia (Bishkek, Kyrgyzstan). The paper conceptualizes such a research training program and gives reference to qualitative methods teaching in the two corresponding universities. What follows is a description of the chosen research topic: "The 'Intersections' of Gender, Family, and Society in Kyrgyzstan" and the course program. With different academic cultures concerning research ethics in the Anglo-Saxon and continental European contexts, a challenge for such a program will be addressed. A short review of the research results of the different students' teams is provided, and the paper is finalized with a self-reflection upon such a joint intercultural undertaking.

Background: The Communication and Tracing App HIV (COMTRAC-HIV) project is developing a mobile health (mHealth) app for integrated care of HIV patients in Germany. The complexity of HIV treatment and continuous care necessitates the need for tailored mHealth solutions. This qualitative study explores design solutions and a prototype to enhance the app's functionality and effectiveness., Methods: A total of eight HIV patients and pre-exposure prophylaxis (PrEP) users, recruited at the HIV Center Frankfurt, participated in focus groups and thinking-aloud tests (TA test). In the focus groups, design solutions were discussed for user-interface clarity, leading to the development of an interactive prototype, the usability of which was evaluated with a TA test. Data collection involved video/audio recordings. Qualitative analysis was conducted using a deductive category system, and focused on app design and usage in focus groups, and layout, navigation, interaction, terminology, comprehension, feedback, and level of satisfaction in TA tests., Results: The app was commended for its simple, clear design, especially its medication reminders and health tracking features. Opinions on the symptom diary varied however, respondents noting it more suitable for HIV users than PrEP users. Privacy concerns suggest avoiding display of HIV-specific information. Suggested improvements include e.g. image uploads, drug interaction checks and prescription tracking. A total of 25 usability issues were identified in the TA test, with most found in the layout (n = 6), navigation (n = 5), interaction (n = 5), and terminology (n = 5) categories. Two examples are non-intuitive controls and illogical button placement. Despite these disadvantages, participants noted positive impressions (n = 5) in the satisfaction category., Conclusion: The study emphasizes the need for patient-centered design in mobile HIV care solutions, highlighting to the app's user-friendliness and potential to enhance care. Further research is necessary to refine the app's functionality and to align it with clinical and patients' privacy needs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Most new parents spend the first few days with their newborns in the hospital., Problem: Although negative hospital care experiences can have short- and long-term negative consequences (e.g., risk of postnatal depression), only a handful of studies have investigated experiences of maternity care after birth., Aim of the Study: The aim was to gather more detailed information on the experiences during the immediate postpartum period at the maternity ward, in order to confirm and complement previous findings with additional data sources., Methods: A content analysis was conducted on 524 textual units comprising ratings of maternity care units in Germany provided by mothers or accompanying individuals. These units were sourced from a publicly accessible website., Findings: The analysis identified three overarching themes that influenced positive or negative experiences: Hospital and Maternity Ward Infrastructure; Midwifery, Medical, and Nursing Care; and Breastfeeding and Establishing a Breastfeeding Relationship., Discussion: The findings indicate systemic challenges within the medical system, including persistent issues such as staff shortages and overworked personnel. Additionally, critical primary support structures related to early parental mental health care and breastfeeding initiation were found to be lacking in certain hospitals., Conclusion: These results underscore the necessity for structural reforms within hospitals to establish a comprehensive prevention network capable of early problem detection and intervention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Filled in by Hanna Maly-Motta, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In this paper, we analyze the subjective inclusion experiences of visually impaired (VI) adult tennis players from an ableism-critical perspective. The primary focus of this research is the inclusive potential of blind tennis from the perspective of VI individuals. Episodic interviews were conducted to capture subjective perspectives. A qualitative text analysis revealed that the interviewees were confronted with multiple ability assumptions by sighted people in their everyday lives. Deficit notions on the performance of VI people included sports, work, and general activities. Participation in blind tennis helped the interviewees build a "competent identity" and acquire various skills useful for their everyday lives as participation in blind tennis was a pathway for competence in sports. Further research is needed to identify exclusion experiences from the perspective of disabled people to recognize the potential of different sports in reducing barriers to participation. [ABSTRACT FROM AUTHOR]

Purpose: In Germany, children diagnosed with cancer survive their initial disease in more than 80%, and the majority will become long-term survivors. Around the age of 18, survivors are transferred to adult healthcare. The transition can be a critical period in the process of care at which many childhood cancer survivors discontinue to participate in regular follow-up care. Hence, the objective of the paper was to explore (a) survivors' attitudes towards pediatric follow-up care and (b) their concerns regarding the transition process to draw conclusions for optimizing pediatric care and transition processes., Methods: We conducted semi-structured interviews with 21 adolescent childhood cancer survivors between the ages of 14 and 20. The survivors were recruited via a pediatric oncology department of a university hospital in Germany. Based on the principles of qualitative content analysis, a deductive-inductive method according to Kuckartz was applied., Results: Based on the interview guide and derived from the exploratory research questions, two key categories were generated: (a) Survivors' attitudes towards pediatric follow-up care, which encompasses all formal and emotional aspects of survivors regarding follow-up care, and (b) their concerns regarding transition from pediatric to adult healthcare, where hindering and facilitating factors for a successful transition occur. Our results show high satisfaction among survivors with follow-up care. Nevertheless, they wish to be more integrated into processes and the organization of their follow-up care. Most adolescent survivors do not feel ready for transition., Conclusion: The integration of survivors into the organization processes and routines, and the promotion of emotional detachment from pediatric health care professionals (HCPs) are important to reduce concerns and uncertainties of adolescent survivors regarding the transition process and to promote subjective readiness for transition. To gain confidence in the adult healthcare, it is crucial to provide tailored education depending on individual requirements and needs and to build trusting relationships between survivors and adult HCPs., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

For the career development of postdocs in academia, universities in Germany are offering mentoring programs to postdocs. They aim to encourage, support and mentor the postdocs toward professorship via face-to-face mentoring, workshops, and networking support. The mentoring programs are carefully designed; however, their success is dependent on multiple factors. The study explores the communication patterns in mentoring between professors and postdocs, and its impact on their professional development. Data was collected and analyzed using Grounded Theory. The data was collected from twenty-five semi-structured in-depth interviews with professors and postdocs across Germany. Classicand Constructivist Grounded Theory was used for data analysis. The paper presents a Communication in Mentoring Model for the professional development of postdocs. The model can be used as a tool to ensure successful communication for better professional relationships in mentoring as well as in professional environments. The paper recommends a longitudinal study to further explore Communication in Mentoring and its impact on postdocs over a period of time. [ABSTRACT FROM AUTHOR]

A growing interdisciplinary literature examines the role of hair textures and styles in Black and mixed‐race women's identity performances. Through an analysis of travel narratives, this paper extends and complements research on the context‐dependency of racialized identity performances. This paper presents an analysis of 24 qualitative interviews with Black and mixed‐race women in England and Germany. The question it seeks to answer is: 'How do changes in context alter Black and mixed‐race women's hairstyling practices as a performance of identity?' Navigating a novel context could lead the women to (1) conform to local standards of beauty and femininity, (2) resist external expectations, (3) try out novel performances and (4) negotiate the complex performance of belonging. All in all, this paper shows that Black and mixed‐race women dialogically re/negotiated and performatively re/created how they identify and how they are identified by others as they moved from one context to another. [ABSTRACT FROM AUTHOR]

Introduction: The digitalisation of the German healthcare system enables a wide range of opportunities to utilize healthcare data. The implementation of the EHR in January 2021 was a significant step, but compared to other European countries, the implementation of the EHR in the German healthcare system is still at an early stage. The aim of this paper is to characterise the structural factors relating to the adoption of the EHR in more detail from the perspective of representatives of stakeholders working in the German healthcare system and to identify existing barriers to implementation and the need for change. Methods: Qualitative expert interviews were conducted with one representative from each of the stakeholder groups health insurance, pharmacies, healthcare research, EHR development and panel doctors. Results: The interviews with the various stakeholders revealed that the implementation process of the EHR is being delayed by a lack of a viable basis for decision-making, existing conflicts of interest and insufficient consideration of the needs of patients and service providers, among other things. Discussion: The current status of EHR implementation is due to deficiency in legal regulations as well as structural problems and the timing of the introduction. For instance, the access rights of various stakeholders to the EHR data and the procedure in the event of a technical failure of the telematics infrastructure are remain unclear. In addition, insufficient information and communication measures have not led to the desired acceptance of EHR use among patients and service providers. [ABSTRACT FROM AUTHOR]

Assuming that policy design can impact gender equity in caretaking, this paper examines how expectant mothers and fathers understand and respond to specific parental leave policy elements when shaping their parenting practices. Taking Germany as a case study, this research draws on semi-structured interviews conducted between October 2019 and March 2020 with 18 couples, who were expecting their first child at the time of the interview. Germany's parental leave policy has shifted substantially since 2007, most notably with the establishment of non-transferable parental leave months for fathers. Exploring the link between policy design at the macro-level and parental involvement at the micro-level, this paper focuses on how mothers and fathers make sense of their leave entitlements when dividing leave, which (policy) aspects they consider as helping or hindering an equal leave division and how mothers and fathers anticipate using parental leave benefits. Results indicate that the current parental leave policy design enables greater equity in caretaking by normalizing some leave-taking by fathers. However, by providing an option for fathers' leaves to be split and to be taken concurrently with mothers the policy limits fathers' solo parenting responsibility and consequently prevents a transformation of gendered parenting practices. [ABSTRACT FROM AUTHOR]

Purpose: The self-initiated nature of migration by self-initiated expatriates (SIEs) may make them more susceptible to the impact of the national context within which their adjustment takes place. Consequently, the failure or success of the expatriation depends on an SIE's ability to adapt to this national context. The paper aims to contribute to the adjustment theory literature by using the contextual angle and examining the impact of historical, legal, employment and hiring contexts on adjustment. Design/methodology/approach: The paper uses data from a qualitative study of 42 in-depth interviews with German SIEs. The study used semi-structured in-depth interviews in order to collect a wide range of information on adjustment experiences, circumstances and expectations, enabling comparative analysis. All participants have self-initiated their move to Britain and relocated without organisational support, held university diplomas, worked according to their qualifications and relocated following a job offer. Findings: Among the study's main findings is impact of national context on adjustment experience, especially the historical relations between the countries involved. German SIEs have enjoyed easy adaptation in their new workplaces due to structurally favourable positions within the local hierarchies of prejudice, which can be attributed to the complex historical relations between Germany and Britain. Furthermore, this study draws the attention to the particularities of the nationally constructed hiring practices. In particular, the speedy recruitment in Britain presented additional challenges in adjustment for some participants, while facilitating it for others. Research limitations/implications: This study focuses on a specific population, and further research is needed to determine whether the findings can be generalised to other groups of SIEs in Britain and elsewhere. Another limitation of the study is the homogeneous nature of the sample in terms of education level and participant employment status (educated at a university level and found employment before relocation). Future research avenues include applying a comparative approach and focusing on the intersection between national context, employment circumstances, educational level and SIE adjustment. Practical implications: The study documents the complex effects of the hiring context on SIE adjustment and suggests that communicating the nationally constructed recruitment practices will align the expectations of both parties. This may increase the effectiveness of hiring and placing within the company and have a positive impact on the adjustment and work performance of the SIE. Furthermore, understating the particularities of each national context can enable international human resources management (IHRM) professionals to assess the specificity of each potential employee and can provide well-considered suggestions concerning the effect of country-specific legal and historical context on their adjustment and hence provide SIEs with tailored support. Originality/value: Although the adjustment of SIEs has attracted considerable research interest in recent years, it is often limited compared to the attention focused on assigned expatriates. This paper adds several original contributions to the IHRM literature. First, it expands knowledge on SIEs adjustment from a single country of origin living in a specific host country. Second, it enables a deep examination of the impact of the specific national context on SIEs adjustment as informed by certain historical and legal relations, as well as locally constructed hiring and employment practices. [ABSTRACT FROM AUTHOR]

Aims: To investigate factors that influence the willingness of inactive nurses to return to nursing in a crisis situation and to identify aspects that need to be considered with regard to a possible deployment. Design: A deductive and inductive qualitative content analysis of semi-structured focus group interviews. Methods: Semi-structured focus group interviews with inactive or marginally employed nurses, nurses who have been inactive for some time and nursing home managers in October and November 2021. The participating inactive nurses had declared their willingness for a deployment during the COVID-19 pandemic or not. Data were analysed using qualitative content analysis. Results: Communication was seen as essential by the participants for an informed decision for or against a temporary return to nursing and to potential or actual deployments. To make them feel safe, inactive nurses need to know what to expect and what is expected of them, for example, regarding required training and responsibilities. Considering their current employment status, some flexibility in terms of deployment conditions is needed. A remaining attachment to care can trigger a sense of duty. Knowledge of (regular) working conditions in nursing can lead to both a desire to support former colleagues and a refusal to be exposed to these conditions again. Conclusion: Past working experiences and the current employment situation play a major role in the willingness of inactive nurses to return to nursing in a crisis situation. Unbureaucratic arrangements must be provided for those who are willing to return. Summary Statement: • What already is known - In crisis situations, not every inactive nurse is willing or able to return to nursing and therefore, the 'silent reserve' may not be as large as suspected. • What this paper adds - Inactive nurses need to know what to expect and what is expected of them for their decision regarding a return to active patient care during a crisis situation. • Implications for practice/policy -- Inactive nurses need to be informed and should be offered free training and refresher courses to ensure patient safety. Impact: This research shows that the group of inactive nurses are not a silent workforce which can be activated anytime. Those who are able and willing to return to direct patient care in crisis situations need the best possible support -- during and between crises. Reporting Method: This study adhered to COREQ guidelines. No Patient or Public Contribution: The involvement of patients or members of the public did not apply for the study, as the aim was to gain insight into the motivations and attitudes of the group of inactive nurses. [ABSTRACT FROM AUTHOR]

In Germany, as in many other European countries, vast changes in the welfare regime – towards workfare – have taken place. As a central activating element of workfare, sanctions were introduced to take effect by temporarily increasing deprivation through benefit cuts. This paper provides first quantitative insights on the effect of first sanctions on deprivation and contributes to the recent debate on the (un)constitutionality of sanctions, which re-emerged after a verdict of the Federal Constitutional Court, criticizing the lack of knowledge about the effects of sanctions on those affected. We implement a difference-in-differences propensity score matching approach that addresses selection on observables and individual time constant unobserved differences. High data accuracy is ensured by combining the "Panel Labour Market and Social Security" (PASS) with administrative data from the Federal Employment Agency. The results illustrate a slightly higher yet statistically insignificant level of deprivation for first-sanctioned unemployment/basic income recipients compared to non-sanctioned recipients. The results hint in the direction that higher levels of deprivation are not what activates the sanctioned beneficiaries to reintegrate into the labour market. We discuss whether the results imply a significant deviation from the socio-cultural subsistence minimum of sanctioned recipients and a failure of the welfare state. [ABSTRACT FROM AUTHOR]

Copyright of Tourism Review is the property of Emerald Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contract-based nature protection schemes are a voluntary mechanism, with a limited contract duration, that aim to raise the acceptance of biodiversity conservation practices in agriculture among farmers and other land users. The purpose of this paper is to analyse the institutional settings of contract-based nature protection based on the-- "Institutions of Sustainability" (IoS) framework in the German Rhine-Sieg district, and to outline the way in which policy measures should be designed to encourage farmers to participate in contract-based nature protection programmes. This was achieved by answering research questions to identify the challenges, potentials and obstacles of a contract-based nature protection scheme in different "sub-arenas" as defined in the IoS framework. Qualitative research methods were used as the methodology. The analysis shows that main constraints for sufficient implementation of contract-based nature protection schemes are the limited consideration of the impact of climate change during the contract period, the limited consideration of regional conditions as regards the measures taken on the ground and an inflexible contract duration. [ABSTRACT FROM AUTHOR]

Aim: To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing. Background: Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care. Introduction: In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles. Methods: We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist. Results: Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance. Discussion: In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications. Conclusion and implications for nursing and/or health policy: In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration). [ABSTRACT FROM AUTHOR]

Background: The communication processes between different stakeholders in outpatient palliative care face challenges when multiprofessional teams want to keep each other updated on patient information. Meanwhile, the software market offers different tools to connect these teams in real-time to improve communication. In the research project ADAPTIVE (Impact of Digital Technologies in Palliative Care), we investigated how information and communication technology affects collaboration and work in multiprofessional teams and what advantages and disadvantages the use of said software might entail. Methods: We conducted 26 semi-structured interviews between August and November 2020 with general practitioners (n = 8), palliative care nurses (n = 17), and a pharmacist (n = 1). They were conducted in a hybrid format, meaning that both face-to-face interviews and telephone interviews were carried out. Subsequently, we analyzed the interviews following the qualitative content analysis according to Kuckartz. Results: Information and communication software has the potential to enable faster communication and delegation of tasks and to simplify communication and task management between providers. Furthermore, it creates the opportunity to decrease unnecessary supervision of duties and responsibilities for physicians in multiprofessional teams. Therefore, it allows facilitating the collaboration between multiprofessional teams that work independently of each other but care for the same patients. All providers have the same knowledge about their patients without time-consuming coordination such as phone calls or search processes in paper documentation. On the other hand, mishandling, poor Internet connection, and unfamiliarity with various features can diminish these benefits. Conclusion: Even though the use of such software offers many advantages, these advantages only reveal themselves if the software is used as it was intended by the developers. Misuse and unawareness of the individual functions can lead to the full potential not being realized. The software developers frequently offer specialized training, and the multiprofessional teams should utilize that to improve team communication, facilitate tasks, and allow physicians to delegate tasks. Trial registration: The study is registered in the German Clinical Trials Register (DRKS): https://www.drks.de/drks%5fweb/navigate.do?navigationId=trial.HTML&TRIAL%5fID=DRKS00021603 (Registration number: DRKS00021603; date of first registration: 02/07/2020). [ABSTRACT FROM AUTHOR]

Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Circular economies are an important pillar of sustainable production and consumption. This particularly applies to the agri-food industry, which is characterised by large amounts of organic waste and by-product streams posing a serious challenge for many food producers. Therefore, respective firms increasingly adopt circular economy business models (CEBMs) to manage these resource flows effectively. However, there is only little knowledge on the functioning of CEBMs in bio-based industries, especially from a socio-economic perspective. We address this gap by exploring enablers and motivations behind such business models as well as the institutional contexts they are embedded in. In methodological terms, we adopt a case study approach using the example of potato production in Lower Saxony (northwest Germany). The core of the paper is a qualitative in-depth analysis of four potato processors, adopting varying business models to valorise their by-product streams (e.g. peels, scraps, pulp) either 'in-house' or in partnerships with external partners. The findings show that the implementation of CEBMs results from a complex interplay of internal and external enablers, with economic considerations as the main impetus for the management of biological reverse cycles. Thereby, we found a shifting economic logic in the assessment of potato by-products from disposable waste to valuable resources for other sectors (e.g. livestock farming, bioenergy, biofuels). While being encouraged by targeted policies, the companies studied feel increasingly affected by emerging sustainability discourses, prompting them to (re)design and (re)frame their CEBMs in view of environmental and societal issues. [ABSTRACT FROM AUTHOR]

Background: Person-centred care (PCC) has been suggested as the preferred model of dementia care in all settings. The EPCentCare study showed that an adapted PCC approach was difficult to implement and had no effect on prescription of antipsychotics in nursing home residents in Germany. This paper reports the qualitative process evaluation to identify facilitators and barriers of the implementation of PCC in German nursing homes from the perspective of participating practice development champions. Methods: Five individual and 14 group interviews were conducted with 66 participants (staff and managers) from 18 nursing homes. The analysis was based on inductive coding to identify factors influencing the PCC implementation process. Identified factors were systematised and structured by mapping them to the four constructs (coherence, cognitive participation, collective action, reflexive monitoring) of the Normalization Process Theory (NPT) as a framework that explains implementation processes. Results: Facilitating implementation factors included among others broadening of the care perspective (coherence), tolerance development within the care team regarding challenging behaviour (cognitive participation), testing new approaches to solutions as a multi-professional team (collective action), and perception of effects of PCC measures (reflexive monitoring). Among the facilitating factors reported in all the NPT constructs, thus affecting the entire implementation process, were the involvement of relatives, multi-professional teamwork and effective collaboration with physicians. Barriers implied uncertainties about the implementation and expectation of a higher workload (coherence), concerns about the feasibility of PCC implementation in terms of human resources (cognitive participation), lack of a person-centred attitude by colleagues or the institution (collective action), and doubts about the effects of PCC (reflexive monitoring). Barriers influencing the entire implementation process comprised insufficient time resources, lack of support, lack of involvement of the multi-professional team, and difficulties regarding communication with the attending physicians. Conclusions: The findings provide a comprehensive and detailed overview of facilitators and barriers structured along the implementation process. Thus, our findings may assist both researchers and clinicians to develop and reflect more efficiently on PCC implementation processes in nursing homes. Trial registration: ClinicalTrials.gov identifier: NCT02295462; November 20, 2014. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the relationship between subjectivity and the other during the course of integration among 50 young Muslims of dual national heritage in Germany. The largest group of migrants within Germany are people of Turkish and Kurdish origin. During the summer and autumn of 2018, we interviewed 50 individuals of both genders aged between 18 and 25. The interviews were carried out and evaluated in North Germany. We saw that the 'feeling of being held', 'being‐able‐to‐process‐(negative)‐experiences' and 'to take responsibility for oneself and other' are characteristics of well‐educated young Muslims. Those who feel at home in their Turkish family or in the Islamic religion are able to process positive and negative experiences and present more (mature) super‐ego structures. This allows them to be able to deal with the challenges of migration and integration. Based on the data, we developed the 'Triadic Model of Integration' within the Lacanian L‐Scheme of Subjectivity. [ABSTRACT FROM AUTHOR]

Collaboration among health care providers is intended to dissolve boundaries between the sectors of health care systems. The implementation of adequate augmentative and alternative communication (AAC) care of people without natural speech depends highly on collaboration among multiple stakeholders such as speech and language pathologists, teachers, or physicians. This paper examines existing barriers to and facilitators of collaboration from a stakeholder perspective. Five heterogeneous focus group interviews were conducted with N= 32 stakeholders including speech and language pathologists, AAC consultants, teachers, employees of sheltered workshops, parents, and relatives of AAC users, and other educational professionals (e.g., employees of homes for persons with disabilities) at three AAC counseling centers in Germany. Interview data were analyzed by structured qualitative content analysis. The results show very different experiences of collaboration in AAC care. Factors were identified that can have both positive and negative effects on the collaboration between all stakeholders (e.g., openness toward AAC, knowledge about AAC, communication between stakeholders). In addition, stakeholder-specific influencing factors, such as working conditions or commitment to AAC implementation, were identified. The results also reveal that these factors may have an impact on the quality of AAC care. Overall, the results indicate that good collaboration can contribute to better AAC care and that adequate conditions such as personnel, and time-related resources, or financial conditions need to be established to facilitate collaboration. [ABSTRACT FROM AUTHOR]

This article explores the findings of a qualitative study comparing social work and human service practice with people who have sought asylum in Germany and Australia. Globally social workers are concerned with the record high of people forcibly displaced worldwide and the Global North host-nations' increasingly hostile, discriminatory and restrictive policies towards people seeking asylum. This policy context is antithetical to the professional values of social workers and human services practitioners. The findings of this study reveal how the policy directly impacts social work and human service practice, creates unique ethical challenges and dilemmas and, subsequently, diverse practice responses. The paper also suggests that the country of practice influences how practitioners perceive and respond to ethical challenges and dilemmas. Through doing so, the findings challenge traditional understandings of critical practice theories that suggest that practice focused solely on the individual level is inadequate for work with people seeking asylum. Due to the diversity of contexts and their influences, we encourage social work and human services to view practice on a personal-political continuum when working with people seeking asylum. [ABSTRACT FROM AUTHOR]

Background: Hybrid working arrangements that combine remote and office work are on the rise. Although hybrid work has been associated with mental health benefits in employees, challenges in the transformation to hybrid persist particularly in public administration organizations which have been connected to a pronounced culture of presence and inadequate technical infrastructure. Further evidence on the link between hybrid working conditions and employee health is needed. To support the establishment of healthy hybrid working conditions, this study aims to identify employees' job demands, resources and support needs in public administration. Methods: Semi-structured interviews were conducted with N = 13 employees who work hybrid in public administration organizations in Northern Germany between February and May 2023. Interviewees were asked about their perceived job demands, resources, and support needs in hybrid work. The data was analyzed in a deductive-inductive approach of qualitative content analysis, primarily supported by the job demands-resources model as a theoretical framework. Results: Several job demands, e.g., an increase in work and meetings, and resources such as personal freedom and responsibility, were identified in the context of hybrid work. A multitude of the reported job resources and demands relate to work organization and social relationships. The results disclose discrepancies between participants' experiences of job demands and resources, underlining the subjectivity of employees' perceptions of hybrid working conditions. Interviewees' support needs for hybrid work also varied, encompassing structural-level aspects such as increased acceptance and promotion of hybrid work in the organization as well as behavioral-level aspects, for instance, strategies and self-discipline for boundaries and structure. Conclusions: This study provides a first comprehensive overview of the job demands, resources and support needs in hybrid work in public administration. This study builds an important basis for further research to understand the impact of hybrid working conditions on health-related employee outcomes. The identified support needs provide a valuable point of reference for health-promoting hybrid working conditions which public administration employers should begin establishing as early as possible in the ongoing transition to hybrid work. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

Introduction: With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance. Methods: In our explorative qualitative case study we conducted semistructured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools. Results: We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons. Discussion: Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed. [ABSTRACT FROM AUTHOR]

Demographic changes have led to an increase in older people in prisons. Whereas the rehabilitative process of younger offenders is geared towards their reintegration into the labour market, successful ageing should be a policy aim for older prisoners. This study explores how older incarcerated persons view their ageing. A qualitative study using a written survey with only the single question What does ageing in prison mean to you? was conducted in Bavaria, Germany. A total of 64 prisoners (61 male, 3 female) supplied answers varying in length from a few words to several pages. The thematic analysis revealed that together with health concerns, social relations and everyday activities, the uncertainty of the future was a central focus point for the older adults in prison. The authors propose that a positive vision of the future needs to be included in any model of successful ageing. If successful ageing is used as an aim for older prisoners, more attention needs to be paid to support interventions during and after the release process. [ABSTRACT FROM AUTHOR]

Background: This study investigates the subjective perceptions of food poverty in Germany by analysing Twitter discourse using the German-language hashtag #IchBinArmutsbetroffen (#IamPovertyAffected) and examines the extent to which various dimensions of a multidimensional theoretical model of food poverty are represented in the discourse. Methods: Employing a combination of computational social science and qualitative social research methods, the research identifies, and analyses tweets related to nutrition by applying a hierarchical dictionary search and qualitative content analysis. By examining the narratives and statements of individuals affected by food poverty, the study also investigates the interplay among different subdimensions of this phenomenon. Results: The analysis of 1,112 tweets revealed that 57.96% focused on the material dimension and 42.04% on the social dimension of food poverty, suggesting a relatively balanced emphasis on material and social aspects of food poverty in the narratives of those affected. The findings reveal that tweets on material food poverty underscore economic challenges and resource scarcity for food. Social food poverty tweets demonstrate widespread deprivation in social participation, leading to isolation, exclusion, and social network loss. Overall, the results elucidate intricate interconnections among subdimensions and multidimensional manifestations of food poverty. Conclusions: This study contributes methodologically by presenting an approach for extracting food-related textual social media data and empirically by providing novel insights into the perceptions and multifaceted manifestations of food poverty in Germany. The results can aid in a better understanding of the phenomenon of food poverty as it currently manifests in Germany, and in developing targeted social, health-promoting, and political measures that address more effectively the empirically evident multidimensionality of the phenomenon. [ABSTRACT FROM AUTHOR]

Background: Supervised injectable opioid treatment (SIOT) is a promising alternative for people living with opioid use disorder (OUD) who have not sufficiently benefitted from oral opioid substitution treatment. Yet, SIOT utilization remains limited in Germany. We propose that this is due to beliefs, or schemas, on SIOT among people living with OUD. Drawing from medical sociology and social psychology, this study explores the emergence and evolution of such schemas on SIOT. Methods: We conducted semi-structured interviews with 34 individuals currently in or eligible for SIOT in two German outpatient treatment facilities and paralleled an inductive qualitative content analysis with the exploration of individual cases. Results: The analysis revealed that peer-to-peer interaction and individuals' practical experiences in therapy are crucial in constructing and changing idiosyncratic and shared schemas of SIOT. When facing ambiguous information, cognitive strategies like subtyping served to mitigate uncertainty. Conclusion: This research has important practical implications for integrating experiential knowledge into clinical care and improve information sharing among people living with OUD. A nuanced understanding of the complex network of informal advice-seeking and -giving among people living with OUD is indispensable to adequately expand treatment modalities of proven effectiveness. [ABSTRACT FROM AUTHOR]

Background: Food-related behaviour is a very complex topic. A common way to reduce complex issues to their essential content is to create a typology. In Germany, with regard to food-related behaviour, the creation of a typology has often been carried out by commercial research institutes, but also by (international) scientific institutes. The former have mostly used quantitative methods, the latter usually have a specific content focus. Within this study, we want to investigate how people integrate eating into their everyday lives while engaging with themselves and the environment, thereby living out personality development and related socialisation. Methods: 37 qualitative interviews were conducted and evaluated by means of content-structuring qualitative analysis and type-forming qualitative content analysis. Interviewees were recruited via recruitment calls using different channels, such as newspapers or university e-mail lists. Participants over the age of seventeen were eligible to take part in the study. Both the individual action processes and the interpretation processes regarding food-related behaviour were taken into account. The final sample consisted of 20 male and 18 female participants with an age range from 18 to 83. Results: The result were seven eating action types, namely: Eating as a way of life, The Relaxed, Eating as self-determination, Eating as a necessary Evil, The Adaptive, The Overstrained and The Controlled. Conclusions: We contribute to the study of food-related behaviour with the chosen qualitative method of type-building and by looking at how people integrate eating into their everyday lives. This contributes to a broader understanding of this phenomenon and complements the findings of existing commercial and academic food-related typing-building activities. Specifically, through identifying "The Overstrained" as a novel eating action type, this study adds to the literature in the field and may be a useful baseline for future research. [ABSTRACT FROM AUTHOR]

Introduction: Hospitalised patients could benefit from the emergence of novel technologies for nursing care. There are numerous technical products available, but these rarely find their way into practice. Further knowledge is required about the circumstances under which technology in nursing is accepted and used. In the research project "Centre for Implementing Nursing Care Innovations", technical innovations are implemented on a trauma surgery inpatient ward in Germany. After implementation, it was investigated: Which implemented technologies are accepted/rejected, and which factors influence the acceptance/rejection of technology for nurses? Material and methods: A focused ethnography was used, containing two approaches: First, participant observation was conducted to examine nurses' and patients' interaction with technologies. Observations were fixed in a field research diary and analysed using evaluative qualitative content analysis. Second, a questionnaire was used by nurses to provide information about the use frequency and technology suitability. The results of the study were consolidated and analysed using the UTAUT model. Results: Seven studied technologies can be summarised in four result categories: (1) A Mobilising mattress, a Special projector and a Sound pillow are accepted and used by nurses and patients, because they offer a way to provide high quality care with little additional effort. (2) A Fall prevention system is consistently used in patient care as a work obligation, but since nurses consider the system error-prone, acceptance is low. (3) An Interactive therapy ball is accepted but nurses cannot use it due to the high workload. (4) An App for nurse-patient communication and a work-equipment tracking system are not used or accepted because nurses do not see a practical benefit in the systems. Discussion: Acceptance or rejection of a product does not necessarily equate to use or non-use of the technology. Before implementation, technology acceptance among users occurs as prejudice--when users are given time to experiment with technology, intention-to-use can stabilize into sustained use. Accepted and used technologies can serve to mask problems (such as staff shortages) and encourage problematic developments, such as the reduction of contact time at the bedside. Therefore, technology acceptance should be qualified in asking to what accepted technology contributes. [ABSTRACT FROM AUTHOR]

Background: Volunteers have always been integral to hospice and palliative care. However, their roles have been left relatively undefined and broad. Aim: This study aims to examine the role of hospice volunteers in German inpatient hospice and palliative care. The question we seek to answer is: What do hospice volunteers contribute to everyday life in inpatient hospice and palliative care units? Methods: We undertook a multicenter, on-site qualitative interview study, utilizing problem-centered interviews with 16 volunteers from five inpatient hospice units and one hospital palliative care unit. Interviews were analyzed using grounded theory. Results: Analysis of the interviews revealed three typical characteristics of how hospice volunteers' describe their own role: (1) performing small acts of kindness, (2) creating a family-like atmosphere, (3) expecting emotional experiences. A common theme across all categories is the emphasis on spontaneous actions and personal experiences. The process of dying becomes an experience interpreted by volunteers as enriching, as a gift, as a "teacher". Conclusion: Granting hospice volunteers freedom to act spontaneously and intuitively benefits hospice and palliative care delivery. Organizations should leave sufficient room for spontaneity in order to involve volunteers effectively. Open and unstandardized roles facilitate dynamic work practices. [ABSTRACT FROM AUTHOR]

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Background: The COVID pandemic is an example of a crisis challenging healthcare systems worldwide. The impact of the pandemic on providing high-quality palliative care calls for a deeper understanding of specialist services during crises. This is essential in preparation for further crises. Aim: To develop a conceptual understanding of the impact of the pandemic on specialist palliative care as an example for arising future crises. Design: Qualitative interview study across Germany, following a constructivist grounded theory methodology. Setting/participants: Eleven semi-structured interviews with experts with overarching knowledge of structures and processes in specialist palliative care between 05–07/2020 and between 02–06/2021, 23 semi-structured interviews with healthcare professionals working in a specialist palliative care setting. Results: The complex system of palliative care provision during crises has properties that cannot be understood as separated parts of the care process. The pandemic led to unique structural and processual challenges characterized by interconnectedness, uncertainty, dynamic, underlying dilemmas, and unclear long-term goal. In response to the pandemic, teams experienced different phases, which enhanced adaption, innovation, and progress within complex care situations. Creative strategy approaches and dynamic responsiveness facilitated innovative development and could lead to long-lasting improvement within services. Availability of information, transparent communication, comprehensible instructions, participation in decision-making, and search for solutions contributed to teams' proactive development throughout the pandemic. Conclusion: Addressing the complex problems in specialist palliative care caused by crises requires system thinking and a learning mindset. This can facilitate teams to overcome the crisis and move forward rather than bounce back to normal. [ABSTRACT FROM AUTHOR]

Demographic development and continuing improvements in supportive and antineoplastic therapies are reasonable predictors of increasing travel activities carried out by patients with malignant diseases. There is a lack of data on travel habits of patients with end-stage oncological diseases. We performed a multi-phased cross-sectional study to gain insights into the intersection of travel medicine and oncology. A total of 82 patients with 21 different cancer entities at a median age of 63 years completed the final questionnaire. 90.2% of all participants rated travelling as an important or very important aspect in their lives, of whom 73.2% had participated in a short- or holiday trip after the cancer diagnosis. All but one (98.8%) participant were about to plan a short- or holiday trip in the near future. Germany (home country) was the most important travel destination, 'Relaxing' and 'enjoying nature' were the most important travel motives. Fatigue and overall (medical) insecurities were major obstacles to carry out travel plans. In conclusion, a high proportion of patients enjoy travelling. Physicians and patients are encouraged to openly discuss holiday-taking in accordance with available guidelines. More research is needed to fully understand needs and obstacles at the crossroads of travel medicine and oncology. [ABSTRACT FROM AUTHOR]

Education for sustainable development (ESD) is a policy guideline which has a significant impact on the teaching of geography in Germany. A central element of this model is to impart and develop in students a goal-oriented action competence to solve sustainability problems. However, action competence in ESD has not yet been scientifically defined or sufficiently researched. This raises the question of how teachers currently teach action competence to students as a central element of ESD. This article examines teachers' understanding of ESD, action competence and their own role in this context. To this end, a literature-based model of geographical action competence in ESD is presented. Subsequently, a qualitative triangulated teacher study is presented, which is analysed with the help of the model. It is shown that teachers generally have a high level of knowledge about ESD and are highly motivated to teach action competence. However, it becomes clear that the teachers seem to differ in their understanding of sustainable action competence as well as in their understanding of their own role. [ABSTRACT FROM AUTHOR]

(1) Background: Individual adoption experiences represent important factors in implementing innovations. In the context of health systems, where the implementation of innovations aims to improve the quality of care, they provide an important basis for developing and adapting implementation strategies. (2) Methods: This study examines the adoption experiences of (tele-)medical experts (n = 13) using the example of telemedicine in the German healthcare system by means of a qualitative, guideline-based interview study. The interview guide, as well as the deductive–inductive analysis, is based on Rogers' adoption theory. The transcription and analysis process was carried out according to Kuckartz. (3) Results: A total of 304 interview statements could be coded and assigned to the five main categories of persuasion, knowledge, implementation, decision and confirmation. More than half of all statements were coded under the main category persuasion, with its subcategories of convictions regarding the implementation of telemedicine (n = 89), international comparison of Germany's development (n = 50), telemedicine as a way of optimizing resources (n = 22) and conviction to understand telemedicine as an overall system (n = 10). (4) Conclusions: This study provides insight into how the implementation of telemedicine in the German healthcare system is perceived by experts and allows for adjustments to the ongoing implementation strategy. [ABSTRACT FROM AUTHOR]

Background: Sepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis. Based on this, concrete recommendations for the organization of care and patient information materials will be developed with close patient participation. Methods: Mixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques. Discussion: The results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae. Trial registration: Registered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023). [ABSTRACT FROM AUTHOR]

Background: "Core values" help to guide practice of health care delivery. The core values of general practice are described in the European definition of general practice by WONCA, e.g. a holistic, comprehensive and continuous care. They may be associated with the idea that the general practitioner is the owner of the practice rather than an employee. Objectives: The objective was to examine the core values of employed GPs in their professional setting and their practical manifestation. Methods: From April to May 2021, we conducted 17 semi-structured telephone-interviews with employed GPs in two districts in Baden-Wuerttemberg, Germany. The data were analysed using qualitative content analysis. Results: We identified twelve core values, including values relevant to patient care and values relevant to the lives of employed GPs. Values with high relevance were job satisfaction, the professional distance from patients, collaboration and collegial exchange, comprehensive care, adequate consultation time and availability to patients. Values with heterogeneous relevance were continuity of care, waiting times and medical autonomy. The value "availability" of employed GPs to patients was associated with both patient care and personal life. The limited availability of employed GPs was accompanied by tensions between these two trends and other values. Conclusion: The values of employed GPs are partly consistent with the current WONCA definition of general practice. There were also indications of new values. The increase in the proportion of employed GPs implies a need to reflect on the core values of general practice, taking into account factors on the part of employed GPs, patients, and practice organisation. [ABSTRACT FROM AUTHOR]

Gender disparities persist in the field of mathematics in German science and academia. From one scientific career level to the next, the proportion of female scientists decreases and women are still underrepresented in the top positions in science/academia. Gatekeeping is assumed to be one reason for the persistence of this disparity. Gatekeepers influence access to and advancement in the science system: They recruit researchers and provide support in the form of knowledge relevant for career advancement and open the way for further career steps, i.e., they hold an important decision-making position regarding the future of prospective female scientists. The study investigates if and if so, how gender disparities are reinforced in recruitment and support processes by gatekeepers in a mathematical cluster of excellence in Germany. Qualitative semi-structured interviews were conducted with 44 scientific gatekeepers in leadership positions. The results show how recruitment and support practices, perceptions, and criteria of scientific potential are interwoven with gender stereotypes, thereby creating potential barriers for female PhD students and postdocs. [ABSTRACT FROM AUTHOR]

Background and aim: Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. Methods: This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. Results: GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. Conclusion: We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context. [ABSTRACT FROM AUTHOR]

Background: In view of demographic change, there is a growing need for qualified nursing professionals. More and more people in need of care prefer to be cared for at home. A shortage of skilled workers and constantly changing and increasing professional requirements are some of the consequences. The aim of this study is to generate further insights into work-related psychosocial stress factors and the resources of outpatient caregivers in their subjective perceptions to derive approaches for possible health-promoting interventions for practice and research that promote healthier and more sustainable work. In addition, coping strategies and needs should be inquired about in order to determine support offers. Methods: Using a semi-structured interview guide, thirty outpatient nursing professionals in Germany were interviewed in 2022. The subject of this interview was the psychosocial working conditions and resources in outpatient care. The collected data were evaluated by means of the Kuckartz qualitative content analysis. Results: This qualitative study identified work-related job demands and resources in outpatient care. The way nurses are treated in the companies they work for and the appreciation of patients were explored as important resources. Physical demands, the time factor, and dealing with personal fates are primarily mentioned as stress factors. The learning effect plays an important role in dealing with these. Conclusion: This study contributes to a better understanding of current job strain and resources as well as job satisfaction in outpatient care. In any case, it became clear that the nursing staff love their profession, which they see more as a vocation. Future quantitative studies are necessary to build on these findings. First ideas of implications for health promotion measures in research and practice have already been derived. [ABSTRACT FROM AUTHOR]

Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic diseases and promoting self‐management are the responsibility of PHC nurses. Recent research assessing enablers of or barriers to nurses' efforts to support patients' participation has mostly not considered the special situation of patients with chronic diseases or focused on the PHC setting. Objective: To investigate enablers of and barriers to PHC nurses' efforts to promote the participation of chronically ill patients in their care. Methods: We interviewed 34 practicing PHC nurses and 23 key informants with advanced knowledge of PHC nursing practice in Brazil, Germany and Spain. The data was analyzed using thematic coding. Results: We identified four categories of barriers and enablers. (1) Establishing bonds with patients: Interviewees emphasized that understanding patients' views and behaviours is important for PHC nurses. (2) Cooperation with relatives and families: Good relationships with families are fundamental, however conflicts within families could challenge PHC nurses efforts to strengthen participation. (3) Communication and cooperation within PHC teams: PHC nurses see Cooperative team structures as a potential enabler, while the dominance of a 'biomedical' approach to patient care is seen as a barrier. (4) Work environment: Interviewees agreed that increased workload is a barrier to patient participation. Discussion and Conclusions: Supporting patient participation should be acknowledged as an important responsibility for nurses by general practitioners and PHC planners. PHC nurses should be trained in communicative competence when discussing participation with chronically ill patients. Interprofessional education could strengthen other professionals' understanding of patient participation as a nursing task. Patient or Public Contribution: This study is part of a research project associated with the research network 'forges: User‐oriented care: Promotion of health in the context of chronic diseases and care dependency'. The study's focus and provisional results were discussed continuously with partners in health and social care practice and presented to and discussed with the public at two conferences in which patient representatives, professionals and researchers participated. [ABSTRACT FROM AUTHOR]

What makes people feel respected or disrespected in political discussions with contrary-minded others? In two survey studies, participants recalled a situation in which they had engaged in a discussion about a political topic. In Study 1 (n = 126), we used qualitative methods to document a wide array of behaviors and expressions that made people feel (dis)respected in such discussions, and derived a list of nine motives that may have underlain their significance for (dis)respect judgments. Study 2 (n = 523) used network analysis tools to explore how the satisfaction of these candidate motives is associated with felt respect. On the whole, respect was associated with the satisfaction or frustration of motives for esteem, fairness, autonomy, relatedness, and knowledge. In addition, the pattern of associations differed for participants who reported on a discussion with a stranger versus with someone they knew well, suggesting that the meaning of respect is best understood within the respective interaction context. We discuss pathways towards theoretical accounts of respect that are both broadly applicable and situationally specific. [ABSTRACT FROM AUTHOR]

Purpose: To produce a culturally adapted translation of the Rapid Assessment of Physical Activity (RAPA) questionnaire for German speaking Austrians and to conduct a linguistic validation of the new language version. Methods: The original English RAPA questionnaire was translated into German for Austria and underwent an independent forward and back translation, followed by cognitive debriefing interviews with older adults aged 55 to 78 years with and without health conditions (n = 13), for linguistic validation. Results: Several distinct choices were made in the translation of the RAPA questionnaire to German, including the use of colloquial terms for 'physical activity' and 'intensity'; and the decision to keep to the original examples and images of different physical activities for illustrating the intensity levels (light, moderate, vigorous) of physical activity. In cognitive debriefing, interviewees commented that some example activities for the respective intensity levels could – depending on the individual – also represent a higher or lower intensity level; and that the wording of RAPA items 4 and 5, which describe the category 'under-active regular' aerobic activity, was difficult to understand. Both issues were addressed and resolved through minor iterative modifications made during the cognitive debriefing process. Conclusions: A new version of the RAPA questionnaire in German for Austria has been produced by forward and back translation and linguistic validation. The questionnaire may now undergo psychometric evaluation. [ABSTRACT FROM AUTHOR]

Background: To understand the health-related quality of life (HRQoL) in inclusion body myositis (IBM) from a holistic perspective on the background of a complex care situation. The focus was on how the patient journey may be structured over the course of this rare disease. Methods: An exploratory qualitative study was performed via in-depth semi-structured interviews. Seven patients (males n = 5) with 2011 European Neuromuscular Centre (ENMC) IBM criteria from the German IBM patient registry were interviewed for this study. The dynamic network approach of resilience and the throughput-model of health services research were used to structure the qualitative analysis. Results: Our results suggest that IBM patients experience the holistic HRQoL and care situation typically in four phases: (1) uncertainty about physical vulnerability until diagnosis, (2) promising treatment approaches, (3) self-management and dyadic coping, (4) weak body, busy mind and caregiver burden. The homophonous in-vivo code "patience journey" describes the frequently reported emotional perspective of the patient journey. Although the overarching theme of perceived social support varied throughout these phases, a reliable patient-partner-dyad may lead to improved HRQoL in the long-term. Conclusions: New hypotheses for future quantitative research were generated to better understand the IBM patients' burden in the long term. The identified relevance of social support emphasizes the patients' need to handle IBM as manageable in medical settings. During exhausting phases of IBM progression, more effective care elements for patients and their partners could disclose varying needs. Strengthening multi-professional healthcare services via individualised informational, practical, or emotional support could improve HRQoL, especially since there is no curative treatment available so far. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore psychosocial consequences of (false) positive liver screening results and to identify influencing factors for perceived strain within a multistage screening programme for liver cirrhosis and fibrosis in Germany. Methods: Between June 2018 and May 2019, all positively screened patients were asked to participate in the study (n = 158). N = 11 telephone interviews and n = 4 follow‐up interviews were conducted. Semi‐structured telephone interviews were carried out. The analysis followed a structuring content analysis approach. Thereby, categories were first defined deductively. Second, the categories were revised inductively based on the data. Results: The main themes found regarding the consequences of the screening were categorised in emotional reactions and behavioural reactions. Few respondents described negative emotional consequences related to screening. Those seem to be mostly driven by suboptimal patient–provider communication and might be worsened when transparent information transfer fails to happen. As a result, patients sought information and support in their social environment. All patients reported positive attitudes towards liver screening. Conclusion: To reduce the potential occurrence of psychosocial consequences during the screening process, medical screening should be performed in the context of transparent information. Regular health communication on the side of health professionals and increasing patients' health literacy might contribute to avoiding negative emotions in line with screening. Patient or Public Contribution: This study recognises the wide‐ranging patients' perspectives regarding the consequences of liver screening which should be taken into consideration when implementing a new screening programme to ensure a patient‐centred approach. [ABSTRACT FROM AUTHOR]

We analyse qualitative data collected from employees at Germany's two main international development organisations, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and Kreditanstalt für Wiederaufbau (KfW) Development Bank, to study how upward accountability and organisational learning interact in the world's second largest foreign aid system. Goffman's 'staging' heuristic is applied to unpack social practices in these two organisations. We find that employees navigate two separate domains, a frontstage and a backstage. They consider the federal bureaucracy an audience expecting a coherent storyline despite the messy realities of foreign aid. In response, they engage in impression management on a frontstage while shielding their backstages from scrutiny to maximise autonomy. As a result, organisational learning at GIZ and KfW in Goffman's terms focuses on collective efficacy at satisfying accountability expectations through staged performances. We relate these insights to the hierarchical structure of Germany's foreign aid system, the role of organisational interests and prevailing professional norms. [ABSTRACT FROM AUTHOR]