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Zusammenfassung Hintergrund Brustkrebs ist die bedeutendste Krebserkrankung bei Frauen. Die tumor- und therapiebedingten Folgen führen zu einer langfristigen Beeinträchtigung der Funktionsfähigkeit. Der nachhaltige Transfer rehabilitativer Erfolge in den Alltag stellt eine Herausforderung für alle Akteure des Systems dar. Der Einsatz von Telemedizin erscheint vor diesem Hintergrund als eine Möglichkeit, das in der Rehabilitation Erreichte im Alltag langfristig zu stabilisieren. Das Ziel der vorliegenden Übersicht ist es die Evidenz von telemedizinischen Nachsorgeangeboten bei Frauen mit Brustkrebs darzulegen und die Wirksamkeit auf verschiedenen Ebenen der Funktionsfähigkeit herauszuarbeiten. Methodik Es erfolgte eine systematische Suche nach deutsch- oder englischsprachigen randomisiert kontrollierten Studien zur Wirksamkeit von telemedizinischen rehabilitativen Nachsorgeangeboten für Frauen mit Brustkrebs in den Fachdatenbanken PubMed und The Cochrane Library im Zeitraum April bis Mai 2020 und einer Aktualisierung der Suche im August 2020. Ergebnisse Insgesamt wurden 11 relevante Publikationen zu 10 Interventionsstudien identifiziert. Es wurde keine Studie aus Deutschland gefunden. Es fanden sich Studien für die Bereiche psychosoziale Interventionen und Interventionen zur Lebensstilveränderung. Hinsichtlich der untersuchten Zielvariablen sind vor dem Hintergrund der heterogenen Studienlage in einzelnen Parametern (therapieinduzierte Wechseljahresbeschwerden, Fatigue, Schlaffunktionen, Adhärenz) Hinweise auf positive Effekte zugunsten der Intervention festzustellen. Für einen Teil der Parameter (mentale Funktionen bzw. emotionale und kognitive Funktionen, gesundheitsbezogene Lebensqualität) kann jedoch keine ausreichende und belastbare Evidenz zur Wirksamkeit konstatiert werden. Schussfolgerungen Die Ergebnisse betonen den Bedarf der stärkeren Evidenzbasierung von telemedizinischen Angeboten zur rehabilitativen Nachsorge der Frauen mit Brustkrebs. Zur Absicherung der Befundlage sind randomisiert kontrollierte Studien im deutschen Versorgungskontext erforderlich.

Zusammenfassung Hintergrund und Ziel In der Gesundheitsförderung und Prävention werden vermehrt digitale Anwendungen – vor allem zur Verhaltensänderung – angewandt und erforscht. Die vorliegende Studie untersucht Einsatzmöglichkeiten digitaler Anwendungen im Rahmen verhältnisorientierter Interventionen in Settings. Methodik Es handelt sich um eine ergänzende Analyse der Ergebnisse eines Scoping Reviews. In acht wissenschaftlichen Datenbanken wurde zu digitaler verhältnisorientierter Primärprävention und Gesundheitsförderung in Settings von 2010–2020 recherchiert. Ergebnisse Es wurden 34 Artikel eingeschlossen. Digitale Anwendungen wurden bisher nur marginal zur Strukturveränderung in Settings eingesetzt. Sie dienen als Tools zum Projektmanagement, zur Vernetzung, Problemidentifikation, Konsensfindung oder als Beteiligungsverfahren. Dabei wird auf partizipative Methoden und Projekte sowie Instrumente wie Labeling, Placement, Prompting, Incentives, Nudges und politische Strategien zurückgegriffen. Schlussfolgerung Es bedarf weiterer Evidenz wie digitale Anwendungen zur Veränderung von Strukturen für gesundheitsfördernde Settings eingesetzt werden können. Gesundheitswissenschaftliche oder soziologische Methoden und Theorien können dabei eine tragende Rolle spielen. Von hoher Relevanz sind die interdisziplinäre und partizipative Entwicklung sowie Implementierung von gesundheitsfördernden Technologien.

Background Antibiotic resistance is a major health threat. Inappropriate antibiotic use has been shown to be an important determinant of the emergence of antibiotic resistance. Decision support systems for antimicrobial management can support clinicians to optimize antibiotic prescription. Objective The aim of this systematic review is to identify factors influencing the implementation of decision support systems for antibiotic prescription in hospitals. Methods A systematic search of factors impeding or facilitating successful implementation of decision support systems for antibiotic prescription was performed in January 2022 in the databases PubMed, Web of Science and The Cochrane Library. Only studies were included which comprised decision support systems in hospitals for prescribing antibiotic therapy, published in English with a qualitative, quantitative or mixed-methods study design and between 2011 and 2021. Factors influencing the implementation were identified through text analysis by two reviewers. Results A total of 14 publications were identified matching the inclusion criteria. The majority of factors relate to technological and organizational aspects of decision support system implementation. Some factors include the integration of the decision support systems into existing systems, system design, consideration of potential end-users as well as training and support for end-users. In addition, user-related factors, like user attitude towards the system, computer literacy and prior experience with the system seem to be important for successful implementation of decision support systems for antibiotic prescription in hospitals. Conclusion The results indicate a broad spectrum of factors of decision support system implementation for antibiotic prescription and contributes to the literature by identifying important organizational as well as user-related factors. Wider organizational dimensions as well as the interaction between user and technology appear important for supporting implementation.

Background Diabetes is a major global epidemic and serious public health problem. Diabetes self-management is a 24/7 challenge for people with type 1 diabetes that influences their quality of life (QoL). Certain apps can support the self-management of people with diabetes; however, current apps do not meet the needs of people with diabetes appropriately, and their safety is not ensured. Moreover, there are a multitude of hardware and software problems associated with diabetes apps and regulations. Clear guidelines are required to regulate medical care via apps. In Germany, apps must undergo 2 examination processes to be listed in the Digitale Gesundheitsanwendungen directory. However, neither examination process considers whether the medical use of the apps is sufficient for users’ self-management. Objective This study aims to contribute to the technology development process of diabetes apps by exploring individual perspectives on desired features and content of diabetes apps among people with diabetes. The vision assessment conducted is a first step toward creating a shared vision among all relevant stakeholders. To ensure adequate research and development processes for diabetes apps in the future, guiding visions from all relevant stakeholders are required. Methods In a qualitative study, 24 semistructured interviews with patients with type 1 diabetes were conducted, among whom 10 (42%) were currently using an app. To clarify the perceptions of people with diabetes regarding the functions and content of diabetes apps, a vision assessment was conducted. Results People with diabetes have concrete ideas of features and content in apps to improve their QoL and allow them to live as comfortably as possible, such as informative predictions through artificial intelligence, improvements in signal loss and value delay through smartwatches, improved communication and information-sharing capabilities, reliable information sources, and user-friendly and discreet messaging options through smartwatches. In addition, according to people with diabetes, future apps should show improved sensors and app connectivity to avoid incorrect values being displayed. They also wish for an explicit indication that displayed values are delayed. In addition, personalized information was found to be lacking in apps. Conclusions People with type 1 diabetes want future apps to improve their self-management and QoL and reduce stigma. Desired key features include personalized artificial intelligence predictions of blood glucose levels, improved communication and information sharing through chat and forum options, comprehensive information resources, and smartwatch alerts. A vision assessment is the first step in creating a shared vision among stakeholders to responsibly guide the development of diabetes apps. Relevant stakeholders include patient organizations, health care professionals, insurers, policy makers, device manufacturers, app developers, researchers, medical ethicists, and data security experts. After the research and development process, new apps must be launched while considering regulations regarding data security, liability, and reimbursement.

Applications related to virtual reality are a rapidly growing area. Thus, these technologies are also increasingly used in the field of medicine and rehabilitation. The primary objective of this prospective pilot study was to investigate the feasibility, user experience and acceptance of a virtual-reality-based system for upper extremity rehabilitation. The study was conducted as a single-center trial over 16 weeks. The eligibility criteria included rehabilitants with upper extremity injuries of at least 18 years of age who were fluent in spoken and written German. After detailed instruction, each participant was asked to complete daily 30 min exercises over 15 training sessions with the virtual reality system consisting of three different training modules. Outcomes were assessed pre-study and post-study using standardized clinical measures. In addition, qualitative interviews with rehabilitants as well as therapists regarding user experience and acceptance were conducted. Six participants were recruited for the pilot study, of which five underwent virtual-reality-based rehabilitation. Overall, the clinical measures showed a positive tendency over the course of the study, even if the results were not significant. Furthermore, the virtual-reality-based training was well accepted by the participants as well as therapists. Given these findings, it will be beneficial to evaluate virtual reality for rehabilitation in further research.

BACKGROUND: In recent years, telemedicine has gained increasing importance in the delivery of pharmaceutical care. The use of video technologies for remote communication between different parties offers the potential to meet the future challenges which arise from the increase in elderly and chronically ill patients. However, the influence of these technologies on patient-related outcomes in pharmaceutical care is not yet sufficiently known.; METHOD: In December 2018 a systematic literature search was conducted in the databases Medline, Cochrane Library and PubPharm. Randomized controlled trials were considered, which investigate real-time video conferencing between pharmacists on the one hand and patients or other healthcare providers on the other hand. The influence on patient related outcomes compared to standard care was assessed. The bias potential was evaluated using the Cochrane Risk-of-Bias instrument. A total of 4 randomized controlled trials could be included.; RESULTS: The studies describe partly complex intervention settings with adults and adolescents suffering from asthma, chronic renal failure, HIV infection, hyperlipidemia, hypertension and/or diabetes. None of the studies considers the interprofessional communication of pharmacists with other service providers. No influence on clinical or psychological endpoints was found. In some cases, an increase in adherence and correct medication use is evident. Healthcare utilization is not influenced. In all studies there is an increased risk of systematic bias.; DISCUSSION: Teleconsultations with pharmacists can rather be used to ensure the general provision of pharmaceutical care than to improve patient-related outcomes. Further studies are necessary to fully depict the influence of telemedical interventions in pharmaceutical care. Copyright © 2020 Elsevier Inc. All rights reserved.

In health promotion and prevention, digital applications, especially for behavioral changes, are being increasingly researched and applied. The aim of this study was to investigate possible uses of digital applications in the context of structurally oriented interventions in these settings.This is a supplementary analysis of the results of a scoping review. Eight scientific databases were searched for digital structural primary prevention and health promotion in settings from 2010-2020.A total of 34 articles were included. Digital applications were found to be used only marginally for structural change in health promoting settings. They served as tools for project management, networking, problem identification, consensus building or participation. Participatory methods and projects were used, as well as tools such as labeling, placement, prompting, incentives, nudges, and political strategies.More evidence is needed on how digital applications can be used to change structures in health promoting settings. Public health or sociological methods and theories can play a supporting role. The interdisciplinary and participatory development and implementation of health promoting technologies is of high relevance.In der Gesundheitsförderung und Prävention werden vermehrt digitale Anwendungen – vor allem zur Verhaltensänderung – angewandt und erforscht. Die vorliegende Studie untersucht Einsatzmöglichkeiten digitaler Anwendungen im Rahmen verhältnisorientierter Interventionen in Settings.Es handelt sich um eine ergänzende Analyse der Ergebnisse eines Scoping Reviews. In acht wissenschaftlichen Datenbanken wurde zu digitaler verhältnisorientierter Primärprävention und Gesundheitsförderung in Settings von 2010–2020 recherchiert.Es wurden 34 Artikel eingeschlossen. Digitale Anwendungen wurden bisher nur marginal zur Strukturveränderung in Settings eingesetzt. Sie dienen als Tools zum Projektmanagement, zur Vernetzung, Problemidentifikation, Konsensfindung oder als Beteiligungsverfahren. Dabei wird auf partizipative Methoden und Projekte sowie Instrumente wie Labeling, Placement, Prompting, Incentives, Nudges und politische Strategien zurückgegriffen.Es bedarf weiterer Evidenz wie digitale Anwendungen zur Veränderung von Strukturen für gesundheitsfördernde Settings eingesetzt werden können. Gesundheitswissenschaftliche oder soziologische Methoden und Theorien können dabei eine tragende Rolle spielen. Von hoher Relevanz sind die interdisziplinäre und partizipative Entwicklung sowie Implementierung von gesundheitsfördernden Technologien.

BACKGROUND Diabetes is a major global epidemic and serious public health problem. Diabetes self-management is a 24/7 challenge for people with type 1 diabetes that influences their quality of life (QoL). Certain apps can support the self-management of people with diabetes; however, current apps do not meet the needs of people with diabetes appropriately, and their safety is not ensured. Moreover, there are a multitude of hardware and software problems associated with diabetes apps and regulations. Clear guidelines are required to regulate medical care via apps. In Germany, apps must undergo 2 examination processes to be listed in the Digitale Gesundheitsanwendungen directory. However, neither examination process considers whether the medical use of the apps is sufficient for users’ self-management. OBJECTIVE This study aims to contribute to the technology development process of diabetes apps by exploring individual perspectives on desired features and content of diabetes apps among people with diabetes. The vision assessment conducted is a first step toward creating a shared vision among all relevant stakeholders. To ensure adequate research and development processes for diabetes apps in the future, guiding visions from all relevant stakeholders are required. METHODS In a qualitative study, 24 semistructured interviews with patients with type 1 diabetes were conducted, among whom 10 (42%) were currently using an app. To clarify the perceptions of people with diabetes regarding the functions and content of diabetes apps, a vision assessment was conducted. RESULTS People with diabetes have concrete ideas of features and content in apps to improve their QoL and allow them to live as comfortably as possible, such as informative predictions through artificial intelligence, improvements in signal loss and value delay through smartwatches, improved communication and information-sharing capabilities, reliable information sources, and user-friendly and discreet messaging options through smartwatches. In addition, according to people with diabetes, future apps should show improved sensors and app connectivity to avoid incorrect values being displayed. They also wish for an explicit indication that displayed values are delayed. In addition, personalized information was found to be lacking in apps. CONCLUSIONS People with type 1 diabetes want future apps to improve their self-management and QoL and reduce stigma. Desired key features include personalized artificial intelligence predictions of blood glucose levels, improved communication and information sharing through chat and forum options, comprehensive information resources, and smartwatch alerts. A vision assessment is the first step in creating a shared vision among stakeholders to responsibly guide the development of diabetes apps. Relevant stakeholders include patient organizations, health care professionals, insurers, policy makers, device manufacturers, app developers, researchers, medical ethicists, and data security experts. After the research and development process, new apps must be launched while considering regulations regarding data security, liability, and reimbursement.

There are dynamic interactions between (digital) technologies and society. Digital technologies have a(re-)structuring effect on social relationships and social innovations in avariety of ways. Because of these characteristics, technological innovations affect our individual lifestyles and living environments. In particular, the development and implementation of interventions with digital (health) technologies is attracting increasing national and international attention (e.g. telematics GP consultations and app-supported patient education programs).Digital health technologies enable new forms of interaction and knowledge-based reproduction in the field of health. The integration of potential users in the development process of digital health technologies and interventions requires the discussion of new research approaches. The interests, needs, and requirements of users may influence the nonuse of digital health technologies. It is above all the successful implementation, involving potential users, that can have an influence on acceptance and integrative use in the later course of care. The discourse on the participatory development and implementation of interventions with digital health technologies in the field of digital public health presents itself as acomplex process characterized by various theoretical approaches and methodological procedures and requiring representation, evaluation, and classification., Zwischen (digitalen) Technologien und der Gesellschaft bestehen dynamische Wechselbeziehungen. Digitale Technologien wirken dabei in vielfältiger Weise (re)strukturierend auf soziale Zusammenhänge und soziale Innovationen. Aufgrund dieser Charakteristik berühren technologische Innovationen unsere individuellen Lebensstile und Lebenswelten. Insbesondere die Entwicklung und Implementierung von Interventionen mit digitalen (Gesundheits‑)Technologien erfahren national und international eine zunehmende Aufmerksamkeit (z. B. telemedizinische Hausarztsprechstunde, app-gestützte Patientenedukationsprogramme). Digitale Gesundheitstechnologien ermöglichen neue Interaktions- und wissensbezogene Reproduktionsformen im Bereich Gesundheit. Die Einbindung potenzieller Nutzer*innen in den Entwicklungsprozess digitaler Gesundheitstechnologien und -interventionen erfordert die Diskussion neuer wissenschaftlicher Methoden. Interessen, Bedarfe und Bedürfnisse der Nutzer*innen können zur Nichtnutzung digitaler Gesundheitstechnologien führen. Vor allem die erfolgreiche Implementierung, unter der Einbindung von potenziell Nutzenden, kann einen Einfluss auf die Akzeptanz und integrative Nutzung im späteren Versorgungsverlauf haben. Der Diskurs über die partizipative Entwicklung und Implementierung von Interventionen mit digitalen Gesundheitstechnologien im Bereich Digital Public Health stellt sich als komplexer Prozess dar, welcher durch verschiedene theoretische Ansätze und methodisches Vorgehen charakterisiert ist und eine Darstellung, Bewertung und Einordnung erfordert.

Zusammenfassung Hintergrund Brustkrebs ist die bedeutendste Krebserkrankung bei Frauen. Die tumor- und therapiebedingten Folgen führen zu einer langfristigen Beeinträchtigung der Funktionsfähigkeit. Der nachhaltige Transfer rehabilitativer Erfolge in den Alltag stellt eine Herausforderung für alle Akteure des Systems dar. Der Einsatz von Telemedizin erscheint vor diesem Hintergrund als eine Möglichkeit, das in der Rehabilitation Erreichte im Alltag langfristig zu stabilisieren. Das Ziel der vorliegenden Übersicht ist es die Evidenz von telemedizinischen Nachsorgeangeboten bei Frauen mit Brustkrebs darzulegen und die Wirksamkeit auf verschiedenen Ebenen der Funktionsfähigkeit herauszuarbeiten. Methodik Es erfolgte eine systematische Suche nach deutsch- oder englischsprachigen randomisiert kontrollierten Studien zur Wirksamkeit von telemedizinischen rehabilitativen Nachsorgeangeboten für Frauen mit Brustkrebs in den Fachdatenbanken PubMed und The Cochrane Library im Zeitraum April bis Mai 2020 und einer Aktualisierung der Suche im August 2020. Ergebnisse Insgesamt wurden 11 relevante Publikationen zu 10 Interventionsstudien identifiziert. Es wurde keine Studie aus Deutschland gefunden. Es fanden sich Studien für die Bereiche psychosoziale Interventionen und Interventionen zur Lebensstilveränderung. Hinsichtlich der untersuchten Zielvariablen sind vor dem Hintergrund der heterogenen Studienlage in einzelnen Parametern (therapieinduzierte Wechseljahresbeschwerden, Fatigue, Schlaffunktionen, Adhärenz) Hinweise auf positive Effekte zugunsten der Intervention festzustellen. Für einen Teil der Parameter (mentale Funktionen bzw. emotionale und kognitive Funktionen, gesundheitsbezogene Lebensqualität) kann jedoch keine ausreichende und belastbare Evidenz zur Wirksamkeit konstatiert werden. Schussfolgerungen Die Ergebnisse betonen den Bedarf der stärkeren Evidenzbasierung von telemedizinischen Angeboten zur rehabilitativen Nachsorge der Frauen mit Brustkrebs. Zur Absicherung der Befundlage sind randomisiert kontrollierte Studien im deutschen Versorgungskontext erforderlich.

**Hintergrund** Das ausbildungsbezogene Stressempfinden auf Ebene von Distress von Studierenden stellt ein hohes Risiko für die Entstehung von psychischen Erkrankungen dar. Die konsequente Nutzung digitaler Anti-Stress-Apps kann dazu beitragen, Versorgungsdefizite in der Vermeidung von stressinduzierten Erkrankungen wirksam auszugleichen, wenn existierende Hilfsangebote nicht genutzt werden, oder helfen, Barrieren zur Nutzung bestehender Interventionsmaßnahmen mindern. In diesem Kontext untersucht der vorliegende Beitrag die Einstellungsakzeptanz und die verbundenen Nutzungsbedingungen Studierender der Universität Bielefeld gegenüber digitalen Anti-Stress-Apps. Basierend auf der Akzeptanz und den Nutzungsbedingungen sollen Anforderungen für die bessere Implementierung digitaler Interventionen geleitet werden. **Methodik** Die Erhebung wurde mittels qualitativer leitfadengestützter Interviews und quantitativer Umfragen an denselben 15 Studierenden (n = 14 Frauen und einem Mann im Alter von 22 bis 31 Jahren) der Universität Bielefeld durchgeführt. Für die Auswertung der Interviews wurde die strukturierte Inhaltsanalyse nach Mayring herangezogen, bei der mit Hilfe von deduktiven und induktiven Kategorien die Transkripte analysiert wurden. Zur Strukturierung und Analyse der Ergebnisse wurde die „unified theory of acceptance and use of technology 2“ (UTAUT 2) eingesetzt. **Ergebnisse** Anhand der UTAUT 2 konnten bedürfnisorientierte Bedingungen zur Nutzung und Einstellung hinsichtlich der Akzeptanz identifiziert werden. Die Einstellungsakzeptanz von Studierenden zu Anti-Stress-Apps ist weitestgehend positiv, geht jedoch nicht einher mit dem Nutzungsverhalten. Die Ergebnisse weisen eine starke Abhängigkeit von individuellen Bedürfnissen auf, was zudem von verschiedenen Alltagssituationen ausgeht, in denen Stress individuell empfunden wird. **Schlussfolgerungen** Bedingungen an die vorhandenen Elemente und Interventionen in einer App zur Stressreduktion müssen in der Softwareentwicklung berücksichtigt werden, damit die Anwendung subjektiv als wirksam wahrgenommen wird. Der Ausbau und die Einführung bedürfnisorientierter Angebote in die Lebenswelt der Nutzer*innen und Nutzergruppen sowie begleitende Maßnahmen zur zielgruppenspezifischen Sensibilisierung, können die Akzeptanz weiter steigern, das Nutzungsverhalten positiv beeinflussen und gegen Stressbelastungen wirken., **Background** Educational distress perceived by students represents a high risk for the development of mental illness. Consistent use of digital antistress apps can effectively address and therefore compensate for care deficits in the prevention of stress-induced mental illnesses. In addition, consequent use can reduce barriers to the use of existing offers. Against this background, the acceptance and conditions regarding use of digital antistress apps by students at Bielefeld University were examined. Based on the acceptance and the conditions of use, requirements for better implementation of digital interventions are identified. **Methods** Semi-structured interviews and quantitative surveys were used to conduct the study among the same 15 students (n = 14 women and 1 man, aged 22–31 years) at Bielefeld University. Mayring’s structured content analysis was used to evaluate the interviews, using deductive and inductive categories to analyze the transcripts. The unified theory of acceptance and use of technology 2 (UTAUT 2) was used to structure and analyze the results. **Results** Using the UTAUT 2, crucial conditions regarding acceptance, use, and attitude were identified. The attitudinal acceptance of students towards antistress apps is largely positive, though this is not associated with usage behavior. Furthermore, our research reveals a strong dependence on individual needs, which is dependent on the individual daily situations and aspects in which stress is experienced. **Conclusion** Conditions on the existing elements and interventions in an app for stress reduction must be considered in software development so that its use is subjectively perceived as effective. The development of needs-oriented offers and introduction into the lifeworld of the users as well as accompanying measures for target group-specific sensitization can further increase the acceptance, positively influence use and work against stress.

Background: New technologies can support family caregivers in the home care of people with dementia but are unknown to many. To reduce the information deficit, the information needed by caregivers must be determined. Aim: The aim of this study is to investigate the information needs of family caregivers regarding new technologies for dementia care at home, taking into account experiences in past research and future information needs. Methods: Episodic interviews were conducted with eight family caregivers of people with dementia and analyzed according to thematic coding. Results: Caregivers used both media-based and interpersonal channels for technology-related research and made heterogeneous experiences. The researched information content and causes of research varied across respondents. The amount of available online information was a barrier in some cases. With regard to future information needs, the diversity of information channels and the quality of information are of high importance. Conclusions: The individual situation-specific needs of family caregivers must be taken into account in the development of new information and counseling services so that information deficits can be eliminated, and the potential of new technologies can be exploited in the home care of people with dementia. Further research is needed on the information needs of people with dementia., Hintergrund: Neue Technologien können Angehörige bei der häuslichen Versorgung von Personen mit Demenz unterstützen, sind jedoch vielen unbekannt. Um das Informationsdefizit abzubauen, müssen die von den Angehörigen benötigten Informationen erfasst werden. Ziel: Die Studie verfolgt das Ziel, die Informationsbedürfnisse Angehöriger zu neuen Technologien der häuslichen Versorgung bei Demenz zu untersuchen, wobei Erfahrungen bei vergangenen Recherchen und künftige Informationsbedürfnisse berücksichtigt werden. Methode: Es wurden episodische Interviews mit acht pflegenden Angehörigen von Personen mit Demenz geführt und anlehnend an das thematische Kodieren ausgewertet. Ergebnisse: Angehörige nutzten für technikbezogene Recherchen medienbasierte sowie interpersonale Informationsquellen und machten dabei heterogene Erfahrungen. Die recherchierten Informationsinhalte und Auslöser der Recherchen variierten zwischen den Befragten. Die Menge verfügbarer Online-Informationen stellte z. T. ein Hindernis dar. Mit Blick auf künftige Informationsbedürfnisse kommt der Diversität von Informationskanälen und der Informationsqualität eine hohe Bedeutung zu. Schlussfolgerungen: Die individuellen situationsspezifischen Bedürfnisse der Angehörigen müssen bei der Entwicklung neuer Informations- und Beratungsangebote berücksichtigt werden, damit Informationsdefizite abgeschafft und die Potenziale neuer Technologien bei der Versorgung von Personen mit Demenz ausgeschöpft werden können. Es bedarf weiterer Forschung zu den Informationsbedürfnissen von Personen mit Demenz.

Information needs of family caregivers regarding new technologies for dementia care at home: A qualitative study

Digital health interventions may contribute to closing the treatment gap for depression by reaching large populations at relatively low costs. This article presents the results of a broad, multisided German survey in 2020 on the acceptance and use of digital health interventions in depression care from the perspective of patients, their relatives, and health professionals. A total of 97 patients and relatives and 229 health professionals participated. Survey participants reported openness towards the use of digital health interventions in depression care but little knowledge and experience in the field. Digital health interventions appear to be a promising opportunity for reducing depressive symptoms and shortening waiting time for depression treatment, especially in rural areas. Providing information and technical competencies may increase awareness and knowledge about digital health interventions and the benefits of depression care.

Breast cancer continues to be the most common maligned tumor disease in women. Diagnosis and treatment-related side effects affect functioning of women in the long run. The provision of rehabilitation aftercare services for breast cancer survivors is often limited by resources and access. Telemedicine seems to be a potential way of the remote delivery of rehabilitation aftercare. The aim of this systematic review is to examine the efficacy of telemedicine-based aftercare interventions for breast cancer survivors regarding specific outcomes of functioning.A systematic search was conducted in April to May 2020 in the databases Pubmed and The Cochrane Library and has been updated in August 2020. Only randomized controlled trials were considered, that examined the efficacy of telemedicine-based interventions for the aftercare of women with breast cancer.In total, 11 publications of 10 intervention studies were identified and included in this review. No study was found from Germany. In general, studies were classified as psychosocial interventions and interventions for lifestyle changes. Regarding the between-study heterogeneity the results indicate positive effects in certain parameters of functioning (therapy-induced menopausal symptoms, fatigue, sleep functions, adherence). However, for certain of the outcomes (mental functions like emotional and cognitive functions, health-related quality of life) there is no sufficient evidence for the efficacy of telemedicine-based interventions in the aftercare for women with breast cancer.The results indicate the need of an evidence-based practice in telemedicine-based interventions in the aftercare for women with breast cancer. In future, well-designed randomized controlled trials are needed in Germany to systematically explore the efficacy of telemedicine-based aftercare interventions.Brustkrebs ist die bedeutendste Krebserkrankung bei Frauen. Die tumor- und therapiebedingten Folgen führen zu einer langfristigen Beeinträchtigung der Funktionsfähigkeit. Der nachhaltige Transfer rehabilitativer Erfolge in den Alltag stellt eine Herausforderung für alle Akteure des Systems dar. Der Einsatz von Telemedizin erscheint vor diesem Hintergrund als eine Möglichkeit, das in der Rehabilitation Erreichte im Alltag langfristig zu stabilisieren. Das Ziel der vorliegenden Übersicht ist es die Evidenz von telemedizinischen Nachsorgeangeboten bei Frauen mit Brustkrebs darzulegen und die Wirksamkeit auf verschiedenen Ebenen der Funktionsfähigkeit herauszuarbeiten.Es erfolgte eine systematische Suche nach deutsch- oder englischsprachigen randomisiert kontrollierten Studien zur Wirksamkeit von telemedizinischen rehabilitativen Nachsorgeangeboten für Frauen mit Brustkrebs in den Fachdatenbanken PubMed und The Cochrane Library im Zeitraum April bis Mai 2020 und einer Aktualisierung der Suche im August 2020.Insgesamt wurden 11 relevante Publikationen zu 10 Interventionsstudien identifiziert. Es wurde keine Studie aus Deutschland gefunden. Es fanden sich Studien für die Bereiche psychosoziale Interventionen und Interventionen zur Lebensstilveränderung. Hinsichtlich der untersuchten Zielvariablen sind vor dem Hintergrund der heterogenen Studienlage in einzelnen Parametern (therapieinduzierte Wechseljahresbeschwerden, Fatigue, Schlaffunktionen, Adhärenz) Hinweise auf positive Effekte zugunsten der Intervention festzustellen. Für einen Teil der Parameter (mentale Funktionen bzw. emotionale und kognitive Funktionen, gesundheitsbezogene Lebensqualität) kann jedoch keine ausreichende und belastbare Evidenz zur Wirksamkeit konstatiert werden.Die Ergebnisse betonen den Bedarf der stärkeren Evidenzbasierung von telemedizinischen Angeboten zur rehabilitativen Nachsorge der Frauen mit Brustkrebs. Zur Absicherung der Befundlage sind randomisiert kontrollierte Studien im deutschen Versorgungskontext erforderlich.

Media reporting can influence the perception and development of attitudes through the frequency and the way certain topics are presented. The German Medical Journal “Deutsches Arzteblatt” is one of the most important media for agenda-setting in Germany. It thus has an influence on opinion-forming and acceptance within the medical profession in regard to innovative healthcare technologies. The aim of this work is to quantify the media representation of telemedicine and deduce the qualitatively depicted acceptance factors. All articles on telemedicine published in “Deutsches Arzteblatt” between 01/01/2008 and 01/01/2018 were reviewed. The type of article, the focus, the connotation, and the degree of explanation were recorded quantitatively as well as the discussed topics and content aspects. In a structured content analysis, acceptance factors were derived based on the unified theory of acceptance and use of technology (UTAUT). The representation of telemedicine in the German Medical Journal has increased significantly in the last 10 years, and shows a tendency towards neutral and balanced reporting. A change in content can be seen. While the focus was still on technical aspects until 2012, it is currently increasing in the scientific–medical field. Emphasis is put on the presentation of expectations of performance and effort as well as the description and modification of framework conditions. Further research is needed, focusing on the relevance of media representation of new forms of care such as telemedicine in order to increase acceptance and to develop attitudes on an individual, organizational, and systemic level.

User acceptance of digital health interventions in light to moderate depressive disorders has been rudimentarily researched and is examined in this study.Problem-centered individual interviews were conducted with 3 affected persons, 3 relatives and 13 health care professionals. The data evaluation was based on the structured qualitative content analysis.Along the Unified Theory of Acceptance and Use of Technology attitudes of affected persons, relatives and health care professionals were presented. Expectations of performance and the supportive framework conditions were the most significant influencing predictors for the positive intention to use.The results provide a basis for prioritizing needs and attitudes in next step. In terms of ethical, sustainable and economical use further research on user acceptance is required.Die Nutzer*innenakzeptanz von digitalen Gesundheitstechnologien bei leicht- bis mittelgradiger Depression ist bislang rudimentär erforscht und wird in vorliegender Studie untersucht.Es wurden problemzentrierte Einzelinterviews mit 3 Betroffenen, 3 Angehörigen und 13 Leistungserbringern (v. a. Medizin, Psychologie, Pflege) durchgeführt und qualitativ ausgewertet.Entlang der Unified Theory of Acceptance and Use of Technology wurden Haltungen von Betroffenen, Angehörigen und Leistungserbringern dargestellt. Die Leistungserwartung und unterstützenden Rahmenbedingungen stellen bedeutsame Prädiktoren für die Nutzungsintention dar.Die Ergebnisse bieten eine Basis, um im Folgeschritt die Kernbedürfnisse und Haltungen zu priorisieren. Im Sinne eines ethischen, nachhaltigen und ökonomischen Einsatzes ist weitere Forschung zur Nutzer*innenakzeptanz notwendig.

BACKGROUND Sexually transmitted infections (STIs) represent a global health risk. Adolescents are at increased risk of infection for several reasons such as lack of knowledge, risky sexual behaviors, and lack of behavioral sills (eg, to negotiate safer sex). Given the fact that adolescents often use digital media and that serious games are considered to have the potential to change knowledge, attitudes and behavior, serious games represent an opportunity for the prevention of STIs. OBJECTIVE The aim of this systematic review was to identify and systematically summarize the dimensions that have been investigated in primary studies on serious games targeting STI prevention among adolescents. METHODS A systematic review was conducted in PubMed and Web of Science. Studies published from 2009 to 2021 were included that assessed the effectiveness of serious games on adolescent sexual health. A total of 18 studies met the inclusion criteria and were categorized according to dimensions of effectiveness and user experience. RESULTS Various dimensions of effectiveness and aspects of user experience were investigated in the primary studies. In total, 9 dimensions of effectiveness were observed: sexual behavior, behavioral intentions, knowledge, attitudes and beliefs, self-efficacy and personal limitations, character traits and future orientation, environmental and individual risk factors, risk perception and risk assessment, as well as normative beliefs and (social) norms. Furthermore, several dimensions related to user experience were investigated in primary studies, that is, motivation, acceptability, trustworthiness, comprehensibility, handling and control, perceived effectiveness, as well as satisfaction. CONCLUSIONS This review provides an overview of serious games interventions that are vastly different in approach, content, and even platform. In previous studies, knowledge has already been comprehensively assessed, and a positive influence of serious games on knowledge about sexual topics is evident. The results clearly show that adolescents’ sexual knowledge has been increased by the serious games interventions. However, methodological and content differences in the surveys make it difficult to draw conclusions about the effectiveness related to changes in attitudes and behavior.

Background Depression is a major cause for disability worldwide, and digital health interventions are expected to be an augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need for mapping the technological landscape and its benefits for users. Objective The purpose of this scoping review was to give an overview of the digital health interventions used for depression. The main goal of this review was to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. Methods A scoping review was conducted to provide a comprehensive overview of the field of digital health interventions for the treatment of depression. PubMed, PSYNDEX, and the Cochrane Library were searched by two independent researchers in October 2020 to identify relevant publications of the last 10 years, which were examined using the inclusion and exclusion criteria. To conduct the review, we used Rayyan, a freely available web tool. Results In total, 65 studies were included in the qualitative synthesis. After categorizing the studies into the areas of prevention, early detection, therapy, and relapse prevention, we found dominant numbers of studies in the area of therapy (n=52). There was only one study for prevention, 5 studies for early detection, and 7 studies for relapse prevention. The most dominant therapy approaches were cognitive behavioral therapy, acceptance and commitment therapy, and problem-solving therapy. Most of the studies revealed significant effects of digital health interventions when cognitive behavioral therapy was applied. Cognitive behavioral therapy as the most dominant form was often provided through web-based systems. Combined interventions consisting of web-based and smartphone-based approaches are increasingly found. Conclusions Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most interventions can be beneficial to achieve a better depression treatment, it can be difficult to determine which approaches are suitable. Cognitive behavioral therapy through digital health interventions has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

Background: The use of information and communication technologies (ICT) in health care is increasing attention. To describe health inequalities and equity with regard to the use of digital health technologies in a care context and to understand interrelationships, it is of particular importance for the field of care research to use models and theories that explain health inequalities and equity in the use of digital technologies. Aims: This article aims to identify models and theories from the field of nursing and health research that explain the phenomenon of health inequalities and the influence of digital health technologies on the emergence of inequalities. Methods: Relevant articles were searched in electronic databases (MEDLINE, CINAHL & SocINDEX) between July and August 2019 in German and English, within the methodological framework of a scoping review. The systematic literature search and data extraction were performed by 2 reviewers. The description of data refers to standard criteria by 8-1Christiansen and Baum (1997). Results: From a total of 25 relevant articles, 2 were identified for inclusion in the current overview. One model is focusing on ICT for health and the other model focuses on eHealth. No nursing theory could be identified in the context of describing the phenomenon of digital inequality. Conclusions: In both models, there is a lack of discussion about the impact of nursing aspects on the use and acceptance of eHealth technologies. One point should also be the development of models and theories that consider the user perspective of vulnerable groups.

Zusammenfassung Ziel der Studie Die Nutzer*innenakzeptanz von digitalen Gesundheitstechnologien bei leicht- bis mittelgradiger Depression ist bislang rudimentär erforscht und wird in vorliegender Studie untersucht. Methodik Es wurden problemzentrierte Einzelinterviews mit 3 Betroffenen, 3 Angehörigen und 13 Leistungserbringern (v. a. Medizin, Psychologie, Pflege) durchgeführt und qualitativ ausgewertet. Ergebnisse Entlang der Unified Theory of Acceptance and Use of Technology wurden Haltungen von Betroffenen, Angehörigen und Leistungserbringern dargestellt. Die Leistungserwartung und unterstützenden Rahmenbedingungen stellen bedeutsame Prädiktoren für die Nutzungsintention dar. Schlussfolgerung Die Ergebnisse bieten eine Basis, um im Folgeschritt die Kernbedürfnisse und Haltungen zu priorisieren. Im Sinne eines ethischen, nachhaltigen und ökonomischen Einsatzes ist weitere Forschung zur Nutzer*innenakzeptanz notwendig.

BACKGROUND Depression is a major cause for disability worldwide, and digital health interventions are expected to be an augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need for mapping the technological landscape and its benefits for users. OBJECTIVE The purpose of this scoping review was to give an overview of the digital health interventions used for depression. The main goal of this review was to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS A scoping review was conducted to provide a comprehensive overview of the field of digital health interventions for the treatment of depression. PubMed, PSYNDEX, and the Cochrane Library were searched by two independent researchers in October 2020 to identify relevant publications of the last 10 years, which were examined using the inclusion and exclusion criteria. To conduct the review, we used Rayyan, a freely available web tool. RESULTS In total, 65 studies were included in the qualitative synthesis. After categorizing the studies into the areas of prevention, early detection, therapy, and relapse prevention, we found dominant numbers of studies in the area of therapy (n=52). There was only one study for prevention, 5 studies for early detection, and 7 studies for relapse prevention. The most dominant therapy approaches were cognitive behavioral therapy, acceptance and commitment therapy, and problem-solving therapy. Most of the studies revealed significant effects of digital health interventions when cognitive behavioral therapy was applied. Cognitive behavioral therapy as the most dominant form was often provided through web-based systems. Combined interventions consisting of web-based and smartphone-based approaches are increasingly found. CONCLUSIONS Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most interventions can be beneficial to achieve a better depression treatment, it can be difficult to determine which approaches are suitable. Cognitive behavioral therapy through digital health interventions has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

BACKGROUND Assistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex. OBJECTIVE The goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development. METHODS A scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies. RESULTS From an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0%), followed by relatives (68/175, 38.9%), and both target groups (30/175, 17.1%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1%) and randomized controlled trials (44/175, 25.1%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5%) of the technology, while others targeted feasibility or usability or were explorative. CONCLUSIONS This review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users’ informational needs is required. Moreover, there is a need for larger studies on the technologies’ effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives.

BACKGROUND Depression is a major cause for disability worldwide and digital health interventions are expected to be a more augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need of mapping the technological landscape, as well as its benefits and challenges for users. OBJECTIVE A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. The purpose of this scoping review was to give an overview of the used DHI for depression. The main goal of this review was then to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. PubMed, Psyndex, and Cochrane were searched by two independent researchers between May 2019 and April 2019 to identify relevant publications and were examined due to inclusion and exclusion criteria. For conducting the systematic review, ‘Rayyan’, a free web-tool, was used. RESULTS In total, 51 studies were included in the qualitative synthesis. After categorizing the field of application in prevention, early detection, therapy and relapse prevention, the search showed dominant numbers of studies in the field therapy (N= 42). There was only one prevention study, three studies for early detection and five studies for relapse prevention. Dominant measures of depression severity were the PHQ-9 or the BDI-II scale. The most dominant therapy approaches were cognitive behavior therapy, acceptance and commitment therapy and problem-solving therapy. Most of the studies revealed significant effects of digital health intervention when cognitive behavior therapy applied. cognitive behavior therapy as the most dominant form was often provided by web-based systems. Combined approaches consisting of web-based and smartphone-based approaches are constantly rising. CONCLUSIONS Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most applications can be beneficial to achieving a better care for depression patients, it can be hindering in determining which approaches in the depression care are suitable. Computerized CBT has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

BACKGROUND Digital technologies are increasingly integrating into peoples’ daily living environments like schools, sport clubs, health care facilities or the local community. These living environments or settings play a crucial role for health promotion and prevention purposes since they affect the health of its members, as the World Health Organization (WHO) declares. Implementing digital health promotion and prevention interventions in settings offers the opportunity to reach specific target groups, to lower the costs of implementation and to improve the health of the population. Until now it lacks scientific evidence that reviews and maps the research field of digital health promotion and prevention in settings. OBJECTIVE The overall objective of this scoping review is to provide an overview of research targeting digital health promotion and primary prevention in settings. It focusses on assessing the range of the scientific literature regarding various outcomes like applied technology, targeted setting and area of health promotion or prevention and on identifying research gaps that result from these findings. METHODS The scoping review was conducted following the framework by Levac et al. [1]. We searched in eight scientific databases (MEDLINE, CINAHL, SocINDEX, PsycINFO, PSYNDEX, IEEE Xplore, BASE and Web of Science), grey literature sources and reference lists for literature on digital setting-based health promotion and prevention published between 2010 and January 2020. The screening of articles was based on a priori defined eligibility criteria. Thus, we included empirical and non-empirical publications published in English or German and excluded articles on secondary or tertiary prevention and on health promotion at the workplace. RESULTS From an initial number of 8,888 records, the literature search led to 200 included publications. Overall, we identified a huge diversity and breadth of literature regarding digital setting-based health promotion and prevention. The variety of technology types extents from computer programs to smartphone applications up to sensor devices. We found various analogue, digital or blended settings in which digital health promotion and prevention takes place. The most frequent analogue settings are schools (19.5%) and neighborhoods or communities (12%). Social media applications are also included because in some studies social media is defined as a (digital) setting. Social media applications account for 31.5% of the identified settings. The most commonly focused area of health promotion and prevention are physical activity (40.5%), nutrition (22.5%) and sexual health (17%). The majority of interventions combine several health promotion or prevention methods including environmental change, providing information, social support, training, incentives and monitoring. Finally, we found that articles mostly report on behavioral rather than structural health promotion and prevention in settings. CONCLUSIONS The research field of digital health promotion and prevention in settings is very broad and heterogeneous. At the same time we identified research gaps regarding the absence of valid definitions of relevant terms (e.g. digital settings) and the lack of literature on structural health promotion and prevention. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies in order to reach health promotion and prevention in settings.

BACKGROUND Depression is often associated with rapid changes in mood and quality of life that persist for a period of 2 weeks. Despite medical innovations, there are problems in the provision of care. Long waiting times for treatment and high recurrence rates of depression cause enormous costs for health care systems. At the same time, comprehensive limitations in physical, psychological, and social dimensions are observed for patients with depression, which significantly reduce their quality of life. In addition to patient-specific limitations, undersupply and inappropriate health care have been determined. For this reason, new forms of care are discussed. Smartphone-based therapy is considered to have great potential due to its reach and easy accessibility. Low socioeconomic groups, which are always difficult to reach for public health interventions, can now be accessed due to the high dispersion of smartphones. There is still little information about the impact and mechanisms of smartphone-based therapy on depression. In a systematic literature review, the health implications of smartphone-based therapy were presented in comparison with standard care. OBJECTIVE The objective of this review was to identify and summarize the existing evidence regarding smartphone-based cognitive behavioral therapy for patients with depression and to present the health implications of smartphone-based cognitive behavioral therapy of considered endpoints. METHODS A systematic literature review was conducted to identify relevant studies by means of inclusion and exclusion criteria. For this purpose, the PubMed and Psyndex databases were systematically searched using a search syntax. The endpoints of depressive symptoms, depression-related anxiety, self-efficacy or self-esteem, and quality of life were analyzed. Identified studies were evaluated for study quality and risk of bias. After applying the inclusion and exclusion criteria, 8 studies were identified. RESULTS The studies examined in this review reported contradictory results regarding the investigated endpoints. In addition, due to clinical and methodological heterogeneity, it was difficult to derive evident results. All included studies reported effects on depressive symptoms. The other investigated endpoints were only reported by isolated studies. Only 50% (4/8) of the studies reported effects on depression-related anxiety, self-efficacy or self-esteem, and quality of life. CONCLUSIONS No clear implications of smartphone-based cognitive behavioral therapy could be established. Evidence for the treatment of depression using smartphone-based cognitive behavioral therapy is limited. Additional research projects are needed to demonstrate the effects of smartphone-based cognitive behavioral therapy in the context of evidence-based medicine and to enable its translation into standard care. Participatory technology development might help to address current problems in mobile health intervention studies.

BACKGROUND Digital games–based learning is a method of using digital games to impart knowledge. Virtual reality (VR) programs are a practical application of this method. Due to demographic changes, the nursing profession will become increasingly important. These VR applications can be of use in training nurses for future professional challenges they may encounter. The continuous development of VR applications enables trainees to encounter simulated real life effectively and to experience increasingly concrete situations. This can be of great importance in nursing education, since 3-dimensionality enables a better visualization of many fields of activity and can prevent potential future errors. In addition to this learning effect, VR applications also bring an element of fun to learning. OBJECTIVE The aim of this qualitative research effort is to observe the degree of acceptance of VR applications by nursing students in Germany. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration. METHODS With a qualitative cohort study, the acceptance of nursing students towards VR applications in anatomy teaching was determined. The 12 participants were first asked to fill out a quantitative questionnaire on their sociodemographic characteristics and the extent to which they valued and liked using technology. The participants were then allowed to test the VR application themselves and were finally asked about their experience in a qualitative interview. For the collection of data and the analysis of results, the unified theory of acceptance and use of technology was used in this study. RESULTS Overall, the study shows that the interviewed persons rated the VR application quite positively. The greatest influence in this was the personal attitude towards technology; the higher this affinity is, the more useful the VR application appears. Social influences can also increase the participant’s own acceptance if peers have a positive attitude towards such applications. The study shows that the trainees' motivation to learn was increased by using VR. We believe this is because each trainee could learn individually and the VR application was perceived as an enjoyable activity. Nevertheless, the cost factor of implementing VR applications in nursing training is currently still an obstacle, as not every institution has such financial capacities. CONCLUSIONS The extent to which the use of VR applications in the training of nursing staff is justified depends on the degree of personal acceptance. The collected results give good practice-oriented insight into the attitude of trainees towards VR. Many of the interviewed persons saw benefits in the use of VR technologies. As VR applications are constantly developing, it is necessary to conduct further studies on VR applications in nursing education and to include other possible disciplines in which these applications can be helpful.

Background Digital games–based learning is a method of using digital games to impart knowledge. Virtual reality (VR) programs are a practical application of this method. Due to demographic changes, the nursing profession will become increasingly important. These VR applications can be of use in training nurses for future professional challenges they may encounter. The continuous development of VR applications enables trainees to encounter simulated real life effectively and to experience increasingly concrete situations. This can be of great importance in nursing education, since 3-dimensionality enables a better visualization of many fields of activity and can prevent potential future errors. In addition to this learning effect, VR applications also bring an element of fun to learning. Objective The aim of this qualitative research effort is to observe the degree of acceptance of VR applications by nursing students in Germany. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration. Methods With a qualitative cohort study, the acceptance of nursing students towards VR applications in anatomy teaching was determined. The 12 participants were first asked to fill out a quantitative questionnaire on their sociodemographic characteristics and the extent to which they valued and liked using technology. The participants were then allowed to test the VR application themselves and were finally asked about their experience in a qualitative interview. For the collection of data and the analysis of results, the unified theory of acceptance and use of technology was used in this study. Results Overall, the study shows that the interviewed persons rated the VR application quite positively. The greatest influence in this was the personal attitude towards technology; the higher this affinity is, the more useful the VR application appears. Social influences can also increase the participant’s own acceptance if peers have a positive attitude towards such applications. The study shows that the trainees' motivation to learn was increased by using VR. We believe this is because each trainee could learn individually and the VR application was perceived as an enjoyable activity. Nevertheless, the cost factor of implementing VR applications in nursing training is currently still an obstacle, as not every institution has such financial capacities. Conclusions The extent to which the use of VR applications in the training of nursing staff is justified depends on the degree of personal acceptance. The collected results give good practice-oriented insight into the attitude of trainees towards VR. Many of the interviewed persons saw benefits in the use of VR technologies. As VR applications are constantly developing, it is necessary to conduct further studies on VR applications in nursing education and to include other possible disciplines in which these applications can be helpful.

E-Health-Leistungen erstrecken sich vom Bereich der onlinebasierten Gesundheitskommunikation uber die intersektorale und interprofessionelle Vernetzung der Akteure im Gesundheitswesen bis hin zur Anwendung von Informations- und Kommunikationstechnologien in der direkten medizinischen Versorgung von Patientinnen und Patienten. Die Implementation von E-Health-Leistungen ist dabei ein vordergrundiges Ziel gesundheitspolitischer Entwicklungsprozesse mit der Absicht, speziell telemedizinische Leistungen flachendeckend in Europa zur Verfugung zu stellen. Dabei sieht sich die Implementation von E-Health als Teil von Pravention, Gesundheitsforderung und medizinischer sowie pflegerischer Versorgung mit unterschiedlichen Herausforderungen konfrontiert. Neben medizin- und sozial-ethischen Fragestellungen sind dies insbesondere Aspekte der Schaffung rechtssicherer Rahmenbedingungen, die Vergutung und Finanzierung der Technologien, die Gestaltung der Technik mit Blick auf eine nutzerinnen- und nutzerorientierten Usability, die Einbeziehung der Technik in die Versorgungsprozesse entlang der Bedarfe und Bedurfnisse der Nutzerinnen und Nutzer, die Gewahrleistung technologischer Interoperabilitat durch einheitliche Standards oder die Wirksamkeitsanalyse von E-Health, sowohl in Bezug auf gesundheitliche als auch okonomische Endpunkte. Der vorliegende Beitrag soll das breite Spektrum von E-Health-Leistungen im Gesundheitswesen systematisieren, Grundlagen der technologie-gestutzten Kommunikation im Gesundheitswesen vermitteln und dabei ausgewahlte rechtliche Rahmenbedingungen in den Blick nehmen. Daruber hinaus werden die ubergeordneten Potenziale der Nutzung von E-Health-Leistungen herausgearbeitet, praktische und ethische Problembereiche betrachtet und auf dieser Grundlage die Implementationsherausforderungen aus unterschiedlichen Perspektiven diskutiert.

In addition to lowering the quality of life of those affected, long periods of treatment and high recurrence rates of chronic wounds cause major economic costs for health care systems. Furthermore, inadequate health care and undersupply of care can be observed in Germany. Thus, new forms of care such as teleconsultation are being discussed increasingly. Recent changes in the remuneration system and macerations in the ban of remote treatment support those trends.A systematic review was conducted in July 2018 using PubMed and CENTRAL databases for randomized controlled trials between 2008 and 2018. Only randomized clinical trials in which patients with chronic wound who received treatment and follow-up by teleconsultation using information and communication technology to share data were included. In total, 6 international clinical trials were identified.Regarding the current state of research, there is no definite evidence that teleconsultation can improve the care of chronic wound patients. Most likely, wound healing time was positively influenced. No correlation was found between mortality and hospitalizations when teleconsultation was used.On the basis of the included studies, the evidence for the care of chronic wounds by teleconsultation is unclear. Further research is needed to examine the health-related and economic benefits of teleconsultation to support integration into health care systems.

The supply of online therapy options for mild to moderate depressive disorders has substantially risen both nationally and internationally in the past years. While the efficacy and efficiency of specific online-based therapeutic services were indicated within the framework of scientific evaluations, little is known about the acceptance of these new therapy options.In a nationwide online survey of online-based therapy options for mild to moderate depressive disorders, the attitude and stance as well as the use intention and the subjectively perceived knowledge of 657 medical practitioners and therapists, active in psychotherapeutic and psychiatric treatment were collated. The impact of the potential predictors on the use intention of online-based therapies, based on the unified theory of acceptance and use of technology, was analyzed by means of a binary logistic regression model.Besides the perceived performance and expense expectations, the supportive framework conditions, the influence of the cooperative environment, the individual technical affinity as well as the evaluation of the prospective significance of online-based therapy proved to be significantly influential predictors on the user intention. Special predictability for a positive user intention was shown related to the perceived potential of online therapy.The results underline the relevance of further evidence-basing of online therapy for mild to moderate depressive disorders. A user-oriented, participatory technology development proves to be just as relevant as a comprehensive sensitization, elucidation and education of potential users for a successful implementation.

The ubiquity of mobile applications makes it difficult to weigh up opportunities and potential risks. One significant aspect of an ethical assessment regarding the development and use of health and medical apps is the lack of clear and consistent guidelines and measures of value. Aim: The aim of this paper was to identify the main ethical determinants associated in the context of health and medical apps and develop a framework for ethical reflection. Methods: A systematic literature search in the database PubMed was undertaken and the journal Biomed Central Medical Ethics was hand searched and 32 met the review criteria. On this basis of the review an interview guide was developed and five purposively selected experts on the field of payers, science, consumers, medical ethics and society were interviewed regarding health and medical apps. Results: There is a lack of consistent and clear guidelines regarding the use of health and medical apps in literature. Indeed, findings refer to established biomedical principles. The interviews identified that several insecurities related to legal and regulatory issues are common. On the other hand, many advantages of the use of health and medical apps have been pointed out by experts. Conclusion: Debates on ethics and the use of health and medical apps should play a significant role in public discussion. Ethical endpoints cannot be considered isolated from each other, and must be regarded as a complex network of aspects connected with each other. Further research should concentrate on the development of consistent guidelines and a framework for reflection of occurring ethical concerns.

Zusammenfassung. Hintergrund: Der Einsatz von Informations- und Kommunikationstechnologien in der ambulanten Pflege erfolgt vor dem Hintergrund des demografischen Wandels mit dem Ziel, auch in Zukunft die Qualität der pflegerischen Versorgung sicherzustellen. Die Akzeptanz der telematischen Anwendungen ist dabei entscheidend für die erfolgreiche Implementation. Ziel: Das Ziel der Untersuchung war eine Erfassung der subjektiven Haltungen und Einstellungen sowie der Nutzungsintention der Pflegekräfte hinsichtlich telematischer Anwendungen in der ambulanten Pflege. Methoden: Auf der theoretischen Grundlage der „Unified Theory of Acceptance and Use of Technology“ (UTAUT) wurde eine Onlineumfrage erstellt, anhand derer deutschlandweit ambulante Alten- und Krankenpflegekräfte sowie Auszubildende in Pflegeschulen befragt wurden. Insgesamt konnten 371 Befragte in die Analyse eingeschlossen werden. Ergebnisse: Der Informationsstand zur Telematik und die eigenen technischen Kompetenzen werden als gering eingeschätzt. Es wird eine verbesserte Transparenz des Pflegeprozesses erhofft; genauso wie eine Erleichterung des Austausches sektorintern und -übergreifend. Dagegen wird befürchtet, dass die telematischen Anwendungen mit erhöhten Kosten, Schulungsaufwand und Technikabhängigkeit einhergehen. Schlussfolgerungen: Die Ergebnisse zeigen die Relevanz der Einstellungen und Bedürfnisse von Nutzerinnen und Nutzern für eine erfolgreiche Implementierung. Aus-, Fort- und Weiterbildungen sollten in Zukunft verstärkt die technologische Kompetenz der Pflegekräfte fördern.

Background Assistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex. Objective The goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development. Methods A scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies. Results From an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0%), followed by relatives (68/175, 38.9%), and both target groups (30/175, 17.1%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1%) and randomized controlled trials (44/175, 25.1%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5%) of the technology, while others targeted feasibility or usability or were explorative. Conclusions This review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users’ informational needs is required. Moreover, there is a need for larger studies on the technologies’ effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives.