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Der Beitrag präsentiert die Arbeit eines DFG-Netzwerks zur Erforschung von Ratgebermedien in Form eines Zwischen- und Erfahrungsberichts. Neben einer Darstellung der verschiedenen Forschungszugänge innerhalb des Netzwerks diskutiert er Möglichkeiten und Grenzen einer Zusammenarbeit der Netzwerkmitglieder vor dem Hintergrund der notwendigen Sensibilität im Umgang mit Forschungsdaten.

Objectives The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system.Setting Primary care practices in Thuringia, Germany.Participants Convenience sample of 16 GPs.Design Qualitative study design with semistructured interviews and content analysis.Results Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists.Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants’ activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians.Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process.Conclusions The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships.

Neben Ratgebern für Eltern und Lehrpersonen existieren ebenso Ratgebermedien, die sich an Kinder richten und die diesen zu verschiedenen Themen Ratschläge bezüglich einer Verhaltungsoptimierung darbieten. Da hierzu bislang kaum Forschungsliteratur existiert, stellt der Beitrag eine Untersuchung vor, in der an Kinder in der mittleren Kindheit adressierte mediale Ratgeberangebote auf dem Buchmarkt und im Internet erhoben und mit Blick auf die angebotenen Themen inhaltsanalytisch ausgewertet wurden. Diese zeigen sich heterogen: Auf dem Buchmarkt wird vor allem Rat zu den Themen Aufklärung/Sexualität, Selbstbewusstsein/Selbstbestimmung, Soziales Verhalten/Streit/Konfliktlösung sowie Umwelt/Nachhaltigkeit gegeben. Im Internet hingegen finden sich zum Teil Themen, die auf dem Buchmarkt nicht vorkommen. Von den entsprechenden Themenüberblicken ausgehend wird anhand eines dokumentenanalytisch ausgewerteten Samples zudem eine erste Charakteristik der kommunikativen Elemente medialer Kinderratgeber herausgearbeitet. Hierbei zeigen sich Blogs im Vergleich zu Büchern überraschenderweise weniger vielfältig. Allerdings ist zu vermuten, dass sich digitale Ratgeberangebote in Bezug auf die gewählten Themen näher an der medialen Lebensrealität von Kindern in Deutschland bewegen. Basierend auf diesen ersten Ergebnissen werden Strategien für die künftige Erforschung von Ratgebermedien für Kinder auf der Angebotsseite vorgeschlagen.

Abstract Background In the healthcare system in Germany, different institutions and actors play specific roles in the discharge and transition of patients from hospitals into primary care (Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen, Wettbewerb an der Schnittstelle zwischen ambulanter und stationärer Gesundheitsversorgung, 2012). However, there are shortcomings in these intersectoral transitions. Especially in older people with cognitive impairment (PCI), discharge management often lacks coordination and cooperation between healthcare providers. This frequently results in higher rates of unscheduled readmission. The project intersec-CM is a randomised controlled trial (RCT) that aims to explore up to what extent an intersectoral care management (ICM) can improve this transition. This ICM is delivered by nurses with special training in care management. The objective of this paper is to describe a mixed-methods process evaluation of the intersectoral care management intervention and the factors that facilitate and inhibit its implementation. Methods Different study designs for process evaluations from previous literature were collected and analysed according to the dimension implementation fidelity, satisfaction with the intervention, feasible transfer into routine care, optimum point of time, frequency and execution of the intervention, and context factors. Results The actor-network theory was chosen as the theoretic framework for the process evaluation. Based on this theory, a mixed-methods design was developed to combine and integrate qualitative and quantitative evaluation methods. The qualitative part includes semi-structured interviews using topic guides (phase 1) and later in-depth interviews with narrative portions (phase 3), which will be analysed by using the qualitative content analysis according to Kuckartz. The quantitative survey (phase 2) is conducted with standardised questionnaires. Discussion Challenges in data collection include the development of interview guidelines, which require different terminologies depending on every specific actor targeted in the intervention. Conducting the interviews, there is a risk of misunderstanding the older PCI by the interviewer and vice versa. However, the combination of qualitative and quantitative approaches as different techniques of process evaluation may help to capture, integrate and analyse data on different dimensions of the intervention. Conclusions The results of our process evaluation may serve as an implementation guideline for intersectoral care management in the German healthcare system. Furthermore, the approach to evaluate the process of a complex intervention in health care for older PCI may serve as a stimulus to broaden the evidence base also of other complex intervention studies to improve health care for this vulnerable group. The study was ethically approved by the Ethics Committee of the Ernst-Moritz-Arndt University of Greifswald. The study has been registered at the U.S. National Library of Medicine. Trial registration ClinicalTrials.gov NCT03359408 . Registered on 2 December 2017. The approximate date when recruitment to the process evaluation of the study will be completed is 31 May 2021.

Abstract Background The sectorization of health-care systems leads to inefficient treatment, especially for elderly people with cognitive impairment. The transition from hospital care to primary care is insufficiently coordinated, and communication between health-care providers is often lacking. Consequences include a further deterioration of health, higher rates of hospital readmissions, and institutionalization. Models of collaborative care have shown their efficacy in primary care by improving patient-related outcomes. The main goal of this trial is to compare the effectiveness of a collaborative care model with usual care for people with cognitive impairment who have been admitted to a hospital for treatment due to a somatic illness. The aim of the intervention is to improve the continuity of treatment and care across the transition between the in-hospital and adjoining primary care sectors. Methods/design The trial is a longitudinal multisite randomized controlled trial with two arms (care as usual and intersectoral care management). Inclusion criteria at the time of hospital admission due to a somatic illness are age 70+ years, cognitive impairment (Mini Mental State Examination, MMSE ≤26), living at home, and written informed consent. Each participant will have a baseline assessment at the hospital and two follow-up assessments at home (3 and 12 months after discharge). The estimated sample size is n = 398 people with cognitive inmpairement plus their respective informal caregivers (where available). In the intersectoral care management group, specialized care managers will develop, implement, and monitor individualized treatment and care based on comprehensive assessments of the unmet needs of the patients and their informal caregivers. These assessments will occur at the hospital and in participants’ homes. Primary outcomes are (1) activities of daily living, (2) readmission to the hospital, and (3) institutionalization. Secondary outcomes include (a) frailty, (b) delirium, (c) quality of life, (d) cognitive status, (e) behavioral and psychological symptoms of dementia, (f) utilization of services, and (g) informal caregiver burden. Discussion In the event of proving efficacy, this trial will deliver a proof of concept for implementation into routine care. The cost-effectiveness analyses as well as an independent process evaluation will increase the likelihood of meeting this goal. The trial will enable an in-depth analysis of mediating and moderating effects for different health outcomes at the interface between hospital care and primary care. By highlighting treatment and care, the study will provide insights into unmet needs at the time of hospital admission, and the opportunities and barriers to meeting those needs during the hospital stay and after discharge. Trial registration ClinicalTrials.gov, NCT03359408; December 2, 2017.

Ratgebermedien sind nahezu allgegenwärtig. In Buchform, im Zeitschriftenformat und auch im Internet bieten sie potentiellen Rezipientinnen und Rezipienten vielfältige Appelle und Strategien zur Optimierung des eigenen Verhaltens oder des Verhaltens anderer hinsichtlich Gesundheit, Pflege, Erziehung, Glück, Erfolg, Sich-Kleiden, Styling, Beauty, gesundem Kochen und zahlreichen weiteren Themen. Ratgebermedien existieren jedoch nicht nur für erwachsene Personengruppen wie Eltern oder Lehrkräfte, sondern auch für Kinder. Im Vergleich zur Elternratgeberforschung bilden das Angebot von Ratgebermedien für Kinder und ihre Inanspruchnahme durch Kinder bislang allerdings ein Forschungsdesiderat. Diesem Zustand begegnet der vorliegende Beitrag durch eine qualitative Explorationsstudie, in der die Inanspruchnahme von Ratgebermedien bei sechs- bis dreizehnjährigen Kindern hinsichtlich der medialen Formate und Themen untersucht wurde. Hierfür wurden neben vier Expertinnengesprächen 30 Interviews mit Kindern im Alter von sechs bis 13 Jahren inhaltsanalytisch ausgewertet. Die Ergebnisse zeigen, dass in der mittleren Kindheit eine hohe thematische Vielfalt an Anleitungen, Ratschlägen und Tipps mittels verschiedener Medien in Anspruch genommen wird. Von den Ergebnissen ausgehend werden Ausblicke für die künftige Erforschung von Ratgeberangeboten für Kinder herausgearbeitet.