A Qualitative Analysis of Cancer Patients' Perceptions of an Interprofessional Counseling Service on Complementary and Integrative Healthcare.

Medical guidelines recommend actively addressing patients' information needs regarding complementary and integrative healthcare (CIH). Within the CCC-Integrativ study, an interprofessional counseling program on CIH was developed and implemented at four comprehensive cancer centers (CCCs) in Germany. As part of the process evaluation, this study examines cancer patients' experiences with interprofessional CIH counseling sessions conducted by a physician and a nurse. Forty problem-centered interviews were conducted using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and analyzed using deductive-inductive content analysis based on Kuckartz and Rädiker's approach. Findings revealed that most participants had prior experience with CIH approaches and were burdened by physiological and psychological symptoms. Counseling sessions focused on cancer- and treatment-related symptoms and appropriate CIH recommendations (e.g., herbal poultice against anxieties and acupressure against nausea). Participants appreciated the mutual exchange and integration of perspectives from different healthcare professions within the interprofessional approach. They noted that the counseling team comprehensively addressed their healthcare and CIH information needs. Suggestions for improvement included the specificity of the CIH recommendations. As the participants only received counseling and no CIH treatments, information about reputable CIH providers was particularly important to many seeking advice. Patients with cancer receiving tailored CIH counseling from two healthcare professionals experienced benefits in CIH counseling for symptom management. The interprofessional teams offered a comprehensive perspective on patients' needs, proposing personalized recommendations for symptom control. These insights may foster collaboration between healthcare professionals interested in CIH counseling, enabling them to expand and consolidate their counseling services.

[Health Promotion and Prevention of Non-Communicable Diseases by Public Health Departments in Baden-Württemberg during the COVID-19 Pandemic: Results of an Online Survey]. / Gesundheitsförderung und Prävention nicht-übertragbarer Erkrankungen durch Gesundheitsämter in Baden-Württemberg während der COVID-19-Pandemie ­ Ergebnisse einer Onlinebefragung.

OBJECTIVES: Disease prevention and health promotion are among the core tasks of German public health services (Öffentlicher Gesundheitsdienst - ÖGD), particularly local public health departments (Gesundheitsämter). Little is known about the extent to which the departments were able to continue activities in the field of health promotion and prevention of non-communicable diseases (HPP-NCDs) during the COVID-19 pandemic. Using the example of public health departments in Baden-Württemberg (BW), we therefore investigated how much staff was available to the departments for HPP-NCDs services, how much staff was actually dedicated to HPP-NCDs during the COVID-19 pandemic, which HPP-NCDs activities were carried out during the pandemic, which were cancelled, and which should be resumed as a priority, according to the public health departments. METHODS: We developed a largely standardized online questionnaire for the survey of the 38 public health departments in BW. Per department one questionnaire was to be completed. The survey took place from 9/1/2022 to 11/4/2022. The data of this explorative cross-sectional study were analyzed in a descriptive-statistical manner using SPSS, version 28. RESULTS: Of the 38 departments, 34 participated in the survey (89%). Departments had a mean of 2.44 full HPP-NCDs staff as planned (median 2.00; SD 1.41; range 0.20-5.00). Under pandemic conditions, a mean of 1.23 full HPP-NCDs staff were deployed (median 0.95; SD 1.24; range 0.00-4.50). Respondents gave examples of 61 HPP-NCDs activities that were conducted under pandemic conditions, and they described 69 HPP-NCDs activities that had to be cancelled. Of the latter, respondents felt that 40 should be resumed as a matter of highest priority. Analysis of the priority activities to be resumed reveals characteristic differences: e. g., resumption of structural prevention activities was viewed more frequently as a matter of hightest priority than resumption of behavioral prevention activities. CONCLUSIONS: During the pandemic, local public health departments in BW deployed, on average, actually only half of their full staff allocated as planned to HPP-NCDs. Comparing different categories of HPP-NCDs activities (cancelled during the pandemic) in terms of the relative frequency with which their resumption is viewed as matter of highest priority, characteristic differences can be observed. It remains an open question which conclusions can be drawn from such differences.

[Information on health promotion and prevention on the websites of Baden-Württemberg's public health services-a first approach]. / Informationen zu Gesundheitsförderung und Prävention auf den Webseiten baden-württembergischer Gesundheitsämter ­ eine erste Annäherung.

BACKGROUND: Health promotion and prevention are core tasks of German public health services (Öffentlicher Gesundheitsdienst). Health communication is, among other things, central to their effectiveness. As the Internet has become an important source of health information and public health services are increasingly in the public eye, their websites are gaining more focus. We therefore investigated how public health services present topics on health promotion and prevention of non-communicable diseases (HPP-NCDs) on their websites. METHODS: The websites of the 38 public health service departments in Baden-Wuerttemberg were examined using qualitative content analysis from June to October 2022. The presentation of the HPP-NCDs topic on the websites as well as the relevant measures were documented. For each measure/activity the addressed target group, the topic, and the type of intervention was collected. RESULTS: The HPP-NCDs topic is addressed on all websites (n = 38); however, the presentation style is heterogeneous. A total of 243 HPP-NCDs measures/activities were identified across the 38 websites. There was a broad spectrum of topics, target groups, and types of intervention used in the measures/activities presented. DISCUSSION: The study shows an extensive but heterogeneous presentation of HPP-NCDs on the websites of public health services. In doing so, they are caught between the requirements of public relations and health information. The use of synergy effects through the joint promotion of nationally relevant informational materials and measures could be beneficial for public health services.

How do former medical and nursing undergraduates describe their learning on an interprofessional training Ward 12-18 months later? - A retrospective qualitative analysis.

BACKGROUND: Interprofessional training wards (IPTWs) seem to deliver good results in terms of development of interprofessional competencies. However, evidence of long-term effects of these training wards on learners' competency development is lacking and little is known about retrospective evaluation of IPTWs. Therefore, this study aimed to explore the retrospective evaluation of competency development and interprofessional collaboration of former undergraduates 12 or more months after a placement on an IPTW. METHODS: Eight follow-up interviews were conducted with four nursing and four medical professionals 12-18 months after they had finished a placement on an ITPW throughout their vocational training. Interviews were translated verbatim and analysed deductively and inductively based on qualitative content analysis. RESULTS: The qualitative content analyses deductively identified two main categories regarding the research question, namely the uniqueness of the programme and interprofessional competencies developed by the Interprofessional Education Collaborative. Sub categories were identified inductively, representing the perceived competency development and the learning opportunities on the IPTW as compared to other clinical placements throughout vocational training and in transition to practice. Interviewees seemed to have developed competencies that are important for interprofessional collaboration such as communication, roles and responsibilities, as well as competencies in patient care and management. Considered beneficial for learning were the opportunity to work self-responsibly and the interprofessional collaboration on the IPTW, both of which were neither possible in almost any other placement nor in transition to practice. CONCLUSION: Findings show that IPTWs can be sufficient in competency development and role clarification and are perceived positively by learners, but structures in clinical practice can impede sustaining competency development and efficient interprofessional collaboration.

[Evidence-based naturopathic nursing interventions in pain management]. / Evidenzbasierte naturheilkundliche Pflegeinterventionen in der Schmerztherapie.

Nurses are confronted with patients suffering from acute and/or chronic pain in all nursing care settings and within all target groups. Although national and international guidelines on chronic pain emphasize the importance of non-pharmacological interventions (for example, hot and cold applications) and educational approaches such as teaching self-management strategies to deal with pain, the most common applied intervention for chronic and acute pain is a pharmacological therapy. The aim of this article is to provide an overview of the potential of naturopathic nursing interventions for the care of patients with chronic and/or acute pain, focusing on so-called external applications such as wraps and compresses, which are safe, have a low-risk profile and are easy to apply, thus making them suitable for self-application. The use of non-pharmacological interventions as well as the counselling and training of patients in naturopathic applications offer nurses the possibility to work in an autonomous field of nursing promoting nursing as an attractive health profession.

Translation and psychometric properties of the German version of the "Interprofessional Socialization and Valuing Scale" (ISVS-21-D).

Understanding of the processes associated with socialization into collaborative work plays an important role in interprofessional education and collaborative practice. In order to evaluate changes in socialization toward interprofessional collaborative practice a measure is needed that captures professional beliefs, attitudes and behaviors of individuals in learning activities and in workplace practice. This article presents the translation and psychometric properties of the German Version of the Interprofessional Socialization and Valuing Scale (ISVS-21). Following translation from English to German, data of the German version of the questionnaire (ISVS-21-D) was collected in six different interprofessional education and practice settings amongst undergraduate students and health professionals. In total, 494 responses were analyzed. Results showed high reliability with Cronbach's alpha .90. Although not all fit indices are in the desired range, results give preliminary indication of the underlying single factor of the ISVS-21-D and suggest that the German version of the ISVS-21-D is a reliable instrument that can be used to measure interprofessional socialization in German health professionals and health care students as well as within other disciplines.

The applicability of interprofessional education for collaborative people-centered practice and care to health plans and workforce issues: A thematic global case review.

Background: This article focuses on a growing, global recognition of the importance of the field of interprofessional education for person-centered collaborative practice (IPECP) expressed through high-level policy and accreditation decisions/actions taking place in 5 countries. Policy decisions are used to motivate strategies related to IPECP that align with national health plans, and workforce issues. Methods: Using a collective of representative stories from around the globe, a grouping of case studies were developed to illustrate different approaches and challenges to IPECP implementation. Results: Institutions from countries of various income levels face many similar challenges in the execution, delivery, and sustainability of IPECP. All programs face issues of financing, of preparing faculty, of developing and organizing curricula, and of bridging between campus and community. Discussion: Policies are being developed that promote a global approach to the inclusion of IPECP in the accreditation and regulation of postsecondary institutions and health service organizations, in keeping with WHO National Health Workforce Accounts. Policies developed promote and demonstrate the benefits of IPECP through remote emergency learning methods. The policies also build national systems for IPECP as an integral part of continuing professional development and lifelong learning. The organization of interprofessional research programs and the increasing publication of their results of such programs will lead to a clearer understanding of the efficacy of the field of IPECP. To ensure sustainability, stakeholders and policymakers should continue to foster policies that facilitate IPECP.

[Heidelberg Milestones Communication (HeiMeKOM) - Experiences, Best Practice Examples and Recommendations from the Final Symposium on January 30 and 31 in 2020]. / Heidelberger Meilenstein Kommunikation (HeiMeKOM) ­ Erfahrungen, Best Practice Beispiele und Empfehlungen aus dem Abschluss-Symposium am 30./31. Januar 2020.

The National Cancer Plan emphasises the importance of medical communication and calls for its integration into medical education and training. In this context, the Milestone Communication Approach meets the communicative challenges in dealing with lung cancer patients. Interprofessional tandems, consisting of doctors and nurses, conduct structured conversations at defined moments with patients and their relatives. The concept aims at shared decision making, continuity in the care of lung cancer patients and the early integration of palliative care. During the symposium on the Heidelberg Milestone Communication in January 2020, recommendations on the care situation of lung cancer patients in advanced stages were developed. In addition, the further adaptability of HeiMeKOM to other settings and hospitals and to other diseases was discussed as well as the possibility of implementing such a concept in standard care. This article presents the experiences, best practice examples and recommendations discussed during the symposium in order to enable their extrapolation to other similarly oriented projects. The long-term goal is to transfer the milestone concept to other hospital, primarily certified lung cancer centers, and to ensure permanent funding. For further dissemination of the concept and, above all, to have it established in standard care, health policy awareness and support are required in addition to the integration of the concept in competence catalogues of continuing medical and nursing education.

Keeping nurses in nursing: a qualitative study of German nurses' perceptions of push and pull factors to leave or stay in the profession.

BACKGROUND: The increasing nursing shortages worldwide has focused attention on the need to find more effective ways to recruit and retain nurses. The aim of this study was to gain understanding of factors that keep German nurses in nursing and explore their perceptions of factors that contribute to nurses leaving or staying in the profession. METHODS: An explorative qualitative study was undertaken at four different hospitals (two university hospitals and two public hospitals) in Baden-Wuerttemberg, a state in South Germany. Semi-structured face-to-face or telephone interviews were conducted with 21 state-qualified nurses who had graduated from a German nursing program. Each interview was pseudonymized and transcribed. Transcripts were coded according to Qualitative Content Analysis with data structured into themes and subthemes. The study was reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist for qualitative research. RESULTS: Two themes emerged from the analysis and each theme had several subthemes: a) PUSH FACTORS i.e. factors that may push nurses to consider leaving the profession included limited career prospects, generational barriers, poor public image of nursing, and workplace pressures; b) PULL FACTORS i.e. factors that nurses wished for and could keep them in the profession included professional pride, improved remuneration, recognition of nursing, professionalisation, and improving the image of nursing as a profession. CONCLUSION: The decision to leave or stay in nursing is influenced by a complex range of dynamic push and pull factors. Nurse Managers responsible for stabilizing the workforce and maintaining their health system will continue to have to navigate challenges until working conditions, appropriate wages and career development opportunities are addressed. A key to tackling nursing shortages may be focusing on pull factors and nurse managers listening in particular to the perspectives of junior nurses directly involved in patient care, as giving them opportunity to further develop professionally, reinforcing a strong and supportive workplace relationships, paying an appropriate salary, and improving the public image of nursing profession. REGISTRATION NUMBER: The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register ( DRKS00017465 ).

Internationally trained nurses and host nurses' perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: a cross-sectional study.

BACKGROUND: The shortage of qualified nurses is a problem of growing concern in many countries. Recruitment of internationally trained nurses has been used to address this shortage, but successful integration in the workplace is complex and resource intensive. For effective recruitment and retention, it is important to identify why nurses migrate and if their expectations are met to ensure their successful integration and promote a satisfying work climate for the entire nursing team. The aim of this study was to examine the perceptions of safety culture, work-life-balance, burnout and job demand of internationally trained nurses and associated host nurses in German hospitals. METHODS: A multicentric, cross-sectional study was conducted with internationally trained nurses (n = 64) and host nurses (n = 103) employed at two university hospitals in the state of Baden-Wuerttemberg, Germany. An anonymous paper-based survey was conducted between August 2019 and April 2020. The questionnaire included sociodemographic questions, questions regarding factors related to migration, and the German version of the Assessment of your work setting Safety, Communication, Operational Reliability, and Engagement (SCORE) questionnaire. SCORE is divided into three sections: Safety Culture Domains (six subscales), Work-Life-Balance (one subscale), and Engagement Assessment Tool (four subscales). RESULTS: Nurses who migrated to Germany were primarily seeking better working conditions, a higher standard of living, and professional development opportunities. Internationally trained nurses reported lower work-related burnout climate (Mean 55.4 (SD 22.5)) than host nurses (Mean 66.4 (SD 23.5)) but still at a moderately high degree (Safety Culture Domains). Host nurses indicated a higher workload (Mean 4.06 (SD 0.65)) (Engagement Assessment Tool) and a lower Work-Life-Balance (Mean 2.31 (SD 0.66)) (Work-Life-Balance) compared to nurses who trained abroad (Mean 3.67 (SD 0.81) and Mean 2.02 (SD 0.86), respectively). No differences were detected for the other subscales. The Safety Culture Domains and Engagement Assessment Tool showed room for improvement in both groups. CONCLUSION: The study suggest that the expectations migrant nurses had prior to migration may not be met and that in turn could have a negative impact on the integration process and their retention. With increasing recruitment of internationally trained nurses from within Europe but also overseas, it is crucial to identify factors that retain migrant nurses and assist integration. TRIAL REGISTRATION: The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register ( DRKS00017465 ).

Impact of an interprofessional training ward on interprofessional competencies - a quantitative longitudinal study.

Complex learning strategies, like interprofessional training wards in which students work autonomously in interprofessional collaboration, can support the development of interprofessional competencies in terms of knowledge, abilities and attitudes. To assess the short-term and long-term effects of a three to five weeks placement on such an interprofessional training ward on nursing and medical undergraduates, a study with pre-post-follow-up design was conducted from April 2017 until February 2019. Outcome measures were the University of the West of England Interprofessional Questionnaire (UWE-IP), the Interprofessional Socialization and Valuing Scale (ISVS), and the Assessment of Interprofessional Team Collaboration Scale (AITCS) measuring interprofessional competencies, including teamwork, communication, interprofessional learning, collaboration, and socialization. 60 medical and 63 nursing undergraduates of the first 16 interprofessional student teams that were placed on the Heidelberg interprofessional training ward (HIPSTA) between April 2017 and November 2018 were included in the study. Data was analyzed using the linear mixed model analysis for longitudinal comparisons of scores before, directly after and three months after the placement on the interprofessional training ward. Statistically significant positive short-term effects in interprofessional competencies were found in all three questionnaires, with effect sizes up to d = 1.05. Statistically significant positive long-term effects with effect sizes up to d = 0.60 were found in the ISVS and the AITCS concerning socialization and collaboration. These results indicate that interprofessional education in a clinical setting positively influences the participants' perception of interprofessional socialization and teamwork. This may possibly lead to improved interprofessional collaboration in their further career. Strategies to yield a sustainable improvement of attitudes toward interprofessional interaction are still needed.

Medication beliefs and use of medication lists - is there a connection? Results from a before-and-after study in Germany.

BACKGROUND: Despite increasing digitalisation the paper-based medication list remains one of the most important instruments for the documentation and exchange of medication-related information. However, even elderly patients with polypharmacy who are at high risk for medication errors and adverse drug events, frequently do not receive or use a complete and comprehensible medication list. Increasing the use of medication lists would be a great contribution to medication safety and facilitate the work of health care providers. METHODS: This study is related to the project MeinPlan (MyPlan) which comprised an information campaign on safe drug administration in the Rhine-Neckar region in South Germany. The campaign was evaluated in a before-and-after study based on a survey among two independent, representative samples of citizens over 65 years. In total, 5034 questionnaires were analysed. While the effects of the primary outcome (the percentage of citizens using a medication list) have been reported elsewhere, this analysis focusses on the effects of the campaign on citizens' medication beliefs and assesses whether medication beliefs are associated with the use of medication lists, the use of over-the-counter drugs and the use of the tools offered by the campaign. Medication beliefs were assessed with the German version of the General Beliefs About Medicines Questionnaire (BMQ) which results in subscales for "General Overuse", "General Usefulness" and "General Harm". The use of medication lists and over-the-counter drugs was assessed with self-developed questionnaire items. RESULTS: No statistically significant change in citizens' medication beliefs before and after the campaign could be detected. Likewise, no association between medication beliefs and the use of medication lists, the use of over-the-counter drugs or the use of the tools offered by the campaign could be shown. CONCLUSIONS: A campaign focussing on the risks of drug administration did not change the medication beliefs of the targeted population. Moreover, citizens' general medication beliefs do not seem to be crucial for their decision to use a medication list or over-the-counter drugs. Strategies to improve the use of medication lists by patients should focus on other influential factors, such as individual benefits and barriers and socio-psychological factors.

Exploring early interprofessional socialization: a pilot study of student's experiences in medical history taking.

Traditional hierarchies and structures in healthcare, as well as traditional professional socialization practices, continue to create barriers to effective interprofessional collaboration. Nevertheless, some studies indicate that early socialization with other health professionals can build bridges and improve understanding of each other's roles and contributions to patient care. This pilot study aimed to gain insights into the nursing and medical students' experiences of interprofessional medical history taking during a collective learning activity. A descriptive case study was conducted using modified interviews based on the speed-dating (SD) technique to explore participants' reasons for the choice of profession (SD1) and experiences of interprofessional history taking (SD2). Data were digitally captured using audio-recordings. An inductive-deductive approach to qualitative content analysis of transcribed responses was undertaken. Eighteen students (medicine n = 6; nursing n = 12) participated. Two main categories with sub-themes emerged from the inductive SD1 analysis: (a) reasons for choosing a career and (b) knowledge about professions. The SD2 deductive analysis identified three major categories with sub-themes: (a) breaking down barriers, (b) interprofessional role learning - interprofessional collaboration and (c) dual-identity development. Our findings showed that early interprofessional socialization of students supported their learning about the complementary roles of doctors and nurses and enabled them to gain early experiences of interprofessional teamwork.

Use of medication lists: A population-based approach to increase the prevalence of medication lists within a region in Germany. A pre-post study
.

OBJECTIVES: Patient-centered medication lists are a useful documentation method to support safe drug treatment, but they are still inconsistently used and are of varying quality. The aim of this study was to evaluate the effects of an information campaign on the prevalence and use of medication lists. MATERIAL AND METHODS: We launched a population-based, low-threshold information campaign within a large region in Germany in order to sensitize the population to the use of medication lists. A survey was sent out at baseline and after 18 months to 5,340 citizens aged ≥ 65 years, covering ~ 4% of the region's population. RESULTS: The response rate was 49.4% (N = 2,640) at baseline and 45.4% (N = 2,427) at follow-up. Sociodemographic details of respondents were similar at both time-points as was the possession rate of a medication list among participants with regular medicine intake (51.6%, N = 1,181/2,288 vs. 51.4%, N = 1,082/2,107). Combining baseline and follow-up data, respondents indicated that their general practitioner was involved in issuing the list most often (N = 1,668/2,263, 73.7%), however, in 195 cases (8.6%), respondents indicated being solely responsible for the list. The majority (90.8%, N = 2,055/2,263) indicated having their list in use for longer than 1 year, but for only half of those, the list was updated within the last year. After the intervention, 6% of the respondents indicated being familiar with the campaign those being more likely to possess a list (69.7% N = 83/119 vs. 50.2% N = 999/1,988). CONCLUSION: The campaign did not change overall possession rate, but respondents who were familiar with the campaign were more likely to possess such a list.

The impact of an interprofessional training ward on the development of interprofessional competencies: study protocol of a longitudinal mixed-methods study.

BACKGROUND: To meet the patients' needs and to provide adequate health care, students need to be prepared for interprofessional collaborative practice during their undergraduate education. On interprofessional training wards (IPTW) undergraduates of various health care professions potentially develop a mutual understanding and improve their interprofessional competencies in clinical practice. To enhance collaboration of 6th-year medical students and nursing trainees in the third year of their vocational training an IPTW (Heidelberger Interprofessionelle Ausbildungsstation - HIPSTA) was implemented at the University Hospital Heidelberg, Germany. On HIPSTA future physicians and nurses take care of the patients self responsibly and in close interprofessional collaboration, supervised by facilitators of both professions. Although there are positive experiences with IPTWs internationally, little is known about the impact of IPTW on the acquisition of interprofessional competencies. For future interprofessional training and implementation of IPTWs evaluation of interprofessional learning and collaborative practice on Germany's first IPTW is of high relevance. METHODS: To evaluate the acquisition of interprofessional competencies the study follows a mixed-methods approach. Quantitative data is collected from undergraduate participants, staff participants and facilitators on HIPSTA (intervention group) and undergraduate participants and staff participants on a comparable 'conventional' ward without special interprofessional training (comparison group) immediately pre and post HIPSTA and, as follow-up, after three to six months (T0, T1, T2), using three questionnaires, namely the University of the West of England Interprofessional Questionnaire (UWE-IP), the Interprofessional Socialization and Valuing Scale (ISVS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Qualitative data is gathered in form of interviews and focus groups based on semi structured guidelines, video recordings of handovers and overt non-participant observations of daily rounds. Quantitative data will be analysed in a longitudinal comparison, presented descriptively and tested with an analysis of variance. Qualitative data will be analysed deductively and inductively. DISCUSSION: The results of the evaluation will give insight in undergraduates', staff's and facilitators' experiences and their self-perception of competency development. In addition the results will help identify benefits, challenges and areas for modification when implementing and establishing similar interprofessional training wards.

[Job Satisfaction of Young Professionals in Health Care]. / Die Arbeitszufriedenheit von Berufseinsteigern in den Gesundheitsberufen.

BACKGROUND: Job satisfaction in health care is currently important in view of workforce shortage in the health care area. The purpose of this study was to evaluate job satisfaction in young health professionals and to identify factors possibly influencing overall job satisfaction. METHODS: About one year after graduating from vocational training, a total of 579 graduates from various health care professions [Nursing (N), Nursing and Geriatric Nursing; Therapy (TP), Physical therapy and Logopaedics; Diagnostics (D), Diagnostic Radiography and Biomedical Science], were invited to participate in an online-survey. Job satisfaction was assessed with the 10-item Warr-Cook-Wall (WCW) job satisfaction questionnaire. Descriptive analysis of the WCW was performed, and the impact of various factors on job satisfaction was determined by stepwise linear regression analysis. RESULTS: In total, 189 graduates (N, n=121; TP, n=32; D, n=36) were included in data analysis (32.6% response rate). Overall job satisfaction in all young professionals was 4.9±1.6 (mean±SD) and was slightly higher in TP (5.4±1.4) compared with N (4.7±1.6) and D (5.0±1.5), respectively. Highest satisfaction was identified with "colleagues" and lowest satisfaction with "income" was identified in all professional groups. Colleagues and fellow workers showed the highest score of association regarding overall job satisfaction in regression analysis. CONCLUSIONS: As a whole, our data suggest good to very good satisfaction in various WCW items of job satisfaction. "Colleagues" were shown to have a high impact on job satisfaction. To improve the attractiveness of job profiles in health care, the presented results may provide a valuable input regarding workforce shortage.

Encountering complexity in collaborative learning activities: an exploratory case study with undergraduate health professionals.

An emerging challenge for educators of the health professions in undergraduate programmes is appropriately and adequately preparing students for the complexity they will encounter in practice. New graduate health professionals report increasing challenges transitioning to practice in contemporary health care environments due to the complexity encountered. Although literature on complexity science in health professional education is growing, research evidence on learning opportunities for students related to complexity remains sparse. This exploratory case study examined first-year health care students' encounters with complexity in a student-driven collaborative learning activity taking place over one academic semester outside the classroom. Rather than reproducing complexity in a scripted simulation activity, these novices were stimulated to adapt and respond to authentic complexity through a challenging amount of independence and definition of only minimal enabling constraints i.e. basic ground rules of the learning activity and goals to be achieved. 67 students were assigned to small groups with four to five members to form 15 interprofessional collectives (laboratory technology n = 9; medicine n = 13; midwifery n = 1; nursing n = 28; physiotherapy n = 7; radiography n = 4; speech language therapy n = 5). Data was collected using a self-reflection form with narrative free text hand-written answers. Open coding and an inductive-deductive approach to qualitative content analysis of transcribed responses resulted in identification of two key themes: a) reflecting on interprofessional collaboration, and b) evaluating the interprofessional collectives. Our findings showed that rather than perceiving the learning activity in its cognitive and collaborative complexity and feeling overwhelmed, first-year health care students described rising to the challenge and stretching outside their comfort zones. Complexity was tacitly experienced but perceived as a stimulating challenge and successfully navigated within the interprofessional collectives as they collaborated together over time.

Developing a Shared Patient-Centered, Web-Based Medication Platform for Type 2 Diabetes Patients and Their Health Care Providers: Qualitative Study on User Requirements.

BACKGROUND: Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients' knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user' adoption is optimal. OBJECTIVE: The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. METHODS: This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. RESULTS: Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients' ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align the platform to users' workflow. CONCLUSIONS: By employing a UCD, this study provides insight into the desired functionalities and usability of patients and HCPs regarding a shared patient-centered, Web-based medication platform, thus increasing the likelihood to achieve a functional and useful system. Substantial and ongoing engagement by all intended user groups is necessary to reconcile differences in requirements of patients and HCPs, especially regarding medication safety alerts and access control. Moreover, effective training of patients and HCPs on medication self-management (support) and optimal use of the tool will be a prerequisite to unfold the platform's full potential.

Students´ perception of interprofessional education in the bachelor programme "Interprofessional Health Care" in Heidelberg, Germany: an exploratory case study.

BACKGROUND: Interprofessional education is receiving increased attention worldwide. This has led to the development of a bachelor programme "Interprofessional Health Care" at the University of Heidelberg, Germany beginning in the winter semester 2011. Aim of this study was to evaluate the students' perception of this innovative programme regarding interprofessional learning. METHODS: An exploratory case study was conducted. A semi-structured guideline was developed and seven focus groups were performed with the students of the first three cohorts in 2012-2014. Data was transcribed and analyzed using content analysis leading to main categories, one of which was titled "interprofessional learning". This article presents the results focussing on the students' experiences regarding interprofessional education and learning during their first two semesters of the programme. RESULTS: Four main categories related to interprofessional learning were developed inductively. Students assessed "interprofessional learning" in general as positive and wished to encounter a more intense experience and collaboration with different health professions during their studies. Students reported to benefit from the programme due to a better understanding of other professions and their different perspectives. They described decreased hesitance to approach other health professions in every day practice. Results are in line with the four domains of the Interprofessional Core Competencies. CONCLUSION: All in all students at an early stage recognized the benefit of interprofessional learning for their studies and their everyday work in practice showing the way forward for the bachelor programme and encouraging more interprofessional encounters with students from other health care programmes.

[Benefits of a Medication List from a Citizen's Perspective -A Qualitative Survey]. / Nutzen eines Medikationsplans aus Sicht der Bürger ­ eine qualitative Befragung.

BACKGROUND: Since October 2016, German patients are entitled to get a medication list if using at least 3 drugs. The patient's individual attitude to a medication list is supposed to be relevant for its use und acceptance. STUDY AIM: Because there is little known about those attitudes, this study examined which potential benefits patients see in possessing a medication list, and why certain patients might not use it. METHOD: In a qualitative survey, 375 citizens of the Rhein-Neckar region were interviewed by using a semi-standardized guide. A content analysis of the interviews was done. RESULTS: Most citizens described medication lists as having private and economic benefits such as for health care or safe drug use. But often, they combine potential benefits with requirements such as age, number of prescribed drugs, or health status. Unsatisfied individual needs, excessive demands or an attitude of rejection are possible reasons for non-use. CONCLUSION: For successful implementation of the medication list, the individual attitude of patients should be assessed to be able to provide tailored information and assistance. The views of citizens about a medication list agree with the aims of the so-called German E-Health Act, but differ particularly with regard to named requirements and prioritisation.