Suchergebnisse

GREEN und THOROGOOD legen mit Qualitative Methods for Health Research ein fundiertes und präzises Einführungsbuch vor. Der Aufbau des Bandes ist dem organisatorischen Ablauf eines Forschungsprojekts angepasst. Es beginnt mit zugrunde liegenden Epistemologien qualitativer Methoden, diskutiert darauf aufbauend Fragestellungen, die bearbeitet werden können, und beschreibt eine Vielzahl qualitativer Methoden und Auswertungsmöglichkeiten. Den Abschluss des Buches bildet eine Diskussion der Besonderheiten von qualitativen Forschungsstudien im Gesundheitsbereich, indem deren besondere Schwierigkeiten und Möglichkeiten ausgeleuchtet werden. Für all diejenigen, die einzelne Themenbereiche vertiefen möchten, gibt es am Ende jeden Kapitels weiterführende Literaturhinweise. GREEN und THOROGOOD vermeiden zugespitzte epistemologische Debatten. Diese Neutralität macht das Buch zu einer sehr guten, klaren Einführung in die Praxis qualitativer Forschung für Gesundheitswissenschaftlerinnen und Gesundheitswissenschaftler, die qualitative Methoden in ihre Arbeit aufnehmen wollen, oder für Novizen und Novizinnen, die erstmals einen qualitativ-empirischen Zugang zu Fragen der Gesundheitsforschung suchen.

Statistics constitute the social universe of which they are gathered. The foundation necessary to develop quantified knowledge about society is the population. If quantified knowledge changes society, the question arises on how individuals become to be represented as population. The population has to be extracted from individuals in a process that we call "populationisation." This encompasses the development of the individual into a segment of a population through the compilation of individual data into population data and its analysis. To describe the process of populationisation, we follow a statistical risk assessment tool, the German Diabetes Risk Score, from its inception in a cohort study to its entry into the public sphere of German society. The population is extracted from individuals that function as research subjects through an identification number. Preprocessed information is entered into a dynamic database that enables its rearrangement according to main aggregates. Through populationisation, a signified is enacted that can be sliced up and that is equal in all its parts. Now predictions can be computed and fed back to society as tools of moral judgment. The acting individual and "society" are—numerically and literally!—entangled in the production and enactment of risk knowledge.

Abstract Background Integrative medicine (IM) is currently the most commonly used term to describe the integration of complementary and alternative medicine (CAM) into conventional medicine. In the definitions of IM the most important feature is the focus on evidence as crucial factor for therapeutic decision-making. However, there are discussions on the term "integrative medicine" with the most notable critique from within CAM that it describes the integration of complementary methods into conventional institutions and into a "conventional framework of thinking". The aim of this qualitative study was to understand the thoughts of leading experts on IM and on the scientific debate in the field as well as their personal opinions about terminology in general. Methods We have conducted semi-standardized interviews with ten leading experts in the field of CAM and integrative medicine in the USA, England, and Germany, who have had leading positions at medical schools or the NIH in 2010 and 2011. Interviews were recorded, transcribed and analyzed using content analysis with the qualitative analysis software maxqda. Results Overall the current terminology was seen as a problem, although most experts agreed that the term "integrative medicine" (IM) described well what they do or they think is useful for medical care. The terminology debate was discussed from four perspectives: 1) from the perspective of medical practice, 2) from the perspective of research, 3) from the perspective of public relations, and 4) from the perspective of health care delivery. These perspectives may be used to evaluate the appropriateness of different terms in use in the field. When interviewees discussed the terminology question, they also discussed the type of health care system they envisioned. Such reflections led the interviewees to caution about too narrow a focus on the terminology question. The question of naming was one about influencing and changing medicine. Conclusion The discussion of the experts demonstrated that the discussion about terminology is an important debate about the shaping of medicine. The experts discussed terminology in the light of "how health care systems" should look like in the future.

Zusammenfassung
Ziel der Studie Die Studie untersucht, inwieweit Medizinische
Fachangestellte durch eine Weiterbildung zu Präventionsberatern präventive
Maßnahmen in Hausarztpraxen unterstützen können.
Methodik Zwischen Juli 2019 und Dezember 2020 wurde in Hausarztpraxen
einer ländlichen Region in Brandenburg präventive Maßnahmen durch ausgebildete
Präventionsberater in Hausarztpraxen angesiedelt. Sie bestanden in der
längerfristigen Unterstützung von Personen bei Lebensstiländerungen in den
Bereichen "Ernährung", "Bewegung" und "Entspannung". Die begleitende Prozess-
und Ergebnisevaluation beinhaltete Prä-Post-Vergleiche ausgewählter
medizinischer Parameter sowie die Untersuchung möglicher Veränderungen der
Gesundheitskompetenz und gesundheitsbezogenen Lebensqualität mithilfe
standardisierter Fragenbögen (HeiQ-Core, SF-12v2). Weiterhin wurden thematische
Analysen von Fortbildungsunterlagen, Teilnehmenden-Befragungen mithilfe eines
Fragebogens, zwei Fokusgruppen mit Präventionsberatern sowie fünf Interviews mit
Studienteilnehmenden durchgeführt.
Ergebnisse Es wurden vier Hausarztpraxen und zwei Gesundheitseinrichtungen
rekrutiert und sieben MFAs zu Präventionsberatern ausgebildet. 38 Personen
wurden in das Präventionsprogramm eingeschlossen. Zwar wurden die
Beratungsgespräche insgesamt nach Fortbildungsvorgaben durchgeführt, doch
sorgten diverse individuelle sowie strukturelle Barrieren für eine geringe
Inanspruchnahme der Intervention.
Schlussfolgerungen Inwieweit am Individuum angepasste präventive Maßnahmen
in Hausarztpraxen erfolgreich mithilfe von zu Präventionsberatern
weitergebildeten MFAs etabliert werden können, steht in starker Abhängigkeit zu
den jeweiligen Praxisstrukturen sowie der vorliegenden Patientenklientel. Eine
erfolgreiche zeitliche Integration und Koordination der Tätigkeiten als
Präventionsberater im Praxisalltag erscheint dabei zielführend für
Interventionen der hier evaluierten Art.

Die Gesundheitsberichterstattung liefert aktuelle und detaillierte Informationen über die Gesundheit der Bevölkerung. Sie ist damit eine wichtige Grundlage für die Gesundheitspolitik und für die Forschung mit dem Ziel der Verbesserung von Gesundheitsförderung, Prävention und Versorgung. Um die gesellschaftliche Vielfalt besser abbilden zu können, zielt das vom Bundesministerium für Bildung und Forschung (BMBF) geförderte Verbundprojekt AdvanceGender auf die geschlechtersensible und intersektionale Weiterentwicklung des Forschungsprozesses populationsbasierter Studien und der Gesundheitsberichterstattung ab. Die drei Teilprojekte widmen sich inhaltlich der Studienteilnahme, Datenanalyse und der Gesundheitsberichterstattung. Aus den Ergebnissen werden Empfehlungen für epidemiologische Studien und für die Gesundheitsberichterstattung entwickelt. ; Peer Reviewed

INTRODUCTION: German government regulations such as physical distancing and limited group numbers, designed to curb the spread of COVID-19, have had far-reaching consequences for the very foundations of social life. They have, to name only a few, transformed greetings and goodbyes, blurred private and public worlds, and complicated basic communication with mandatory mask wearing. The ethnographic study CoronaCare investigates how these sociopolitical measures affect social health, a form of health which unfolds through and across social relations. It explores how caring as a fundamental human activity and one integral to sustaining social health is impacted when in-person and person-to-person contacts are restricted and everyone is radically redefined as at risk from others and a risk to others. It explores care relationships, relationships involving the giving or receiving of care in everyday life, institutional settings such as an assisted living facility, and informal settings, such as a housing block. Inside of the pandemic, relationships are a pivotal site at which the negotiation of caring and risk is intensified and where the consequences for social health and social life more generally are pronounced. METHODS AND ANALYSIS: This ethnographic project aims to understand the tensions that arise in the lives of individuals and communities living under the sociopolitical regulations and to analyse the tacit forms of practice that individuals and communities develop to uphold social health. Fueled by citizen science, the ethnography uses a variety of methods namely telephone and video interviews with 60–70 research participants, the collection of ethnographic material including video and audio diaries, storyboards, first-person camera footage, photographs and a survey to enrich the sample description based on the Copenhagen Psychosocial Questionnaire. The analysis will draw on elements of grounded theory and through the aid of the qualitative software MAXQDA it will rigorously document and explain how the ...

Background: Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. Methods: The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95% confidence interval). Results: Depression scores increased significantly during the study period (β = .03, 95% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95% CI [0.13, 0.38]), but not in administrators (β = .03, 95% CI [−0.04, 0.11]). Conclusion: Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.