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We use numbers and fractions every day, for example when we are doing our shopping or baking a cake. But mathematics is, of course, much more: it is the language of science, or, to use Galileo's words, “the book of Nature is written in mathematical language” (Galileo, 1623) and some mathematical competencies beyond basic arithmetic are required in most professions. Basic mathematics, i.e., elementary arithmetic, elementary geometry and some elements of calculus, is taught in school, not just for everyday life, but as a tool for many different professions. In school, however, mathematics is either “loved” or “hated”, as Hersh and John-Steiner masterfully describe in their book “Loving and Hating Mathematics” (Hersh and John-Steiner, 2010). Research in mathematics education has definitely contributed to reducing school students' hatred of mathematics and this reduction may be seen as one of its many goals.
In contrast with mathematics, the field of mathematics education is strongly interdisciplinary; the closest field to influence it directly is psychology. In fact, mathematics education is consistently shaped by both behavioral and cognitive perspectives, since so many factors—the power of visualizations, the effect of representation formats, but also factors like gender, self-efficacy, etc.—influence and sometimes determine students' performance.
Our aim for this Research Topic and for the collection of papers we are now publishing has thus been to illustrate the relevance of such various psychological perspectives for mathematics education using the contributions of colleagues from around the world. All the contributions we have collected address these interdisciplinary perspectives explicitly or implicitly.
Maturity models are increasingly used to advance the processes of organizations, including Higher Education Institutions. In this paper, we review existing maturity models to analyze and optimize the accessibility of organizations. Therefore, we conducted a systematic literature research in the databases Web of Science, IEEE Xplore, BASE, ACM, and Google Scholar, resulting in 13 different maturity models. An additional web search on maturity models for accessibility found another 12 maturity models that we added to the results. Finally, we analyzed the 25 maturity models in more detail, specifically the indicators that each maturity model uses to measure accessibility. The most frequent indicators were “responsibility”, “competences & training”, and “monitoring”, with differences in the frequencies when separated by target group. Out of the 25 maturity models found, only 6 focused on Higher Education Institutions. None of the existing maturity models focuses on teaching and learning of accessibility explicitly.
Introduction:
Results from experimental research in instructional psychology
imply that a deep menu structure of a e-learning website may provide useful segmentation. However, menu depth also increases the need for navigation and thus, might have impairing eects on learning. Furthermore, instructional support can be provided by including a checklist, to ensure that learners reflect on their
study progress. The study aimed at investigating which menu structure is beneficial for e-learning websites and whether a checklist could compensate the negative effects of an unfavorable menu structure.
Methods:
Therefore, in an online experiment, we let 101 students learn facts about rocks from an e-learning website with either a deep or a flat menu structure. We further manipulated whether metacognitive support through a checklist was provided or not. Learning outcomes, cognitive load, metacognitive factors as well
as learning time were measured.
Results:
Results show no main eects of the menu depth or the presence of
a checklist on retention and transfer performance. Learning achievements in percent for retention were 37.31 (deep menu/checklist), 31.10 (deep menu/no checklist), 36.07 (flat menu/checklist), 38.13 (flat menu, no checklist) and for transfer were 35.19 (deep menu/checklist), 34.40 (deep menu/no checklist), 37.78 (flat menu/checklist), 33.23 (flat menu, no checklist). Yet, there are hints that the deeper menu structure had a negative eect on learning processes: The deep menu structure led to an enhanced extraneous cognitive load (ECL) and reduced
learning efficiency. However, providing a checklist had beneficial eects mainly when learning with a deep menu structure but not overall. Unexpectedly, the presence of the checklist did not influence metacognitive measures.
Discussion:
Our study suggests that possible costs of a deep menu structure
should be considered when designing instructional checklists. However, the study also provides a way in which these costs can be compensated, which is by using a checklist. Implications for instructional research and e-learning are discussed.
Parental self-efficacy (PSE) is an essential predictor of parenting practices and child development. The content-specificity of PSE is not well understood: Previous studies are based on either measure of general parental self-efficacy or task-specific parental self-efficacy but not measures of both constructs. Thus, we do not know how both constructs are related. With data from the “AQuaFam” study, we compared four-factor models to investigate the structure of PSE. It was a priority whether (1) task-specific and general PSE could be assessed separately or (2) be mapped in a hierarchical model with task-specific PSE factors and a superordinate factor of general PSE. A Chi-square test shows no significant model improvement, which indicates general and task-specific PSE being separate dimensions. US studies suggest that low-income parents, migrants, or parents with a lower educational status experience lower PSE. To adequately support these parents, we need to know whether differences according to families’ background characteristics occur in task-specific and general PSE beliefs. We tested general PSE and PSE in four parenting tasks for differences according to families’ background characteristics. Parents with a university degree they were self-efficacious in communicating responsible media use than parents without a university degree. Parents with a non-German family language they were self-efficacious in communicating a responsible media use, caring for a sick child, and in their general PSE compared to parents with German as a family language. The results of the group differences are discussed in the context of how to support different parent groups.
Introduction
Interprofessional collaboration of physicians and midwives is essential for appropriate and safe care of pregnant and parturient women as well as their newborns. The complexity of woman-centered care settings requires the continuous exchange of information and the coordinated implementation of multi-and interprofessional care concepts. To analyze the midwives’ perspective on the multi-and interprofessional care process during pregnancy, birth and postpartum period, we aimed to adapt and psychometrically evaluate the Interprofessional Collaboration Scale (ICS).
Methods
The ICS (13 items) was answered by 299 midwives for (i) prenatal and postpartum care as well as (ii) perinatal care. Three items on equitable communication (EC) identified in qualitative interviews with N = 6 midwives were added as further aspects of quality in collaborative midwifery care. Confirmatory factor analysis was used to test competing theoretically hypothesized factorial model structures, including both care settings simultaneously, i.e., birth and prenatal/postpartum.
Results
A two-dimensional structure assuming the 13 original ICS items and the 3 items on EC as psychometric distinct item groups accounts for the data best. After deleting 5 ICS items with insufficient indicator reliability, a very good-fitting model structure was obtained for both prenatal/postpartum as well as perinatal care: χ2df = 192 = 226.35, p = 0.045, CFI = 0.991, RMSEA = 0.025 (90%CI: [0.004; 0.037]). Both the reduced ICS-R and the EC scale (standardized response mean = 0.579/1.401) indicate significantly higher interprofessional collaboration in the birth setting. Responsibility in consulting, attitudes toward obstetric care and frequency of collaboration with other professional groups proved to be associated with the ICS-R and EC scale as expected.
Discussion
For the adapted ICS-R and the EC scale a good construct validity could be confirmed. Thus, the scales can be recommended as a promising assessment for recording the collaboration of midwives with physicians working in obstetric care from the perspective of midwives. The instrument provides a validated assessment basis in midwifery and obstetric care to identify potentially divergent perspectives within interprofessional care teams in woman’s centered care.
Hintergrund
In der COVID-19-Pandemie ging die Versorgung nichtübertragbarer Erkrankungen zeitweise deutlich zurück, auch weil Menschen Angst vor einer Ansteckung hatten. Wir führen eine Bestandsaufnahme zur organisationalen Gesundheitskompetenz in der Regelversorgung nichtübertragbarer Erkrankungen in der ersten Welle der COVID-19-Pandemie durch und fragen: Inwiefern wurden Menschen mit gesundheitlichen Beschwerden dabei unterstützt, gesundheitskompetente Entscheidungen für oder gegen die Inanspruchnahme von Versorgungsleistungen zu treffen?
Methodik
Strukturierende Inhaltsanalyse der Internetpräsenzen der Mitglieder der Arbeitsgemeinschaft der Wissenschaftlich Medizinischen Fachgesellschaften (AWMF; n = 179), der kassen(zahn)ärztlichen Vereinigungen (K(Z)Ven; n = 38), ausgewählter Krankenkassen (n = 21), ausgewählter Behandlungseinrichtungen (n = 25) und überregionaler Anbieter von Gesundheitsinformationen (n = 5) zu Informationen und Angeboten zum Thema.
Ergebnisse
Die geprüften Internetpräsenzen informieren weitgehend rund um COVID-19, aber nur selten darüber, wie man sich bei einer (vermuteten) anderen Erkrankung in Bezug auf die Inanspruchnahme von Versorgungsleistungen verhält. 2 Portale von Anbietern von Gesundheitsinformationen, eine Krankenkasse, aber keine der KVen bieten explizite Entscheidungshilfen an. KVen weisen öfter, aber nicht durchgängig auf die generelle Möglichkeit von Videosprechstunden hin.
Diskussion
Für die meisten Patient*innen gab es damit keine gezielten Informationen zu dem Thema. Angesichts der Fortdauer der COVID-19-Pandemie gilt es, vorhandene vertrauenswürdige, qualitativ hochwertige Informations- und Beratungskapazitäten auszubauen und ihre Bekanntheit zu erhöhen, um gesundheitskompetente Entscheidungen auch in der Pandemie zu ermöglichen.
Abstract
Mathematical word problem solving is influenced by various characteristics of the task and the person solving it. Yet, previous research has rarely related these characteristics to holistically answer which word problem requires which set of individual cognitive skills. In the present study, we conducted a secondary data analysis on a dataset of N = 1282 undergraduate students solving six mathematical word problems from the Programme for International Student Assessment (PISA). Previous results had indicated substantial variability in the contribution of individual cognitive skills to the correct solution of the different tasks. Here, we exploratively reanalyzed the data to investigate which task characteristics may account for this variability, considering verbal, arithmetic, spatial, and general reasoning skills simultaneously. Results indicate that verbal skills were the most consistent predictor of successful word problem solving in these tasks, arithmetic skills only predicted the correct solution of word problems containing calculations, spatial skills predicted solution rates in the presence of a visual representation, and general reasoning skills were more relevant in simpler problems that could be easily solved using heuristics. We discuss possible implications, emphasizing how word problems may differ with regard to the cognitive skills required to solve them correctly.
The results of three meta-analyses show that the effectiveness of learning from animations, when compared to learning from static pictures, is rather limited. A recent re-analysis of one of these meta-analyses, however, supports that learning from animations is considerably more effective than learning from static pictures if the specifics of the displayed changes need to be learned. In order to further validate this finding as well as to clarify the educational strengths and weaknesses of animations and static pictures, an experimental study with three groups was conducted. Overall, 88 university students participated in the study. One group of learners (n = 30) watched a single picture of a gear mechanism, one group of learners (n = 28) watched four pictures, and one group of learners (n = 30) watched an animation. All groups had to identify specific motions and spatial arrangements covered by the gear mechanism. While learners who watched the animation exhibited the best performance with respect to the identification of motions, learners who watched the pictures showed the best performance with respect to the identification of spatial arrangements. The effect sizes are large. The results of the study help to clarify when animations and when static pictures are most suitable for learning.
Prior research indicates that student teachers frequently have misconceptions about multimedia learning. Our experiment with N = 96 student teachers revealed that, in contrast to standard texts, refutation texts are effective to address misconceptions about multimedia learning. However, there seems to be no added benefit of making “concessions” to student teachers’ prior beliefs (i.e., two-sided argumentation) in refutation texts. Moreover, refutation texts did not promote the selection of appropriate multimedia material. This study suggests that refutation texts addressing multimedia-learning misconceptions should be applied in teacher education. Yet, further support seems needed to aid the application of the corrected knowledge.
Science competencies are considered an important 21st century skill. How this skill develops in childhood is, however, not well understood, and in particular little is known about how different aspects of science competencies are related. In this prospective study with 58 children aged 5–6 years, we investigate the development of two aspects of science competence: scientific thinking and science content knowledge. Scientific thinking was assessed with a comprehensive 30-item instrument; science content knowledge was measured with an 18-item instrument that assesses children’s knowledge with regard to melting and evaporation. The results revealed basic competencies in scientific thinking and science content knowledge at the end of kindergarten (46% and 49% correct, respectively, both different from chance). In mid-kindergarten, children performed better than chance on the assessment of science content knowledge (40% correct) but not on the assessment of scientific thinking (34% correct). Science content knowledge in mid-kindergarten predicted children’s science content knowledge at the end of kindergarten, as well as scientific thinking (both at 6 years). The opposite pattern did not hold: scientific thinking in mid-kindergarten did not predict science content knowledge at the end of kindergarten. Our findings show initial science competencies during kindergarten, and they suggest that children’s science content knowledge and scientific thinking are interrelated in a meaningful way. These results are discussed with respect to the different hypotheses that connect scientific thinking and science content knowledge as key features of science competencies. Implications for research and teaching are discussed.
Der Beitrag gibt einen kurzen Überblick über die Diskussion (und aktuelle Forschung) zur Fachspezifität von Unterrichtsqualität aus der Perspektive der Mathematikdidaktik. Sowohl theoretische als auch empirische Argumente verdeutlichen, dass bei einer Konzeptualisierung von Unterrichtsqualität fachspezifische Aspekte nicht außer Acht gelassen werden sollten. Die Berücksichtigung fachspezifischer Aspekte bezieht sich derzeit meist auf die Spezifizierung von Kriterien bei der Erfassung Unterrichtsqualität durch Ratings. Wir argumentieren jedoch, dass Kriterien dabei nicht die einzige relevante Varianzquelle darstellen, in der sich Fachspezifität niederschlägt. Um der Fachspezifität von Unterrichtsqualität systematisch auf die Spur zu kommen, schlagen wir daher eine mehrdimensionale Perspektive auf die Fachspezifität von Unterrichtsqualität als Grundlage für empirische Forschungsstrategien vor. Demnach zeigt sich die Fachspezifität von Unterrichtsqualität in unterschiedlichen Varianzquellen (Kriterien, Situationen, Ratern), die sich durch verschiedene Grade an Fachspezifität systematisch auf die eingeschätzte Unterrichtsqualität auswirken können. Insbesondere illustrieren wir anhand eines Beispiels, wie das fach- und inhaltsbezogene Wissen von Ratern (und damit die Fachspezifität von Ratern) ihre Interpretationen von Kriterien und Unterrichtssituationen beeinflussen und sich systematisch in ihren Einschätzungen von Unterrichtsqualität niederschlagen können.
Die aktuellen Diskussionen um die Fachspezifität von Unterrichtsqualität und die Erweiterung der Basisdimensionen für Unterrichtsqualität sind aus unserer Perspektive zeitgemäß, qualitätsvoll und lassen einen großen Mehrwert für die Unterrichtsforschung erwarten. Mit Bezug zu einem gemeinsamen Forschungsprojekt zur Optimierung von Videoartefakten für die Lehrer*innenbildung wird in unserem Beitrag herausgearbeitet, dass Unterrichtsqualität vor allem von den im Unterrichtsprozess umgesetzten Lehr- und Lernaktivitäten abhängt. Angehende Lehrpersonen sollten zwischen qualitätsvollen und weniger qualitätsvollen Lehr‑/Lernaktivitäten unterscheiden können. Wir plädieren für die verstärkte forschungsbezogene Entwicklung von Unterrichtsartefakten, anhand derer das optimale Zusammenwirken fachspezifischer und fächerübergreifender Unterrichtsmerkmale modelliert und empirisch geprüft werden kann. Über einen solchen Ansatz ließe sich die Frage nach fachspezifischen und fächerübergreifenden Qualitätsmerkmalen auf der Basis konkreter Unterrichtspraktiken weiter klären. Im Ausblick schlagen wir vor, für die Lehrer*innenbildung Standardsituationen für Qualitätsmerkmale von Fachunterricht zu definieren.
Bisherige Untersuchungen zu kognitiv aktivierendem Unterricht belegen überwiegend positive Effekte auf die Leistungsentwicklung der Schülerinnen und Schüler. Jedoch wird die Wirkung eines solchen Lernangebots bei leistungsschwächeren Lernenden selten untersucht. Der Fokus des vorliegenden Beitrags liegt daher auf der Nutzung und Wirkung kognitiv aktivierenden Unterrichts bei Schülerinnen und Schülern an Haupt- und Realschulen. Es wurde untersucht, (1) ob es einen Zusammenhang zwischen der beobachteten kognitiven Aktivierung und dem Ausmaß selbstberichteter kognitiver Aktivität der Schülerinnen und Schüler gibt und (2) ob sich die in den beobachteten Unterrichtsstunden erzielten Lernzuwächse der Schülerinnen und Schüler mit dem Ausmaß kognitiver Aktivierung im Unterricht und der selbstberichteten kognitiven Aktivität erklären lassen. Dazu wurden 60 videographierte Mathematikstunden hinsichtlich ihres Ausmaßes an kognitiver Aktivierung hochinferent bewertet, die entsprechenden Schülerinnen und Schüler (N = 608) aus der achten Jahrgangsstufe an Haupt- und Realschulen zu ihrer kognitiven Aktivität im Unterricht befragt sowie ihre Leistung im Prä-Post-Design erfasst. Die Vorhersage der kognitiven Aktivität bzw. des Leistungszuwachses wurde mithilfe eines Mehrebenen-Designs untersucht. Erwartungswidrig zeigte sich Evidenz für die Nichtexistenz eines Zusammenhangs zwischen kognitiver Aktivierung und kognitiver Aktivität, jedoch bestätigen die Ergebnisse die Annahme, dass der Leistungszuwachs der Schülerinnen und Schüler unter anderem durch das Ausmaß kognitiver Aktivierung in den Lernbegleitungsphasen moderiert wird. Implikationen für die weitere Forschung werden diskutiert.
The world is facing severe global challenges such as climate change, food security, rising migration, social justice, or the current corona crisis. In these times, citizenship education seems more important than ever. How can this citizenship education relate to mathematics and science learning? The research project MaSDiV (Supporting mathematics and science teachers in addressing diversity and promoting fundamental values) connected mathematics and science with citizenship education by modeling real-life problems relevant to society. In this paper, we present the foundational design features of the PD course as well the results from the accompanying evaluation of this PD course, which was implemented by partners in six countries to support teachers in connecting mathematics and science education with citizenship education. More specifically, we investigate how participating teachers experienced the PD program; how their self-efficacy beliefs, learning-related beliefs, as well as teaching practices change; and which factors contributed to that change. In order to investigate the outcome of the PD program, we surveyed N = 311 mathematics and science teachers’ pre- and post-participation of the PD in six different European countries. Among others, our results show that in general, most participating teachers reported a high overall satisfaction with the course across all six participating countries. They also indicate that teachers’ self-efficacy beliefs about using relevant contexts, their learning-related beliefs about the benefits of using contexts, as well as their own teaching practice changed significantly after participating in the MaSDiV PD course.
Die Schließung von Kindertageseinrichtungen (Kita) als Maßnahme zur Eindämmung des Corona-Virus stellte frühpädagogische Fachkräfte kurzfristig vor veränderte Tätigkeitsbedingungen und Möglichkeiten, den weiterhin bestehenden Bildungsauftrag umzusetzen. Die Zusammenarbeit mit Eltern, mit und ohne digitale Medien, spielt in dieser Hinsicht eine wichtige Rolle. Der Beitrag untersucht a) wie häufig und in welcher Form Fachkräfte die Elternzusammenarbeit in der Corona-Schließzeit umsetzten, b) welche Einstellungen frühpädagogische Fachkräfte zu digital-gestützter und allgemeiner Elternzusammenarbeit in der Corona-Schließzeit hatten und c) welche Rolle die Qualifikation der Fachkräfte, ihre Einstellungen und ihre wahrgenommene Unterstützung im Hinblick für die digitale und nicht digitale Elternzusammenarbeit in der Corona-Schließzeit spielten. Datenbasis bildet eine bundesweite Onlinebefragung von 3513 Fachkräften in Kitas während der Corona-Schließzeit. Die Ergebnisse zeigen, dass die wahrgenommene eigene Rolle im Hinblick auf die Elternzusammenarbeit einen positiven Einfluss darauf hat, ob mit den Eltern Kontakt aufgenommen wurde. Ob dieser Kontakt über digitale Medien passiert, hängt unter anderem von den Einstellungen der Fachkräfte zu digitalen Medien, der erwarteten Reaktion der Eltern auf diese Form der Elternzusammenarbeit und von der technischen Unterstützung im Implementationsprozess digitaler Medien in der Elternzusammenarbeit ab. Die Ergebnisse werden in Bezug auf strukturelle Bedingungen von Einrichtungen und professionelle Kompetenzen frühpädagogischer Fachkräfte für eine breite Implementierung digitaler Medien in der frühpädagogischen Praxis diskutiert.
In the course of demographic change, the notion of age(ing) seen as something unavoidable has changed into something more adaptable. Through a healthy lifestyle, which aims at the self-responsible management of physical risks through fitness and discipline, individuals can expand their independence. However, the chances of doing so depend largely on one’s social position. In addition, the shift in health ideology towards the individual and the trend towards active ageing may lead to social pressure for some individuals. This qualitative interview study attempts to shed more light on this field of tension: What are the benefits and constraints of working on the body in the gym? Furthermore, what similarities and differences can be identified in identity constructions in the two samples with regard to the different underlying healthcare systems? The evaluation of the interviews was based on qualitative content analysis and was carried out with technical support (MAXQDA). It appears that for the respondents creating a fit body results primarily in self-empowerment gains. At the same time, submissions to Western body and fitness norms are also evident. Inequalities in health opportunities exist in both countries: While the respondents in the German sample (26 interviews) rely on public health services, the privileged American women (14 interviews) are covered by private insurance. They indicate that claiming government benefits appears as a stigmatisation of one’s own way of life. Consequently, a lack of resources in the form of cultural and economic capital prevents successful age(ing).
Zusammenfassung
Das Konzept der digitalen Gesundheitskompetenz ist das Ergebnis der zunehmenden gesellschaftlichen Durchdringung von digitalen Medien und deren Nutzung im Alltag. Infolge der hohen Zugänglichkeit und Allgegenwärtigkeit von Gesundheitsinformationen steigt die Notwendigkeit nicht nur des Suchens und Findens, sondern insbesondere der Einschätzung ihrer Verlässlichkeit und der darauf bezogenen Selektion und Anwendung für eigene Gesundheitsbelange. Gerade im Kontext der Digitalisierung ist zudem zu berücksichtigen, dass die Nutzenden nicht nur passiv rezipieren, sondern aktiv am Kommunikationsgeschehen durch Interaktion mit bestehenden Inhalten oder durch eigene Informationsbeiträge teilhaben.
Der vorliegende Beitrag gibt eine Übersicht über den aktuellen Forschungsstand zur digitalen Gesundheitskompetenz, wobei der Fokus vor allem auf dem Kindes- und Jugendalter liegt. Neben seiner terminologisch-konzeptionellen Verortung und der notwendigen Verschränkung mit dem Ansatz der Medienkompetenzen wird das Verhältnis von digitaler Gesundheitskompetenz und sozialer sowie gesundheitlicher Ungleichheit betrachtet. Als ungleichheitsgenerierend wird dabei weniger der unterschiedliche Zugang zu digitalen Medien angesehen, sondern vor allem die Unterschiede in den zum Umgang notwendigen Kompetenzen. Nach einer Übersicht über die wenigen bisher verfügbaren Instrumente zur Erfassung der digitalen Gesundheitskompetenz werden am Beispiel des Settings Schule erste Überlegungen zu ihrer individuellen und strukturellen Stärkung angestellt.
Objective
The aim of the current project was the development, implementation and evaluation of the programme, Motivational‐Volitional Intervention‐Movement After Breast Cancer (Mo‐Vo‐BnB), an intervention for the sustainable promotion of physical activity of breast cancer survivors.
Methods
In a multi‐stage interdisciplinary development process, the pedagogical‐didactic, psychological and physical evidence‐based programme was developed and implemented for women after breast cancer who were approved for medical rehabilitation and were minimally, physically active (<60 min/week). Train‐the‐trainer seminars were carried out for the implementation. Four sessions were implemented in two German clinics. The training quality, didactic methods and accompanying material were evaluated 6 weeks and 12 months after implementation by patients, trainers and project members (n = 127 evaluations).
Results
The standardised and published MoVo‐BnB programme can provide practical and quality training. Content and methods can be implemented according to the manual. Training quality, didactic methods, and accompanying materials were evaluated positively.
Conclusion
The results suggest that MoVo‐BnB is a useful standardised intervention for promoting the physical activity of breast cancer survivors. The demonstrated process is also suitable for other projects.
Clinical trial registration
German Clinical Trials Register (DRKS): DRKS00011122; Trial registration date: 2016 October 13.
Background
When parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences.
Methods
We conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview.
Results
Parents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of “good” health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition.
Conclusion
One suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs—provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.
Hintergrund
Die Anzahl multipel chronisch erkrankter Älterer steigt, und Multimorbidität geht mit hoher Inanspruchnahme von Gesundheitsleistungen einher. Um Selbstständigkeit und Verbleib in der Häuslichkeit zu erhalten, wird zunehmend ein integriertes Versorgungsmanagement eingesetzt. Zur Wirksamkeit in der Zielgruppe der multipel chronisch erkrankten Älteren liegen aber kaum belastbare Daten vor.
Ziel der Arbeit
Bewertung der Wirksamkeit von integriertem Versorgungsmanagement bei Erwachsenen und Abschätzung der Übertragbarkeit auf ältere, multimorbide Personen in Deutschland.
Methoden
Systematische Literaturrecherche in der Cochrane Library mit Einschluss von Cochrane-Reviews (CR) zu (a) den 13 häufigsten Gesundheitsproblemen im Alter, mit (b) Komponenten des integrierten Versorgungsmanagements bei (c) Erwachsenen jeden Alters. Experten schätzten die Übertragbarkeit der eingeschlossenen CR auf multipel chronisch erkrankte Ältere in Deutschland ein.
Ergebnisse
Aus 1412 Treffern wurden 126 CR eingeschlossen. Zur Endpunktkategorie Selbstständigkeit und funktionale Gesundheit zeigten 25 CR klinisch relevante Ergebnisse mit moderater Evidenzqualität. Folgende Interventionskomponenten wurden – unter Berücksichtigung identifizierter Barrieren – als übertragbar eingeschätzt und könnten für ein effektives, indikationsspezifisch integriertes Versorgungsmanagement multipel chronisch erkrankter Älterer herangezogen werden: (1) körperliche Aktivierung, (2) multidisziplinäre Interventionen, (3) das Selbstmanagement verstärkende Interventionen, (4) kognitive Therapieverfahren, (5) telemedizinische Interventionen und (6) Disease-Management-Programme.
Schlussfolgerungen
Die identifizierten Komponenten sollten in versorgungs- und patientennahen randomisierten kontrollierten Studien auf Wirksamkeit bei gebrechlichen Älteren geprüft werden.