Pilot testing of a questionnaire to assess Elderspeak in nursing care: a quantitative study Abstract: Background: Interactions between caregivers and older care dependent people can be characterized by condescending and patronizing communication patterns, which are referred to as Elderspeak. To raise awareness and encourage reflection on language behavior, the previous project EldAS developed a questionnaire to assess Elderspeak in nursing care. Aim: The aim of the study was to pilot the questionnaire developed to measure Elderspeak and to evaluate its psychometric properties (construct validity and reliability). Methods: The questionnaire was completed by nursing staff in paper form (two clinics) and as an online survey (throughout Germany). The psychometric properties were examined using exploratory factor analysis. In addition, internal consistency and item discrimination were determined. Results: A total of 779fully completed questionnaires were available. Factor analysis revealed three factors. Three items had to be removed from the questionnaire due to poor statistical parameters. The items show selectivity coefficients ranging from 0.32 to 0.79 and internal consistency ranging from 0.54 to 0.85. Conclusions: The questionnaire can be used to raise awareness in clinical practice and research, taking into account its existing limitations. However, further testing is necessary.

Initiation and implementation of pediatric palliative care in pediatric oncology: A qualitative interview study Abstract: Background: Pediatric palliative care in pediatric oncology is typically introduced only at the end of life, despite proven benefits for quality of life. Its implementation in German-speaking routine care has been little studied. Aim: The study aimed to capture the understanding and implementation of pediatric palliative care in pediatric oncology from the perspective of different professional groups and to identify barriers to and facilitators of early integration. Methods: In a qualitative descriptive study, twelve semi-structured single interviews were conducted from February to May 2024 with nurses, physicians, one psychosocial staff member and one pedagogical staff member of a German tertiary care hospital. Data were analyzed using qualitative content analysis according to Gläser and Laudel (2010), reporting follows the SRQR. Results: Key barriers are the association of "palliative" with dying, divergent definitions of when to start care, lack of pediatric-specific standards, and communication deficits. Nurses tend to identify palliative care needs earlier but are underrepresented in tumor boards. Facilitators include transparent communication, interprofessional training, spaces for ethical reflection, and early involvement of specialized outpatient palliative care. Conclusions: Early implementation requires standards aligned with the German S3-guideline, structural inclusion of nursing in decision-making forums, and a reconceptualization of "palliative" in communication with families and professionals.

Experiences of early postoperative mobilisation following open abdominal surgery: A qualitative study Abstract: Background: Early mobilisation is crucial for recovery and avoiding complications after surgery. Guidelines and recommendations for promoting mobility are available in surgery and intensive care medicine. However, specific recommendations for implementation in nursing care, taking patient experiences into account, remain unclear. Aims: The study explores patients' subjective experiences of early postoperative mobilisation following open abdominal surgery in general wards. Methods: Between August and December 2024, semi-structured interviews were conducted with patients (n = 15) after open abdominal surgery in four German hospitals and evaluated using structured qualitative content analysis. Results: Early postoperative mobilisation after open abdominal surgery was experienced by patients as physically challenging, emotionally ambivalent, but manageable with qualified support. Key factors influencing the experience are adequate preparation, reliable support, and individually tailored, empathetic support. Conclusions: Professional support is key to ensuring safety during early postoperative mobilisation. Nursing staff has a significant impact on the patient's experience of the mobilisation process and can positively influence it through individual education. Previous experiences, personal motivation and the desire for autonomy are educational starting points.

Implementation and development of the APN role in primary health care in Germany: A qualitative study Abstract: Background: An increasing number of patients with multimorbidity and associated special care needs are facing a declining number of general physicians. This calls for new approaches. Internationally, Advanced Practice Nurses (APNs) are successfully deployed in primary care of multimorbid patients. In Germany, this practice has not yet been established. Successful implementation requires, among other things, specific support. Aim: The aim of the study is to examine the APN perspective on the process of their own role implementation and development in the GP practice setting in Germany. Methods: The qualitative longitudinal study is based on 26 qualitative interviews with APNs at three measurement points. The data was analyzed using content analysis. Results: Experiencing one's own competencies and supporting role implementation are key elements in the role development of APNs in primary care. Confidence in one's actions as well as support, crisis management and trust appear to be essential factors for success. Conclusion: In addition to imparting clinical knowledge, effective support for APNs in developing and implementing their roles must also include offerings that assist with the specific processes of clarifying the role associated with establishing a professional APN identity.

Follow-up on nursing research in German hospitals: A cross-sectional study Abstract: Background: Nursing research is internationally recognised as an integral part of the nursing profession. However, little is known about the status of institutionalisation of nursing science in German hospitals. Therefore, more than 15 years ago, the Federal Working Group for Nursing Research and Quality Management of the German Nurses Association conducted a cross-sectional study to assess the status of nursing research in German hospitals. This article reports the findings of an updated version of that study. Aims: The study was conducted to assess the current state of nursing research in German hospitals and to identify areas for improvement. Methods: Responsible individuals for nursing research at German hospitals, with over 500 beds per hospital, participated in this online survey. Data were analyzed descriptively. Results: Data from 65 participants were eligible for analysis (30% response rate). 54% of participants were from hospitals with 501-1000 beds, and nearly half (49%) were affiliated with university hospitals. Twenty-eight hospitals (44%) reported to have implemented nursing research, of which 23 (82%) had established a nursing research department. Several suggestions for improvement were made, including the development of organisational strategies for the implementation of nursing research departments and improved research funding. Conclusions: Participants were aware of the importance of nursing research; however, the findings do not appear to indicate the widespread establishment of nursing research in German hospitals. Safe funding and national strategies to improve the establishment of nursing research in German hospitals could be strategies for improvement.

Integration of Bachelor-Level Nurses into Clinical Practice - Perspectives of Clinical Facilitators: A (empty) Scoping Review Abstract: Background: Germany marked a key step towards academisation with the introduction of primary qualifying bachelor's degree programs in nursing. The aim is to integrate scientific expertise more effectively into direct patient care. However, integration into clinical practice often proves difficult, due in part to unclear roles and structural barriers. While previous research has primarily focused on the perspective of graduates, insights into the perspective of clinical mentors during the integration process are lacking. Aim: The aim of this scoping review was to provide an overview of existing research on the integration of bachelor's degree graduates into clinical practice from the perspective of clinical mentors. Methods: The report was prepared in accordance with the PRISMA-ScR checklist, and the review was registered with OSF. The search was conducted using the Medline, Web of Science, and CINAHL databases, as well as through manual searches. Results: Of 547 identified sources, none met the inclusion criteria that explicitly examined the perspective of clinical mentors on the integration of bachelor's degree graduates into German hospitals. Conclusions: The lack of research hinders the understanding of successful integration processes of bachelor's degree graduates into nursing practice. Future research should specifically incorporate the perspective of clinical mentors in order to develop practical strategies and sustainable implementation concepts.

Factors affecting the use of self-help services among family caregivers with a history of migration: A qualitative analysis from the perspective of providers Abstract: Background: Despite the high potential of self-help services for relief and support for family caregivers, people with a history of migration remain significantly underrepresented. Aim: While previous research has mainly focused on the perspective of family caregivers, this study explores the viewpoint of self-help service providers. Methods: To identify factors influencing the participation of family caregivers with a history of migration in self-help services, 13 semi-structured expert interviews with 16 self-help group providers across Germany were conducted and analyzed using qualitative content analysis. Results: Key barriers include language difficulties, culturally shaped role perceptions, lack of information, experiences of discrimination, and insufficient intercultural openness. Facilitating factors comprise low-threshold, locally accessible and native-language services, digital formats, peer-to-peer approaches, cultural mediators, and participatory design. Cooperation with communities and institutions, as well as supportive political frameworks, were also identified as crucial for sustainable participation. Conclusions: The findings extend existing research by adding organizational and systemic perspectives. Participatory, culturally sensitive, and digitally-supported approaches are essential to improve accessibility and acceptance of self-help groups for family caregivers with a history of migration. The study provides practical recommendations for the diversity-oriented development of self-help services.

Development and piloting of a digital interprofessional round in home care: a participatory Case Study Abstract: Background: In Germany, structures and incentives for interprofessional collaboration (IPC) between home nursing services (HNS) and general practitioners (GPs) are largely lacking; patients have so far been only marginally involved in these processes. Digital technologies may support IPC. Within the TeleCare project, a digital interprofessional round (DIR) was developed to facilitate interprofessional coordination in home care. Aim: What conditions are necessary to implement digital interprofessional rounds between a GP practice and HNS under routine care conditions? What challenges arise during their implementation in everyday practice? Methods: DIR were co-developed in a participatory process with teams of HNS and GP practices. Conditions, opportunities, and challenges of implementation were examined using an exploratory case study approach. Qualitative data were collected through nine individual interviews, six group discussions, one focus group, and eight participant observations with HNS and practice teams, and analyzed using qualitative content analysis. Results: Four tandems from HNS and GP practices participated. Structures to enable and test DIR were established. Supporting factors included established cooperation, patient involvement, and perceived time savings. Challenges included the coordination effort, lack of suitable occasions, and heterogeneous communication structures. Conclusions: Sustainable implementation of DIR requires technical and organizational adjustments, a strong willingness to cooperate and supportive political frameworks.

Development and piloting of a nurse-led telemedicine care model in rural areas: a feasibility study Abstract: Background: Older residents in rural long-term care facilities often face unmet needs for primary and specialist medical care. Expanded nursing roles and telemedicine may help to address these gaps. Aim: The aim was to develop and test a nurse-led, telemedicine-supported care model to strengthen primary care delivery in long-term care facilities. Methods: A feasibility study described the structures and technical requirements of the living lab approach as well as the interprofessional collaboration between doctors, wound care specialists and nursing professionals (PFP). The iterative, user-centered development of the intervention was assessed using a mixed-methods design, integrated into further development and piloted over six months. Focus groups, interviews, workshops, and usability feedback enabled the participatory involvement of all stakeholders. Results: Users rated the developed work processes and structures positively. Interprofessional communication was improved and patient care benefited from the new procedures. A total of 32 residents participated in 46 teleconsultations. The scope of expanded nursing activities also included tasks according to the German Federal Joint Committee (Gemeinsamer Bundesausschuss [G-BA], 2011), although their independent execution was limited by regulatory restrictions. Conclusion: The application of expanded nursing activities within the care model is feasible. However, full implementation and sustainable interprofessional integration will require regulatory adjustments and secure long-term financing.

PRISM for prioritizing disease-related topics in inpatient systemic sclerosis assessment: A descriptive-qualitative study Abstract: Background: Systemic sclerosis (SSc) is a rare disease characterized by heterogeneous clinical courses. The wide range of disease-related issues is perceived as a complex burden of disease. The Systemic Sclerosis Assessment (SScA) currently lacks a tool that supports patients in independently prioritizing these issues. The Pictorial Representation of Illness and Self Measure (PRISM) could be suitable for this purpose. Aims: This study examines which factors healthcare professionals (HCPs) in nursing, occupational therapy, and management in an inpatient rheumatology setting perceive as influencing the implementation of PRISM into the SScA. Additionally, the experiences of SSc-patients with PRISM in the prioritization of disease-related issues will be highlighted. Methods: In this primarily qualitative, multi-method process evaluation, semi-structured interviews were conducted with five HCPs and 14 patients, along with an in-depth, standardized survey of the interdisciplinary team, followed by a descriptive analysis. Results: The HCPs found PRISM helpful in better understanding the context of the patient's situation. Patients felt that PRISM made them feel seen and taken seriously in shared decision-making. PRISM enabled visual prioritization of topics in the SScA. The sample size allows only for context-specific findings. Conclusions: PRISM shows potential in the SScA for visualizing disease-related topics. Further conceptual clarification regarding standardized application is necessary prior to broader implementation.

The Structured Information Collection as a data source for AI applications: a qualitative study of data quality Abstract: Background: Artificial intelligence (AI) to support nursing care planning is gaining attention. However, the effectiveness and reliability of AI-based applications depend on the quality of training data. Objective: This study examines to what extent nursing needs documented within the Structured Information Collection (SIS) can serve as training data for AI-driven decision support systems in care planning. Methods: A qualitative process analysis was conducted. Data were collected through eleven semi-structured interviews on documentation practices in two long-term care facilities. The interviews were analyzed using qualitative content analysis and the METRIC framework was applied to assess data quality. Results: Limitations in data quality were identified across all five clusters of the METRIC framework, especially considering the dimensions of completeness, accuracy, and precision. Conclusions: The data collected within the SIS were found to be only partially suitable for training AI applications for care planning. Improvements in data quality could be achieved through adjustments in documentation practices and an expansion of the data pool. Furthermore, approaches should also be considered to enhance the performance of AI systems. Training nursing professionals is essential to foster the responsible use of AI applications in nursing practice. Limitations: The findings are based on eleven qualitative interviews conducted in two care facilities and therefore do not reflect the full range of documentation culture across care settings.