scholarly journals Compreensão da família acerca da asma infantil em uma unidade de urgência e emergência pediátrica

2014 ◽  
Vol 5 (1/2) ◽  
pp. 13-16
Author(s):  
Mirna Albuquerque Frota ◽  
Kamila Ferreira Lima ◽  
Maria Caroline Almeida Magalhães ◽  
Ana Lúcia Araújo Gomes ◽  
Ludmila Do Nascimento Alves ◽  
...  
Keyword(s):  
Data Collection ◽  
Customer Service ◽  
Health Professionals ◽  
Childhood Asthma ◽  
Cáncer De Mama ◽  
Emergency Unit ◽  
Structured Interviews ◽  
Children With Asthma ◽  
Asthma Child ◽  
Exacerbation Of Symptoms

Resumo: Objetivou-se compreender o significado da asma infantil por familiares durante a exacerbação dos sintomas. Estudo qualitativorealizado em Fortaleza-Ce. A coleta dos dados ocorreu entre agosto e novembro de 2014, mediante 14 entrevistas semiestruturadas. Foi realizadaa análise de conteúdo e posteriormente, emergiram as categorias: significados atribuídos à asma; gatilhos que exacerbam os sintomasda asma; Impressão da família acerca dos entraves cotidianos da criança com asma. Os profissionais de saúde que atuam numa emergênciapediátrica precisam conhecer as reais necessidades desta clientela, com o intuito de melhorar o atendimento e consequentemente minimizaros eventos agudos e as exacerbações.Descritores: Asma; Criança; Manejo. Enfermagem.Family understanding of childhood asthma in an emergency unit and pediatric emergencyAbstract: Aimed to understand the meaning of childhood asthma by family members during the exacerbation of symptoms. Qualitativestudy in Fortaleza-Ce. Data collection took place between August and November 2014 by 14 semi-structured interviews. Contentanalysis was performed, and then, the following categories emerged: meanings attributed to asthma; triggers that exacerbate asthmasymptoms; Family impression about the daily obstacles of children with asthma. Health professionals working in a pediatric emergencyneed to know the real needs of this clientele, in order to improve customer service and thereby minimize acute events and exacerbations.Descriptors: Asthma; Child; Handling; Nursing.La comprensión de la familia del asma infantil en una unidad de emergencias y urgencias pediátricasResumen: Este artículo tiene como objetivo caracterizar la organización estructural de las unidades básicas de la Estrategia Salud de La Familia(ESF), con vistas a efectivación de la assistência em la prevención de los cánceres de la mama e del cuello uterino. Estudio transversal, de enfoquecuantitativo, desarollado em 61 unidades del ESF. Los resultados revelaran la falta de algunos recursos de la infraestructura importantes parala execución del trabajo de lo enfermero, así como la falta de algunos profesionales. La falta de los espacios apropriados para la efecacia de laasistencia a prevención de ambos los cánceres interfiere diretamente em la calidad prestada.Descriptores: Prevención de Cáncer de Mama, Neoplasia Del Cuello Uterino Atención, Primaria de Salud.

scholarly journals Changing relationships: how does patient involvement transform professional identity? An ethnographic study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045520
Author(s):  
Marie-Pierre Codsi ◽  
Philippe Karazivan ◽  
Ghislaine Rouly ◽  
Marie Leclaire ◽  
Antoine Boivin
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Health Professionals ◽  
Clinical Care ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Administrative Team ◽  
Nurse Clinician ◽  
New Perspective ◽  
Relational Framework

ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.

Acidentes de trabalho entre mulheres brasileiras atendidas em uma unidade de emergência

2009 ◽  
Vol 3 (4) ◽  
pp. 908
Author(s):  
Cristiane Aparecida Silveira ◽  
Maria Lúcia Carmo Cruz Robazzi ◽  
Liliana Amorim Alves ◽  
Sandra Verônica Valenzuela Suazo
Keyword(s):  
Data Collection ◽  
Occupational Health ◽  
Health Professionals ◽  
Descriptive Study ◽  
Ethics Committee ◽  
Sao Paulo ◽  
Occupational Accidents ◽  
São Paulo ◽  
Emergency Unit ◽  
Paulo State

Objective: to identify the occurrence of Occupational Accidents among women attended in a hospital in São Paulo city, characterizing them. Methods: observational, non-experimental and descriptive study, from quantitative approach. An instrument has been validated by experts for data collection; it were studied the patients’ charts from 2002 to 2003, in an Emergency Unit of a teaching hospital of the Sao Paulo State, Brazil. The study has been approved by the Research Ethics Committee of Clinics Hospital of the Faculty of Medicine University of São Paulo (4799/2004). Results: 82 women were victims of 117 Occupational Accidents. Most of the 82 female Occupational Accidents victims were between 25-40 years old (52.78%); 47.56% were married. Most of the women were nursing technicians and aides (29,27% each). Most of the Occupational Accidents (32.93%) were caused by falls.  Conclusions: suggestions are presented to minimize these events, in terms of protecting women’s work and train health professionals to enable them to offer better care to these accident victims. Descriptors: occupational health; female work; emergency medical services.

scholarly journals Evaluación participativa del programa de educación continua en detección temprana del cáncer de mama

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Devi Nereida Puerto Jimenez ◽  
Luis Fernando Fontibón Vanegas ◽  
María Lourdes Calderón ◽  
Ximena Pedraza
Keyword(s):  
Early Detection ◽  
Continuing Education ◽  
Health Professionals ◽  
Cáncer De Mama ◽  
Structured Interviews ◽  
Education Programs ◽  
Training Time ◽  
Documentary Analysis ◽  
Knowledge Competencies ◽  
Criteria For Diagnosis

Los programas de educación continua en detección temprana del cáncer son una herramienta útil y necesaria en la adquisición de conocimientos, competencias y habilidades requeridas por los profesionales de la salud. En Colombia existen falencias en la formación de profesionales en estas áreas, derivando en la falta de estandarización de técnicas y procedimientos, e inadecuada unificación de criterios de abordaje diagnóstico y terapéutico de los pacientes. El estudio buscó evaluar el programa de educación continua en detección temprana del cáncer de mama implementado por el Instituto Nacional de Cancerología entre 2016-2018. Se realizó un estudio con metodología mixta concurrente, con diseño analítico descriptivo, a partir de un análisis documental, entrevistas semiestructuradas, análisis de las encuestas de satisfacción, y de los exámenes pre y pos de las capacitaciones realizadas. Se realizó un muestreo no probabilístico y a conveniencia, la población seleccionada fueron los sujetos involucrados (profesionales capacitados, capacitadores, creadores), entre los años 2016 a 2018. Dentro de los resultados se encontró, que el nivel de satisfacción con el curso fue del 97.5%; resaltando la metodología basada en el aprendizaje activo, la educación por competencias, la pertinencia de los temas abordados, la utilización de modelos anatómicos en silicona y la experticia de los capacitadores. Se encontraron diferencias estadísticamente significativas posterior a la intervención educativa (V=439; p=0.001). Quedaron en evidencia barreras de tipo económico, administrativo y de divulgación; además, se sugiere implementar el curso de manera sistemática, aumentando la cobertura, divulgación y tiempo de capacitación, ofreciendo prácticas con pacientes. Concluyendo que, la implementación de programas de educación continua en profesionales de la salud son una herramienta útil y necesaria en la adquisición de competencias básicas en detección temprana del cáncer y debe contar con una estructura definida, organizada y en concordancia con los programas y políticas públicas del país. Continuing education programs in early detection of cancer are a useful and necessary tool for the acquisition of knowledge, competencies, and skills required by health professionals. In Colombia, there are shortcomings in the training of professionals in these areas, resulting in a lack of standardization of techniques and procedures, and inadequate unification of criteria for diagnosis and therapeutic patient management. This study sought to evaluate the continuing education program in early detection of breast cancer implemented by the National Cancer Institute of Colombia between 2016 and 2018. A concurrent mixed methodology study was conducted, with descriptive analytical design, based on a documentary analysis, semi-structured interviews, analysis of satisfaction surveys, and pretest and posttest exams. A non-probability convenience sampling was performed; the selected population consisted of subjects involved in the program (trained professionals, trainers, creators) between 2016 and 2018. Among the results, the level of satisfaction with the course was found to be 97.5%, highlighting the methodology based on active learning, competency-based education, the relevance of the topics addressed, the use of anatomical silicone models, and the expertise of trainers. Statistically significant differences were found after the educational intervention (V=439; p=0.001). Economic, administrative, and dissemination barriers were evidenced. In addition, it was suggested to implement the course in a systematic way, increasing its coverage, dissemination, and training time, as well as to offer internships with patients. The study concludes that the implementation of continuing education programs among health professionals are a useful and necessary tool for the acquisition of basic skills in early cancer detection and must have a defined and organized structure in accordance with existing programs and public policies in the country.

scholarly journals When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma

2018 ◽  
Author(s):  
Yuen-yu Chong ◽  
Doris Leung ◽  
Yim-wah Mak
Keyword(s):  
Hong Kong ◽  
Childhood Asthma ◽  
Asthma Management ◽  
Structured Interviews ◽  
Educational Training ◽  
Chinese Parents ◽  
Children With Asthma ◽  
Qualitative Descriptive ◽  
Conventional Content Analysis ◽  
Primary Form

Many parents have difficulty managing childhood asthma. In Hong Kong (HK), while medication is the primary form of treatment, traditional Chinese medicine is another favored option. In addition, HK follows a dual-track healthcare system, which may pose unique experiences for Chinese parents in childhood asthma management. This qualitative descriptive study aimed to explore the experiences of HK Chinese parents in caring for their children with asthma. Methods: Fourteen HK Chinese mothers of children (aged 3-10) suffering from asthma were purposively sampled to participate in individual, semi-structured interviews. A realist approach following conventional content analysis was used to interpret the interviews. Results: The mothers expressed feelings of uncertainty, fear of asthma crises, and searching for ways to cope. These feelings triggered various strategies to control their child’s asthma. As long as the child’s asthma symptoms recurred, the mothers’ distress continued. Their distress was sometimes exacerbated by self-doubt and worries about whether they would receive adequate support from their family and healthcare professionals. Conclusion: Helping parents to understand their limits may help them be more open to varied aspects of their caregiving experiences, and thus to cope better. Psychological interventions together traditional educational training may help to alleviate parents’ psychological difficulties.

scholarly journals Reading mediation as a communication resource for hospitalized children: support for the humanization of nursing care

2009 ◽  
Vol 17 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Carina Ceribelli ◽  
Lucila Castanheira Nascimento ◽  
Soraya Maria Romano Pacífico ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Data Analysis ◽  
Data Collection ◽  
Nursing Care ◽  
Health Professionals ◽  
Qualitative Data ◽  
Hospitalized Children ◽  
Structured Interviews ◽  
Development Processes ◽  
Health Institutions ◽  
Communication Resource

The Live Library in Hospitals Project is a strategy adopted by several health institutions for the purpose of providing hospitalized children and adolescents the reading mediation of infant-juvenile stories through professionals and volunteers capable of this function. This study aimed to find out to what extent the reading of stories strategy proposed by this project in hospitals can be a communication resource to use with hospitalized children. In order to do that, empirical data collection was carried out through the use of semi structured interviews with the reader and children above the age of seven years and observation of reading sections. The qualitative data analysis was doing it and it was verified that the reading mediation favors the dialogs and relationships; contribute for the expansion of the diagnostic and therapeutic and development processes of children, relatives and health professionals.

scholarly journals Perceptions and feelings of the family member/caregiver expressed before the patient on home care

Rev Rene ◽  
2015 ◽  
Vol 16 (6) ◽  
pp. 848
Author(s):  
Naianny Jonas Fogaça ◽  
Marina Medeiros Carvalho ◽  
Selma Rodrigues Alves Montefusco
Keyword(s):  
Content Analysis ◽  
Data Collection ◽  
Qualitative Study ◽  
Home Care ◽  
Health Professionals ◽  
Structured Interviews ◽  
Analysis Technique ◽  
The Family ◽  
Care Company ◽  
At Home

Objectives: to analyze the perceptions and feelings expressed by relatives regarding the patient undergoing home care. Method: this is a descriptive and qualitative study, with data collection carried out through semi-structured interviews at home, developed with fourteen family members of patients assisted by a home care company. Data were organized by content analysis technique. Results: perceptions and feelings expressed were: insecurity, fear, anxiety, worry, feelings of deprivation of liberty and at the same time, gratitude for the care, comfort, safety and proximity to care control, preferring the admitted patients at home and rated the care as satisfactory. Conclusion: home care should be seen as an innovative humanized care modality that aims to reverse the logic of work of health professionals, which is not limited to meet the clinical needs of patients, but also provide necessary support to the families involved.

Model Kaderisasi Anggota Partai Politik Islam dalam Membentuk Pemimpin Islami

2017 ◽  
Vol 2 (2) ◽  
pp. 103-114
Author(s):  
Muhammad Saiful Haq AlFaruqy ◽  
Ahmad Sarbini ◽  
Asep Iwan Setiawan
Keyword(s):  
Data Collection ◽  
Learning Process ◽  
Structured Interviews ◽  
The West ◽  
West Java ◽  
Qualitative Descriptive

Penelitian ini dilakukan untuk mengentahui tugas pokok Bidang Kaderisasi DPW PKS Jawa Barat, untuk mengetahui proses tahapan dan sistem model kaderisasi PKS yang marhalah (berjenjang), untuk mengetahui dan mendapatkan data dalam memebentuk kader pemimpin Islami Bidang Kaderisasi DPW PKS Jawa Barat. Metode yang digunakan dalam penelitian ini ialah deskrptif kualitatif dengan tekinik pengeumpulan data berupa wawancara terstrurktur, observasi, dan studi dokumentasi.. Hasil dari penelitian ini menunjukan bahwa model kaderisi dalam menciptakan pemimpin Islami melalui tahapan-tahapan pembinaan kader yang marhalah (berjenjang). Yaitu, Pertama, ta’lim proses pembelajaran yang mana bertujuan para kader diberikan kurikulum kaderisiasi partai. Kedua, Tandzhim yang mana setelah pembelajaran diharapkan para kader dapat mengasah dan mengimplementasikan hasil kurikulum kaderisasi. Ketiga, taqwin para kader harus dapat menginternalisasi ajaran Islam dalam partai maupun kehidupan berbangsa dan bernegara. This research was conducted to identify the main tasks of the West Java PKS DPW Cadre Field Division, to find out the stages and stages of the PKS cadre model model that is marhalah (tiered), to find out and obtain data in forming the Islamic leaders cadre of the West Java PKW DPW Cadre. The method used in this study is a qualitative descriptive with data collection techniques in the form of structured interviews, observations, and documentation studies. The results of this study indicate that the cadre model in creating Islamic leaders through the stages of training cadres who are marhalah (tiered). That is, First, ta'lim the learning process in which the cadres aim to be given a party cadre curriculum. Second, Tandzhim which after learning is expected that the cadres can hone and implement the results of the regeneration curriculum. Third, taqwin of cadres must be able to internalize the teachings of Islam in the party and the life of the nation and state.

scholarly journals Post-stroke fatigue: an exploratory study with patients and health professionals to develop a patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Johansen Skogestad ◽  
Marit Kirkevold ◽  
Petra Larsson ◽  
Christine Råheim Borge ◽  
Bent Indredavik ◽  
...  
Keyword(s):  
Future Development ◽  
Health Professionals ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Initial Hospital

Abstract Background Post-stroke fatigue (PSF) is commonly reported and described as disabling by patients recovering from stroke. However, a major challenge is how to accurately diagnose and assess PSF. Therefore, the aim of this study was to explore PSF as it is experienced by stroke survivors and described by health professionals to guide future development of a PSF-specific PROM. Methods Individual semi-structured interviews were conducted with stroke survivors experiencing PSF (n = 9) and three focus groups were conducted with health professionals (n = 16). Data were analyzed through inductive content analysis. Results The analysis revealed four themes illustrating the experience and descriptions of PSF: 1) PSF characteristics, 2) interfering and aggravating factors, 3) management, and 4) PSF awareness, which refers to stroke survivors first becoming aware of PSF after their initial hospital admission. Conclusion This study highlights the complexity and multidimensionality of PSF. The results from this study will guide future development of a PSF-PROM and support its content validity.

scholarly journals POS0160-HPR THE CARE PROCESS OF HIP AND KNEE OSTEOARTHRITIS: GIVING AN ACCOUNT OF PATIENTS’ EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 292.2-293
Author(s):  
S. Battista ◽  
M. Manoni ◽  
A. Dell’isola ◽  
M. Englund ◽  
A. Palese ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Health Professionals ◽  
Emotional Experience ◽  
Functional Limitations ◽  
Care Quality ◽  
Care Process ◽  
Exact Science ◽  
Structured Interviews ◽  
Patients Experience

Background:The care process is often a complex and intimate process experienced by patients. Osteoarthritis (OA) care is usually characterised by multimodal interventions that consider the broader array of symptoms and functional limitations and often require a high level of patients’ compliance. Despite efforts to improve the quality of care of patients suffering from OA, and the publication of state-of-the-art clinical practice guidelines [1], the quality of the care process, as experienced by patients, seems to be suboptimal [2]. Hence, it is essential to investigate how patients experience this process to highlight potential elements that can enhance or spoil it to optimise the care quality.Objectives:To explore the patients’ experience of the received OA care process.Methods:Qualitative study, 10 semi-structured interviews were performed. The interview guide was created by a pool of healthcare professionals (physiotherapists, psychologists, nurses) and expert patients. It investigated the emotional experience, beliefs, expectations, perceived barriers and facilitators towards conservative treatments perceived by patients suffering from OA. The interviews lasted approximately one hour, were transcribed verbatim and analysed independently by two authors, who labelled their core parts to find categories and subcategories. A theme-based analysis was performed following an ecological paradigm, naturalistic epistemology, philosophy of phenomenological research.Results:Our analysis revealed 7 main categories with several subcategories (Fig. 1). 1) Uncertainty as some patients perceived treatment choice not to be based on medical evidence “there is an almost religious way of thinking on how to deal with the pathology. It is not an exact science when you choose the physicians you choose the treatment”. 2) Relationship with the self and the others as some patients did not feel understood or even shameful and hopeless about their condition. 3) Patients’ and Health Professionals’ beliefs about the pathology management where common thoughts were the perceived (ab)use of passive therapies, the movement as something dangerous and that OA is “something that you try to resist to, but (surgery) is your destiny”. 4) facilitators and 5) barriers of the adherence to therapeutic exercise that revolve around the cost of the therapy, the time needed and the willingness to change life habits. 6) Patients’ attitudes towards pathology in which the oldest patients perceive OA as “something I have to accept since I am getting old” and the youngest as “Something I have to fight”. 7) Relationship with food in which diet is seen as something that “you force yourself to follow” which is useful only to lose weight and not to preserve a high health status and where overeating is used “to eat your feelings”.Figure 1.Categories and Subcategories stemmed from the analysis of the patients’ interviewsConclusion:Patients suffering from hip and knee OA seem to experience an uncertain care process. The lack of clear explanations and the attitude towards conservative treatment, which is considered as “a pastime while waiting for surgery,” fosters the importance of providing patients with adequate information about the treatment, to shift their beliefs and improve their awareness. This will enhance a patient-centred and shared decision-making treatments.References:[1]Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013;72:1125–35.[2]Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.Acknowledgements:This work is part of the project funded by EULAR Health Professionals Research Grant 2020.Disclosure of Interests:None declared

scholarly journals Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eva Seckler ◽  
Verena Regauer ◽  
Melanie Krüger ◽  
Anna Gabriel ◽  
Joachim Hermsdörfer ◽  
...  
Keyword(s):  
Primary Care ◽  
Data Collection ◽  
Older People ◽  
Process Evaluation ◽  
Feasibility Study ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Care Pathway ◽  
Main Trial ◽  
Telephone Helpline

Abstract Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).

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