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Piel J, Hörold M, Brandstetter S, Drewitz KP, Hrudey I, Schmitt R, Apfelbacher C. COVID-19 crisis management of German ICU clinicians in leadership - a metaphor analysis. Front Public Health 2023; 11:1160094. [PMID: 37663843 PMCID: PMC10470881 DOI: 10.3389/fpubh.2023.1160094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/19/2023] [Indexed: 09/05/2023] Open
Abstract
The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. "Crisis" became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier ("to unite everyone behind this flag"), the distributor ("sometimes it is a crazy patchwork [wahnsinniges Gestückel]") or the critic ("we are the fool for everything"). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders' self-image.
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Affiliation(s)
- Julia Piel
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Karl-Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ilona Hrudey
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Rudolf Schmitt
- Faculty of Social Sciences, University of Applied Sciences Zittau-Görlitz, Görlitz, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Hörold M, Apfelbacher C, Gerhardinger K, Rohr M, Schimmelpfennig M, Weigt J, Brandstetter S. Parents' and Health Care Professionals' Perspectives on Prevention and Prediction of Food Allergies in Children: Protocol for a Qualitative Study. JMIR Res Protoc 2023; 12:e41436. [PMID: 36947117 PMCID: PMC10131891 DOI: 10.2196/41436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Food allergy in children is increasing in prevalence in the western world and appears to become an important health problem. Parents of children at risk of food allergy live with the fear of allergic reaction, especially when the children are very young. The paradigm shift in allergy prevention in the last decade-away from allergen avoidance toward a tolerance induction approach-challenges both parents and health care professionals, as they have to deal with changing information and new evidence that often contradicts previous assumptions. Yet, research on health information-seeking behavior and needs of parents on primary prevention of food allergy in children as well as on prediction and prevention strategies of German health care professionals is lacking. OBJECTIVE The aim of the study is to explore and understand parents' and health care professionals' perspectives on the prediction and prevention of food allergies. We are particularly interested in information needs, information seeking, and health care usage and place a special focus on families' experiences when their child is at risk or diagnosed with food allergies. Furthermore, food allergy prediction and prevention strategies of health care professionals will be explored. METHODS This study is part of the NAMIBIO (food allergy biomarker) app consortium, which aims to identify early predictors for the development of food allergy in children and develop apps to guide health care professionals and parents of children with a high risk of food allergy toward prevention and timely tolerance induction. The study uses a qualitative approach with topic-guided interviews and focus groups with parents of children (0-3 years) and health care professionals. Data collection will continue until theoretical saturation is reached. The qualitative content analysis will be used according to Kuckartz to identify overarching themes toward information needs and seeking behavior as well as usage of health care and health care professionals' predictive and preventive strategies. In addition, a constructivist grounded theory approach will be used to explore and understand parents' experiences, interactions, and social processes in families in daily life. RESULTS Recruitment and data collection started in February 2022 and is still ongoing. CONCLUSIONS The qualitative study will provide insight into parents' information-seeking behavior and needs regarding the prevention of food allergy in children, parents' use of pediatric primary care, and health care professionals strategies for the prediction and prevention of food allergies in children. We assume that our results will highlight the challenges associated with the paradigm shift in allergy prevention for both parents and health care professionals. The results will be used to make practical recommendations from the user's perspective and inform the development of the NAMIBIO apps. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41436.
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Affiliation(s)
- Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Katharina Gerhardinger
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Magdalena Rohr
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Maria Schimmelpfennig
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Julia Weigt
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
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Piel J, Hörold M, Drewitz KP, Hrudey I, Brandstetter S, Apfelbacher C. „Es war ein Monsterakt“, „…das ist
gnadenlos, wo wir stehen“, „Wir sind ja durch die Hölle
schon einmal gegangen“ – Bebilderte Erfahrungen des
Pandemiemanagements von Intensivmedizinerinnen in deutschen
Krankenhäusern – eine Metaphernanalyse. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- J Piel
- Institut für Sozialmedizin und Gesundheitssystemforschung,
Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg,
Magdeburg, Deutschland
| | - M Hörold
- Institut für Sozialmedizin und Gesundheitssystemforschung,
Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg,
Magdeburg, Deutschland
| | - K-P Drewitz
- Institut für Sozialmedizin und Gesundheitssystemforschung,
Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg,
Magdeburg, Deutschland
| | - I Hrudey
- Institut für Sozialmedizin und Gesundheitssystemforschung,
Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg,
Magdeburg, Deutschland
| | - S Brandstetter
- Universität Regensburg, Klinik und Poliklinik für
Kinder- und Jugendmedizin (KUNO-Kliniken), Regensburg, Deutschland
| | - C Apfelbacher
- Institut für Sozialmedizin und Gesundheitssystemforschung,
Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg,
Magdeburg, Deutschland
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Hörold M, Gottschalk M, Debbeler CM, Heytens H, Wissel A, Ehrentreich S, Braun-Dullaeus R, Apfelbacher C. Patients' perspectives on the challenges of chronic heart
disease care in rural areas: A qualitative study. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Hörold
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
| | - M Gottschalk
- Universitätsklinikum Magdeburg, Universitätsklinik
für Kardiologie und Angiologie, Magdeburg, Deutschland
| | - CM Debbeler
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
| | - H Heytens
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
| | - A Wissel
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
| | - S Ehrentreich
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
- Universitätskinikum Magdeburg, Universitätsklinik
für Unfallchirurgie, Magdeburg, Deutschland
| | - R Braun-Dullaeus
- Universitätsklinikum Magdeburg, Universitätsklinik
für Kardiologie und Angiologie, Magdeburg, Deutschland
| | - C Apfelbacher
- Otto-von-Guericke-Universität Magdeburg, Insitut für
Sozialmedizin und Gesundheitssystemforschung, Magdeburg,
Deutschland
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Hörold M, Drewitz KP, Piel J, Hrudey I, Rohr M, Brunnthaler V, Hasenpusch C, Ulrich A, Otto N, Brandstetter S, Apfelbacher C. Intensive Care Units Healthcare Professionals’ Experiences and Negotiations at the Beginning of the COVID-19 Pandemic in Germany: A Grounded Theory Study. INQUIRY 2022; 59:469580221081059. [PMID: 35522185 PMCID: PMC9082755 DOI: 10.1177/00469580221081059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Faced with the pandemic of the novel coronavirus (SARS-CoV-2), healthcare professionals (HCPs) in intensive care units (ICU) adjusted their organizational, operational, and personal procedures to ensure care for COVID-19 patients. We used grounded theory approach to explore ICU HCPs' perspectives on professional action at the beginning of the COVID-19 pandemic in Germany from March to July 2020. The study aimed to examine implicit principles on negotiating social practice and interaction of ICU HCPs in an exceptional situation, which was characterized by a high level of changes. We conducted theme-guided qualitative telephone/virtual interviews with 39 ICU HCPs from ten German federal states. The data collection followed the principles of theoretical sampling. We adpoted grounded theory approach proposed by Charmaz and discussed using Lüscher’s theoretical concept of ambivalence. The analysis revealed five interconnected categories about the ICU HCPs’ negotiation of social practice and interaction at the beginning of the COVID-19 pandemic in Germany. In this context, a complex field of ambivalence (key category) emerged between habits and routines of a pre-pandemic normality. Pragmatic restructuring processes were initiated, which quickly resulted in a new normality of a “daily routine of preparation”. Dealing with ambivalence offers the potential for change.
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Affiliation(s)
- Madlen Hörold
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Karl Philipp Drewitz
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Julia Piel
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Ilona Hrudey
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Magdalena Rohr
- University of Regensburg, Faculty of Medicine, Medical Sociology, Regensburg, Bavaria, Germany
- University of Regensburg, University Children’s Hospital Regensburg (KUNO-Clinics), Regensburg, Bavaria, Germany
| | - Vreni Brunnthaler
- University of Regensburg, Faculty of Medicine, Medical Sociology, Regensburg, Bavaria, Germany
| | - Claudia Hasenpusch
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Angela Ulrich
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Niklas Otto
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
- University Hospital Magdeburg, Magdeburg, Saxony-Anhalt, Germany
| | - Susanne Brandstetter
- University of Regensburg, University Children’s Hospital Regensburg (KUNO-Clinics), Regensburg, Bavaria, Germany
| | - Christian Apfelbacher
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
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Swart E, Feißel A, Hasoon A, Hörold M, Hupach H, Matterne U, Piontek K, Schaefer M, Stallmann C, Strecker M, Apfelbacher C. Practical training in medical sociology "Analysis of social environments of living quarters". A field experiment during the COVID-19 pandemic. GMS J Med Educ 2021; 38:Doc27. [PMID: 33659632 PMCID: PMC7899116 DOI: 10.3205/zma001423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 05/25/2023]
Abstract
Background: In the summer semester 2020, a new format was introduced at the Otto-von-Guericke-University Magdeburg for first-year medical students in the subject of medical sociology with a neighborhood-related social environment analysis. Didactic approach: Due to the COVID-19 pandemic, the didactic concept had to be changed at short notice from seminar group-related fieldwork in different districts of Magdeburg to individual work at the place of study or home, supplemented by accompanying online offers. The students were asked to characterize their neighborhood in terms of quality of life, health and illness as well as medical care by means of interviews with inhabitants of their immediate living environment, a neighborhood inspection with the taking of photographs and an analysis of official secondary data. The aim was to gain initial experience in scientific work (data collection, presentation and interpretation of results, as well as reporting). An evaluation of this new course and conclusions derived from it for its further development will be reported. Evaluation: 51 percent of the students participated in an evaluation of the course. The clear majority rated the internship as "good" or "very good". As a suggestion for improvement, the desire for optional supplementary individual counseling and better formal preparation for the performance assessments were expressed several times. Two thirds of those surveyed consider the online teaching format to be useful even in post-pandemic times.
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Affiliation(s)
- Enno Swart
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Annemarie Feißel
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Aiad Hasoon
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Madlen Hörold
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Heike Hupach
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Uwe Matterne
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Katharina Piontek
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Matthes Schaefer
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Christoph Stallmann
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Marco Strecker
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
| | - Christian Apfelbacher
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Germany
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Hörold M, Landenberger M. [Promoting self care in patients with chronic obstructive lung disease in ambulatory care - an observational study]. Pflege 2015; 28:245-6. [PMID: 26244803 DOI: 10.1024/1012-5302/a000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hörold M, Landenberger M. [Self-management support for patients with chronic obstructive pulmonary disease in ambulatory care--an observational study]. Pneumologie 2014; 68:802-10. [PMID: 25377228 DOI: 10.1055/s-0034-1390875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This cross-sectional study focuses on the status of COPD-related fears and impairments of adult patients receiving ambulant care as well as their use of self-management strategies. On the basis of the COPD Clinical Questionnaire, COPD Disability Index, COPD Assessment Test and the COPD Anxiety Questionnaire, COPD-dependent fears and impairments were determined in a convenience sample. Furthermore, data on important characteristics of the illness experience were gathered by semi-standardised interviews. Altogether, 80 patients (average age: 67.1 ± 8.5 years) took part in the quantitative interviews. In addition, 10 patients (average age: 68.2 ± 4.1 years) took part in qualitative interviews. Results showed that there were disease-related impairments in the areas of respiration, recovery and physical stress as well as in family and domestic obligations. Furthermore, illness-dependent fears had a high relevance in the study population. The management of COPD-related fears and taking into consideration information and counseling needs of these patients are important intervention approaches. On the basis of the presented results, evidence-based, multi-disciplinary, and disease-, situation- and above all, patient' needs-related interventions could be planned to support patients in self-management skills.
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Affiliation(s)
- M Hörold
- Institut für Gesundheits- und Pflegewissenschaft der Medizinischen Fakultät der Martin-Luther-Universität Halle-Wittenberg (Direktorin: Prof. Dr. phil. Gabriele Meyer)
| | - M Landenberger
- Institut für Gesundheits- und Pflegewissenschaft der Medizinischen Fakultät der Martin-Luther-Universität Halle-Wittenberg (Direktorin: Prof. Dr. phil. Gabriele Meyer)
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