Community health nurses are important at community level for strengthening primary care and health-promoting structures. In the Austrian context, the relevance and prioritization of 13 internationally identified areas of competence are examined by means of problem-centered, guided interviews. All competence areas were identified as relevant, especially prevention, communication, evidence-based practice, and networking; others, such as disaster preparedness and research, are considered contextually relevant. The results underline the crucial role of community health nurses in providing access to healthcare, especially in structurally underserved regions. However, their professionalization and effectiveness require continuous skills development through training with a generalist foundation and context-specific specializations. Community Health Nurses

Interprofessionelle Zusammenarbeit ist eine zentrale Voraussetzung für eine qualitativ hochwertige Versorgung im zunehmend komplexen Gesundheitssystem. Interprofessionelle Ausbildung (Interprofessional Education, IPE) gilt als wirksamer Ansatz zur Förderung kooperativer Kompetenzen und zur Entwicklung einer interprofessionellen Identität, die gemäß der Extended Professional Identity Theory ergänzend zur professionsspezifischen Identität entsteht. Vor diesem Hintergrund untersuchte die vorliegende Studie, inwiefern ein neu entwickeltes interprofessionelles Pflichtlehrformat zur Veränderung der erweiterten professionellen Identität (Extended Professional Identity, EPI) von Studierenden unterschiedlicher Gesundheits- und Sozialberufe beiträgt und wie das Lehrformat von den Teilnehmenden bewertet wird. Es wurde eine multizentrische Beobachtungsstudie mit einem einarmigen Prä-Post-Design durchgeführt. Analysiert wurden retrospektiv ausgewertete Befragungsdaten aus einer dreitägigen interprofessionellen Lehrveranstaltung an zwei Ausbildungsstandorten. Die EPI wurde mithilfe der Extended Professional Identity Scale (EPIS) zu Beginn und am Ende der Lehrveranstaltung erhoben. Ergänzend erfolgte eine querschnittliche Evaluation mittels standardisiertem Online-Fragebogen. Es nahmen Studierende der Humanmedizin, der diplomierten Gesundheits- und Krankenpflege, Physiotherapie, Psychologie, Diätologie und Sozialen Arbeit teil. Die Lehrveranstaltung wurde seitens der Studierenden positiv bewertet, wobei signifikante Unterschiede zwischen den Studiengängen bestanden. In der Gesamtstichprobe zeigte sich eine signifikante Zunahme der erweiterten professionellen Identität mit großer Effektstärke. Besonders ausgeprägt waren die Effekte bei Studierenden der Pflegeberufe, während bei Medizinstudierenden moderatere, jedoch signifikante Veränderungen beobachtet wurden. Auch kurzzeitige, strukturierte interprofessionelle Pflichtformate können die Entwicklung interprofessioneller Identität wirksam fördern. Die Ergebnisse unterstreichen die Bedeutung einer zielgruppensensiblen curricularen Gestaltung interprofessioneller Ausbildung.

Complementary therapies are becoming increasingly popular with patients. Specialized clinics can offer complementary medicine to patients in the German healthcare system, taking into account specific structural requirements. However, little is known about the patients treated in these hospitals. For this purpose, 12,457 hospital stays were analysed from 2007 to 2024 in an approved acute care hospital to obtain more information about the illnesses, comorbidities, length of stay in hospital, age, and chronicity of the patients. Approximately half of the hospital stays examined showed pain-related disorders (49.3%), followed by common internal medical conditions (11.7%) and psychological diagnoses (10.3%). Women showed on mean 14 secondary diagnosis (median 9.0, IQR 6.0), male patients 9.1 (median 9.0, IQR 6.0). 5562 stays showed five or more comorbidities. Considering all hospital stays, the female gender predominated (N = 9680, 77.7%, 95% CI 77.0-78.4% vs. male N = 2777, 22,3%, 95% CI 21.6-23.0%). The mean age of female patients was 64.6 (median 65.0, IQR25.0) of male patients 64.8 (median 66.0, IQR 24.0). The mean length of stay was 12.2 days (median 14, IQR 7.0). A large number of patients have chronic conditions, with pronounced pain and psychological impairments. A complementary medicine treatment concept focuses on the treatment of chronically ill patients with multiple diseases.

Primärversorgung ist essenziell für funktionierende Gesundheitssysteme. In Österreich dominieren Hausärzt*innen, während andere Länder wie etwa Norwegen auf akademisch ausgebildetes Pflegepersonal im Community Health Nursing (CHN) setzen. In Österreich werden erste Schritte zur Integration von CHN unternommen, darunter Pilotprojekte in verschiedenen Gemeinden, um deren Potenzial in der Primärversorgung zu erproben. Das Ziel war, die Bedeutung und das Spektrum der Kompetenzen von CHN im Bereich Gesundheits- und Pflegemanagement sowie fortgeschrittene klinische Kenntnisse in Österreich zu erheben und zu bewerten. Insgesamt wurden 15 Interviews mit Expert*innen aus verschiedenen Bereichen des Sozial- und Gesundheitswesens geführt. Kompetenzen im Bereich Gesundheits- und Pflegemanagement in Kombination mit fortgeschrittenen klinischen Fähigkeiten spielen auf mehreren Ebenen eine entscheidende Rolle. Einerseits muss die CHN in der Lage sein, komplexe Gesundheitssituationen ganzheitlich zu erfassen und daraus die entsprechenden Maßnahmen abzuleiten. Andererseits bildet vertiefte Pflegekompetenz im pflegerischen Bereich eine tragende und zentrale Säule der täglichen Arbeit. Die theoretische und praktische Ausbildung von CHN sollte sich auf die Bewältigung komplexer Situationen ausrichten und dabei einen ganzheitlichen Ansatz verfolgen. Dies bedeutet, dass neben vertiefter Pflegekompetenz auch die Entwicklung von Fähigkeiten im evidenzbasierten Denken, der interdisziplinären Zusammenarbeit und der individuellen Betreuung der Patient*innen im Vordergrund stehen sollte.

Background: Multiple sclerosis (MS) leads to early retirement in one-third of patients. The aim of this study is to analyze the difficulties at work and to collect suggestions for support measures at the workplace to maintain the ability to work for people with MS. Methods: Qualitative interviews were conducted with 20 people affected by MS. The participants’ experiences with workplace support were summarized and suggestions for workplace measures were presented. Results: Lack of offers of health-related measures and missing adjustments of the workplace has been analyzed. Offering flexible working hours and measures against fatigue is desired. Intensifying the cooperation between labor market service, health care providers and companies can help reintegrate affected people. Conclusions: Workplace education about MS and health-related measures is needed. Technical adaptations and flexible working hours can support in maintaining workability. Measures against fatigue must be developed and companies must set further measures to support people with illnesses.

Community Health Nursing plays a crucial role in primary care across Europe, with each country adopting distinct approaches. In Austria, the increasing healthcare demands necessitate a reevaluation of Community Health Nurses (CHNs) competencies, skills, and roles. The current descriptions of these aspects for CHNs in Austria lack comprehensiveness, posing a challenge to effectively meet these demands. Objective: The aim of the present study is to explore the clinical skills, health management, and nursing management competencies among CHNs.

Digital and telemedicine innovations are increasingly central to healthcare transformation, yet their adoption and diffusion remain complex. While the Diffusion of Innovations (DOI) theory explains staged adoption processes, it underrepresents socio-political and institutional factors. The Social Shaping of Technology (SST) approach complements DOI by focusing on the co-construction of technology through cultural, organizational, and political dynamics. This study investigates how DOI and SST can be combined to explain the adoption and diffusion of digital health innovations, with a focus on telemedicine in the German healthcare system. Using the Decision Matrix for Theory Borrowing, DOI and SST were selected as complementary frameworks. A secondary analysis of 12 expert interviews was conducted using SST-based content analysis. Data were coded according to Rogers' five adoption stages and four SST dimensions. Findings were mapped in a DOI–SST matrix and analysed across micro-, meso-, and macro-levels. The analysis shows that innovation trajectories are shaped by interdependent socio-technical factors across all adoption stages. Key barriers include cultural skepticism, organizational inertia, fragmented governance, and economic misalignment. The Socio-Technical Adoption and Diffusion Model for Healthcare (STAD-HC) was developed to represent these dynamics, linking DOI's stage logic with SST's contextual dimensions. The STAD-HC model offers a multi-level framework to analyse how digital health technologies are adopted, contested, and institutionalized. By integrating behavioural processes with structural influences, it provides practical guidance for managing innovation and supports future research on complex digital health technologies such as AI and blockchain.

The World Health Organization identifies primary care as foundational to both health systems and broader community development. In Austria, general practitioners dominate first-level care, unlike countries such as Norway, Finland, and Ireland, which integrate nurses into primary care. In response in 2020, the Austrian government planned to introduce a community health nursing model. This article focuses on the public health competencies required for community health nurses. The study aims to identify key public health competencies for community health nurses, providing insights to inform their training and education. Fifteen experts in community health nursing and public health were interviewed in a qualitative study. Transcripts were analyzed using qualitative content analysis, adhering to recognized research standards. Public health competencies are vital for community health nurses working across Austria’s health and social care systems. Key areas include: (a) institutions, structures, and health policy, (b) data competency — collecting, interpreting, and applying data, particularly in epidemiology and research, (c) population engagement — working effectively with diverse and vulnerable populations, informed by social epidemiology. Public health competencies are essential to the role of community health nurses in Austria. Training should emphasize epidemiology, health systems knowledge, and disaster preparedness to support their contribution to health equity, system resilience, and improved population outcomes.

Objective: Austria's healthcare system is highly fragmented and decentralized, with primary care typically delivered by independent physicians and limited integration of other health professions. To address this, the federal government is piloting a community health nursing system across several regions from 2022 to 2024. This study explores the essential generic competencies required for community health nurses (CHN) within the Austrian healthcare and social systems, aiming to inform future training guidelines. Methods: Fifteen experts in community health nursing and public health participated in qualitative interviews. The transcripts were analyzed using Qualitative Content Analysis, following established research standards. Results: Findings highlight the importance of generic competencies – grouped into six professional, sixteen personal, and sixteen social skills – as key enablers of CHN effectiveness. Social competencies enhance patient relationships, personal competencies support autonomous and responsible practice, and professional competencies enable comprehensive care for complex cases. Communication emerged as the most frequently cited competency across all categories, along with information delivery, education, and social interaction skills. Conclusions: Expanding the scope of community health nurses through a structured set of competencies could strengthen primary care and promote more integrated service delivery in Austria’s healthcare system.

Background and objective: The Austrian healthcare system is characterized by a high degree of fragmentation, with primary healthcare mainly delivered by independent physicians. However, there are limited integrations of other healthcare professions into primary care. The Austrian federal government plans to introduce a community health nursing system in the future. Currently (period from the beginning of 2022 to the end of 2024), corresponding pilot projects are running in numerous communities in Austria. The present study addresses the question of what social competencies a community health nurse in Austria needs to have. This study investigates the importance of social competencies in community health nursing within the context of the Austrian healthcare and social care system. From this, recommendations for the education of community health nurses in Austria can be derived. Methods: Fifteen qualitative, problem-centered interviews were conducted with experts in community health nursing and public health. Qualitative content analysis, following the approach of Mayring (2015), was employed. Results: The study identified several key social competencies, including communication, information dissemination and education, cultural and social competencies, pedagogical skills, leadership skills, relationship-building, assertiveness, respect for individuality, self-management, moderation and presentation, understanding of family systems, trust in other healthcare professions, negotiation skills, social justice, and dealing with gender diversity. Conclusions: Social competencies are vital for community health nurses, enabling them to establish trust, address health disparities, and meet the needs of vulnerable groups. Continuous professional development and training can enhance these competencies, thereby improving community health outcomes. Expanding the professional scope of non-physician groups, such as community health nurses, could be beneficial within the Austrian healthcare system. Future education programs for community health nurses in Austria should emphasize the development of social competencies.

Patients with chronic peripheral neuropathy suffer greatly and their quality of life is often restricted. Drug therapy can be accompanied by undesirable side effects and intolerances, or the hoped-for effect does not materialize. Therefore, in addition to drug therapy, attempts are also made to treat the physical symptoms with complementary procedures. In the case of severe forms, the search for a suitable form of therapy is difficult. Complex treatments can be an innovative way to treat peripheral neuropathy. At the same time, several different therapy methods are carried out at high frequency by a specialized treatment team. This study aimed to provide an overview of possible complementary forms of therapy. The focus was on a comparison of two interdisciplinary complex therapies that are used in severe cases in an acute inpatient care setting in Germany. The six dimensions (energy, sleep, pain, physicality, emotional response and social isolation) of the Nottingham Health Profile (NHP) were used to assess quality of life. Both complex treatments (naturopathic complex therapy/multimodal pain therapy) showed a significant reduction in impairment in all dimensions of the NHP. In addition, a multivariate analysis was carried out to take into account several influencing variables at the same time. At the time of admission to the hospital, the degree of chronicity was recorded for each patient. This allowed statements to be made about the effect of the respective therapy depending on the chronification stage of the patient. It has been shown that patients with acutely exacerbated pain with the highest degree of chronicity also benefit from both complex treatments. The naturopathic complex treatment gives the treatment team more options. Aspects such as nutrition, methods from phytotherapy and traditional Chinese medicine can be integrated into inpatient care. Thus, a patient-centered, holistic therapy can take place. However, an interdisciplinary holistic therapy requires more time for both the practitioner and the patient. This should be taken into account in the health systems in the context of the diagnosis related groups.

BACKGROUND: Multiple sclerosis (MS) is a chronic inflammation of the central nervous system that can result in cognitive and physical deficits. It can lead to early retirement in 50% of the cases in the first 15 years of the disease without governmental support and to date, there are only a few studies which focus on measures to support people with MS at the workplace. OBJECTIVE: The aim of this study is to analyse the governmental support measures to maintain the working capacity of people with MS and to provide improvements and further approaches for their support. METHODS: A two-stage study was conducted by means of qualitative interviews. The first study was conducted using the problem-centred form with 10 experts from the health and social care sector who work with people affected by MS. The second study was conducted using qualitative interviews in biographical form with 20 people suffering from MS. RESULTS: The study participants mentioned various suggestions for improving the existing governmental support measures, such as a central support office for illness-related questions, relaxing the strict requirements for support measures, giving the regulation of support measures to federal government, changing the pension system and providing financial support for individual therapies and outpatient therapies. Currently, MS patients lack knowledge about contact persons for MS-specific questions, as well as intensive cooperation between labour market service, health service providers and companies to help find a job. CONCLUSION: A combination of the governmental support measures available so far with the proposed optimisations or additions by MS patients and experts can lead to a significant reduction in disease-specific absences and limitations, which in turn results in the preservation of the ability to work. All suggestions from the interviews need to be explored further to investigate a possible implementation.

(1) Background: Individual adoption experiences represent important factors in implementing innovations. In the context of health systems, where the implementation of innovations aims to improve the quality of care, they provide an important basis for developing and adapting implementation strategies. (2) Methods: This study examines the adoption experiences of (tele-)medical experts (n = 13) using the example of telemedicine in the German healthcare system by means of a qualitative, guideline-based interview study. The interview guide, as well as the deductive–inductive analysis, is based on Rogers’ adoption theory. The transcription and analysis process was carried out according to Kuckartz. (3) Results: A total of 304 interview statements could be coded and assigned to the five main categories of persuasion, knowledge, implementation, decision and confirmation. More than half of all statements were coded under the main category persuasion, with its subcategories of convictions regarding the implementation of telemedicine (n = 89), international comparison of Germany’s development (n = 50), telemedicine as a way of optimizing resources (n = 22) and conviction to understand telemedicine as an overall system (n = 10). (4) Conclusions: This study provides insight into how the implementation of telemedicine in the German healthcare system is perceived by experts and allows for adjustments to the ongoing implementation strategy.

(1) Background: The Austrian health care system is extremely fragmented. Primary care is mainly provided by self-employed GPs. Other health professionals are rarely integrated into primary care. But, according to the political plans of the Austrian government, a system of community nurses and community health nurses should be implemented and several pilot projects have already been started. (2) Objective: The present study explores the skills and competences needed in the planning, management and collaboration for the change in the system and gives recommendations for community health nurse education in Austria. (3) Methodology: Fifteen qualitative, problem-centered interviews were conducted with experts in the field of community health nursing and analyzed using qualitative content analysis. (4) Results: The skills and competences often and widely mentioned are interprofessional collaboration, cooperation with other actors, systems thinking, project and change management, and basic management skills, including strategic planning, communication, accounting and finance. Areas such as health planning and lobbying are also highlighted. The main competences are broken down into subcompetences, making it possible to create a detailed competence grid. Competences in planning, management and collaboration are particularly important in the initial stages of the first implementation of a community health nursing system. (5) Conclusions: Skills and competences in these areas occupy a central position. A multilayered breakdown of these competences is required in order to create a targeted requirements profile. Due to the small-scale fragmentation of the Austrian health care system, collaboration and coordination are more difficult and costly, but all the more important. The aforementioned skills and competences represent an essential expansion of nursing education in Austria.

Background: Adoption and diffusion processes are integral parts of the dissemination of innovations yet, they have been studied only fragmentarily in the healthcare systems field. This article outlines the goal of a PhD thesis in progress and

Background and objective In Austria, pilot projects on community (health) nursing are currently running (period beginning of 2022 until end of 2024) in numerous communities. Prevention and health promotion are an integral part of the daily work of community health nurses. This paper explores the question of which specifications or areas related to competence in prevention and health promotion are of particular relevance to a community health nurse working in Austria.Study design and methods We conducted 15 qualitative, problem-centered interviews with experts in community health nursing as well as public health, which were transcribed verbatim. Qualitative content analysis was used for analysis.Results Competence in prevention and health promotion is important for community health nurses. Components are the compilation of prevention plans and the development of health promotion measures. In detail, this includes the planning and implementation of information events, health education, early access to young people, empowerment of vulnerable groups, leadership role, knowledge of health, disease and their determinants, health monitoring, assessment of risk factors, environmental health, measures for early detection (screening, etc.), the creation of structures and institutions in the community, and the development of population- and individual-based health resources.Discussion Competence in the areas of prevention and health promotion allows the community health nurse - within the given professional legal framework - to assume personal responsibility in many areas. In the context of creating local structures and institutions, there is an important interface with skills in planning, collaboration, and management. Measures for early detection can be seen as expandable in Austria from a health economic perspective; this could be a task of the community health nurse. In the course of health pedagogy, it must be possible to communicate relevant content at the lay level. Nursing practice and training of professions in Austria are still very individual-centered and disease oriented; a rethinking including the concept of salutogenesis should take place. Furthermore, goal-oriented education should take place at the master's level.Conclusion Skills and competences in the field of prevention and health promotion are key for community health nurses. A salutogenetic orientation in the field of professional practice and education is necessary. Central components of competence in prevention and health promotion are knowledge of health determinants, the development of population-based and individual-related health resources, and access to young people and vulnerable groups.

In Österreich laufen aktuell (Zeitraum Anfang 2022 bis Ende 2024) Pilotprojekte zu Community (Health) Nursing (CHN) in zahlreichen Gemeinden. Prävention und Gesundheitsförderung bilden einen integralen Bestandteil der täglichen Arbeit von Community Health Nurses. Die vorliegende Arbeit geht der Frage nach, welche Spezifikationen bzw. Bereiche im Zusammenhang mit der Fähigkeit/Kompetenz Prävention und Gesundheitsförderung für eine Community Health Nurse, die in Österreich tätig ist, von besonderer Relevanz sind. Wir führten 15 qualitative, problemzentrierte Interviews mit Expert:innen im Bereich CHN sowie Public Health, die wortwörtlich transkribiert wurden. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse. Die Kompetenz Prävention und Gesundheitsförderung zählt zu den zentralen Kernbereichen, die eine Community Health Nurse jedenfalls abdecken sollte. Bestandteile sind das Schnüren von Präventionsplänen sowie der Aufbau von Gesundheitsförderungsmaßnahmen. Dazu zählen im Einzelnen die Planung und Durchführung von Informationsveranstaltungen, Gesundheitspädagogik, der frühzeitige Zugang zu jungen Menschen, das Empowerment von vulnerablen Gruppen, die Leadership-Rolle, Kenntnisse über Gesundheit, Krankheit und ihre Determinanten, Gesundheitsmonitoring, Einschätzung von Risikofaktoren, Umweltgesundheit, Maßnahmen der Früherkennung (Screening etc.), die Schaffung von Strukturen und Institutionen in der Gemeinde sowie die Entwicklung bevölkerungseigener und individuumsbezogener Gesundheitsressourcen. Der Kompetenzbereich Prävention und Gesundheitsförderung erlaubt es der Community Health Nurse – innerhalb des vorgegebenen berufsrechtlichen Rahmens – in vielen Bereichen Eigenverantwortung zu übernehmen. Im Kontext der Schaffung von Strukturen und Institutionen vor Ort liegt eine wichtige Schnittstelle zu Kompetenzen im Bereich Planung, Zusammenarbeit und Management. Maßnahmen der Früherkennung können in Österreich aus gesundheitsökonomischer Perspektive als ausbaufähig betrachtet werden, hier könnte ein Schwerpunkt der Community Health Nurse liegen. Im Zuge der Gesundheitspädagogik müssen zugehörige Inhalte auch auf Laienebene kommuniziert werden können. Tätigkeitsfeld und Ausbildung der Pflegeberufe sind in Österreich nach wie vor sehr individuumszentriert und pathogenetisch ausgerichtet, ein Umdenken unter Einbeziehung des Gedankens der Salutogenese sollte erfolgen. Eine zielgerichtete Ausbildung sollte zudem auf Masterebene stattfinden. Fähigkeiten und Kompetenzen im Bereich Prävention und Gesundheitsförderung bilden ein effektives Kernthema der Community Health Nurse. Eine salutogenetische Orientierung in Tätigkeitsfeld und Ausbildung ist nötig. Zentrale Bestandteile der Kompetenz Prävention und Gesundheitsförderung sind Kenntnisse über Gesundheitsdeterminanten, die Entwicklung bevölkerungseigener und individuumsbezogener Gesundheitsressourcen sowie der Zugang zu jungen Menschen und vulnerablen Bevölkerungsgruppen.