Lehrstuhl für Community Health Nursing (CHN)

Self-care has an important role to play in patients with chronic conditions. The term self-care refers to specific activities performed with the intention of improving or restoring health and well-being, as well as treating or preventing disease. Self-care refers to the general health decisions people make about physical exercise, healthy eating, good hygiene, self-medication and avoiding health risks such as smoking or excessive drinking. The spectrum of self-care ranges from taking care of minor ailments to long-term conditions and rehabilitation. Individuals perform self-care alone or with support from their next of kin and/or professionals such as nurses or GPs. Enhancing self-care is a key concept of disease management for many types of chronic conditions. People with chronic conditions, their carers and family members are valued as co-producers of health. While self-care aligns well with the wish for greater patient autonomy there is also the risk of overburdening people. It needs to be recognised that self-care is not possible for everyone and that some people do not have family support available to help them. Thus, the aim of our research programme is to conduct cutting-edge research from the perspective of people with chronic conditions. We undertake rigorous research to shed light on wide-ranging self-care aspects relevant to their personal lives, and to provide an evidence base for ‘enhancing self-care’.

Mission statement

Our mission is to enable people with chronic diseases to engage in on-going self-care up to a level acceptable to them and to conduct cutting-edge research that is relevant and close to their personal lives with the aim of improving health and well-being.

A meta-synthesis of qualitative studies exploring barriers and facilitators to self-care recommendations in heart failure patients (completed): Towards developing an evidence-based complex intervention to reduce hospital (re-)admissions (Mar 2015 – Jul 2016)

SUMMARY

Heart failure (HF) is a serious debilitating clinical syndrome that occurs when the pump action of the heart is unable to meet the body’s metabolic demands. There are an estimated 23 million people with HF worldwide. In 2006, the German Federal Office of Statistics reported 317.000 cases of HF requiring hospitalisation. The cost of illness caused by HF is estimated at 2.9 billion Euros. Despite improvements in treatment, international studies report that HF frequently requires admission to hospital. Many of the costs are attributed to hospitalisation. The majority of hospital visits could be prevented if more attention was placed on self-care. Despite international evidence supporting the positive outcomes related to HF self-care, patients frequently fail to adhere. Developing appropriate interventions to improve self-care is a key area for future research. Given the complexity of increasing adherence to HF self-care, a systematic synthesis of qualitative studies would enable researchers, practitioners and policy makers to benefit from the drawing together of a large body of qualitative research in this area which could result in the development of new interventions.

OBJECTIVES

To systematically review and synthesise multiple qualitative studies of barriers and facilitators to heart failure self-care recommendations in order to develop a robust theoretical and empirical basis for designing prospective, ‘patient-centered’, evidence-based interventions as recommended by the Medical Research Council (MRC) framework. This meta-synthesis of qualitative studies integrates and summarises the evidence that exists on barriers and facilitators to HF self-care. Based on the findings of this qualitative meta-synthesis, a step-wise approach is being followed to fully develop an evidence-based complex intervention with the aim of enhancing self-care recommendations in heart failure patients to reduce hospital (re-) admissions. This study has thus laid the foundation for Study #2.

DFG Fund code: HE 7352/1-1

Status: completed

Developing a manual containing well-defined, theory-based behaviour change interventions to enhance self-care adherence in heart failure patients (completed). Enhancing self-care adherence in heart failure patients by developing a manual containing well-defined and theory-based behaviour change interventions through the application of the COM-B behaviour model (ACHIEVE study, Feb 2019 – May 2021)

SUMMARY

Although international guidelines recommend on-going self-care as part of routine heart failure management, and despite evidence supporting the positive outcomes related to self-care, patients are frequently unable to adhere. Heart failure self-care can be modified and enhanced through behaviour change interventions (BCIs). However, previous self-management interventions have shown limited success in improving adherence to self-care because they were neither theory-based nor well defined, which precludes the identification of underlying causal mechanisms as well as transparency and reproducibility of the intervention. Thus, we developed an intervention manual containing theory-based BCIs that are well-defined using eight descriptors proposed to describe BCIs in a standardised way. The manual will serve as a blueprint, which then can be applied with confidence in a subsequent exploratory trial that seeks to enhance patients’ adherence to self-care. To manage the process of developing BCIs in a systematic fashion, the ACHIEVE work programme consisted of four stages. Behaviour change interventions are based on selected statements of findings that were derived by our research team in a recently completed qualitative meta-summary project (HE 7352/1-1) and findings from a quantitative meta-analysis published by Kessing et al. (2016). These two up-to-date comprehensive reviews synthesising qualitative and quantitative studies were used to extract factors (target behaviours) associated with self-care adherence / non-adherence (Stage 1). Extracted behaviours associated with adherence/non-adherence will then be mapped onto the ‘Capability, Opportunity, Motivation and Behaviour’ (COM-B) model, thus capturing the underlying mechanisms that are involved (Stage 2). To develop approaches for change, the ‘Taxonomy of Behaviour Change Techniques’ were used to allow effective mapping of the target behaviours (barriers to self-care) onto established behaviour change techniques to overcome barriers to self-care (Stage 3). Normalisation Process Theory (NPT) was then used to identify relevant contextual factors in Germany in order to overcome the difficulties of implementing theoretically derived interventions into everyday practice. NPT assists in identifying factors that promote/inhibit the effective and sustained incorporation of interventions into routine clinical work. Finally, a consensus development method (Delphi technique) was employed to fine-tune content and acceptability of the intervention manual (Stage 4) to increase the likelihood of successfully piloting and implementing future BCIs into the German health care system.

OBJECTIVES

Based on the 37 statements of findings from our qualitative meta-summary, we will develop theory-based BCIs suited to improve adherence to self-care behaviour in HF patients. Underlying factors that function as barriers to self-care will be identified and linked to a behaviour model to provide strategies for behaviour change techniques that are capable of modifying behaviour associated with non-adherence to self-care. Thus, the objective of this study is to design a feasible intervention and compile a manual containing well-defined, theory-based BCIs. To manage the process of developing BCIs in a systematic fashion, our work programme consists of four stages (Stage 1-4). The concept and outline of a future exploratory trial that aims to enhance self-care adherence in patients with HF will lay the ground for pilot testing the manual.

DFG Fund code: HE 7352/1-2

Status: completed

Ehringfeld, I., Steinhoff, P., Störk, S., Whittal, A. & Herber, O.R. (2023). The voting scheme determines the winner. Considering possible options for designing a Delphi study. International Journal of Qualitative Methods. Volume 22:1-8. DOI: 10.1177/16094069221148871.

Baltes, M., Stephan, A., Herber, O.R. & Meyer, G. (2022). Fear of falling from the perspective of affected persons: A systematic review and qualitative meta-summary using Sandelowski and Barroso’s method. International Journal of Older People Nursing 2022;00:e12520. DOI: 10.1111/opn.12520.

Bradbury-Jones, C., Taylor, J.; Miller, R. & Herber, O.R. (2021). Improving the visibility and description of theory in qualitative research: The QUANTUM typology. SSM - Qualitative Research in Health 2 (2022) 100030. DOI.org/10.1016/j.ssmqr.2021.100030.

Whittal, A., Ehringfeld, I., Steinhoff, P. & Herber, O.R. (2021). Determining contextual factors for a heart failure self-care intervention: A consensus Delphi study (ACHIEVE). Health Education & Behavior. Oct 4;10901981211043116. DOI.org/10.1177/10901981211043116.

Herber, O.R., Ehringfeld, I., Steinhoff, P. & Whittal, A. (2021). Identifying relevant factors for successful implementation into routine practice: expert interviews to inform a heart failure self-care intervention (ACHIEVE study). BMC Health Services Research 21:585. DOI.org/10.1186/s12913-021-06596-w.

Bradbury-Jones, C., Aveyard, H., Herber, O. R., Isham, L., Taylor, J., & O’Malley, L. (2021). Scoping reviews: the PAGER framework for improving the quality of reporting. International Journal of Social Research Methodology 1-14. DOI: 10.1080/13645579.2021.1899596

Whittal, A., Atkins, L., & Herber, O. R. (2021). What the guide does not tell you: reflections on and lessons learned from applying the COM-B behavior model for designing real life interventions. Translational Behavioral Medicine 11(5):1122-1126. DOI: 10.1093/tbm/ibaa116

Herber, O. R., Krischel, M., & Whittal, A. (2020). Ethical aspects of self-care: Comment on Riegel et al (2019) Self-care research: Where are we now? Where are we going?. International Journal of Nursing Studies 111. DOI: 10.1016/j.ijnurstu.2020.103758

Herber, O. R., Ehringfeld, I., Steinhoff, P., & Whittal, A. (2021). Identifying relevant factors for successful implementation into routine practice: expert interviews to inform a heart failure self-care intervention (ACHIEVE study). BMC health services research, 21(1). doi:10.1186/s12913-021-06596-w

Bradbury-Jones, C., Aveyard, H., Herber, O.R., Isham, L., Taylor, J. & O’Malley, L. (2020). Scoping Reviews: The PAGER framework for improving the quality of reporting (accepted for publication in The International Journal of Social Research Methodology on 2 March 2021).

Whittal, A., Atkins, L. & Herber, O.R. (2020). What the guide does not tell you: Reflections on and lessons learned from applying the COM-B behaviour model for designing real life interventions. (accepted for publication in Translational Behavioral Medicine on 21 October 2020).

Herber, O.R., Krischel, M. & Whittal, A. (2020). Ethical aspects of self-care: comment on Riegel et al. (2019) Self-care research: Where are we now? Where are we going? International Journal of Nursing Studies 111. [ahead of print] DOI.org/10.1016/j.ijnurstu.2020.103758.

Whittal, A., Störk, S., Riegel, B. & Herber, O.R. (2020). Applying the COM-B behaviour model to overcome barriers to heart failure self-care: A practical application of a conceptual framework for the development of complex interventions (ACHIEVE study). European Journal of Cardiovascular Nursing. [ahead of print] DOI: 10.1177/1474515120957292.

Irvine, F., Clark, M.T., Efstathiou, N., Herber, O.R., Howroyd, F., Gratrix, L., Sammut, D., Trumm, A., Hanssen, T.A., Taylor, J. & Bradbury-Jones, C. (2020). The state of mixed-methods research in nursing: A focused mapping review and synthesis. Journal of Advanced Nursing. [ahead of print] DOI: 10.1111/jan.14479.

Herber, O.R. & Barroso, J. (2020). Lessons learned from applying Sandelowski and Barroso’s approach for synthesising qualitative research. Qualitative Research 20(4):414-431.

Herber, O.R., Bradbury-Jones, C., Böling, S., Combes, S., Hirt, J., Koop, Y., Nyhagen, R., Veldhuizen, J.D. & Taylor, J. (2019). What feedback do reviewers give when reviewing qualitative manuscripts? A Focused Mapping Review and Synthesis. BMC Medical Research Methodology 20:122. DOI.org/10.1186/s12874-020-01005-y.

Herber, O.R., Wilm, S., Fiege, A., Ernstmann, N., Pfaff, H. & Icks, A. (2019). Die DFG Nachwuchsakademie 2017 – Wissenschaftliche Nachwuchsförderung in der Versorgungsforschung [The Junior Research Academy 2017 in Health Services Research of the German Research Foundation: Promotion of Young Researchers] Das Gesundheitswesen 82:992-997. DOI 10.1055/a-1082-0966.

Bradbury-Jones, C., Breckenridge, J.P., Clark, M.T., Herber, O.R., Jones, C. &Taylor, J. (2019). Advancing the science of literature reviewing in social research: The focused mapping review and synthesis. International Journal of Social Research Methodology. DOI.org/10.1080/13645579.2019.1576328.

Pentzek, M., Santos, S., Wollny, A., Gummersbach, E., Herber, O.R., in der Schmitten, J., Icks, A., Abholz, H.-H. & Wilm, S., (2019). Which patients with type 2 diabetes mellitus are perceived as ‘difficult’ by general practitioners? Primary Care Diabetes. PCD-760. DOI.org/10.1016/j.pcd.2019.01.001.

Herber, O.R., Kastaun, S., Wilm, S. & Barroso, J. (2019). From qualitative meta-summary to qualitative meta-synthesis: Introducing a new situation-specific theory of barriers and facilitators for self-care in patients with heart failure. Qualitative Health Research 29(1): 96-106. DOI: 10.1177/1049732318800290.

Jones, M.C., Smith, K., Herber, O.R., White, M., Steele, F. & Johnston, D.W. (2018). Intention, beliefs and mood assessed using electronic diaries predicts attendance at cardiac rehabilitation: An observational study. International Journal of Nursing Studies 88: 143-152. DOI.org/10.1016/j.ijnurstu.2018.08.015.

Herber, O.R., Atkins, L., Störk, S. & Wilm, S. (2018). Enhancing self-care adherence in patients with heart failure: A study protocol for developing a theory-based behaviour change intervention using the COM-B behaviour model. BMJ Open 8:e025907.

Wollny, A., Pentzek, M., Herber, O.R., Abholz, H.-H., in der Schmitten, J., Icks, A., Wilm, S. & Gummersbach, E. (2018). General practitioners' attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study. BMC Family Practice 19(1):49.

Herber, O.R., Bücker, B., Metzendorf, M.-I. & Barroso, J. (2017). A qualitative meta-summary using Sandelowski and Barroso’s method for synthesizing qualitative research to explore barriers and facilitators to self-care in heart failure patients. European Journal of Cardiovascular Nursing 16(8):662-677.

Bradbury-Jones, C., Breckenridge, J., Clark, M.T., Herber, O.R., Wagstaff, C. & Taylor, J. (2017). The state of qualitative research in health and social care: Findings from a focused mapping review and synthesis. The International Journal of Social Research Methodology 20(6):627-645.

Herber, O.R., Smith, K., White, M. & Jones, M.C. (2016). Just not for me’ – Contributing factors to non-attendance/non-completion at phase III cardiac rehabilitation in acute coronary syndrome patients: A qualitative enquiry. Journal of Clinical Nursing 26(21-22):3529-3542.

Taylor, J., Bradbury-Jones, C., Breckenridge, J., Jones, C. & Herber, O.R. (2016). Risk of vicarious trauma in nursing research: A focused mapping review and synthesis. Journal of Clinical Nursing 25(19-20):2768-2777.

Smith, J.P. & Herber, O.R. (2014). Ethical issues experienced by mental health nurses in the administration of antipsychotic depot and long acting intramuscular injects: A qualitative study. International Journal of Mental Health Nursing 24(3):222-230.

Herber, O.R., Mülders, V., Schwappach, D., Thürmann, P.A., Wilm, S. (2014). Patient information leaflets: informing or frightening? A focus group study exploring patients’ emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices. BMC Family Practice 15:163. Awarded “Highly Accessed” status.

Bradbury-Jones, C., Taylor, J. & Herber, O.R. (2014). How theory is used and articulated in qualitative research: Development of a new typology. Social Science & Medicine 120:135-141.

Bradbury-Jones, C., Taylor, J. & Herber, O.R. (2014). Vignette development and administration: a framework for protecting research participants. International Journal of Social Research Methodology 17(4):427-440.

Pentzek, M., Wollny, A., Herber, O.R., Porst, R., Icks, A., Abholz, H.-H. & Wilm, S. (2012). Item construction in sequential mixed methods studies – description of an approach. German Journal of Family Medicine 88(12):520-527. (Article in German)

Herber, O.R., Jones, M.C., Smith, K. & Johnston, D.W. (2012). Assessing acute coronary syndrome patients’ cardiac related beliefs, motivation and mood over time to predict non-attendance at cardiac rehabilitation. Journal of Advanced Nursing 68(12):2778-2788.

Herber, O.R. & Johnston, B.M. (2013). The role of health care support workers in providing end-of-life care in the community: A systematic literature review. Health & Social Care in the Community 21(3):225-235. Selected for the March 2014 special virtual issue ‘Supportive and Palliative Care’ of the journal. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2524/homepage/virtual_issues.htm.

Herber, O.R. & Bradbury-Jones, C. (2010). Editorial: The postdoctoral paradox. A specification of nursing science? Nurse Education Today 31:537-538.

Bradbury-Jones, C. & Herber, O.R. (2010). Editorial: Creativity in nursing research: Five Thinking Hats. International Journal of Nursing Studies 48(2):143-144.

Herber, O.R. & Bradbury-Jones, C. (2010). Editorial: Cross my heart and hope to die! The use of pledges in health care. Journal of Clinical Nursing 20(21):2981-2983.

Herber, O.R., Wollny, A., Pentzek, M., Abholz, H.-H., Icks, A. & Wilm, S. (2010). What do general practitioners tell about their patients with diabetes mellitus type 2? Possible reasons for insufficient blood glucose control. Zeitschrift für Allgemeinmedizin / German Journal of Family Medicine 86(5):203-208. (Article in German)

Herber, O.R., Schnepp, W. & Rieger, M.A. (2009). Recruitment rates and reasons for community physicians’ non-participation in an interdisciplinary intervention study on leg ulceration. BMC Medical Research Methodology 9:61. Awarded “Highly Accessed” status.

Herber, O.R., Rieger, M.A. & Schnepp. W. (2008). The impact of the Tandem Practice Model for the professionalisation of nursing. Pflege & Gesellschaft 13(3): 234-245. (Article in German)

Herber, O.R., Schnepp, W. & Rieger, M.A. (2008). Developing a nurse-led education programme to enhance self-care agency in leg ulcer patients. Nursing Science Quarterly 21(2):150-155.

Herber, O.R., Schnepp, W., Rieger, M.A. & Wilm, S. (2008). „…since that time there is a healing momentum“: A nurse-led education programme for the enhancement of self-care agency in leg ulcer patients in Tandem practices. Pflegewissenschaft 10(11):581-586. (Article in German)

Herber, O.R., Schnepp, W. & Rieger, M.A. (2007). A systematic review on the impact of leg ulceration on patients’ quality of life. Health & Quality of Life Outcomes 5:44. Awarded “Highly Accessed” status.

Herber, O.R. & Kroeger, A. (2003). Pyrethroid-impregnated curtains for Chagas’ disease control in Venezuela. Acta Tropica 88(11):33-38.

Whittal, A. & Herber, O.R. (2021). Health behaviour change interventions for heart failure self-care: a theory-based manual. Book of Abstracts – 35th Annual Conference of the European Health Psychology Society (EHPS), virtual event. (page 117).

Herber, O.R., Ehringfeld, I., Steinhoff, P., Störk, S. & Whittal, A. (2021). Understanding relevant factors for implementation of a heart failure self-care intervention. Book of Abstract – 20th German Congress for Health Services Research (DKVF), Düsseldorf: German Medical Science GMS Publishing House. virtual event. DOI: 10.3205/21dkvf337.

Herber, O.R., Steinhof, P., Ehringfeld, I. & Whittal, A. (2021). Enhancing self-cre of patients with heart failure: optimising intervention implementation. Book of Abstracts – RCN International Nursing Research Conference 2021, virtual event – Hopin. (session no: 5.5.3; abstract no: 0272; page 49).

Whittal, A., Atkins, L., Steinhoff, P., Ehringfeld, I., Störk, S. & Herber, O.R. (2020). Developing theory-based interventions to improve heart failure self-care adherence based on the COM-B behaviour model: the ACHIEVE study. Book of Abstract – 19th German Congress for Health Services Research (DKVF) virtual conference. DOI: 10.3205/20dkvf149.
Full abstract: https://pubmed.ncbi.nlm.nih.gov/33909892/

Whittal, A. & Herber, O.R. (2019). Developing a manual containing well-defined and theory-based behaviour change interventions for enhancing self-care of patients with heart failure. Book of Abstract – 18th German Congress for Health Services Research (DKVF), Berlin, Germany. DOI: 10.3205/19dkvf041.
Full abstract: https://www.egms.de/static/de/meetings/dkvf2019/19dkvf041.shtml

Whittal, A. & Herber, O.R. (2019). Developing a manual of behaviour change interventions for patients with heart failure (M0437). DEGAM Book of Abstracts – 53. Congress for General Practice and Family Medicine. German Medical Science Publishing House. DOI: 10.3205/19degam040.
Full abstract: https://www.egms.de/static/de/meetings/degam2019/19degam040.shtml

Herber, O.R. & Whittal, A. (2019). Developing a theory-based intervention manual to enhance self-care of patients with heart failure. Book of Abstracts – RCN International Nursing Research Conference and Exhibition 2019, Sheffield, England (session no: 1.7.3; abstract no: 0275; page 17).
Full abstract: https://www.rcn.org.uk/professional-development/research-and-innovation/research-events/rcn-2019-research-conference

Herber, O.R., Kastaun, S., Wilm, S. & Barroso, J. (2018). Von der qualitativen Metasummary zur qualitativen Metasynthese: Entwicklung einer neuen situationsspezifischen Theorie von hinderlichen und fördernden Faktoren für die Selbstpflege von Menschen mit Herzinsuffizienz. DEGAM Book of Abstracts – 52. Congress for General Practice and Family Medicine. German Medical Science Publishing House. DOI: 10.3205/18degam045. (abstract in German).
Full abstract: www.egms.de/static/en/meetings/degam2018/18degam045.shtml

Herber, O.R. (2018). From qualitative meta-summary to qualitative meta-synthesis: developing a new situation-specific theory of barriers and facilitators for self-care in heart failure patients. European Academy of Nursing Science Summer Conference 2018: Leadership in Nursing – Challenges for the Future. BMC Nursing 17 (Suppl 1):34.
Full abstract: https://bmcnurs.biomedcentral.com/track/pdf/10.1186/s12912-018-0301-3.pdf

Jones, M., Smith, K., Herber, O.R., White, M., Steele, F. & Johnston, D. (2017). Intention, beliefs and mood from weekly diaries predict attendance at cardiac rehabilitation. Book of Abstracts – RCN International Nursing Research Conference, Oxford, England (page 51).

Bradbury-Jones, C., Breckenridge, J., Clark, M., Herber, O.R., Taylor, J. & Wagstaff, C. (2017). The state of qualitative research in health and social science literature: findings from a focused mapping review and synthesis. Book of Abstracts – RCN International Nursing Research Conference, Oxford, England (page 47)

Bücker, B., Herber, O.R., Metzendorf, M.-I. & Wilm, S. (2016). Self-care at patients with heart failure – A qualitative meta-synthesis on barriers and facilitators. DEGAM Book of Abstracts – 50. Congress for General Practice and Family Medicine (page 251) (abstract in German).

Herber, O.R., Bradbury-Jones, C. & Taylor, J. (2014). Degrees of theoretical visibility in qualitative studies: development of a novel typology. Book of Abstracts - RCN International Nursing Research Conference. Royal College of Nursing: London (page 38).

Thürmann, P.A., Mülders, V., Simic, D., Herber, O.R., Schwappach, D. & Wilm, S. (2010). Focused conference group: P04 – Pharmacoepidemiology, current controversies and opportunities in patients’ preferences for written information about effects and undesirable side effects of drugs. Basic & Clinical Pharmacology & Toxicology 107(Suppl. 1) paper No. 2894.

Simic, D., Mülders, V., Herber, O.R., Wilm, S., Schwappach, D. & Thürmann, P.A. (2010). Was Patienten wissen wollen – Eine Neugestaltung der Packungsbeilage aus Patieintensicht. Zeitschrift für Allgemeinmedizin / German Journal of Family Medicine, 86(Suppl. 8), 60-61.

Thürmann, P.A., Mülders, V., Simic, D., Herber, O.R., Schwappach, D. (2010). Patients’ preferences for written information about effects and undesirable side effects of drugs. Basic & Clinical Pharmacology & Toxicology, 107 (Suppl. 1), 162–692, page 616, paper 2894.

Herber, O.R., Mülders, V., Wilm, S., Thürmann, P.A. (2009). „...es könnte sein, dass der Patient, bevor er den Packzettel zu Ende gelesen hat, verstorben ist “ – Zur Weiterentwicklung von Packungsbeilagen aus Patientensicht. Zeitschrift für Allgemeinmedizin 108, Sonderausgabe DEGAM/DKVF (Abstract WS 221).

Mülders, V., Herber, O.R., Wilm, S., Schwappach, D., Thürmann, P.A. (2009). Patients’ preferences for written information about effects and undesirable side effects of drugs. British Journal of Clinical Pharmacology 68(46) (Abstract No. 86).

Herber, O.R., Schnepp. W. & Rieger, M.A. (2008). „…seitdem ist ein heilendes Moment drin“: Die pflegerische Begleitung zur Erhöhung der Selbstpflegekompetenz von Patienten mit Ulcus cruris in Tandempraxen. Phlebologie 37(4); A46.

Rieger, M.A., Herber, O.R. & Schnepp, W. (2008). Die Tandempraxis als innovative Versorgungsform für Patienten mit Ulcus cruris. Phlebologie 37(4); A7.

Herber, O.R., Schnepp, W. & Rieger, M. (2007) Probleme bei der Rekrutierung von niedergelassenen Ärzten für eine interdisziplinäre Interventionsstudie zu Ulcus cruris, Poster 46, Prävention und Gesundheitsförderung, Suppl 1; 108-109.

Rieger, M., Vollmar, H.C., Kempkens, D., Herber, O.R., Bücker, B., Isfort, J., et al. (2007) Rekrutieren lernen: Versorgungsforschung in der Allgemeinmedizin, Poster 99, Prävention und Gesundheitsförderung, Suppl 1; 133.

Herber, O.R., Rieger, M.A. & Schnepp, W. (2006). Die Selbstpflegedefizit-Theorie als Grundlage für eine pflegerische Intervention bei hausärztlich betreuten Patienten mit Ulcus cruris venosum. Zeitschrift für Allgemeinmedizin 82; 4.

Rieger, M.A., Herber, O.R., Mayer, H., Schnepp, W., Bienstein, C. & Butzlaff, M. (2006). Patienten mit Ulcus cruris venosum zur Selbstpflege befähigen: Konzept und Durchführung einer randomisiert-kontrollierten Studie in Hausarztpraxen. Zeitschrift für Allgemeinmedizin 82; 4.