It is always gratifying when a doctoral thesis is not only scientifically significant but also has practical relevance, thus gaining the opportunity to be published in more than just the required number of copies. The supervisors and reviewers of this work – none of whom, to clarify, are related to the author – are also pleased to have been asked to provide a brief foreword for the publication of this dissertation. In the field of nursing, developments and efforts often stand in contrast to each other: demographic change, along with medical advancements and rising expectations, leads to increased nursing costs. This, combined with a growing tendency towards economically rational considerations of social and charitable aspects, poses challenges.