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Kuske S, Köberlein-Neu J. [Implementing systematically: To what extent can implementation science make an educational contribution to health care practice?]. Z Evid Fortbild Qual Gesundhwes 2024; 184:34-39. [PMID: 38296739 DOI: 10.1016/j.zefq.2023.11.007] [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] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/07/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Implementation science is currently struggling with the challenge to translate its findings into implementation practice in health care. Therefore, it is of interest to explore to what extent advanced trainings are relevant for health care practice to support knowledge circulation, and what needs to be considered in their design. DESIGN OF EDUCATIONAL INITIATIVES AND TRAINING Internationally, numerous initiatives have emerged in recent years to make implementation science more accessible to health care implementers. They focus, in particular, on the development of curricula for actors in health care practice and the widespread implementation of these qualification programs. In German-speaking countries, the interest in health services research is particularly evident at the level of Master's degree programs to make implementation science accessible to health care. However, these efforts need to be complemented by a participatory, needs-oriented and theory-based approach to advanced training for implementers in health care practice. This will enable the required competencies to be addressed on different levels of training and the further development of training formats. DISCUSSION Recent literature shows that implementers in German-speaking countries can benefit from a training program tailored to their needs. International experience in the field of advanced training in implementation science for health care practice allows us to derive essential components for the development of advanced training for the German-speaking region.
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Affiliation(s)
- Silke Kuske
- Fliedner Fachhochschule, Düsseldorf, Deutschland.
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Kollikowski A, Gabriel KMA, Schiffmann L, Gágyor I, Güthlin C, Heuschmann PU, Langhorst J, Keil T, Löffler C. Complementary Medicine in Acute Care Hospitals: Questionnaire Survey with Heads of Bavarian Hospitals. Complement Med Res 2023; 30:415-423. [PMID: 37673058 DOI: 10.1159/000531930] [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: 04/20/2023] [Accepted: 07/09/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION The demand for complementary medicine (CM) is well studied in the outpatient sector, but representative data on type and extent of inpatient care using CM are missing. Therefore, our aim was to examine the range of CM treatments offered and the types of indications for using CM in acute care hospitals in the German state of Bavaria. METHODS We conducted a cross-sectional questionnaire survey by contacting the medical heads of all 388 Bavarian acute care hospitals between November 2020 and April 2021. The questionnaire included a wide range of CM to assessed availability of CM supply, most frequent indications, and medical specialities. Furthermore, we assessed basic information about the hospital and the participating medical staff. RESULTS A total of 101 (26%) hospitals participated in the survey. At least one CM treatment was offered by 92% of the responding hospitals and 75% offered at least 5 therapy modalities (mean of 10 treatments, range: 0-25). These were most commonly massage therapies (68%), relaxation techniques (63%), phytotherapy (60%), mindfulness-based treatments (53%), art, diet, and exercise therapies (each 48%), aromatherapy (46%), acupuncture, and compresses/poultices (both 42%). The most reported medical conditions for CM treatments (in descending order) were chronic pain, mental disorders, degenerative affections, sleep disorders, fatigue syndrome, functional gastrointestinal disorders, and acute pain. CONCLUSION According to the Bavarian acute care hospitals that participated in our postal survey, a considerable part offered CM. Further research should include personal interviews and more detailed assessments of indications and attitudes for the use of CM in acute care hospital settings. Einleitung Die Nachfrage nach Komplementärmedizinischen Verfahren (CM) ist für den ambulanten Sektor gut untersucht, aber es fehlen Daten über Art und Umfang der komplementärmedizinischen Versorgung im stationären Bereich. Unser Ziel war es daher, das CM-Angebot und die medizinischen Indikationen in Akutkrankenhäusern im Bundesland Bayern zu untersuchen. Methoden Wir führten eine Querschnittsbefragung durch, bei der die klinischen Leitungen aller 388 bayerischen Akutkrankenhäuser zwischen November 2020 und April 2021 angeschrieben wurden. Der Fragebogen inkludierte ein breites Spektrum an CM-Verfahren und erfasste deren Verfügbarkeit, die häufigsten Indikationen und Anwendungsgebiete. Ergänzend wurden grundlegende Informationen des Krankenhauses und des medizinischen Personals erfragt. Ergebnisse Insgesamt nahmen 101 (26%) Krankenhäuser an der Befragung teil. Die meisten Ausfüllenden hatten mindestens zwei Jahrzehnte klinische Berufserfahrung. Mindestens eine CM Behandlung wurde von 92% der teilnehmenden Krankenhäuser angeboten und 75% boten mindestens 5 Therapiemodalitäten an (Mittelwert: 10 Behandlungen; Spanne: 0–25). Dabei handelte es sich am häufigsten um Massagen (68%), Entspannungstechniken (63%), Phytotherapie (60%), achtsamkeitsbasierte Behandlungen (53%), Kunst-, Ernährungs-und Bewegungstherapie (jeweils 48%), Aromatherapie (46%), Akupunktur und Kompressen/Umschläge (jeweils 42%). Die häufigsten genannten Indikationen für CM-Behandlungen waren (in absteigender Reihenfolge) chronische Schmerzen, psychische Störungen, degenerative Erkrankungen, Schlafstörungen, Erschöpfungssyndrom, funktionelle Magen-Darm-Beschwerden und akute Schmerzen. Schlussfolgerung Nach Angaben der bayerischen Akutkrankenhäuser, die an unserer postalischen Umfrage teilgenommen haben, bietet ein erheblicher Teil CM an. Weitere Untersuchungen sollten persönliche Interviews und detailliertere Bewertungen der Indikationen und Einstellungen für den Einsatz von CM in Akutkrankenhäusern umfassen.
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Affiliation(s)
- Anne Kollikowski
- Comprehensive Cancer Center, University Hospital of Würzburg, Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Katharina M A Gabriel
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Lisa Schiffmann
- Comprehensive Cancer Center, University Hospital of Würzburg, Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Ildiko Gágyor
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Corina Güthlin
- Institute of General Practice, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Jost Langhorst
- Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
| | - Thomas Keil
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Claudia Löffler
- Comprehensive Cancer Center, University Hospital of Würzburg, Würzburg, Germany
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
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Schmitz C. [What Kind of Doctors Will be Needed in the Future?]. Praxis (Bern 1994) 2023; 112:383-387. [PMID: 37282517 DOI: 10.1024/1661-8157/a004003] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
What Kind of Doctors Will be Needed in the Future? Abstract: To get a notion regarding the future of medical doctors, the changes in the health care system and in society must be considered, for only then can the future professional profile be envisaged. The following text shall illustrate why more diversity among patients and staff as well as more diverse care settings are to be expected due to the coming social developments. Consequently, the professional role of medical doctors will become more fluid and more fragmentary. Medical careers will include more role changes in the future, and the question of co-evolution in the health professions will become much more relevant. All this raises fundamental considerations regarding education and training, but also regarding one's professional identity.
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Girbig G, Biedermann T, Hertl M, Elsner P, Welzel J, Hischke S, Honak L, Augustin M. Strukturen und Leistungsmerkmale der Hautkliniken in Deutschland: Aktuelle Bestandsaufnahme und Langzeitverlauf. J Dtsch Dermatol Ges 2021; 19 Suppl 5:5-13. [PMID: 34662488 DOI: 10.1111/ddg.14618_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Gefion Girbig
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie am Biederstein, Technische Universität München, München
| | - Michael Hertl
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Marburg (UKGM), Marburg
| | - Peter Elsner
- Klinik für Dermatologie und Allergologie, Friedrich-Schiller-Universität, Jena
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Medizincampus Süd, Augsburg
| | - Sandra Hischke
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Laura Honak
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Matthias Augustin
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
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Müller H, Münch U, Bongard S, Hauch H, Sibelius U, Berthold D. [Bereavement care in Germany: Framework for a stepped care model]. Z Evid Fortbild Qual Gesundhwes 2021; 162:40-44. [PMID: 33785289 DOI: 10.1016/j.zefq.2021.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/27/2022]
Abstract
The loss of a loved one can have serious health implications. In Germany, however, bereavement care services often provide support regardless of risk or need. A structural framework within which these services are provided systematically and which enables the establishment of qualitative standards throughout Germany has not yet been proposed. A British stepped care model for professionalized bereavement support is actually being discussed internationally. In this paper the British model is adapted to the German context in order to improve nationwide bereavement care services.
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Affiliation(s)
- Heidi Müller
- Internistische Onkologie und Palliativmedizin, Medizinische Klinik V, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| | - Urs Münch
- Klinik für Allgemein- und Viszeralchirurgie, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - Stephan Bongard
- Institut für Psychologie, Goethe-Universität, Frankfurt am Main, Deutschland
| | - Holger Hauch
- Palliative Care Team für Kinder und Jugendliche Mittelhessen, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| | - Ulf Sibelius
- Internistische Onkologie und Palliativmedizin, Medizinische Klinik V, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| | - Daniel Berthold
- Internistische Onkologie und Palliativmedizin, Medizinische Klinik V, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland.
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Goetz K, Warkentin N, Weiss L, Kasprick L. "We are the patients' advocates": Care and case managers' reasons to participate in a geriatric health care project - A qualitative study. Z Evid Fortbild Qual Gesundhwes 2021; 161:28-32. [PMID: 33454231 DOI: 10.1016/j.zefq.2020.12.004] [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] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/11/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Healthcare provision for the multimorbid elderly is complex. Care and Case Managers (CCMs) can help to coordinate and structure outpatient care for these patient groups. This approach will be realized in the project RubiN ("Continuous Care in Regional Networks"), which is funded by the Federal Joint Committee. The aim of the present qualitative study was to explore the motivation to work as a CCM. METHODS As part of the qualitative study framework, semi-structured interviews with CCMs were conducted as part of a joint kick-off event. The interviews were focused on the reasons and motivation for participating in the RubiN project. The transcribed interviews were analyzed using qualitative content analysis. RESULTS Eight of 20 CCMs agreed to take part in the interviews. One of the main motivations for taking part in RubiN was to shift away from working conditions that were perceived as stressful and towards an activity that was experienced as appreciative. The CCMs felt that their professional expertise was recognized by other service providers, and that appreciation of their role increased through their active involvement in the care of geriatric patients. CONCLUSIONS Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.
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Affiliation(s)
- Katja Goetz
- Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
| | - Nicole Warkentin
- Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Fischer F, Raiber L, Boscher C, Winter MHJ. COVID-19-Schutzmaßnahmen in der stationären Altenpflege - Ein Mapping Review pflegewissenschaftlicher Publikationen. Pflege 2020; 33:199-206. [PMID: 32811330 DOI: 10.1024/1012-5302/a000745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Protective measures against COVID-19 in elderly care - A mapping review of publications in nursing science Abstract. Background: Protective measures to combat the COVID-19 pandemic are associated with isolation among people in need of elderly care. Due to the known adverse effects of social isolation on health, discussions have been held about the ethical legitimacy and commensurability of these measures. AIM The article aims to show in which format the discourse in scientific publication on protective measures against COVID-19 took place and which contents have been addressed. METHODS A mapping review in PubMed has been conducted. All publication types of scientific papers on nursing care of older people were considered. The results were synthesized in form of a quantitative content analysis of key aspects. RESULTS The 38 articles included in the synthesis show that only a small part of the scientific publications on the COVID-19 pandemic deals with people living in nursing homes. Although critical aspects related to the isolation caused by the protective measures against the COVID-19 pandemic are named in half of the contributions, specific measures to address the negative effects of the isolation are rarely mentioned. CONCLUSIONS There is a need for further activities in research and nursing practice in order to meet the demand and desiderata of those in need of care and to enable personal responsibility and self-determination even in a special situation such as the COVID-19 pandemic.
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Affiliation(s)
- Florian Fischer
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten
| | - Lea Raiber
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten
| | - Claudia Boscher
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten
| | - Maik H-J Winter
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten
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Knorr M, Beyer A, Radicke F, Thomé-Soós F, Hoffmann W, van den Berg N. [Geriatric care in rural areas: Results from two standardized surveys of care providers]. Z Evid Fortbild Qual Gesundhwes 2020; 153-154:97-103. [PMID: 32532675 DOI: 10.1016/j.zefq.2020.05.006] [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] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Due to a growing elderly population the number of age-related diseases increases and thus the need for geriatric care. In rural areas with low population density and few healthcare providers there is a risk of inadequate care. AIM OF THE STUDY The aim of our investigation was to identify gaps in care and preferred improvement approaches in rural areas from the perspective of local care providers. METHODS 1,545 healthcare providers from two rural regions were surveyed on the care situation (assessment according to the German school grading system), improvement approaches and problems (simple frequencies). The participants' answers were categorized and analyzed by their work location according to the central-place concept of high-order, middle-order and lower-order (basic) centers. RESULTS 348 healthcare providers participated (response rate: 22.5 %). The outpatient and inpatient care situation in geriatrics was rated "satisfactory" on average. Geriatric care is most often jeopardized by long waiting times for specialist treatment (71.0 %). Significant differences in the rating were found in the coverage of geriatric care by inpatient care (p=0.0018) and the accessibility of medical facilities by public transport (p=<0.001). These were better rated in the higher-order centers. The preferred approach to improve care was intersectoral networking (62.3 %) among care providers. CONCLUSIONS In rural areas, supply problems in geriatrics exist, in particular accessibility and waiting times in middle-order and basic centers. Solutions of regional, intersectoral and interprofessional care were approved by a majority of the participants.
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Affiliation(s)
- Melanie Knorr
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland.
| | - Angelika Beyer
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland.
| | - Franziska Radicke
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
| | - Friederike Thomé-Soós
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
| | - Wolfgang Hoffmann
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
| | - Neeltje van den Berg
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
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Abstract
Challenges in dementia care at home - The situation at home of a married couple Abstract. Background: People with dementia and their relatives are faced with major challenges due to complex dementia symptoms. Families need information and counselling in order to find adequate dementia care services tailored to their needs. AIM This case report's objective is to exemplify the domestic situation of a married couple who is faced with significant challenges within the family and the care system due to the husband's dementia and Parkinson's disease. METHODS The Dementia Care Nurse project included case monitoring; by means of different assessments relevant information was recorded and the family's situation described. RESULTS The family's problems and their need for support were multifaceted and entailed reimbursement of costs, application for care services as well as management of challenging behaviours and reduction of the caregiver's psychosocial burden. CONCLUSIONS The family, particularly the spouse caregiver, was effectively supported in meeting the challenges of dementia, e. g. by drawing on professional services and sorting out entitlement to benefits. From the perspective of the experience in the project, independent counselling structures such as a case management approach are indispenable in order to stabilise the domestic situation.
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Affiliation(s)
- Manuela Grünzig
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
| | - Christine Schiller
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
| | - Thomas Klatt
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
| | - Gabriele Meyer
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
| | - Stephanie Heinrich
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
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Kaess M, Herpertz SC, Plener PL, Schmahl C. [Borderline Personality Disorders]. Z Kinder Jugendpsychiatr Psychother 2019; 48:1-5. [PMID: 31755846 DOI: 10.1024/1422-4917/a000700] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Borderline Personality Disorders Abstract. Within the framework of the German task force "Transitional Psychiatry" (DGKJP and DGPPN), a group of experts discussed the significance of adolescence for the mental healthcare of Borderline Personality Disorder (BPD) in Germany. They identified particular gaps and problems within the following areas: early detection, access to specific outpatient psychotherapy, prolonged inpatient treatment, and polypharmacy. The authors then describe various recommendations and demands regarding the generation and dissemination of knowledge about BPD as well as potential adaptations within the German healthcare system.
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Affiliation(s)
- Michael Kaess
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz.,Sektion für Translationale Psychobiologie in der Kinder- und Jugendpsychiatrie, Klinik für Kinder- und Jugendpsychiatrie, Zentrum für psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Sabine C Herpertz
- Klinik für allgemeine Psychiatrie, Zentrum für psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Paul L Plener
- Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Wien, Österreich/Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Ulm, Ulm, Deutschland
| | - Christian Schmahl
- Klinik für Psychosomatik, Zentralinstitut für Seelische Gesundheit, Mannheim, Deutschland
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Rücker S, Büttner P, Lambertz B, Karpinski N, Petermann F. [Resilient or Risk Group? Psychological Burden at Unaccompanied Refugee Minors (URM) in Germany]. Prax Kinderpsychol Kinderpsychiatr 2017; 66:242-58. [PMID: 28393649 DOI: 10.13109/prkk.2017.66.4.242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Resilient or Risk Group? Psychological Burden at Unaccompanied Refugee Minors (URM) in Germany Unaccompanied minors (umA in German) are considered as a risk group for psychological disorders. In international studies a high prevalence for trauma, anxiety, and depression were reported. A sample of N = 52 unaccompanied minors living in Germany was questioned on symptom severity as well as stress experience with the Refugee Health Screening-15. More than each second unaccompanied minor shows clinically relevant symptom severity and stress experience. In age-specific analyses the highest stress levels were found among the youngest unaccompanied minors. Therefore, specifically adapted settings for care should be applied for this high-risk group.
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Bruggmann P. [Gaps in Hepatitis C Care of People Who Use Drugs]. Praxis (Bern 1994) 2017; 106:359-363. [PMID: 28357908 DOI: 10.1024/1661-8157/a002629] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Drogenkonsumierende sind mit einer Prävalenz von 56 % die grösste Hepatitis-C-Risikogruppe in der Schweiz. Ihre ungenügende Versorgungssituation stellt ein ernsthaftes Problem für die öffentliche Gesundheit dar, einerseits durch die Weiterverbreitung des Virus und anderseits durch die Folgeerkrankungen der Infektion mit den entsprechenden Kosten. Es sind neue Ansätze gefragt in der Hepatitis-C-Versorgung bei Drogenkonsumierenden. Eine Suchterkrankung und auch Hepatitis C sind chronische Leiden, die häufig von weiteren chronischen Krankheiten begleitet werden. Sie bedürfen einer integrierten multidisziplinären Versorgung. Mit einer Einbindung der Hepatitis-C-Versorgung in das medizinische Grundversorgungssetting können bislang unerreichte Patientengruppen behandelt werden. Die aktuelle Entwicklung in der HCV-Therapie, weg von anspruchsvollen interferonbasierten Behandlungsschemata und hin zu einfachen Kombinationstherapien, unterstützt die Versorgung dieser Risikogruppe.
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Affiliation(s)
- Philip Bruggmann
- 1 Arud Zentren für Suchtmedizin, Zürich
- 2 Institut für Hausarztmedizin, Universität Zürich
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Abstract
Zusammenfassung. In der Schweiz sterben jährlich mehr Personen an den Folgen von Hepatitis C als an jenen von HIV. Schätzungsweise 83 000 Menschen sind mit dem Hepatitis-C-Virus infiziert. Mehr als die Hälfte von ihnen ist nicht getestet und hat somit keine Chance, von den neuen, hochwirksamen Hepatitis-C-Medikamenten zu profitieren. Mit einer Heilung dieser systemischen Infektionskrankheit, die mit den neuen Medikamenten in über 90 % der Fälle erreicht werden kann, kann sowohl die leberbedingte als auch die extrahepatische Morbidität und Mortalität stark gesenkt werden. Mit der Vision der Elimination von Hepatitis C bis 2030 plant und implementiert die Schweizerische Hepatitis-Strategie Massnahmen auf allen Ebenen zur Bekämpfung dieser folgenschweren Epidemie.
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