Gesundheitswesen最新文献

{"title":"[Patient and population participation in the healthcare system: On the (im)possibility of a comprehensive survey].","authors":"Daniela Rojatz, Anna-Kristina Wahl","doi":"10.1055/a-2606-2053","DOIUrl":"https://doi.org/10.1055/a-2606-2053","url":null,"abstract":"<p><p>In its resolution on social participation, the World Health Assembly called on member states to involve patients and the population in decision-making processes in the healthcare system. Furthermore, the resolution calls for the monitoring of participation processes. The survey of examples of participation in the context of health, which was carried out in 2023, comes closest to such monitoring for Austria. The article summarises lessons learned from the survey.The learning experiences are based on the analysis of process-produced data from a questionnaire survey on examples of patient and population participation in the healthcare system commissioned by the Federal Ministry of Social Affairs, Health, Care and Consumer Protection in Austria. Data included were pretest results, workshop protocols to reflect on the survey instrument and results as well as limitations in the survey report. The contents of the documents included were paraphrased and analysed thematically.The results of the questionnaire survey showed that central to the planning and implementation of a survey were (1) the objective of the survey, including clarification of the objective and the areas to be covered, (2) the target group, including clarification of the target group and requirements adapted to it, and (3) reaching the target group, including motivators, choice of words and dissemination channels. The learning experiences were summarised in ten key questions for the development of similar survey instruments.A survey of examples of participation is possible and provides an overview of which groups are involved in which areas and how. Without concrete specifications as to which groups should be involved, the survey remains exploratory and does not allow any conclusions to be drawn about representativeness. The design of the survey is also caught between breadth (short questionnaire with potentially high response rate) and depth (long questionnaire with lower response rate). The checklist presented here is intended to support similar surveys. Without an orientation framework as to where participation should take place and who acts as the contact person for these processes, such surveys remain exploratory.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentor, driving force and companion for healthcare research.","authors":"Thomas Bierbaum, Martin Härter, Wolfgang Hoffmann, Jochen Schmitt","doi":"10.1055/a-2597-5739","DOIUrl":"https://doi.org/10.1055/a-2597-5739","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Psychiatry Enquiry and its Impact as Reflected in Oral History Interviews].","authors":"Felicitas Söhner, Heiner Fangerau","doi":"10.1055/a-2592-5912","DOIUrl":"10.1055/a-2592-5912","url":null,"abstract":"<p><p>This article examines the impact of the 1975 expert report on psychiatric care in Germany (Psychiatry Enquete) through the analysis of oral history interviews. From the memories of contemporary witnesses, we reconstruct their perspectives on the reform process surrounding the Psychiatry Enquete and its effects. Our aim is to contribute to a nuanced understanding of the Enquete and its complex effects on psychiatric practice and reform dynamics.This article analyses participants' perceptions and patterns of interpretation through 28 interviews with those involved in post-war psychiatry. A secondary analysis of the interviews allows aspects of the Enquête that have not been adequately addressed to be captured and new research perspectives to be developed, taking into account ethical and data protection standards.There was a tension between the effects of the Enquete documented in the literature and the memories of the contemporary witnesses. On the one hand, the memoirs emphasised the Enquete as a significant turning point in the reform process of psychiatry, while on the other hand, in retrospect, other voices criticised shortcomings in the implementation of the Enquete and the reforms that followed. These included inadequate representation of certain stakeholder groups and a lack of historical reflection.Although the interviews do not specifically address the impact of the Enquete, they do demonstrate its lasting influence on institutional and personal developments. In retrospect, the Enquete as a central reform step in West Germany is also integrated into the professional thinking and self-image of the interviewees in the sense of a narrative of progress.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"474-483"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[WHO clinical practice guidelines for influenza: an update].","authors":"Jana Meixner, Barbara Nußbaumer-Streit, Isolde Sommer","doi":"10.1055/a-2571-3357","DOIUrl":"10.1055/a-2571-3357","url":null,"abstract":"<p><p>Every year, more than one billion people around the world are infected with influenza, an acute infection of the respiratory tract. Influenza spreads from person to person through air, contaminated hands or objects. Antiviral and immunomodulatory drugs are available for treatment of patients and prophylaxis of exposed persons. Reverse transcription polymerase chain reaction (RT-PCR), nucleic acid amplification tests (NAATs) and rapid tests are available for the diagnosis of influenza. Objective The aim of this World Health Organization (WHO) guideline is to provide recommendations for the diagnosis, drug treatment and prophylaxis of influenza.This updated guideline has been developed in accordance with standards for trustworthy guidelines. The recommendations are based on systematic reviews on safety and effectiveness. They take into account the magnitude of benefits and harms of treatments, the reliability of the evidence, and the needs of patients and healthcare professionals.For non-severe influenza, there is a conditional recommendation to use baloxavir if the risk of severe illness is high. Antivirals are not recommended if the risk is low. There is also a strong recommendation against the use of antibiotics if bacterial co-infection is unlikely. Oseltamivir is conditionally recommended for severe influenza. Not recommended are peramivir and zanamivir, as well as macrolide antibiotics (in the absence of co-infection), mTOR inhibitors and plasma therapy, and corticosteroids. Baloxavir and oseltamivir are conditionally recommended for prophylaxis in asymptomatic persons who have been exposed to seasonal influenza viruses and would be at very high risk of becoming hospitalised. For zoonotic influenza, laninamivir and zanamivir are also conditionally recommended in addition to baloxavir and oseltamivir, regardless of individual risk. For diagnosis, the use of NAAT or digital immunoassay (DIA) for suspected non-severe influenza and nucleic acid amplification test (NAAT) for suspected severe influenza is recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"484-486"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Care dynamics of \"Free & Open Air\" Music Festivals in Rural Communities using the example of the Pol'and Rock Festival: an epidemiological, retrospective study 2017-2022].","authors":"Philipp Humbsch, Maja Studzinska, Izabela Jastrzebska, Robert Gintrowicz","doi":"10.1055/a-2422-4252","DOIUrl":"10.1055/a-2422-4252","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of the epidemiology of illnesses at music festivals is limited. Music festivals challenge the medical staff and local communities providing healthcare services to the guests. Objective The aim of this study was to identify and compare reasons for medical treatment of visitors at festivals, PPTT (patients per ten thousand), TTRH (transport to hospital rates) and the time of day when treatment was carried out at one of the largest free-of-charge outdoor music festivals in Europe from 2017 to 2022. The goal was to identify the characteristics of such events.</p><p><strong>Methods: </strong>The retrospective study used data from the medical documentation provided by the organizer of the \"Pol'and Rock\" festival in Poland. The correlations between PPTT, TTHR, visitor count, patient count, and time of day were examined. Important features in the organization of medical support were described.</p><p><strong>Results: </strong>There had been 1.48 million visitors at the festival since 2017 to 2022, and 6,719 needed medical care. There were two peaks in patient count, one from 12-2 pm and another from 8-10 pm (p<0.0001). The median PPTH was 45, and the median TTRH was 0.0638.</p><p><strong>Conclusion: </strong>There is no significant correlation between PPTT, TTRH, and the number of visitors during the study period at the events. The time of day has a significant impact on patient count. Long transportation distances from the festival grounds to the nearest hospital make it important to provide on-site high-quality care. Further investigations on the epidemiology of music festivals are necessary.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"487-496"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irren ist menschlich – 50 Jahre Psychiatrie-Enquete.","authors":"Helmut Brand, Manfred Wildner","doi":"10.1055/a-2588-8200","DOIUrl":"https://doi.org/10.1055/a-2588-8200","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"87 7","pages":"451-453"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishing psychiatry as a field of municipal policy].","authors":"Matthias Albers","doi":"10.1055/a-2541-9762","DOIUrl":"10.1055/a-2541-9762","url":null,"abstract":"<p><p>How did psychiatry develop as a field of municipal politics in Germany? Decisive prerequisites for this can be found in the reform psychiatry of the early 20th century, but above all in the socio-medical reform movement of the Weimar period, when municipal health authorities set up counselling and support services for mentally ill people. These were instrumentalised by National Socialism for its racist extermination programme, and it was not until the psychiatric reform that began in the 1970s that these approaches were taken up again. The far-reaching responsibilities of the municipal authorities, which had already been established in the Weimar period, supported the resurgence of an active organisation of the local psychiatric care system by the municipal health authorities. With its own social psychiatric services, the task of coordinating psychiatry and structures such as psychosocial working groups, health conferences and community psychiatric associations, psychiatry has become a field of active municipal policy with the goal of an inclusive society.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"460-466"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[History of ideas and psychiatric reform: Italy, Great Britain and Germany].","authors":"Thomas Becker, Stefan Weinmann, Uta Gühne","doi":"10.1055/a-2560-1372","DOIUrl":"10.1055/a-2560-1372","url":null,"abstract":"<p><p>Ideas and societal structure interact. This paper focuses on relationships between the history of ideas and mental health reform in Italy, Great Britain and Germany. The Italian reform process is based on the ideas of Jean-Paul Sartre, Michel Foucault, phenomenology and Antonio Gramsci, with issues of human rights and social inclusion taking central stage; diagnostic concepts are (temporarily) put in brackets. In Great Britain, there is a strong tradition of empiricism coupled with Erving Goffman's institutional critique and analysis, evangelical (and Quaker) traditions of 'pauper and lunacy' politics, and high-quality evaluation of services. In (the Federal Republic of) Germany, Foucault, Goffman, anthropological-phenomenological psychiatry and international impulses are relevant. With its radical institutional critique and transformation towards comprehensive community care (in the face of tight finances), Italy's mental health reforms are impressive. In Great Britain there is a long-term orientation towards community mental health care, evidence-based services and a focus on patient rights (mixed with neoliberal elements in recent decades). In Germany, mental hospital reform was carried out based on the recommendations of a national Psychiatric Enquiry (White Paper, Psychiatrie-Enquête, 1975) but large psychiatric institutions are not closed, community psychiatric transformation is delayed. There is a recent surge of integrated care models with flexibility of care provision across the inpatient-community divide.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"454-459"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fifty years of psychiatric reform in Germany: East and West].","authors":"Dyrk Zedlick, Jörg Holke, Matthias Rosemann, Klaus Obert","doi":"10.1055/a-2549-0658","DOIUrl":"10.1055/a-2549-0658","url":null,"abstract":"<p><p>The development of psychiatric reform in Germany over the last 50 years has been characterized by a heterogeneity that should not be underestimated, as can also be observed in other European countries. The fact that the reform process in both the \"old\" Federal Republic of Germany and the former German Democratic Republic began quite belatedly was also due to the consequences of \"euthanasia\" during the National Socialist era and the delayed social and professional reappraisal of euthanasia. This article traces the major lines of development of the reform and outlines some of the current challenges in mental health services, especially community psychiatry.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"467-473"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Legal requirements for information and their influence on patient satisfaction].","authors":"Wolfgang Briegel, Pilar Lopez de Miguel","doi":"10.1055/a-2493-4143","DOIUrl":"10.1055/a-2493-4143","url":null,"abstract":"<p><p>The German Patientenrechtegesetz defines, among other things, medical obligations in connection with the provision of information. To date, the extent to which these legal requirements also influence patient satisfaction with information has not been investigated in Germany.The study employed an anonymized patient survey on satisfaction with information, which was recorded using a validated 10-item questionnaire.189 consultations (n=105 female, n=84 male patients) were included in the analysis. 87.8% (n=166) of the patients were undergoing inpatient treatment, 12.2% (n=23) were treated as outpatients. The patients were on average 53.2 years old (standard deviation: 20.3 years, range: 15 to 97 years) and were distributed across the following treatment areas: Anesthesia: n=68; Surgery: n=60; Internal Medicine: n=56; Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy: n=5 patients. Overall, there was a high level of satisfaction with the information provided, which did not differ significantly between the genders. However, patients were more satisfied if they were informed by doctors with German as their mother tongue (p=0.005; d=0.214) or by specialists (p<0.001; d=0.288). The duration of the consultation was significantly positively correlated with patient satisfaction (p=0.002, r=0.211). It was also shown that the physician's level of training (specialist: yes/no) was the most important factor (adjusted odds ratio: 4.48).The requirements of the Patientenrechtegesetz with regard to the comprehensibility and thoroughness of the information conveyed, as well as the proficiency of the medical practitioner, have been demonstrated to foster patient satisfaction. It is thus imperative that sufficient professional competence is always ensured. For medical practitioners whose native language is not German, the utilization of translation programs, pictorial or video-based supplementary materials is recommended to facilitate comprehension and minimize any potential language barriers. Moreover, the duration of the consultation should be tailored to the specific needs of the individual patient in order to optimize satisfaction. In order to achieve this, it would be prudent to ascertain from patients in advance the level of detail they would prefer the consultation to encompass.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"497-500"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}