Psycho-social medicine最新文献

{"title":"Re-revisiting Andersen's Behavioral Model of Health Services Use: a systematic review of studies from 1998-2011.","authors":"Birgit Babitsch,&nbsp;Daniela Gohl,&nbsp;Thomas von Lengerke","doi":"10.3205/psm000089","DOIUrl":"https://doi.org/10.3205/psm000089","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to assess the use and implementation of the Behavioral Model of Health Services Use developed by Ronald M. Andersen in recent studies explicity using this model.</p><p><strong>Methods: </strong>A systematic search was conducted using PubMed in April 2011. The search strategy aimed to identify all articles in which the Andersen model had been applied and which had been published between 1998 and March 2011 in English or German. The search yielded a total of 328 articles. Two researchers independently reviewed the retrieved articles for possible inclusion using a three-step selection process (1. title/author, 2. abstract, 3. full text) with pre-defined inclusion and exclusion criteria for each step. 16 studies met all of the inclusion criteria and were used for analysis. A data extraction form was developed to collect information from articles on 17 categories including author, title, population description, aim of the study, methodological approach, use of the Andersen model, applied model version, and main results. The data collected were collated into six main categories and are presented accordingly.</p><p><strong>Results: </strong>Andersen's Behavioral Model (BM) has been used extensively in studies investigating the use of health services. The studies identified for this review showed that the model has been used in several areas of the health care system and in relation to very different diseases. The 1995 version of the BM was the version most frequently applied in the studies. However, the studies showed substantial differences in the variables used. The majority of the reviewed studies included age (N=15), marital status (N=13), gender/sex (N=12), education (N=11), and ethnicity (N=10) as predisposing factors and income/financial situation (N=10), health insurance (N=9), and having a usual source of care/family doctor (N=9) as enabling factors. As need factors, most of the studies included evaluated health status (N=13) and self-reported/perceived health (N=9) as well as a very wide variety of diseases. Although associations were found between the main factors examined in the studies and the utilization of health care, there was a lack of consistency in these findings. The context of the studies reviewed and the characteristics of the study populations seemed to have a strong impact on the existence, strength and direction of these associations.</p><p><strong>Conclusions: </strong>Although the frequently used BM was explicitly employed as the theoretical background for the reviewed studies, their operationalizations of the model revealed that only a small common set of variables was used and that there were huge variations in the way these variables were categorized, especially as it concerns predisposing and enabling factors. This may stem from the secondary data sets used in the majority of the studies, which limited the variables available for study. Primary studies are urgentl","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/psm000089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of social support for people with type 2 diabetes - a qualitative study with general practitioners, practice nurses and patients.","authors":"Katja Goetz,&nbsp;Joachim Szecsenyi,&nbsp;Stephen Campbell,&nbsp;Thomas Rosemann,&nbsp;Gernot Rueter,&nbsp;Elke Raum,&nbsp;Herrmann Brenner,&nbsp;Antje Miksch","doi":"10.3205/psm000080","DOIUrl":"https://doi.org/10.3205/psm000080","url":null,"abstract":"<p><strong>Objective: </strong>Social support is an important element of family medicine within a primary care setting, delivered by general practitioners and practice nurses in addition to usual clinical care. The aim of the study was to explore general practitioner's, practice nurse's and people with type 2 diabetes' views, experiences and perspectives of the importance of social support in caring for people with type 2 diabetes and their role in providing social support.</p><p><strong>Methods: </strong>Interviews with general practitioners (n=10) and focus groups with practice nurses (n=10) and people with diabetes (n=9). All data were audio-recorded, fully transcribed and thematically analysed using qualitative content analysis by Mayring.</p><p><strong>Results: </strong>All participants emphasized the importance of the concept of social support and its impacts on well-being of people with type 2 diabetes. Social support is perceived helpful for people with diabetes in order to improve diabetes control and give support for changes in lifestyle habits (physical activity and dietary changes). General practitioners identified a lack of information about facilities in the community like sports or self-help groups. Practice nurses emphasized that they need more training, such as in dietary counselling.</p><p><strong>Conclusions: </strong>Social support given by general practitioners and practice nurses plays a crucial role for people with type 2 diabetes and is an additional component of social care. However there is a need for an increased awareness by general practitioners and practice nurses about the influence social support could have on the individual's diabetes management.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/6f/PSM-09-02.PMC3413874.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30824135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body weight changes and outpatient medical care utilisation: Results of the MONICA/KORA cohorts S3/F3 and S4/F4.","authors":"Silke B Wolfenstetter,&nbsp;Petra Menn,&nbsp;Rolf Holle,&nbsp;Andreas Mielck,&nbsp;Christa Meisinger,&nbsp;Thomas von Lengerke","doi":"10.3205/psm000087","DOIUrl":"https://doi.org/10.3205/psm000087","url":null,"abstract":"<p><strong>Objectives: </strong>To test the effects of body weight maintenance, gain, and loss on health care utilisation in terms of outpatient visits to different kinds of physicians in the general adult population.</p><p><strong>Methods: </strong>Self-reported utilisation data were collected within two population-based cohorts (baseline surveys: MONICA-S3 1994/95 and KORA-S4 1999/2001; follow-ups: KORA-F3 2004/05 and KORA-F4 2006/08) in the region of Augsburg, Germany, and were pooled for present purposes. N=5,147 adults (complete cases) aged 25 to 64 years at baseline participated. Number of visits to general practitioners (GPs), internists, and other specialists as well as the total number of physician visits at follow-up were compared across 10 groups defined by body mass index (BMI) category maintenance or change. Body weight and height were measured anthropometrically. Hierarchical generalized linear regression analyses with negative binomial distribution adjusted for sex, age, socioeconomic status (SES), survey, and the need factors incident diabetes and first cancer between baseline and follow-up were conducted.</p><p><strong>Results: </strong>In fully adjusted models, compared to the group of participants that maintained normal weight from baseline to follow-up, the following groups had significantly higher GP utilisation rates: weight gain from normal weight (+36%), weight loss from preobesity (+39%), maintained preobesity (+34%), weight gain after preobesity (+43%), maintained moderate obesity (+48%), weight gain from moderate obesity (+107%), weight loss from severe obesity (+114%), and maintained severe obesity (+83%). Regarding internists, those maintaining moderate obesity reported +107% more visits; those with weight gain from moderate obesity reported +91%. The latter group also had +41% more consultations with other physicians. Across all physicians, mean number of visits were estimated at 7.8 per year for maintained normal weight, 9 for maintained preobesity, 11 for maintained moderate obesity, and 12 for maintained severe obesity. Among those with weight loss, the mean number of visits were 8.7, 10.6 and 10.8 for baseline preobesity, moderate obesity, and severe obesity, respectively. Finally, those with weight gain from normal weight and preobesity reported 9.4 and 9.3 visits, respectively, and those with baseline moderate and follow-up severe obesity reported 13.1 visits (the most overall). Women reported higher GP and other physician utilisation. While all utilisation rates increased with age, GP utilisation was lower in middle to high SES groups.</p><p><strong>Conclusion: </strong>Compared to maintained normal weight over a 7- to 10-year period, maintained overweight, weight gain and weight loss are associated with higher outpatient physician utilisation in adults, especially after baseline obesity. These effects only partly became insignificant after inclusion of incident diabetes or first cancer into the model. Future ","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc09"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/8e/PSM-09-09.PMC3488805.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific predictor analyses for the incidence of recurrent headaches in German schoolchildren.","authors":"Jennifer Gaßmann,&nbsp;Antonia Barke,&nbsp;Hester van Gessel,&nbsp;Birgit Kröner-Herwig","doi":"10.3205/psm000081","DOIUrl":"https://doi.org/10.3205/psm000081","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to identify psychosocial risk factors for the incidence of recurrent headache (HA) in children/adolescents (8-15 years).</p><p><strong>Method: </strong>In 2003 (Wave 1) a representative, population-based sample of 8800 parents was mailed a questionnaire. Those who took part were asked to participate again one year later (Wave 2). Of the parents originally contacted, 47.3% participated in both surveys. Potential risk factors concerning the areas 'school' and 'emotional and behavioural problems' were collected in Wave 1. Binary logistic regression analyses were performed to assess their predictive value for HA in Wave 2.</p><p><strong>Results: </strong>Univariable regression analyses showed that for boys and girls most of the predictor variables influenced the incidence of recurrent HA, but only to a very low extent. When all variables were assessed jointly in a multivariable model, these factors lost their predictive power for boys. For girls, 'academic problems' and 'dysfunctional stress coping' were shown to increase the chance for the incidence of recurrent HA.</p><p><strong>Discussion: </strong>In contrast to previous findings, school-related factors and emotional and behavioural problems failed to predict HA in boys, and only two factors appeared relevant with regard to girls. This might be due to the strict unidirectional design, which focussed exclusively on the incidence of HA.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc03"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/e8/PSM-09-03.PMC3413875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30824136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of sociodemographic factors on the utilisation of support services for family caregivers of elderly dependents - results from the German sample of the EUROFAMCARE study.","authors":"Daniel Lüdecke,&nbsp;Eva Mnich,&nbsp;Christopher Kofahl","doi":"10.3205/psm000084","DOIUrl":"https://doi.org/10.3205/psm000084","url":null,"abstract":"<p><strong>Objectives: </strong>As in nearly all European countries, demographic developments in Germany have led to both a relative and an absolute increase in the country's elderly population. The care and support needed by these people is primarily provided by relatives or friends and close acquaintances within the home environment. The major challenges for society are to sustain, promote and support these informal resources. In order to achieve this, it is crucial that family caregivers are provided with situation-specific services that support them and relieve their burden of care. The major challenges for society are therefore to sustain, promote and support informal resources and to provide the opportunity for the use of services aimed at assisting and relieving the burden of family caregivers.</p><p><strong>Methods: </strong>In the context of the EUROFAMCARE study, 1,003 family caregivers from Germany were interviewed at home about their experiences using a standardized questionnaire. Included in the study were primary caregivers providing at least four hours of personal care or support per week to a relative aged 65 years or older. Subjects solely providing financial support were excluded. In this paper, a linear regression analysis has been conducted to analyse impact of sociodemographic factors on the utilisation of support services.</p><p><strong>Results: </strong>The family caregivers were 54 years on average (SD=13.4), 76% of them were female. The dependent elderly were 80 years on average (SD=8.3), and 69% of them were women. 60% of them were receiving long-term care insurance benefits. Use of support services aimed directly at family caregivers is very low. After including certain services aimed primarily at those in need of care but also often serving as a source of relief for family caregivers, the percentage of caregivers using support services increased slightly. Among sociodemographic characteristics, caregivers' gender and education level have the greatest influence on services use. Other influential factors are caregivers' perception of their caregiving burden and their assessment of the dependent family member's need for assistance and support.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc06"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/3a/PSM-09-06.PMC3488802.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of social determinants on the use of prevention and health promotion services: Results of a systematic literature review.","authors":"Christian Janßen,&nbsp;Stefanie Sauter,&nbsp;Christoph Kowalski","doi":"10.3205/psm000085","DOIUrl":"10.3205/psm000085","url":null,"abstract":"<p><strong>Background: </strong>The following analysis aims to determine whether differences in the use of prevention and health promotion services in Germany can be attributed to health inequality between different social status groups measured by education, occupation and income and where certain improvements can be made in health promotion and prevention efforts and research to reduce those differences.</p><p><strong>Methods: </strong>A systematic literature search was conducted using MedPilot to identify relevant articles published between 1998 and 2010 in the Medline, Medizinische Gesundheit, CC Med, Deutsches Ärzteblatt and Sozialmedizin (SOMED) databases, the Hogrefe, Karger, Krause and Pachermegg and Thieme publisher databases, the Cochrane Database of Systematic Reviews (CDSR), the Cochrane Database of Abstracts of Reviews of Effectiveness (DARE), and the Cochrane Central Register of Controlled Trials.</p><p><strong>Results: </strong>A total of 23 empirical studies on the topic of \"prevention, health prevention and social inequality\" met the criteria for inclusion in the review. 20 of the 23 reviewed studies provided relatively clear evidence of a significant association between higher social status and greater use of prevention and health promotion services. According to the reviewed studies, gender tends to have a greater effect on the use of prevention and health promotion services than characteristics of vertical social inequality. No studies were found dealing with tertiary prevention or using qualitative methods to explore their research questions.</p><p><strong>Conclusions: </strong>Overall, the review shows that there is sufficient evidence for the relationship between social status and the use of prevention and health promotion services and that this association is both significant and relevant. There are, however, a few \"blind spots\" in research on this topic, such as a lack of studies on tertiary prevention, especially with regards to prevention and health promotion services use among men, as well as general studies on health promotion among men and women. There is also a lack of published intervention studies demonstrating how to better reach the socially disadvantaged.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/psm000085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of medical services use. How comparable are the results of large-scale population surveys in Germany?","authors":"Enno Swart","doi":"10.3205/psm000088","DOIUrl":"https://doi.org/10.3205/psm000088","url":null,"abstract":"<p><strong>Background: </strong>The large-scale representative population surveys conducted by Germany's Robert Koch Institute (RKI) contain questions pertaining to health and its determinants as well as the prevalence and frequency of outpatient services utilization. The same holds for the Socioeconomic Panel (SOEP, Sozio-ökonomisches Panel) and the Bertelsmann Healthcare Monitor (Gesundheitsmonitor) surveys. The purpose of this study is to examine the comparability of the instruments used in these surveys and their results.</p><p><strong>Methods: </strong>The questions on outpatient care utilization examined in this study were taken from the public use files of the East-West Health Survey (Ost-West Survey; OW1991), the 1998 Federal National Health Survey (Bundesgesundheitssurvey; BGS1998), the 2003 Telephone Health Survey (TEL2003), and the 2009 German Health Update (Gesundheit in Deutschland aktuell GEDA2009). The study also used data from the 26 waves of the SOEP (1984-2009) and the 16 waves of the Bertelsmann Healthcare Monitor (2001-2009) studies.</p><p><strong>Results: </strong>In the OW1991 and the BGS1998, questions on outpatient services utilization differ by the types of physicians inquired about. The four-week prevalence of contact with general practitioneers (GP) was 29% in the OW1991; the twelve-month prevalence in the BGS1998 was 69%. The OW1991 and the BGS1998 also surveyed participants on the number of physician contacts made during those reference periods (average number of contacts: 1.8 over the previous four weeks (OW1991) and 4.9 over the previous 12 months (BGS1998)). The TEL2003 inquires into the three-month prevalence of contact with private practice physicians in general (63%) as well as the number of contacts with primary care physicians over the previous twelve months (88% with at least one contact, average number of contacts: 4.6, range: 1-92). In the GEDA2009 survey, 88% of participants reported having contacted a physician at least once over the previous twelve months and an average of 6.1 contacts with all physicians working under contract with the German statutory health insurance (SHI) funds. The 2009 SOEP survey revealed a 28% three-month prevalence of contact with all types of physicians and an average of 3.6 contacts (among participants who had made at least one contact during this period). According to the Bertelsmann Health Monitor, the twelve-month prevalence of contact with GPs was 82%, with the average number of contacts being 5.0. The Bertelsmann Health Monitor also surveys participants on contacts made with four other types of physicians; the OW1991 and the BGS1998 ask about contacts made with over ten different types of physicians when examining the frequency of services use.</p><p><strong>Conclusions: </strong>Not only do the target groups of the RKI surveys, the SOEP and the Bertelsmann Health Monitor differ; their questions on outpatient care utilization also differ in terms of examined reference per","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc10"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/22/PSM-09-10.PMC3488806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of sex and gender role on responses to pressure pain.","authors":"Birgit Kröner-Herwig,&nbsp;Jennifer Gaßmann,&nbsp;Marie Tromsdorf,&nbsp;Elfi Zahrend","doi":"10.3205/psm000079","DOIUrl":"https://doi.org/10.3205/psm000079","url":null,"abstract":"<p><strong>Background: </strong>Several studies on experimental mechanical pain suggested a strong influence of sex demonstrating females to be more sensitive. We examined the hypothesis that not only sex but also gender role affects pain responsiveness and looked for mediators of this effect.</p><p><strong>Method: </strong>As indicators of pain the threshold the intensity and the unpleasantness of pressure stimuli were measured, as well as sensory and affective quality of pain. The gender role of 74 students was assessed by the Bem Sex Role Inventory (BSRI). Furthermore several psychological variables assumed to be potential mediators (catastrophising, fear of pain, depressive symptoms, pain coping) were obtained.</p><p><strong>Results: </strong>ANOVA revealed significant main effects of sex in all pain variables except affective quality of pain. Contrary to our hypothesis gender role had no influence on pain responses, neither was there an interaction of sex and gender. Fear of pain just missed the significance level identifying it as mediator of the sex effect on affective pain.</p><p><strong>Conclusions: </strong>In summary, our study corroborated previous findings that women are more responsive to mechanical pain stimuli with effect sizes being medium to large, whereas gender role did not predict any of the assessed pain parameters. No convincing evidence was found that the influence of sex is predominantly mediated by psychological characteristics of the individual.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":" ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/psm000079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40148429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of heatwave risks to health: results of an qualitative interview study with older people and their carers in Freiburg, Germany.","authors":"Martin-Immanuel Bittner,&nbsp;Ulrich Stößel","doi":"10.3205/psm000083","DOIUrl":"https://doi.org/10.3205/psm000083","url":null,"abstract":"<p><strong>Aims and objectives: </strong>Heatwaves can pose a severe threat to health, especially to older people. However, warnings do not necessarily lead to preventive action. This study aims at exploring individual risk perception and adaptive measures of older people and their carers. Their views are explored, taking into account personal backgrounds.</p><p><strong>Methods: </strong>Questionnaire-based interviews were administered to 20 men and women (64-94 years, living in their own homes or nursing homes) and 13 carers. A qualitative analysis following a framework approach was performed.</p><p><strong>Results: </strong>The majority of respondents stated that older people might be compromised by heatwaves; however, a large proportion of respondents saw themselves as less affected than the average population. Most respondents adopted preventive measures during heatwaves and a majority received warnings or pieces of information. The role of general practitioners in direct warning situations was judged controversial. Survey respondents displayed resistance to the use of technical devices to monitor potentially dangerous situations. In addition, the results support many previous findings. In particular, the relative concepts of ageing, variety of information channels used, and control orientations could be confirmed.</p><p><strong>Conclusions: </strong>General practitioners hold a position of trust and play a central role in the promotion of preventive action, but there are also limitations to their outreach. Many respondents could be classified as socially active, which has implications for preventive information campaigns. Information campaigns using different channels and targeting a larger audience should be considered. The degree of information of carers can partly be improved.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc05"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/95/PSM-09-05.PMC3474954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30990145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups.","authors":"Holm Thieme,&nbsp;Bernhard Borgetto","doi":"10.3205/psm000086","DOIUrl":"https://doi.org/10.3205/psm000086","url":null,"abstract":"<p><p>Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG.</p>","PeriodicalId":88305,"journal":{"name":"Psycho-social medicine","volume":"9 ","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/51/PSM-09-08.PMC3488804.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31034465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}