Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[Coding of child abuse and neglect in hospitals in Germany: overview and classification of administrative data].","authors":"Teresa Walter, Jörg M Fegert, Andreas Jud","doi":"10.1007/s00103-024-04002-4","DOIUrl":"10.1007/s00103-024-04002-4","url":null,"abstract":"<p><strong>Background: </strong>Child maltreatment is a significant problem in Germany. Hospital data on child maltreatment serve as a crucial foundation for planning effective prevention measures. These data enable an assessment of the extent to which at-risk children and adolescents are identified, supported, and protected. A systematic evaluation and classification of all hospital data relevant to child maltreatment in Germany is still lacking. Therefore, the aim of this article is to gain an overview of the data in this field and thus bridge the gap.</p><p><strong>Methods: </strong>Descriptive analyses of (partially) inpatient data on child abuse and neglect (secondary diagnosis in ICD-10: T74.0, T74.1, T74.2, T74.3, T74.8, T74.9) + (procedure OPS: 1‑945.0, 1‑945.1) from the 2019-2023 data collection period. The variables age, gender, and main diagnoses relevant to maltreatment are considered in each case. The data were analyzed via the publicly accessible data browser of the Institute for the Hospital Remuneration System (InEK).</p><p><strong>Results: </strong>The number of diagnosed cases of child maltreatment of (partially) inpatients is detached from prevalence rates in the population; in consequence, there is a significant underreporting of all forms of maltreatment, with boys and girls being recognized differently for different forms of maltreatment. In addition, the frequent lack of a link between child maltreatment-related diagnoses and procedures performed becomes apparent.</p><p><strong>Conclusion: </strong>In addition to raising awareness, training, and further education of healthcare professionals, there is also a need for investment in political change.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"150-159"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dealing with assisted suicide-knowledge, attitudes and experiences of members of the German Association for Palliative Medicine].","authors":"Jacqueline Schwartz, Yann-Nicolas Batzler, Manuela Schallenburger, Alexandra Scherg, Jonas Jansen, Stefan Meier, Remo Küppers, Heiner Melching, Ulrich Grabenhorst, Wiebke Nehls, Claudia Bausewein, Martin Neukirchen","doi":"10.1007/s00103-024-03960-z","DOIUrl":"10.1007/s00103-024-03960-z","url":null,"abstract":"<p><strong>Background: </strong>In February 2020, the Federal Constitutional Court declared § 217 of the German Criminal Code void. Ever since, assisted suicide services have been legal in Germany. This study aims to describe the knowledge, attitudes and experiences of members of the German Association for Palliative Medicine (DGP) regarding assisted suicide.</p><p><strong>Methods: </strong>Online survey with members of the DGP from July to September 2023 using Qualtrics®. The study group developed the questionnaire based on current literature; it was adapted following an initial application among young physicians and an interprofessional panel of experts with consensus voting. Data was analysed using descriptive and explorative statistics.</p><p><strong>Results: </strong>991 DGP-members (18%) participated, of which physicians made up 57.0% (n = 545/957) and nurses 23.4% (n = 224/957). Of the participants, 197/851 (23.1%) incorrectly stated that assisted suicide is prohibited by professional code, 430/914 (47.1%) rejected a restriction of palliative care teams to suicide prevention measures, and 766/930 (82.4%) rejected personal involvement in assisted suicide regardless of a patient's health status. For patients in palliative situations, 473/926 (51.1%) could imagine participating in assisted suicide, and 71% wanted new legislation regulating assisted suicide.</p><p><strong>Conclusion: </strong>There are gaps in the knowledge of the participating members of the DGP regarding the legal and professional status of assisted suicide. Further educational work is needed in this regard. The participants can more easily imagine assisted suicide for people in palliative disease trajectories. As in surveys of members of other medical societies, the attitudes of more experienced staff are reflected. Compared to younger healthcare professionals, they have a more restrictive attitude towards the concept of assisted suicide.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"141-149"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Barriers to accessing abortion care: an analysis from the perspective of unintended pregnant women-findings from the ELSA study].","authors":"Daphne Hahn, Rona Torenz, Ines Thonke, Sarah Eckardt, Maria Schneider, Anke Wyrobisch-Krüger, Ulrike Busch, Cornelia Helfferich, Tilmann Knittel, Maika Böhm, Petra Brzank, Christine Knaevelsrud, Silvia Krumm, Sarah Schumacher","doi":"10.1007/s00103-024-03987-2","DOIUrl":"10.1007/s00103-024-03987-2","url":null,"abstract":"<p><strong>Introduction: </strong>Barriers to accessing abortion care can delay access to services, which can lead to delayed abortion and health risks. Barriers include geographical accessibility, confidentiality, waiting times, stigmatization, poor or inaccessible information and the cost of abortion. This article examines barriers to accessing abortion care in Germany. This includes barriers in the availability and accessibility of care services, access to information, costs associated with abortion and organisational barriers.</p><p><strong>Methods: </strong>The analyses are based on data from an online cross-sectional survey of 594 women in Germany who had an unwanted pregnancy terminated, which was conducted as part of the ELSA Study in 2021 and 2022.</p><p><strong>Results: </strong>The findings indicate that access to abortion care in Germany is associated with various barriers for many women. Of the respondents, 80.1% reported at least one barrier to accessing abortion, 65.5% reported more than two barriers and 40.5% reported three or more barriers. In particular, the non-disclosure of the procedure and the associated fear of stigmatisation represented hurdles for many participants.</p><p><strong>Discussion and conclusion: </strong>The results of the study underline the need to improve access to safe abortions. Reducing access barriers therefore includes the decriminalisation of abortion, a comprehensive care structure, financial support services, improved information services and the reduction of stigmatisation and discrimination.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"28-37"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Abortions in Germany-results of federal statistics].","authors":"Heiko Pfaff","doi":"10.1007/s00103-024-03994-3","DOIUrl":"10.1007/s00103-024-03994-3","url":null,"abstract":"<p><p>After a decline in the number of annual abortions from around 130,000 in the years 1996 to 2004 to around 100,000 since 2013/14, there was recently a certain increase again to 106,000 abortions in 2023. The decline from 2004 to 2013 was driven by a decrease in the number of women of childbearing age and a lower probability of having an abortion in the key age groups. When comparing the result structures over time, the constant development towards the use of Mifegyne® is noticeable. Regarding the duration of the terminated pregnancy, the proportion of early abortions has increased in recent years.There are differences in structures between the federal states. The probability of an abortion by age is relatively low in the south of the Republic but is above average in the city states and the new federal states. Further differences between the federal states can be identified with regard to the type of intervention used or the provider. The proportion of abortions carried out in another federal state also varies. The number of reporting healthcare providers can offer basic statistical information. Legal developments have been initiated, primarily for improved regionalization of data-while respecting statistical confidentiality.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"3-10"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Innovation in abortion care during the COVID-19 pandemic in Germany, France and Great Britain : Paths to maintaining access and building system resilience].","authors":"Céline Miani, Jana Niemann","doi":"10.1007/s00103-024-03995-2","DOIUrl":"10.1007/s00103-024-03995-2","url":null,"abstract":"<p><p>The COVID-19 pandemic has had a drastic impact on healthcare systems. They had to react, adapt and innovate in order to build resilience, that is maintain healthcare access and health equity. For example, access to abortion services during the pandemic was increasingly facilitated through \"Telehealth for Early Medical Abortion\" (TEMA).This narrative review article compares Germany, France and Great Britain in terms of abortion numbers, methods and settings from 2018 to 2023. Changes in the availability of services and legislation during the pandemic are presented, and the differences between the countries, as well as various innovation factors, are discussed. We used national statistics and conducted a literature and online search (Rapid Review).In the three countries, there are differences in abortion rates, the share of medical abortions and the impact of the pandemic. In France and Great Britain, where medical abortion is the main method of abortion and where abortion care was more accessible before the pandemic than in Germany, a series of innovations were officially introduced to facilitate access during the pandemic. They included teleconsultations and the mailing of abortion medication. Most changes have been sustained since then, contributing to addressing historic and systemic health inequities in terms of access. In Germany, innovations during the pandemic have been crafted mainly by civil society organisations, offering for the first time teleabortion services.The COVID-19 pandemic provoked or accelerated innovation in terms of abortion care in France, Germany and Great Britain. The sustainability and scaling-up of those innovations remain fragile, especially in Germany, where the disruptive approach of civil society organisations has not yet found its way into mainstream healthcare services.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"53-61"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Mitteilungen des Arbeitskreises Blut des Bundesministeriums für Gesundheit.","authors":"Ruth Offergeld","doi":"10.1007/s00103-024-03966-7","DOIUrl":"10.1007/s00103-024-03966-7","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"114"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562647","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":"[Guideline project termination of pregnancy in the first trimester].","authors":"Anton Scharl, Stefanie Wallwiener","doi":"10.1007/s00103-024-03988-1","DOIUrl":"10.1007/s00103-024-03988-1","url":null,"abstract":"<p><p>The termination of a pregnancy in the first trimester is regulated by law. Guidelines serve the purpose of presenting the current state of medical science in order to enable the best possible care. S3 guidelines represent the highest level of guideline development and contain all elements of systematic development, including systematic research, evaluation of the evidence, and structured consensus-building using formal technology. The existing S2k guideline is to be raised to an S3 level. For this purpose, the Institute for Quality and Efficiency in Health Care (IQWiG) conducted an evidence search on eight central questions. The result showed a predominantly very poor level of evidence. The article describes the development of the S3 guideline and the existing problems and limitations.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"62-68"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766567","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":"Tätigkeitsbericht der Zentralen Ethik-Kommission für Stammzellenforschung (ZES) : 21. Bericht nach Inkrafttreten des Stammzellgesetzes (StZG) für den Zeitraum vom 01.01.2023 bis 31.12.2023.","authors":"","doi":"10.1007/s00103-024-03971-w","DOIUrl":"10.1007/s00103-024-03971-w","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"105-113"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521092","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":"[Methods to quit smoking-a quantitative online survey on facilitators and barriers (RauS-study)].","authors":"Bernd Werse, Larissa Steimle, Heino Stöver","doi":"10.1007/s00103-024-03970-x","DOIUrl":"10.1007/s00103-024-03970-x","url":null,"abstract":"<p><strong>Background: </strong>Smoking is still the largest preventable health risk in Germany, which is why a higher success rate in smoking cessation would benefit both public and individual health. In order to achieve this, a better understanding of the smoking cessation methods used and the factors that facilitate and prevent smoking cessation is required. The RauS study therefore aimed to investigate which methods have been used in attempts to stop smoking, how successful these methods have been, and which factors have been perceived as helping or hindering smoking cessation.</p><p><strong>Methods: </strong>From March to December 2022 a quantitative online survey was conducted among current or former smokers over 14 years of age (N = 6192).</p><p><strong>Results: </strong>Of the sample, 93% have tried to quit smoking at least once. In general, for the respondents who did or did not use e‑cigarettes/tobacco heaters, \"personal willpower\" was the most frequently used and perceived as the most helpful method. Among people who have used e‑cigarettes/tobacco heaters to quit smoking, e‑cigarettes with nicotine were used most frequently and were rated as the most helpful. Potential or concrete health consequences were most likely to be perceived as motivating. Rituals associated with smoking were the main barrier to quit smoking, while withdrawal symptoms played a much smaller role.</p><p><strong>Discussion: </strong>Overall, the results show that the focus on \"nicotine addiction\" in smoking cessation should be reconsidered, and social and ritual dimensions should be addressed more strongly. For at least some of those affected, e‑cigarettes may be a helpful method of reducing harm and/or quitting smoking.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"88-96"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Understanding vaccination behavior of healthcare workers in German hospitals-results from the OKaPII study].","authors":"Elisa Wulkotte, Nora Katharina Schmid-Küpke","doi":"10.1007/s00103-024-03982-7","DOIUrl":"10.1007/s00103-024-03982-7","url":null,"abstract":"<p><strong>Background: </strong>Influenza vaccination coverage in Germany is generally low. Even in hospitals, the demand for influenza vaccination is lacking although it has the potential to prevent the spread of the influenza virus and diseases. To take effective actions, a deeper understanding of vaccination behavior of healthcare workers is crucial.</p><p><strong>Methods: </strong>OKaPII is an annual German-wide online survey of clinical staff on influenza vaccination. Differences in vaccination behavior were tested for occupation, sex, and age, and differences in knowledge were tested between physicians and nurses. We used logistic regressions to analyze associations between psychological determinants and vaccination behavior among physicians and nursing staff.</p><p><strong>Results: </strong>From 115 clinics, 15,312 employees participated in the survey (17 April to 15 May 2023). In the 2022/23 season, 58.7% of the participants were vaccinated against influenza. The vaccination coverage was 80.7% for physicians and 51.1% for nursing staff . The vaccination behavior of physicians and nursing staff was significantly associated with collective responsibility and confidence in vaccination safety. Of the knowledge items, 87.2% were answered correctly by physicians and 62% by nursing staff.</p><p><strong>Discussion: </strong>We identified significant differences in vaccine uptake between occupational groups in German hospitals. Low vaccination coverage has existed for years, especially among nursing staff. Tailored interventions should promote the idea of protecting vulnerable people and confidence in the safety of vaccination. Increased education, especially on vaccination safety issues, can have a positive impact on the decision to vaccinate. Possibilities to get vaccinated despite time constraints in the workplace should be provided.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"79-87"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}