Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[The progress of participation research. A sociological analysis of its institutionalization].","authors":"Markus Schäfers, Gudrun Wansing","doi":"10.1007/s00103-026-04275-x","DOIUrl":"10.1007/s00103-026-04275-x","url":null,"abstract":"<p><p>Participation research has emerged as an interdisciplinary field of research that focuses on the social participation of people with disabilities. More than a decade after its founding and initial phase, the question arises as to the current state of its development. This article examines the progress of participation research from a sociological perspective and reconstructs it as a process of progressive institutionalization. The analysis of structural, social, epistemic, and sociopolitical aspects paints an ambivalent picture. In particular, the network formation and the emergence of a transdisciplinary epistemic culture point to significant progress in institutionalization. Furthermore, the field of research has high political relevance. However, the structural anchoring of participation research within the academic system has so far been only modest.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"866-872"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395976","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":"[The role of medical care centres in outpatient healthcare for adults with disabilities-a qualitative case study of two medical care centres].","authors":"Thorsten Meyer-Feil, Jana Stucke, Cornelia Weiß","doi":"10.1007/s00103-026-04265-z","DOIUrl":"10.1007/s00103-026-04265-z","url":null,"abstract":"<p><strong>Introduction: </strong>Since 2015, German social law has facilitated the founding of outpatient healthcare centres for adults with intellectual and multiple disabilities (MZEBs). MZEBs have emerged in a field characterized by tension between the need for an inclusive regular healthcare, which should be open to everyone, and special needs that must be provided in specialised centres. The target groups of MZEBs are still equivocal. One central aim of the research project called MeZEB funded by the German innovation fund was to get a better understanding of the role MZEBs play in healthcare based on daily care practice.</p><p><strong>Methods: </strong>Qualitative comparative case study of two MZEBs from 2019-2022 with a mixed-methods design and a qualitative main study, including open interviews at two timepoints with persons with disability or with their relatives or professional caregivers. Participatory observation of practice, focus groups with the MZEB team and expert interviews were also completed.</p><p><strong>Results: </strong>Users had high expectations of MZEBs due to negative experiences in outpatient standard care. Use of MZEBs showed substantial variation-from single consultations to long-term continuous use. MZEBs play an important role in providing access to special therapies and medical aids through interdisciplinary counselling and socio-medical diagnostics and assessment. MZEBs offered relief in terms of time, organisation and emotion and had the potential to improve individual care. At the same time, there are indications of ambivalent attitudes towards MZEBs as well as further unserved needs.</p><p><strong>Discussion: </strong>The examined MZEBs differed fundamentally in terms of their task profile and approach to care. Therefore, it follows that patients and their relatives are unclear of what services can be expected from an MZEB. The option of being able to treat patients themselves and having a stronger focus on regional care needs and closer cooperation between MZEBs seem sensible.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"936-944"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435215","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":"[Participation of people with disabilities in the labour market: facilitators and barriers from a legal perspective].","authors":"Felix Welti","doi":"10.1007/s00103-026-04267-x","DOIUrl":"10.1007/s00103-026-04267-x","url":null,"abstract":"<p><p>Participation of disabled persons in working life is a key dimension of participation in society. The UN Convention on the Rights of Persons with Disabilities, European Union Law and the German Basic Law all mandate equal rights of disabled persons to work. For this reason, occupation duty and compensational levy, discrimination bans and duties to reasonable accommodation, and the accessibility of working places exist. The role of sheltered work is controversial. There are interactions between social security in cases of invalidity and the realization of the rights to education, health and rehabilitation. Further research is urgently needed.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"881-885"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429837","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":"[Twenty-five years after publication of the \"International Classification of Functioning, Disability and Health\"-what research and practice can learn from each other].","authors":"Anke Scheel-Sailer","doi":"10.1007/s00103-026-04274-y","DOIUrl":"10.1007/s00103-026-04274-y","url":null,"abstract":"<p><p>The International Classification of Functioning, Disability and Health (ICF) was published in 2001 to establish a framework for describing the functioning and limitations in functioning of people with disabilities or chronic conditions within the biopsychosocial model. The use of the ICF has been discussed over the past decade from the perspective of research for practice.The ICF has been used in the fields of medical care, research, education, and policy. Closely linked to the health strategy of rehabilitation, the ICF has contributed to a better understanding of rehabilitation. Examples include the activities of the World Health Organization, the ICF Core Sets as a basis for describing functioning of selected clinical health conditions, the integration of the ICF concept into guidelines, and national and international implementation projects. The ICF concept has been integrated into numerous training courses, and continuing education modules are offered. In the areas of social inclusion and vocational reintegration, the use of the ICF has led to participation planning based on entitlement to benefits and ICF-oriented needs assessment.Although the ICF has proven itself as a concept in all the areas described, there remains a gap between demonstration projects developed in research and the widespread use of the ICF. Demonstration projects often reveal a level of complexity and effort that makes consistent use in everyday life difficult. Political support and further developments in research and society, based on the experiences gained, are necessary to establish the tool's effectiveness as a health indicator and to promote social integration and participation on a nationwide scale.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"873-880"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410550","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":"[Reporting on Inclusion in Germany: Development, Knowledge Base, and Limitations Following the Ratification of the UN Convention on the Rights of Persons with Disabilities].","authors":"Elisabeth Wacker","doi":"10.1007/s00103-026-04276-w","DOIUrl":"10.1007/s00103-026-04276-w","url":null,"abstract":"<p><p>By ratifying the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) in 2009, Germany undertook to systematically promote the participation of people with disabilities and to report on this regularly. According to the National Action Plan, the data on people with impairments and disabilities are to be improved, with particular attention being paid to the human rights perspective set out in the Convention. To date, three reports designed in accordance with this approach have been published under the programmatic title \"Federal Government Report on the Living Conditions of People with Disability: Participation-Impairment-Disability\"; a fourth is currently available as a draft.This reporting supports the transition to inclusion-oriented social integration assistance (Eingliederungshilfe) and rehabilitation, which has become mandatory throughout Germany following the ratification of the UN Convention on the Rights of Persons with Disabilities. As value- and impact-oriented reporting, it can make a significant contribution to this through nuanced and diversity-sensitive data quality. The participation survey is now intended to further expand and continuously improve this solid body of knowledge.This narrative overview traces the development of Participation Reporting, from its normative and institutional foundations through to the current phase of data collection and transformation. It examines the functions, limitations, and unresolved issues of such reporting and asks whether reports actually improve participation. To this end, it clarifies the conceptual foundations, analyses methodological developments and data issues, highlights tensions between different understandings of disability, and outlines the institutional roles involved.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"855-865"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429863","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":"[Aging with intellectual and developmental disabilities or severe multiple disabilities-health, participation, and care in later life].","authors":"Lotte Habermann-Horstmeier","doi":"10.1007/s00103-026-04262-2","DOIUrl":"10.1007/s00103-026-04262-2","url":null,"abstract":"<p><p>Over the past decades, life expectancy in Germany has steadily increased. This trend also applies to people with physical, intellectual, and multiple disabilities, although their life expectancy remains at a significantly lower level. Compared with the general population, differences are evident in health, social participation, and quality of life. Multimorbidity, chronic diseases, and frailty occur earlier and more frequently in people with intellectual disabilities and severe multiple disabilities, leading to limitations in daily life and increased care needs. For some individuals with intellectual and developmental disabilities (IDD), disability-specific risk factors also play a role, such as a higher prevalence of epilepsy and mental health disorders, or, in the case of Down syndrome, the early onset of dementia.In addition to medical challenges, psychosocial factors become increasingly important in later life, including loneliness, inadequate social participation, and grief over the loss of previously mastered abilities. Despite improvements in care, the average life expectancy of people with severe intellectual and developmental disabilities and severe multiple disabilities remains substantially reduced. Like most people, they generally wish to grow old and die in familiar surroundings. However, due to inadequate support and care services, many are often forced to accept an unwanted move to a residential nursing home for older adults.This review article discusses epidemiological data, the specific challenges faced by ageing people with intellectual and developmental disabilities, and the practical implications for improving care and social participation.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"926-935"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350884","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":"[Large-scale surveys on the work situation of people with health impairments and disabilities in Germany-expanding the potential for analysis].","authors":"Lena Hünefeld, Alper Eker, Sophie Teborg","doi":"10.1007/s00103-026-04202-0","DOIUrl":"10.1007/s00103-026-04202-0","url":null,"abstract":"<p><strong>Introduction: </strong>Sound knowledge of the current work situation, captured using suitable and up-to-date indicators, is a key prerequisite for the appropriate and accessible design of working conditions. Survey data enable a differentiated description of this situation and the tracking of developments. The aim of this article is to provide a systematic overview of large-scale surveys on the work situation of people with impairments or disabilities in Germany and to examine the potential for analysis.</p><p><strong>Methods: </strong>A total of 15 large-scale surveys involving people with health impairments and providing information on their work situation were systematically analyzed. An inductively and deductively developed category system was used that structured the topics as \"impairment/disability,\" \"work situation,\" and \"individual characteristics.\" In addition, a distinction was made between three target groups: \"people with impairments,\" \"people with self-assed disabilities,\" and/or \"people with externally assessed disabilities.\"</p><p><strong>Results: </strong>For the period from 2018 to 2024, seven relevant surveys can be identified that, to varying extents, contain detailed information on all three target groups and their employment situation in the primary labor market.</p><p><strong>Discussion: </strong>Gaps in the survey data become apparent, for example, with regard to inclusive working conditions or workplace adaptations. Therefore, existing large-scale surveys would need to be systematically expanded in terms of both content, through differentiated items, and methodology, through inclusive sampling and survey designs.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"886-896"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354024","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":"[Equal opportunities in access to medical rehabilitation].","authors":"Maria Mader, Lia Seibel, Stefanie Neudecker, Jana Stucke, Anna Brinkmann, Oliver Razum","doi":"10.1007/s00103-026-04268-w","DOIUrl":"10.1007/s00103-026-04268-w","url":null,"abstract":"<p><strong>Background: </strong>Access to medical rehabilitation in Germany is largely standardized, yet influenced by various contextual conditions. This study examines the extent to which people with pre-existing disabilities face differences in access to medical rehabilitation compared with all people in need of rehabilitation.</p><p><strong>Methods: </strong>Two qualitative studies were analyzed: MeReMBe (Medizinische Rehabilitation für Menschen mit einer vorbestehenden Behinderung) (2/2024-1/2026) and FöBeR(Förderliche Faktoren bei der Beantragung einer medizinischen Rehabilitation) (04/2021-08/2022). Both studies used maximum variation sampling. A total of 19 expert interviews and 8 focus groups with stakeholders involved in the rehabilitation process were conducted. The data were transcribed, pseudonymized, and analyzed using structuring content analysis.</p><p><strong>Results: </strong>Applications to rehabilitation are often initiated by relatives and other close persons as well as by general practitioners, who play a key role in the access process. Due to cognitive and communication impairments, for example, the usual communicative decision-making process is often not possible. In addition, the indication-oriented structure of the rehabilitation system impedes access because complex or multiple impairments often cannot be clearly assigned to a single indication category.</p><p><strong>Discussion: </strong>To support access to medical rehabilitation, potential rehabilitation patients and those involved in the process (e.g., relatives and healthcare professionals) require more low-threshold information and counseling options to fully benefit from the potential offered by medical rehabilitation. Diversity-related factors can interact in the access process and reinforce each other (e.g., disability and migration background). Complex or specific needs are insufficiently considered here, making it difficult to provide access to care.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"918-925"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419066","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":"[Artificial intelligence and occupational participation in Germany: a narrative review].","authors":"Mareike Decker, Sara Hamideh Kerdar, Patricia Traub","doi":"10.1007/s00103-026-04271-1","DOIUrl":"10.1007/s00103-026-04271-1","url":null,"abstract":"<p><p>The literature shows that, despite existing limitations, artificial intelligence (AI) can provide new opportunities to support people with disabilities at work. However, the current state of research in Germany on the use of AI to facilitate participation in working life is unclear. The aim of this narrative review is therefore to provide an up-to-date overview of projects and publications conducted or published in Germany. A structured search was carried out in several databases and relevant websites covering the period from 2020 to 2025. Projects and publications focusing on the use of AI in an occupational context for people with disabilities were included. A thematic analysis was conducted to identify the opportunities and challenges associated with the use of AI. A total of 16 projects and 8 publications were identified. The analysis shows that AI can help to overcome barriers, for example by supporting work processes and promoting self-determination. At the same time, challenges become apparent, particularly regarding data protection, a lack of transparency in data processing, and potential additional personnel and financial resources required when using AI-supported (assistive) technologies. Based on the analysis of projects and publications, the article concludes with practical recommendations and implications for future research on the implementation of AI-based technologies to promote participation in working life.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"897-908"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547973","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":"[Medical aids for children and adolescents following the legislative change-a status report].","authors":"Fleming Caje, Peter Borusiak","doi":"10.1007/s00103-026-04264-0","DOIUrl":"10.1007/s00103-026-04264-0","url":null,"abstract":"<p><strong>Introduction: </strong>The provision of assistive devices-such as wheelchairs, communication aids, or orthoses-tailored to individual needs is of paramount importance for children and adolescents with disabilities in terms of their participation and development. In February 2025, Section 33 (5c) was added to Book V of the Social Code (SGB V) as part of the Healthcare Strengthening Act (GVSG) to simplify the provision of medical aids when prescribed by social pediatric centers (SPZ) or medical centers for adults with disabilities (MZEB). The aim of this assessment was to examine the current status of implementation and the effects of the legislative change.</p><p><strong>Methods: </strong>Using a mixed-methods approach, two web-based surveys were conducted among employees at SPZs and affected parents. In addition, in-depth semi-standardized interviews were conducted with various stakeholders in this process: SPZ employees, health insurance representatives, and medical aid providers.</p><p><strong>Results: </strong>The effects of the legislative change have so far been only partially apparent in many areas. There are differing views on the procedure and the need for additional reviews. The burden on the families affected remains very high. Our survey points to ambiguities in the wording of the legislative change on the one hand and to significant communication-related obstacles on the other.</p><p><strong>Discussion: </strong>The current situation is partly characterized by false expectations, misunderstandings, and communication barriers. The burden falls largely on the parents of children with complex care needs. Improved information and communication among the stakeholders, as well as a clarification of the legislative intent, could improve the implementation of the regulation.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"945-952"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366924","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}