-
1
المؤلفون: Stefanie Joos, Sven Karstens, Joachim Szecsenyi, Jost Steinhäuser, Katja Krug, Jonathan C. Hill
المصدر: PLoS ONE, Vol 10, Iss 8, p e0136119 (2015)
PLoS ONEمصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Referral, Cost effectiveness, Attitude of Health Personnel, MEDLINE, lcsh:Medicine, Nursing, General Practitioners, Germany, medicine, Remuneration, Humans, lcsh:Science, Referral and Consultation, Physical Therapy Modalities, Qualitative Research, Aged, Physician-Patient Relations, Multidisciplinary, Primary Health Care, business.industry, lcsh:R, Guideline, Focus Groups, Middle Aged, Focus group, Family medicine, Female, Perception, lcsh:Q, business, RA, Psychosocial, Low Back Pain, Qualitative research, Research Article
الوصف: Background and Objective\ud The STarT Back stratified primary care approach has demonstrated clinical and cost effectiveness in the UK, and is commonly used by General Practitioners (GPs). However, it remains unknown how this approach could be implemented into the German healthcare system. The aim of this study was therefore to explore the views and perceptions of German GPs in respect to using a stratified primary care for low back pain (LBP).\ud \ud Methods\ud A 90-minute think-tank workshop was conducted with 14 male and five female GPs, during which the STarT-Back-Screening-Tool (SBST) and related research evidence was presented. This was followed by two focus groups, based on a semi-structured interview guideline to identify potential implementation barriers and opportunities. Discussions were audiotaped, transcribed and coded using a content analysis approach.\ud \ud Results\ud For the three deductively developed main themes, 15 subthemes emerged: (1) application of the SBST, with the following subthemes: which health profession should administer it, patients known to the GP practice, the reason for the GP consultation, scoring the tool, the tool format, and the anticipated impact on GP practice; (2) psychologically informed physiotherapy, with subthemes including: provision by a physiotherapist, anticipated impact, the skills of physiotherapists, management of patients with severe psychosocial problems, referral and remuneration; (3) the management of low-risk patients, with subthemes including: concern about the appropriate advising health professional, information and media, length of consultation, and local exercise venues.\ud \ud Conclusions\ud The attitudes of GPs towards stratified primary care for LBP indicated positive support for pilot-testing in Germany. However, there were mixed reactions to the ability of German physiotherapists to manage high-risk patients and handle their complex clinical needs. GPs also mentioned practical difficulties in providing extended advice to low-risk patients, which nevertheless could be addressed by involvement of specifically trained medical assistants.
وصف الملف: application/pdf
-
2
المؤلفون: Florian Metzger, Janina Geib, Thomas Dresler, Monika A. Rieger, Stefanie Joos, Gerhard W. Eschweiler
المصدر: BioMed Research International
BioMed Research International, Vol 2015 (2015)مصطلحات موضوعية: Male, medicine.medical_specialty, Article Subject, media_common.quotation_subject, Acupuncture, Ear, MEDLINE, Alternative medicine, lcsh:Medicine, General Biochemistry, Genetics and Molecular Biology, Auricular acupuncture, Germany, Surveys and Questionnaires, Acupuncture, Humans, Medicine, Depression (differential diagnoses), Aged, media_common, Aged, 80 and over, Protocol (science), Depressive Disorder, Major, General Immunology and Microbiology, business.industry, Addiction, lcsh:R, General Medicine, Middle Aged, Outcome parameter, Treatment Outcome, Physical therapy, Feasibility Studies, Female, business, Acupuncture Points, Research Article
الوصف: Background. Due to an increasing number of elderly people suffering from major depression and potential side effects of the prescribed drugs, the introduction of new therapeutic approaches is needed. Currently, in Germany, auricular acupuncture is no part of clinical care for gerontopsychiatric patients. Based on promising clinical experiences and existing evidence for treating addiction and trauma, a benefit of auricular acupuncture integrated in existing treatment programs in elderly patients may be hypothesized. Within this project auricular acupuncture according to the National Acupuncture Detoxification Association (NADA) will be integrated in the multimodal treatment regime for elderly patients with major depression in a daytime ward setting.Methods/Design. To evaluate the feasibility and acceptance a mixed method approach is used. In a day clinic, a sample of 20 psychogeriatric patients with the diagnosis of major depression will be enrolled. The patients will receive a total of nine auricular acupuncture treatments according to the standardized NADA protocol in a group setting. The therapeutic process, its organization, the experience, and the willingness of patients to participate will be evaluated by interviews with patients and the therapeutic team. Data will be analyzed qualitatively using content analysis. Additionally, quantitative outcome parameters will be measured by standardized questionnaires.
وصف الملف: text/xhtml
-
3
المؤلفون: Claudia M. Witt, Ralf Kohnen, M Lindner, Stefanie Joos, Eckhart G. Hahn, Benno Brinkhaus, Stefan N. Willich
المصدر: Complementary Medicine Research. 12:139-143
مصطلحات موضوعية: Complementary Therapies, medicine.medical_specialty, Status quo, Medizinische Fakultät -ohne weitere Spezifikation, media_common.quotation_subject, Decision Making, Alternative medicine, MEDLINE, German, Germany, Humans, Medicine, ddc:610, Curriculum, Schools, Medical, media_common, Medical education, business.industry, Medical school, language.human_language, Complementary and alternative medicine, Family medicine, language, business, Attitude to Health
الوصف: Introduction: There is a growing demand for complementary and alternative medicine (CAM) in Western societies. This trend has lead to the gradual integration of CAM courses into medical school curricula. The aim of this study was to survey key decision makers at German medical schools with regard to their views on CAM and to examine the extent to which CAM has already been integrated in the German medical school system. Materials and Methods: A questionnaire was sent to 753 clinic and institute directors at German medical schools. Results: A total of 500 questionnaires (66%) were returned. 39% of respondents had a positive opinion of CAM, 27% had a neutral opinion and 31% had a negative opinion. 3% of respondents were unsure. The CAM therapies viewed most positively were osteopathy (52%), acupuncture (48%), and naturopathy (41%). Most respondents were in favor of integrating CAM into the medical system. However, a larger percentage favored its use in research (61%) and teaching (59%) rather than in the treatment of patients (58%). Only 191 respondents (38%) indicated that CAM treatment methods had been integrated into the curriculum of their respective medical schools. In these schools, CAM was mainly used in patient treatment (35%), followed by research (22%) and education (21%). Conclusions: Our data show that the majority of respondents were in favor of integrating CAM into medical school curricula. However, at the time of our survey, only a small percentage of medical schools had actually put this into practice. The reasons for this discrepancy are unclear and should be further investigated. Hintergrund: Die Inanspruchnahme von Naturheilverfahren und Komplementärmedizin (complementary and alternative medicine, CAM) steigt in den westlichen Industrienationen. Dieser Trend fördert die Integration von Lehrinhalten von Naturheilverfahren und Komplementärmedizin an den medizinischen Hochschulen. Ziel der Umfragestudie war es, die Meinung von Entscheidungsträgern an den medizinischen Hochschulen Deutschlands bezüglich Naturheilverfahren und Komplementärmedizin zu erfragen und den Stand der Integration von CAM in die medizinischen Hochschulen zu dokumentieren. Material und Methoden: Ein Fragebogen wurde an insgesamt 753 Klinikdirektoren und ausgewählte Institutsleiter an medizinischen Hochschulen in Deutschland verschickt. Ergebnisse: Insgesamt wurden 500 Fragebögen (66%) zurückgesandt. 39% der Antwortenden hatten eine positive Meinung zu CAM, wohingegen 27% eine neutrale und 31% eine ablehnende persönliche Meinung hatten (3% unklar). Osteopathie (52%), Akupunktur (48%) und Naturheilverfahren (41%) waren die am häufigsten positiv eingeschätzten Therapieverfahren. Die meisten Antwortenden sprachen sich für die Integration von CAM in Forschung (61%), Lehre (59%) und Patientenversorgung (58%) an den medizinischen Hochschulen aus. 38% der Antwortenden gaben an, dass CAM in ihre universitären Kliniken bzw. Institute integriert wurden, wobei der Fokus auf der Patientenversorgung (35%), gefolgt von Forschung (22%) und Lehre (21%) lag. Schlussfolgerungen: Die Studienergebnisse zeigen, dass sich die Mehrzahl der Antwortenden für eine Integration von CAM an den medizinischen Hochschulen ausspricht. Allerdings wurde dies bisher nur zu einem sehr geringen Prozentsatz in die Praxis umgesetzt. Die Gründe für diesen Widerspruch sind unklar und sollten weiter erforscht werden.
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fc2269ff2185491584078aafd97d2c5b
https://doi.org/10.1159/000085227 -
4
المؤلفون: Kayvan Bozorgmehr, Amir Mohsenpour, Stefanie Joos, Christine Schneider
المصدر: Systematic Reviews
مصطلحات موضوعية: Asylum seekers, Health Status, Refugee, MEDLINE, Emigrants and Immigrants, Medicine (miscellaneous), Qualitative property, CINAHL, Health Services Accessibility, Empirical research, Germany, Environmental health, Health care, Protocol, Medicine, Refugees, business.industry, Grey literature, Public relations, Evidence mapping, Access, Health services, Social Sciences Citation Index, Health-care provision, Research Design, Systematic review, business, Systematic Reviews as Topic
الوصف: Background There are more than 100,000 asylum seekers registered in Germany, who are granted limited access to health services. This study aims to provide a systematic overview of the empirical literature on the health status of and health-care provision to asylum seekers in Germany in order to consolidate knowledge, avoid scientific redundance, and identify research gaps. Methods/design A systematic review and evidence mapping of empirical literature on the health status of and health-care provision to asylum seekers in Germany will be performed. We will apply a three-tiered search strategy: 1. search in databases (PubMed/MEDLINE, Web of Science, IBSS, Sociological Abstracts, Worldwide Political Science Abstracts, CINAHL, Sowiport, Social Sciences Citation Index, ASSIA, MedPilot, DNB), dissertation and theses databases, and the internet (Google); 2. screening references of included studies; 3. contacting authors and civil society organizations for grey literature. Included will be studies which report quantitative and/or qualitative data or review articles on asylum seekers in Germany, published in German or English language. Outcome measures will include physical, mental, or social well-being, and all aspects of health-care provision (access, availability, affordability, and quality). Search results will be screened for eligibility by screening titles, abstracts and full texts. Data extraction comprises information on study characteristics, research aims, and domains of health or health-care services analyzed. The quality of studies will be appraised and documented by appropriate assessment tools. A descriptive evidence map will be drawn by categorizing all included articles by research design and the health conditions and/or domains of health-care provision analyzed. The body of evidence will be evaluated, and a narrative evidence synthesis will be performed by means of a multi-level approach, whereby quantitative and qualitative evidence are analyzed as separate streams and the product of each stream is configured in a final summary. Discussion This systematic review will provide an evidence map and synthesis of available research findings on the health status of and health-care provision to asylum seekers in Germany. In anticipation of identifying areas which are amenable to health-care interventions, deserve immediate action, or further exploration, this review will be of major importance for policy-makers, health-care providers, as well as researchers. Systematic review registration PROSPERO 2014: CRD42014013043 Electronic supplementary material The online version of this article (doi:10.1186/2046-4053-3-139) contains supplementary material, which is available to authorized users.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::60d9624c8a6746aaf744c9e212e44b83
https://pub.uni-bielefeld.de/record/2935255 -
5
المؤلفون: Antje Miksch, Kathrin Kiolbassa, Andreas Loh, Stefanie Joos, Katja Hermann, Joachim Szecsenyi, Katja Goetz
المصدر: BMC Family Practice
BMC Family Practice, Vol 12, Iss 1, p 25 (2011)مصطلحات موضوعية: Adult, Male, Attractiveness, Students, Medical, Medical psychology, Attitude of Health Personnel, Cross-sectional study, education, General Practice, Specialty, MEDLINE, Likert scale, German, Young Adult, Nursing, Germany, Humans, Medicine, Life Style, lcsh:R5-920, Motivation, Career Choice, business.industry, language.human_language, Cross-Sectional Studies, language, Female, lcsh:Medicine (General), Family Practice, business, Career choice, Research Article
الوصف: Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase the number of aspirants for general practice.
-
6
المؤلفون: Stefanie Joos, Antonius Schneider, Joachim Szecsenyi, Peter Engeser, Bernd Löwe, Stefan Barie
المصدر: Journal of evaluation in clinical practice. 16(3)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Applied psychology, MEDLINE, Primary care, Physicians, Primary Care, Diagnosis, Differential, Germany, Surveys and Questionnaires, medicine, Humans, Psychiatry, Final version, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Uncertainty, Middle Aged, Focus group, Action (philosophy), Scale (social sciences), Anxiety, Female, medicine.symptom, Heuristics, business
الوصف: Rationale, aims and objectives: Diagnostic uncertainty plays an important role in primary care. Nevertheless, the practical way how general practitioners (GPs) deal with uncertainty remains unclear. The purpose was to develop a questionnaire which describes and measures the level of action and active reasoning in dealing with uncertainty. Methods: Raw items for the 'GP action scale' and 'GP diagnostic reasoning scale' were derived by literature research. The questionnaire was modified by focus group discussion. The final version was administered to 325 GPs. The results of the 'Dealing with uncertainty questionnaire' (DUQ) were compared with the scales of the 'Physician Reaction to Uncertainty' (PRU) questionnaire. PRU measures affective reactions to uncertainty. Results: Item-scale correlation of the 'GP action scale' and 'GP diagnostic reasoning scale' ranged from 0.41 to 0.61 and from 0.31 to 0.53, respectively. Crohnbach's alpha for 'GP action scale' was 0.75 and for 'GP diagnostic reasoning scale' 0.62. The 'GP diagnostic action scale' was significantly positively associated with 'Anxiety due to uncertainty', 'Concern about bad outcomes' and 'Reluctance to disclose mistakes to physicians', scales of PRU. In female doctors, 'Concern about bad outcomes' correlated positively with the 'GP diagnostic reasoning scale' (0.213; P < 0.05). In male doctors, 'Anxiety due to uncertainty' correlated negatively with the 'GP diagnostic reasoning scale' (-0.163; P < 0.05). Conclusions: Diagnostic reasoning in primary care appears as a complex process using typical primary care inherent 'heuristics'. Affective intolerance against uncertainty correlates with self-rated diagnostic activity. Affective reactions to uncertainty might influence gender-specific reactions to uncertainty in different ways.
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)