Die Versorgung von Menschen mit Migrationshintergrund in der psychosomatischen Rehabilitation

Abstract

It was evaluated in an inpatient rehabilitation setting whether patients with mental or psychosomatic disorders people with a migration background are treated less frequently, profit less from the treatment, and have a higher risk for a negative outcome. On the basis of a prospective sample (n=25,066), the healthcare utilization of inpatient rehabilitation institutions, the level of mental stress, the quality of treatment, and the influence of risk factors were reviewed. Patients with a migration background show a lower level of health care utilization and a higher level of overall mental stress. Turkish patients and patients from the former Yugoslavia show the poorest treatment results. The regression analysis underlines clinical and sociodemographic factors as independent, negative predictors for good treatment results. Treatment concepts should be more strongly oriented to the needs of patients with a migration background and socioeconomically deprived patients.

Symptom manifestation and treatment effectiveness, -obstacles and -facilitators in Turkish and Moroccan groups with depression in European countries: A systematic review

“…Turkish-Germans showed similar symptom reduction to native Germans and other immigrant groups in the two studies with control groups, including one with a large national sample(Mösko et al, 2011, Zollmann et al, 2016. However, Turkish-German patients showed the smallest treatment effect sizes regarding depression, other symptoms and general psychopathology in a small sample(Mösko et al, 2011). Moreover, Turkish-German patients showed a lower reintegration into working life after treatment than native German did(Zollmann et al, 2016).…”

“…This study excluded unemployed patients (students, housewives, retired patients), which might have affected the external validity of the findings. Turkish-Germans showed similar symptom reduction to native Germans and other immigrant groups in the two studies with control groups, including one with a large national sample(Mösko et al, 2011, Zollmann et al, 2016. However, Turkish-German patients showed the smallest treatment effect sizes regarding depression, other symptoms and general psychopathology in a small sample(Mösko et al, 2011).…”

“…Mösko et al, 2011; Nickel et al., 2006a;Zollmann et al, 2016). Intention-to-treat analyses revealed significant improvement of Turkish-German patients at discharge on depressive, somatic, anxiety, and phobic symptoms, as well as paranoid ideation, psychoticism, hostility and the global severity index(Nickel et al, 2006a;Zollmann et al, 2016).…”

Herausforderungen und Potenziale hausärztlicher Versorgung in einer multikulturellen Gesellschaft

“…Versorgungsdefizite von Menschen mit Migrationshintergrund existieren in erster Linie in Bereichen, die vornehmlich zum hausärztlichen Arbeitsfeld zählen: Prävention, Gesundheitsförderung und Rehabilitation [3,9,19,20]. Kinder durchlaufen zu geringeren Teilen die Vorsorgeuntersuchungen (U-Untersuchungen) vollständig, sie zeigen eine höhere Kariesprävalenz und sind häufiger übergewich-tig als deutsche Kinder [21].…”

“…Die Prävalenz psychiatrischer Erkrankungen wie Depressionen und somatoforme Störungen ist im Verhältnis zur Bevölkerungszahl bei Menschen mit Migrationshintergrund überdurchschnittlich hoch [24]. Dennoch werden Einrichtungen wie psychosomatische Rehabilitationskliniken [19] oder psychiatrische Tageskliniken [25] von ausländischen Patienten deutlicher seltener in Anspruch genommen. Das HilfeSuch-Verhalten bei psychischen Problemen führt einen großen Teil der Migranten nicht zu niedergelassenen Psychiatern oder psychiatrischen Notfallambulanzen, sondern zum Hausarzt [26].…”