Psychosomatische Sprechstunde in der Hausarztpraxis – ein neues Kooperationsmodell von Psychosomatik und Allgemeinmedizin

Hartmann, Mechthild; Finkenzeller, Caroline; Boehlen, F.; Wagenlechner, Petra; Peters-Klimm, Frank; Herzog, Wolfgang

doi:10.1055/a-0795-2048

Cited by 3 publications

(5 citation statements)

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“…GPs reported an unexpectedly high willingness to accept and use the offer and 76% of the approached patients were successfully referred to an initial contact. The specialists also considered the model to be practicable and meaningful, and emphasized that it facilitated to see a broad patient spectrum [24]. A qualitative study conducted with German psychotherapeutic health specialists investigated cross-sectoral collaboration between primary and psychosocial care providers through the implementation of video consultations in primary care.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Structural Reform of Outpatient Psychotherapy in Germany (ES-Rip Trial) - A Qualitative Study of Provider Perspectives

Poß-Doering

Hegelow

Borchers

et al. 2021

Preprint

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Background: Access to outpatient mental healthcare can be challenging for patients. In Germany, a national structural reform was implemented in 2017 to accelerate and enhance access to outpatient psychotherapy and reduce waiting times. During the first phase of the study ’Evaluation of a structural reform of the outpatient psychotherapy guideline (ES-RiP)’ and embedded into a process evaluation, the implementation was to be evaluated through assessing general practitioners’ (GPs) and psychotherapists’ (PTs) perspectives regarding utilization of provided new measures, and perceived potential for optimization. Particular focus was on patients with a comorbidity of mental disorders and chronic physical conditions (cMPs). Methods: This exploratory cross-sectional qualitative study used on-site and online focus group discussions and semi-structured open-ended telephone interviews with GPs and outpatient PTs. Generated data were analyzed using thematic framework analysis. Descriptive statistics were used to analyze participant characteristics collected via a socio-demographic questionnaire. Results: Perspectives on the structural reform were heterogenous. GPs and PTs considered the component of timely initial psychotherapeutic assessment consultations beneficial. GPs disapproved of their deficits in detailed information about the structural reform and exchange with outpatient PTs. Improvement suggestions included structured short information exchange and joint quality circles. The overall number of available outpatient PTs in rural areas was perceived as insufficient. For patients with cMPs, GPs saw patient barriers for therapy access and continuity in low intrinsic motivation, physical impediments and older age. PTs also saw patient challenges regarding low intrinsic motivation and keeping scheduled appointments. They considered post-reform administrative efforts to be high and reported that the regulations (conformity) lead to planning difficulties and financial losses. Reform elements were tailored to fit in with PTs key therapy areas. Stronger networking and joint lectures were suggested as remedy for the currently still limited exchange with GPs. Unlike the GPs, PTs emphasized that accepting patients into psychotherapeutic treatment was independent of a possibly present chronic physical disease.Conclusions: The findings contribute to understanding the integration of the delivered structural reform into daily care processes and provides an indication about reached targets and potential improvements. Further phases of the ES-RiP study can build on the findings and broaden insights. Trial registration: Registration-ID DRKS00020344 (DRKS German Register of Clinical Trials; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020344)

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Section: Discussionmentioning

confidence: 99%

Evaluating the Structural Reform of Outpatient Psychotherapy in Germany (ES-Rip Trial) - A Qualitative Study of Provider Perspectives

Poß-Doering

Hegelow

Borchers

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…In addition, we found seven instruments measuring one or more social problems (e.g., related to family, partner violence, finances). When specific social problems were addressed, they were related to intimate partner violence (IPV) in female participants (2). Finally, we also found instruments (6) measuring psychological aspects (e.g., stress, anxiety, depression) to identify probable "cases.…”

Section: Instrument Characteristicsmentioning

confidence: 92%

“…One instrument was described as a classification system and conceptual framework. The instruments were mostly completed with paper and pencil (19) but also on a tablet or computer (2). For one instrument, the method was not reported.…”

Section: Instrument Characteristicsmentioning

confidence: 99%

“…Since general practitioners (GPs) are usually the first point of contact for people with any health-related concern, patients visit their GP not only for medical reasons but also for psychosocial problems (PSPs) (1)(2)(3)(4). Here we take problems to be "a source of perplexity, distress, or vexation", while we take PSPs to refer to problems related to the conditions in which people are born, grow, live, work, and age (5).…”

Section: Introductionmentioning

confidence: 99%

“…However, studies also show that GPs only correctly identify a fifth to a half of patients with relevant PSPs and that social factors are not considered to have much importance (37,48). Possible consequences, such as inadequate diagnoses, nonspecific or no intervention or treatment at all, and ineffective use of time have also been extensively described (2,34,35,37,40,41,43,44,(49)(50)(51)(52)(53)(54)(55).…”

Section: Introductionmentioning

confidence: 99%

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Identifying patients with psychosocial problems in general practice: A scoping review

Schwenker

Deutsch²,

Unverzagt³

et al. 2023

Front. Med.

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ObjectiveWe conducted a scoping review with the aim of comprehensively investigating what tools or methods have been examined in general practice research that capture a wide range of psychosocial problems (PSPs) and serve to identify patients and highlight their characteristics.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Joanna Briggs Institute Reviewer’s Manual on scoping reviews. A systematic search was conducted in four electronic databases (Medline [Ovid], Web of Science Core Collection, PsycInfo, Cochrane Library) for quantitative and qualitative studies in English, Spanish, French, and German with no time limit. The protocol was registered with Open Science Framework and published in BMJ Open.ResultsOf the 839 articles identified, 66 met the criteria for study eligibility, from which 61 instruments were identified. The publications were from 18 different countries, with most studies employing an observational design and including mostly adult patients. Among all instruments, 22 were reported as validated, which we present in this paper. Overall, quality criteria were reported differently, with studies generally providing little detail. Most of the instruments were used as paper and pencil questionnaires. We found considerable heterogeneity in the theoretical conceptualisation, definition, and measurement of PSPs, ranging from psychiatric case findings to specific social problems.Discussion and conclusionThis review presents a number of tools and methods that have been studied and used in general practice research. Adapted and tailored to local circumstances, practice populations, and needs, they could be useful for identifying patients with PSPs in daily GP practice; however, this requires further research. Given the heterogeneity of studies and instruments, future research efforts should include both a more structured evaluation of instruments and the incorporation of consensus methods to move forward from instrument research to actual use in daily practice.

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Identifying patients with psychosocial problems in general practice: a scoping review protocol

et al. 2021

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IntroductionPsychosocial problems (PSPs) are common issues associated with negative health outcomes. Since general practitioners are the first point of contact for any health-related concern, understanding their options to recognise patients with PSPs plays an important role as it is essential for early intervention and can prevent serious conditions. The objective of our scoping review is to map published evidence on the usage of instruments to identify patients with PSPs in general practice.Methods and analysisWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute Reviewer’s Manual on scoping reviews. A systematic search of four electronic databases (Medline (Ovid), Web of Science Core Collection, PsycInfo, Cochrane Library) will be conducted for quantitative and qualitative studies published in English, Spanish, French and German. Main study characteristics as well as information on identification instruments will be extracted and visualised in structured tables to map the available evidence. The protocol has been registered with Open Science Framework, https://osfio/c2m6z.Ethics and disseminationThis study does not require ethical approval as we will not collect personal data. Dissemination will consist of publications, presentations and other knowledge translation activities.

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Psychosomatische Sprechstunde in der Hausarztpraxis – ein neues Kooperationsmodell von Psychosomatik und Allgemeinmedizin

Cited by 3 publications

References 1 publication

Evaluating the Structural Reform of Outpatient Psychotherapy in Germany (ES-Rip Trial) - A Qualitative Study of Provider Perspectives

Evaluating the Structural Reform of Outpatient Psychotherapy in Germany (ES-Rip Trial) - A Qualitative Study of Provider Perspectives

Identifying patients with psychosocial problems in general practice: A scoping review

Identifying patients with psychosocial problems in general practice: a scoping review protocol

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