Rechtliche Rahmenbedingungen, Qualitätssicherungsprogramme, Zertifizierungen, DRGs, OPS, Pflege als Therapie

The establishment of structural and minimum features within the DRG system by the operations and procedure key (OPS) gave the neurological early rehabilitation phase B a definitional framework and ensured standardization. In the field of nursing, it has given rise to a new self-image and a boost to interdisciplinarity. The assignment of patients at the interface between acute inpatient treatment and rehabilitation remains problematic. The article gives an overview of the regulatory framework

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Die deutsche Krankenhauspolitik: Eine Geschichte verpasster Strukturreformen?

Zeitschrift für Wirtschaftspolitik ◽

10.1515/zfwp-2018-0001 ◽

2018 ◽

Vol 67 (1) ◽

pp. 1-28

Author(s):

Heidi Dittmann

Keyword(s):

Structural Changes ◽

Regulatory Framework ◽

Operating Costs ◽

German Hospital ◽

Structural Components ◽

Drg System ◽

Hospital Reform ◽

Hospital Structure Act ◽

Hospital Finance

Abstract: The introduction of the DRG system in 2003/04 can be considered the last real hospital reform. Although the latest reform was called Hospital Structure Act due to its insufficient structural components it is sometimes referred to as missed reform. Essential aspects of the institutional background remained unchanged. However, a closer look reveals even the introduction of the DRG system was only a change in the reimbursement of operating costs. Further structural changes were neither discussed nor induced. The same applies to all subsequent reforms. The key parameters of the regulatory framework are for the greater part the same as those established by the German Hospital Finance Act in 1972. Against this backdrop, the presented paper discusses the institutional background and potential reasons for its continuance. The focus is on the question, whether missed reforms are based on its optimality or which alternative explanations seem to be convincing.

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Can the Academic Self-Concept be Positive and Realistic?

Zeitschrift für Pädagogische Psychologie ◽

10.1024/1010-0652.19.3.132 ◽

2005 ◽

Vol 19 (3) ◽

pp. 129-132 ◽

Cited By ~ 6

Author(s):

Reimer Kornmann

Keyword(s):

Academic Performance ◽

Opposite Effect ◽

Self Esteem ◽

Point Of View ◽

The Other ◽

Self Concept ◽

High Ability ◽

Self Image ◽

Other Hand

Summary: My comment is basically restricted to the situation in which less-able students find themselves and refers only to literature in German. From this point of view I am basically able to confirm Marsh's results. It must, however, be said that with less-able pupils the opposite effect can be found: Levels of self-esteem in these pupils are raised, at least temporarily, by separate instruction, academic performance however drops; combined instruction, on the other hand, leads to improved academic performance, while levels of self-esteem drop. Apparently, the positive self-image of less-able pupils who receive separate instruction does not bring about the potential enhancement of academic performance one might expect from high-ability pupils receiving separate instruction. To resolve the dilemma, it is proposed that individual progress in learning be accentuated, and that comparisons with others be dispensed with. This fosters a self-image that can in equal measure be realistic and optimistic.

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Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽

10.1027/0227-5910/a000279 ◽

2014 ◽

Vol 35 (6) ◽

pp. 398-405 ◽

Cited By ~ 17

Author(s):

Michael R. Nadorff ◽

Thomas E. Ellis ◽

Jon G. Allen ◽

E. Samuel Winer ◽

Steve Herrera

Keyword(s):

Risk Factor ◽

Suicidal Ideation ◽

Inpatient Treatment ◽

Improve Method ◽

Sleep Problems ◽

Psychiatric Inpatients ◽

Poor Sleep ◽

Treatment Termination ◽

Suicidal Patients ◽

The Relationship

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

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The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽

10.1027/0227-5910/a000511 ◽

2018 ◽

Vol 39 (5) ◽

pp. 397-405 ◽

Cited By ~ 3

Author(s):

Steven Vannoy ◽

Mijung Park ◽

Meredith R. Maroney ◽

Jürgen Unützer ◽

Ester Carolina Apesoa-Varano ◽

...

Keyword(s):

Primary Care ◽

Low Socioeconomic Status ◽

Thematic Analysis ◽

Older Men ◽

Primary Care Providers ◽

Depression Treatment ◽

Care Providers ◽

Low Socioeconomic ◽

Self Image ◽

The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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