[Conditions and strategies for the development of guidelines for the rehabilitation of patients with psychiatric and psychosomatic disorders].
In comparison to other countries, the German health care system can be characterized by an exceptionally extended system of inpatient psychotherapeutic treatment. About 20,000 beds are available in three different, partly mutually competitive medical settings: psychosomatic/psychotherapeutic hospital treatment, psychiatric hospital treatment and psychosomatic rehabilitation. The article first describes the latest developments and issues concerning the demarcation of tasks in these three therapeutic inpatient settings. The implementation of guidelines may contribute to a common understanding and function as a rational corrective with regard to the treatment appropriate for each individual case. Previous efforts to develop guidelines for the treatment of patients with psychiatric disorders are described. A special focus is put on the question of whether existing guidelines already fulfil the specific requirements for the rehabilitative treatment of these patients. The analysis reveals substantial deficits concerning the development of guidelines for the inpatient psychotherapeutic treatment in general as well as for the specific setting of psychosomatic/psychotherapeutic rehabilitation. Given this situation, the authors propose a strategy with 5 stages to the development of guidelines for this target group.
Koch
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U
Arbeitsgruppe Psychotherapie- und Versorgungsforschung, Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin des Universitätsklinikum Hamburg-Eppendorf, Hamburg.
Schulz
H
H
D003131:Combined Modality Therapy; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005858:Germany; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D009313:National Health Programs; D010343:Patient Admission; D017410:Practice Guidelines as Topic; D011602:Psychophysiologic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D011613:Psychotherapy; D011785:Quality Assurance, Health Care; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*
Voraussetzungen und Strategien zur Entwicklung von Leitlinien in der Rehabilitation von Patienten mit psychischen/psychosomatischen Störungen.