[Psychosomatic basic care in the general hospital - an empirical investigation of the bio-psycho-social stress, treatment procedures and treatment outcomes from the vantage point of medical doctors].
OBJECTIVE
The present study investigates the psycho-social stress, the treatment procedures and the treatment outcomes of stressed patients in the hospital from the perspective of the hospital doctors.


METHODS
Physicians from all disciplines who had completed the course "Psychosomatic Basic Care" as part of their specialist training documented selected treatment cases.


RESULTS
2,028 documented treatment cases of 367 physicians were evaluated. Anxiety, depression and family problems were the most common causes of psychosocial stress. In over 40 % of the cases no information was found on the medical history. Diagnostic and therapeutic conversations took place with almost half the patients (45%). From the vantage point of the physicians patients receiving diagnostic and therapeutic conversations achieved significantly more positive scores with respect to outcome variables than patients without these measures. Collegial counseling was desired for more than half of the patients and took place mainly among the ward team. There were few significant differences in the views of surgical and nonsurgical physicians.


CONCLUSIONS
Psychosomatic basic care in general hospitals is possible, albeit with some limitations. Patients undergoing psychosocial interventions have better treatment outcomes. Therefore, extending training to 80 hours for all medical disciplines seems reasonable.
Abteilung für Psychosomatische Medizin und Psychotherapie, Freiburg. kurt.fritzsche@uniklinik-freiburg.de
Kurt
K
Fritzsche
Inna
I
Schäfer
Michael
M
Wirsching
Rainer
R
Leonhart
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003479:Curriculum; D004502:Education, Medical, Continuing; D005260:Female; D005858:Germany; D006760:Hospitalization; D006769:Hospitals, General; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology; D008875:Middle Aged; D010817:Physician-Patient Relations; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D011611:Psychosomatic Medicine / Q000193:education; D011613:Psychotherapy / Q000193:education; D013315:Stress, Psychological / Q000150:complications