Gesundheitsförderung

Gesundheitsf ö rderung
  • 文章类型: Journal Article
    由于医疗保健提供成本的增加和对医疗服务需求的增加,德国卫生系统面临压力。有了新的联合政府,德国加大了建设现代化,预防和高质量卫生服务的创新基础设施。联盟协议气氛强劲,创新,和可持续性重点,同时反映了新政府实施预防措施的雄心,互连,以及德国的现代医疗系统。然而,该协议缺乏有关计划实现的详细信息,特别是关于如何根据医疗保健支出的增加来资助这些措施的问题。因此,这项研究的目的是解释新政府的计划,并回答德国如何在新的立法时期确保和资助基于人口的预防计划的问题,尽管医疗保健成本不断上升,但促进健康的措施和创新的解决方案。通过分析联盟协议的相关内容,并借鉴专家研讨会,本文建议在新的立法时期为数字化和创新护理形式建立预防基金和灵活的薪酬模式。我们的发现可能有助于确定可持续资助健康促进的可行方法,德国医疗系统的预防和创新。
    The German health system is under pressure due to increasing costs of healthcare provision and rising demand for health services. With the new coalition government, Germany has increased efforts to build a modern, innovative infrastructure for prevention and high-quality health services. The coalition agreement has a strong climate, innovation, and sustainability focus, reflecting at the same time the ambition of the new government to implement a preventive, inter-connected, and modern healthcare system in Germany. However, the agreement lacks detailed information on the achievement of the plans, especially concerning the question of how those measures should be funded in light of increasing expenditures for healthcare. Thus, the objectives of this study are to interpret the new government\'s plans and answer the question of how Germany in the new legislative period can ensure and fund population-based prevention programmes, health-promoting measures and innovative solutions despite the rising healthcare costs. By analysing the relevant content of the coalition agreement and drawing on an expert workshop, this paper suggests the establishment of a prevention fund and flexible remuneration model for digitalised and innovative forms of care in the new legislative period. Our findings may help identify feasible approaches to sustainable financing of health promotion, prevention and innovation in the German healthcare system.
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  • 文章类型: Journal Article
    Occupational safety and health promotion in the context of nurse staffing: A scoping review Abstract. Background: Increasing workload has led to a rise in mental and physical burden among nurses. In order to prevent this, it should be investigated, whether and to what extent aspects of occupational safety and health promotion can be integrated into nurse-staffing ratios. Aims: The objective of this scoping review was to identify ways and approaches of including occupational safety and health promotion into existing nurse-staffing ratios. Methods: A scoping review was conducted. The literature search took place in relevant professional databases. Articles in English and German language published between January 2015 and April 2020 with a focus on (care) organisations, staffing, occupational safety and/or health promotion, and person-related services were included. Results: Fifteen articles met the inclusion criteria. Three main topics were identified: staffing methods, leadership and control, and work organisation and design. No evidence was found regarding the inclusion of occupational health and safety and health promotion in staffing procedures. However, there is a demand for consideration of aspects \"beyond numbers\". Conclusions: In the further development of staffing-ratios, factors should be included that go beyond quantifiable measures and, by doing so, also address occupational safety and health promotion.
    Zusammenfassung. Hintergrund: Die zunehmende Arbeitsbelastung hat einen Anstieg der psychischen und physischen Belastungen von beruflich Pflegenden zur Folge. Um diesem Umstand vorzubeugen, sollten Möglichkeiten der Berücksichtigung von Arbeitsschutz und Gesundheitsförderung in Personalbemessungsverfahren im pflegerischen Kontext überprüft werden. Fragestellung / Ziel: Inwieweit und in welcher Form können Arbeitsschutz und Gesundheitsförderung in bestehende Personalbemessungsverfahren integriert werden? Methode: Zur Beantwortung der Forschungsfrage wurde ein Scoping Review durchgeführt. Die Literaturrecherche fand in einschlägigen Fachdatenbanken statt. Eingeschlossen wurden englisch- und deutschsprachige Artikel, veröffentlicht zwischen Januar 2015 und April 2020 mit dem Fokus auf (Pflege-)Organisationen, Personalbemessung, Arbeitsschutz und/oder Gesundheitsförderung sowie personenbezogene Dienstleistungen. Ergebnisse: Es wurden 15 Artikel identifiziert. Die Hauptthemen darin waren: Staffing-Methoden (im Sinne von Personalbesetzung), Führung und Steuerung sowie Arbeitsorganisation und -gestaltung. Hinweise auf eine Einbindung von Arbeitsschutz und Gesundheitsförderung in Personalbemessungsverfahren wurden nicht gefunden. Jedoch besteht die Forderung nach Berücksichtigung von Aspekten, die über rein berechenbare Faktoren hinausgehen (Beyond Numbers). Schlussfolgerungen: Bei der Weiterentwicklung von Personalbemessungsverfahren sollten Arbeitsschutz und Gesundheitsförderung aufgenommen und stärker beforscht werden. Eine Engführung auf quantifizierbare Werte sollte vermieden werden.
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  • 文章类型: Journal Article
    In order to strengthen health promotion spreading knowledge is as essential as tackling typical problems of its implementation. Both aspects can be adressed by using game-based learning approaches. To this end, we specifically developed a discussion game divided into four phases of play. Our aim is to (1) spread facts, (2) raise awareness of the topic and (3) promote well-informed political opinion-forming at individual as well as group levels. Experience shows that these objectives can be achieved with this game. The game as a whole or parts of it can easily be integrated into university teaching in different ways. In addition, there is major potential for using the game in lifelong learning settings and health promotion projects. In the next step the game will be adapted to enable its implementation in the workplace as a special setting for health promotion.
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  • 文章类型: Journal Article
    Einleitung: Ziel dieser systematischen Übersicht war die Bewertung der verfügbaren Evidenz zur Wirkung der Kneipp-Therapie. Methoden: MEDLINE, Embase, Web of Science, Cochrane-Library und CAMbase wurden nach relevanten Artikeln, veröffentlicht zwischen 2000 und 2019, durchsucht. Graue Literatur wurde über Google Scholar und andere Tools bezogen. Studien mit jeglicher Art von Studiendesign, die die Effekte der Kneipp-Therapie untersuchten, wurden eingeschlossen. Die Qualitätsbewertung erfolgte mittels EPHPP-QAT. Ergebnisse: 25 Quellen, darunter 14 kontrol-lierte Studien, wurden eingeschlossen. Gemäß EPHPP-QAT wurden 3 Studien \"stark\", 13 \"moderat\" und 9 \"schwach\" bewertet. Neun (64%) der kontrollierten Studien berichteten signifikante Verbesserungen nach Kneipp-Therapie im Gruppenvergleich bei chronisch-venöser Insuffizienz, Hypertonie, leichter Herzinsuffizienz, menopausalen Be-schwerden und Schlafstörungen in verschiedenen Patientenkollektiven sowie verbesserte Immunparameter bei gesunden Probanden. Im Hinblick auf Depression und Angst bei Mammakarzinom-Patientinnen mit klimakterischen Beschwerden, Lebensqualität bei Post-Polio-Syndrom, krankheitsbedingten polyneuropathischen Beschwerden und Inzidenz von Erkältungsepisoden bei Kindern konnten keine signifikanten Gruppenunterschiede festgestellt werden. Elf unkontrollierte Studien berichteten Verbesse-rungen bei allergischen Symptomen, Dyspepsie, Lebens-qualität, Herzratenvariabilität, Infekten, Hypertonie, Wohlbefinden, Schmerz und polyneuropathischen Beschwerden. Diskussion/Schlussfolgerung: Die Kneipp-Therapie scheint bei zahlreichen Beschwerdebildern in verschiedenen Patientenkollektiven positive Effekte zu bewirken. Zukünftige Studien sollten noch stärker auf eine methodisch sorgfältige Studienplanung achten (Kontrollgruppen, Randomisierung, adäquate Fallzahlen, Verblindung), um Verzerrungen entgegenzuwirken.
    BACKGROUND: The aim of this systematic review was to evaluate the available evidence on the effect of Kneipp therapy.
    METHODS: MEDLINE, Embase, Web of Science, Cochrane Library and CAMbase were searched for relevant articles published between 2000 and 2019. Grey literature was obtained through Google Scholar and other tools. Studies with any kind of study design that examined the effects of Kneipp therapy were included. The quality assessment was carried out using EPHPP-QAT.
    RESULTS: 25 sources, including 14 controlled studies, were included. According to EPHPP-QAT, 3 studies were rated as “strong,” 13 as “moderate” and 9 as “weak.” Nine (64%) of the controlled studies reported significant improvements after Kneipp therapy in a between-group comparison in chronic venous insufficiency, hypertension, mild heart failure, menopausal complaints, and sleep disorders in different patient collectives as well as improved immune parameters in healthy subjects. Regarding depression and anxiety in breast cancer patients with climacteric complaints, quality of life in post-polio syndrome, disease-related polyneuropathic complaints and incidence of cold episodes in children, no significant group differences were found. Eleven uncontrolled studies reported improvements in allergic symptoms, dyspepsia, quality of life, heart rate variability, infections, hypertension, well-being, pain and polyneuropathic complaints.
    CONCLUSIONS: Kneipp therapy seems to be beneficial for numerous symptoms in different patient groups. Future studies should pay even more attention to methodologically careful study planning (control groups, randomisation, adequate case numbers, blinding) to counteract bias.
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  • 文章类型: Journal Article
    Research in the field of health promotion generates evidence-based knowledge and has the potential to increase the acceptance, impact and long-term effectiveness of interventions. Typically, a distinction is made between qualitative and quantitative approaches. Yet, with complex and multidimensional re-search questions in the field of health promotion a combination of the two approaches has proven useful. Using mixed-methods designs promises, among other things, to compensate for weaknesses of the individual methods, to improve the scope of the results, and to provide a comprehensive insight into the topic. In this systematic review of two German journals we examine the role of the mixed-methods approach in the field of health promotion and how it can be translated into specific research projects. The review\'s results show that mixed-methods designs are implemented in various contexts. In most studies, the quantitative research strand plays the central role. The use of the mixed-methods designs in health promotion can be further discussed, especially taking into account technical innovations in the field of data collection or with regard to the interpretative potential of qualitative research. The presentation of the review is based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) by the Equator Network.
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  • 文章类型: Journal Article
    OBJECTIVE: Starting from the claim that public health interventions should aim to improve health equity, the article examines which methodological approaches of health economic evaluation exist to support the analysis of equity-related outcomes of different interventions.
    METHODS: Critical review of the relevant literature.
    RESULTS: Against the background of the normative foundations of health economic evaluation, three methodological approaches and three practical methods are presented that allow for considering health equity concerns in health economic evaluations. Implications of the different approaches and references to the German context are discussed.
    CONCLUSIONS: The use of the instruments presented offers good potential to improve transparency with respect to distributive effects of different allocation decisions. This appears to be necessary in order to meet demands for health equity improving public health interventions - especially in the context of the German Prevention Act.
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  • 文章类型: Journal Article
    BACKGROUND: The proportion of adults suffering from hypertension worldwide was estimated at 31.1 % in 2010. The aim of this study was to evaluate the effects of lifestyle changes in patients with arterial hypertension (AH) in primary care.
    METHODS: Systematic literature search in the online databases PubMed, Embase, Cochrane and Opengrey. Only randomized controlled trials of the years 2005 to 2017 in German or English were considered.
    RESULTS: 11 studies out of 458 identified references were evaluated. The patient groups investigated were very heterogeneous and underwent different types of intervention. Educating patients about the clinical picture, regular self-measurements of blood pressure, or patient memories of maintaining a healthy lifestyle have been used most frequently.
    CONCLUSIONS: There is a need for further studies focusing on primary care. However, many lifestyle interventions seem to show very good effects in patients with pre-existing AH (secondary prophylaxis), so these measures should form the basis of antihypertensive therapy in all patients with AH. In addition, it is important to maintain advice on a healthy lifestyle during drug therapy.
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  • 文章类型: Journal Article
    BACKGROUND: The German Prevention Act mandated long-term care insurance funds to support long-term care facilities in designing health-promoting structures. One area of action is the promotion of the cognitive resources of nursing home residents. The objective of this systematic review was to describe and analyze interventions and intervention components that improve cognitive resources of nursing home residents.
    METHODS: First, we conducted a search for systematic reviews to identify relevant randomised controlled trials in Medline via PubMed, the Cochrane Library, CINAHL, Gerolit, Embase, Psyndex, and Livivo; additional sources were hand-searched. Second, references of all relevant randomized controlled trials (n=43) were extracted from the identified systematic reviews (n=26). The original articles of the primary studies included were then considered and data extracted using criteria for the evaluation of complex interventions. The quality of evidence was assessed using the GRADE approach.
    RESULTS: Nine interventions to promote cognitive resources were identified: cognitive stimulation, cognitive training, physical training, art and music interventions, bright light, multicomponent stimulation, multisensory stimulation, care staff training and reminiscence. The quality of the underlying evidence in the inpatient long-term care setting was predominantly low, therefore, it was not always possible to draw clear conclusions regarding the efficacy of the interventions. The low quality of evidence was mainly due to the high heterogeneity as well as the low number and limited methodological quality of the primary studies.
    CONCLUSIONS: In general, a wide range of nonpharmacological interventions were reported. Due to the limited evidence, however, these may be regarded as ideas only or possible options for promoting the cognitive resources of nursing home residents.
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  • 文章类型: Journal Article
    BACKGROUND: Long-term care insurance funds have been mandated by the German Prevention Act to support long-term care facilities in the implementation of health-promoting structures. One area of action is the promotion of the nursing home residents\' psychosocial health. The objective of this systematic review was to describe and analyze interventions and intervention components related to the psychosocial health of nursing home residents.
    METHODS: First, we conducted a search for systematic reviews and meta-analyses in Medline via PubMed, the Cochrane Library, CINAHL, Gerolit, Embase, Psyndex, and Livivo, and hand-searched additional sources. Second, references of all relevant randomized controlled trials (n=86) were extracted from the identified systematic reviews (n=27). The original articles of the included primary studies were then analyzed using criteria for the evaluation of complex interventions. The GRADE approach was used to assess the quality of the evidence.
    RESULTS: Seventeen interventions for promoting the psychosocial health of nursing home residents were identified. The majority of the study participants were nursing home residents with dementia. Since the underlying evidence was predominantly very low, it was not possible to draw clear conclusions concerning the efficacy of the interventions for psychosocial health outcomes. The best indications of positive effects were found for reminiscence, mealtime interventions, music therapy, and special care staff training.
    CONCLUSIONS: The diversity and heterogeneity of the interventions made both classification and consistent judgments of the quality of the evidence difficult. From the perspective of promoting the psychosocial health of nursing home residents, the identified interventions should only be considered as suggestions or proposals for prevention and health promotion measures, and future studies should evaluate their implementation.
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  • 文章类型: Journal Article
    “对我来说,学校的压力是我一生中最重要的。“-基于经验的对学校健康促进生活世界方向的影响学校是支持青少年发展所有过程的关键系统。在资格旁边,作为人格发展的一部分,青春期的所有发展任务都可以在学校环境中进行,通过紧密的相互作用。这两者相互影响,并且受到年轻人健康的影响,这对于促进青少年发展和促进年轻人日常生活中的福祉至关重要。一方面,冒险行为会影响健康和发育进步。另一方面,在应对生活和管理青少年正常发育的任务方面,生物心理社会变化可能会对年轻人提出挑战。健康状况不佳会进一步限制年轻人进入促进发展所必需的系统和社交互动。在这种情况下,健康促进中的生活世界取向成为社会工作的一个基本组成部分,尤其是学校社会工作(Rademaker,2017b).本文提出了一个关于健康的整体观点,作为年轻人日常生活的重要组成部分。本文特别关注社会工作的潜力,使年轻人能够利用可用的资源来促进与健康相关的机构。一项三角研究(2013-2015年)提供了一个实证例子。根据对500名15-16岁学生的问卷调查(N=395),可以确定三种健康类型,一个健康的,一个不健康的,一个平均的,在焦点小组讨论中采访了典型案例(N=12)。可以重建参与者生活世界中资源和结构边界的相互作用,以了解健康相关机构如何在年轻人的生活中出现,并塑造他们的健康选择。
    \"For me, Pressure at School is the Most Relevant in my Life\" - Empirical Based Implications for Life World Orientation in Health Promotion at School School is a key system that supports all processes of adolescent development. Next to qualification, as one part of personality development, all developmental tasks of adolescence can take place within the school environment, through close interplay. This interplay both influences, and is influenced by young people\'s health which is essential to promote adolescent development and foster wellbeing in everyday life for young people. On one hand, risk taking behaviour can impact health and developmental progress. On the other hand, biopsychosocial changes can emerge to challenge young people in terms of coping with life and managing the tasks of normal adolescent development. Experiencing ill health can further limit young people\'s access to systems and social interaction essential to promote development. In this instance, life world orientation in health promotion becomes one fundamental part of social work, especially school social work (Rademaker, 2017b). In this paper a holistic perspective on health is formulated, as an essential part of young people\'s daily life. The paper specifically focusses on social work\'s potential to empower young people to engage with their available resources to promote health related agency. A triangulated study (2013-2015) provides an empirical example. Based on a questionnaire with 500 pupils aged 15-16 years (N = 395), three health types could be identified, a healthy, an unhealthy and one in average, and prototypical cases (N = 12) were interviewed in focus group discussions. The interplay of resources and structural borders in the life world of the participants could be reconstructed to provide understanding of how health related agency emerges in the lives of young people and shape their option to health.
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