ZusammenfassungMehr als die Hälfte der deutschen Bevölkerung hat Schwierigkeiten
im Umgang mit Gesundheitsinformationen. Es ist eine wichtige Aufgabe der
Versorgungsforschung zu untersuchen, wie sich die Professionen und
Organisationen des Gesundheitssystems dieser Herausforderung stellen
können. Das DNVF Memorandums Gesundheitskompetenz (Teil 1) nimmt
Begriffsbestimmungen der individuellen und organisationalen Gesundheitskompetenz
vor, präsentiert den nationalen und internationalen Forschungsstand und
stellt ethische Aspekte der versorgungsbezogenen Gesundheitskompetenzforschung
dar. Weiterhin wird die Relevanz der Gesundheitskompetenzforschung in
verschiedenen Lebensphasen, bei unterschiedlichen Personengruppen sowie in
verschiedenen Kontexten der Gesundheits- und Krankenversorgung erarbeitet. Vor
diesem Hintergrund werden zentrale Forschungsgegenstände und
zukünftige Forschungsdesiderata abgeleitet.
Currently, early detection of breast cancer offers the most promising possibility to optimize the diagnosis and treatment of breast cancer and, as a result, reduce breast cancer mortality and improve health related quality of life in women.
The KFU targeted group of women was reached and the organised mammography screening programme was well perceived by invited women. For developing a lasting communication strategy information deficits have to be considered along with beliefs and attitudes of elegible women.
Treatment decisions in oncology are based on a balance between the efficacy of therapy and its side effects. Patients with metastases and patients with a limited prognosis are a particular challenge, since communication about the disease situation and the expected therapeutic benefit is difficult not only for patients, but also for physicians. The aim of this study was therefore to compare the benefits expected of therapy by patients and physicians. Questionnaires were sent to 9,000 breast cancer patients and to 6,938 physicians. The questionnaires described 10 cases of breast cancer in the metastatic setting. The patients and physicians were asked to state the treatment benefit they would require to decide for the therapy options chemotherapy, endocrine therapy, antibody therapy, radiotherapy, and bisphosphonates. Additionally, the participants provided data on patient and physician characteristics. Expected treatment benefits were compared between patients and physicians, and influencing factors that modified the expected benefit were identified. Patients expected much greater benefits from the therapies offered than the physicians. For all treatment modalities, about 50 % or more of patients expected more than a 12-month increase in overall survival from all therapies. Among the doctors, this proportion ranged from 7 to 30 %. Among patients, previous experience of side effects and having young children in the family were the strongest influencing factors. Among the doctors, age and level of education had a strong influence on the expected prognostic improvement to indicate a therapy option. As expectations of treatment differ greatly between patients and doctors, a structured approach to solving this conflict is required. There appear to be some indicators that might help address the problem, such as the physicians' level of training and experience and the patients' specific social circumstances.
. Patients were included consecutively between March and November 2010. The Cologne Patient Questionnaire-Breast Cancer (CPQ-BC) was used, which assesses a number of aspects of hospital care as perceived by the patients, among them provider-patient interaction, the diseasespecific information provided, the quality of organization, and room amenities. 128 of 195 Breast Care Centers and 160 of 251 hospitals participated in the study. 8226 patients consented to the survey. The questionnaires of 7301 patients could be included in the analyses (89%). Overall, the results showed that patients are satisfied with their hospital stay and that the accreditation criteria are implemented in a way that serves the patients. However, there is room for improvement for a number of issues, for example with regard to the provision of information and patient involvement in decision making. In addition, for a number of indicators substantial differences were found between the hospitals. The results of the survey provide information on the breast centersʼ development and can be used by the centersʼ surgery locations for benchmarking purposes, to identify strengths and weaknesses, and to take actions.
Zusammenfassung
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