Our aim was to analyze the existing body of evidence about inpatient care of patients suffering from rheumatoid arthritis (RA). The report was induced by the executive board of the German Society of Rheumatology which assigned the "Oliver-Sangha committee" to dissect and point out the tasks of inpatient care during the next few years. A systemic search of the literature was performed covering the years 1966 to 2001. A total of 16 studies were selected and thoroughly appraised in a systematic way. Four randomized controlled trials addressing the question could be identified. All of them included only patients in a clinical condition allowing outpatient care as well. Two studies indicate some advantage of inpatient care in comparison to outpatient treatment. Two studies, both equivalence studies from design, reveal that RA patients do not generally experience additional benefit from hospitalization. Consideration of two additional cohort studies demonstrates the increased need of inpatient care in RA patients. None of the studies was derived from the German health care system. Emergency cases were not the subject of any of these trials. General statements about the value of inpatient care of RA patients can not be drawn from the analyzed studies. The committee makes suggestions for future investigations that may help to answer this important question considering the special circumstances of the German health care system.
The German Association against Rheumatism and Arthritis considers the improvement of health literacy as one of their most important tasks. In local groups people with arthritis have the chance to exchange experiences and to benefit from consultation. Individual experiences are merged into a collective knowledge. Numerous printed media as well as information and exchange via the internet help to improve health literacy. Self-management courses and patient education courses are specific instruments to improve the competences of people with arthritis to manage their own condition. Through exercise programs, which are offered locally, the Association strives to improve self-efficacy regarding exercise. A survey of the members showed that the activities of the patient association are well accepted and valued. The empowered patient has more and more become a partner in the micro-level communication with their doctor. On the macro-level, patient representatives play an important role in the committees of the German self-administration of health insurance and physician organizations.
BackgroundPeople with arthritis often do not receive optimum care and support due to difficulties in navigating the health care system in Germany. In Germany one of the main difficulties of the health system is a lack of cooperation between different health care providers.ObjectivesDeutsche Rheuma-Liga wants to provide information and advice for people with different levels of health literacy and different needs, offering a broad range of contact forms and different media.MethodsDeutsche Rheuma-Liga provides information personally, on telephone helplines and on the internet. Information is provided by peers and specialized professional advice is offered regarding specific issues (legal, medical). For three years a project has been carried out on the national level providing an additional guiding service (Rheuma-Lotse) in two regional offices and a specialised guiding service for people with rare forms of arthritis. We offer written information in a wide range of print materials, in the internet, in social media and internet forums. Information is tailored to different age groups and to different levels of health literacy. A new line of leaflets provides information for people who are not able to read difficult and long texts.ResultsA member/nonmember survey showed that the members view Deutsche Rheuma-Liga as the second most important provider of information. Only the GP is considered even more important. However, Deutsche Rheuma-Liga has not yet reached a similar result with non-members.ConclusionsMore effort will be necessary to reach the general public and provide information about the many information and advice services to people who have not yet had contact with Deutsche Rheuma-Liga.Disclosure of InterestNone declared
Struktur und Entwicklung der Selbsthilfe ▼ Die Selbsthilfe ist im Gesundheitsbereich aber längst aus den Privatzimmern hervorgekommen und wirkt zunehmend nach außen [ 1 ] . In einigen Fällen war wie bei der Rheuma-Liga bereits bei der Gründung auch die Bereitstellung von selbstbestimmten Hilfeangeboten oder die politische Interessenvertretung Teil der Zielsetzung. Die auf Außenwirkung angelegte Arbeit beginnt mit der Öff entlichkeitsarbeit der örtlichen Gruppen, um die eigenen Treff en bekannt zu machen, reicht über Beratungsangebote für gleichermaßen Betroff ene, die (noch) nicht zu regelmäßigen Gruppentreff en kommen wollen, und reicht heute bis hin zu bundesweiten Aufklärungskampagnen, Dienstleistungsangeboten, Forschungsförderung und kollektiver Interessenvertretung. Der GKV Spitzenverband geht in seinem Leitfaden zur Selbsthilfeförderung 2009 davon aus, Ursula Faubel ▼ Selbsthilfe als gegenseitige Unterstützung von gleichermaßen Betroff enen kommt in ihrem Kern ohne jedes "Amt" aus. Wenn eine Gruppe von Menschen sich im privaten Raum regelmäßig triff t, um sich zu einem gemeinsamen Problem auszutauschen und gegenseitig zu stärken, brauchen sie dazu keine Vorsitzende und keine Geschäftsführerin 1 . Autor U. Faubel Institut Deutsche Rheuma-Liga Bundesverband, Bonn Zusammenfassung ▼ Ehren-und hauptamtliche Tätigkeit ergänzt sich in Nonprofi t-Organisationen. In gemeinnützigen Organisationen existieren häufi g Mischformen zwischen bezahltem und unbezahltem Engagement. Hinsichtlich der Motivation fi nden sich bei haupt-und ehrenamtlichen Führungskräften ähnliche Perspektiven. Selbsthilfeorganisationen im Gesundheitswesen unterscheiden in der Aufgabenverteilung, ob für bestimmte Aufgaben eher eine Betroff enenkompetenz oder eine professionelle Fachkompetenz benötigt wird. Sie stellen die vorrangige Berücksichtigung der Betroff enenperspektive in Hinblick auf die Zieldefi nition und Richtlinienkompetenz sicher und ermöglichen Betroff enen ihre besonderen Kompetenzen in Arbeitsfeldern wie der Peer-GroupBeratung und der Interessenvertretung einzubringen. Abstract ▼
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