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Papers by Marieluise Dierks
Counsellors of Independent Health Information Centres according to 65b Social Security Code V pro... more Counsellors of Independent Health Information Centres according to 65b Social Security Code V provide the public with comprehensive information on health and disease-related themes, as well as on their financial, service, and legal aspects; they also provide extensive counselling and psychosocial support. The counsellors mostly have a university background in educational, social, medical, or legal disciplines; they usually have long-term experience in counselling as well as additional professional qualifications. In addition to the provision of information, independent health information centres must also be active in assuring and promoting their own quality control. Different measures are applied for this purpose, however at this time there are no standardised, high-quality activities of the independent health information centres to ensure quality.
Handbuch Partizipation Und Gesundheit, 2012
Public Health Forum, 2011
Zielgruppengerechte Gesundheitskommunikation, 2009
ABSTRACT Gesundheit ist ein hochgeschätztes Gut. In der Werteskala der deutschen Bürgerinnen und ... more ABSTRACT Gesundheit ist ein hochgeschätztes Gut. In der Werteskala der deutschen Bürgerinnen und Bürger werden Gesundheit und eine gute Gesundheitsversorgung an einer der oberen Stellen genannt (vgl. Stiftung für Zukunftsfragen 2007). Auch der Gesundheitsmarkt wächst: Informationen, Produkte und Dienstleistungen sind in immer größerer Zahl verfügbar. Gleichzeitig hat sich das Rollenverständnis der Menschen im Gesundheitswesen gewandelt – Patienten sollen und wollen heute als gleichberechtigte Partner in der Arzt-Patienten-Beziehung auftreten (vgl. Härter, Loh und Spies 2005), ihre Bedürfnisse und Erwartungen formulieren (vgl. Coulter und Magee 2003; Dierks et al 2006, S. 13 ff.), angesichts der Informationsflut zwischen adäquaten und inadäquaten Informationen unterscheiden, die „richtige“ Behandlungseinrichtung finden, über Finanzierungsfragen und damit zusammenhängende Rechte und Pflichten informiert sein (vgl. Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen 2002, S. 257 ff.), ihre Rechte als Patienten kennen und individuell und kollektiv aktiv vertreten (vgl. Hart 2003, 330 ff.) und sich in einem zunehmend marktwirtschaftlich organisierten System zurechtfinden.
BMC health services research, 2007
The political objective in many countries worldwide is to give better consideration to the intere... more The political objective in many countries worldwide is to give better consideration to the interests of patients within the health system. The establishment of a federal government commissioner for the issues of patients in the health system in Germany in 2004 is part of these endeavours. The structure and field of activities of this institution has been unique so far. This study investigates for the first time the inquiries the commissioner receives from the public. A 33% sampling (n = 850) of the written inquiries (correspondence and e-mails) addressed to the commissioner in the first six months of the year 2005 (n = 2580) was investigated. In a procedure comprising combined qualitative and quantitative levels, the material was thematically encoded and the inquiries allocated to the resulting categories (multiple nominations). The results are presented in descriptive form and investigated especially with respect to sex and age-specific differences. The interdependences between the...
Social Science & Medicine, 2007
The World Health Organisation (WHO) concept of responsiveness has been defined as a measure of ho... more The World Health Organisation (WHO) concept of responsiveness has been defined as a measure of how well the health system responds to the population's legitimate expectations of non-health aspects of health care provision. It comprises eight domains: dignity, prompt attention, autonomy, choice of health care provider, clear communication, confidentiality, quality of basic amenities, and access to social support networks. The concept is of particular relevance to mental health care systems because of the specific dependency and vulnerability of their users. We tested its applicability to mental health care with five focus groups of experienced mental health care users in Hannover, Germany. The focus groups revealed 492 statements about users' expectations in mental health care. Most concerned attention (115), dignity (108) and autonomy (86). The quotations were assigned to the eight responsiveness domains. In addition, the domain of prompt attention was extended and renamed attention, and the new domain continuity was created. The findings correspond with the literature on health care expectations of non-mental health patients, but differ slightly from the results of a WHO study on overall health care responsiveness. The need for widening the concept of continuity and extending the attention domain reflects the nature of mental health care of providing predominately long-term care. Our analysis indicates the feasibility of the responsiveness concept (if altered as proposed) as a tool for assessing the quality of mental health service from the users' point of view. It should also be further developed to quantitatively evaluate mental health care systems and to benchmark system performance.
Public Health Forum, 2007
Die gesundheitliche Versorgung a¨lterer, chronisch kranker und multimorbider Menschen in Deutschl... more Die gesundheitliche Versorgung a¨lterer, chronisch kranker und multimorbider Menschen in Deutschland ist defizita¨r. Die Versorgungs-abla¨ufe und -strukturen sind unzureichend auf den Versorgungsbedarf dieser Zielgruppe ausgerichtet, was nicht zuletzt an starren Barrieren zwischen den beteiligten Berufsgruppen, Fachdisziplinen, Institutionen und Diensten liegt. In Anbetracht der demografischen Entwicklung, die mit einem zunehmenden Anteil hochaltriger Menschen mit ihren alterstypischen gesundheitlichen Problemen einhergeht, ist es entscheidend, die gesundheitliche Versorgung besser an die tatsa¨chlichen Bedu¨rfnisse der Betroffenen anzupassen (Dierks und Schaeffer, 2006;. Obwohl die Gruppe der Hochbetagten mittlerweile auch in der Versorgungsforschung wahrgenommen wird (Mayer und
Patient Education and Counseling, 2013
European Journal of General Practice, 2010
Setting health and treatment priorities is necessary when caring for multiple and complex patient... more Setting health and treatment priorities is necessary when caring for multiple and complex patient issues. This is already done in the doctor-patient consultation-yet implicitly rather than explicitly. The aim of this European General Practice Network workshop was to advance a consultation approach that deals with shared priority setting. The workshop was divided into three parts: (1) how to gain a comprehensive health overview for patients with multiple problems as a basis for priority setting; (2) how to establish priorities considering patient and doctor perspectives; and (3) how to practice a communication style that achieves shared priority setting. The workshop participants preferred to gain information on patients' health status using documentations from patient records rather than conducting systematic assessments. The group emphasized that medical as well as everyday life problems need to be considered when determining priorities, a procedure that requires time and resources not readily available in daily practice. Existing skills for person-centred communication with patients should be applied in order to agree on priorities. Overall it became apparent how challenging it is to arrange and prioritize an array of health problems in a consultation with patients. Existing concepts augmented by innovative systematic methods may be the way forward.
BMC Health Services Research
Background: Evidence-based information is a precondition for informed decision-making and partici... more Background: Evidence-based information is a precondition for informed decision-making and participation in health. There are several recommendations and definitions available on the generation and assessment of so called evidence-based health information for patients and consumers (EBHI). They stress the importance of objectively informing people about benefits and harms and any uncertainties in health-related procedures. There are also studies on the comprehensibility, relevance and user-friendliness of these informational materials. But to date there has been little research on the perceptions and cognitive reactions of users or lay people towards EBHI. The aim of our study is to define the spectrum of consumers' reaction patterns to written EBHI in order to gain a deeper understanding of their comprehension and assumptions, as well as their informational needs and expectations.
Counsellors of Independent Health Information Centres according to 65b Social Security Code V pro... more Counsellors of Independent Health Information Centres according to 65b Social Security Code V provide the public with comprehensive information on health and disease-related themes, as well as on their financial, service, and legal aspects; they also provide extensive counselling and psychosocial support. The counsellors mostly have a university background in educational, social, medical, or legal disciplines; they usually have long-term experience in counselling as well as additional professional qualifications. In addition to the provision of information, independent health information centres must also be active in assuring and promoting their own quality control. Different measures are applied for this purpose, however at this time there are no standardised, high-quality activities of the independent health information centres to ensure quality.
Handbuch Partizipation Und Gesundheit, 2012
Public Health Forum, 2011
Zielgruppengerechte Gesundheitskommunikation, 2009
ABSTRACT Gesundheit ist ein hochgeschätztes Gut. In der Werteskala der deutschen Bürgerinnen und ... more ABSTRACT Gesundheit ist ein hochgeschätztes Gut. In der Werteskala der deutschen Bürgerinnen und Bürger werden Gesundheit und eine gute Gesundheitsversorgung an einer der oberen Stellen genannt (vgl. Stiftung für Zukunftsfragen 2007). Auch der Gesundheitsmarkt wächst: Informationen, Produkte und Dienstleistungen sind in immer größerer Zahl verfügbar. Gleichzeitig hat sich das Rollenverständnis der Menschen im Gesundheitswesen gewandelt – Patienten sollen und wollen heute als gleichberechtigte Partner in der Arzt-Patienten-Beziehung auftreten (vgl. Härter, Loh und Spies 2005), ihre Bedürfnisse und Erwartungen formulieren (vgl. Coulter und Magee 2003; Dierks et al 2006, S. 13 ff.), angesichts der Informationsflut zwischen adäquaten und inadäquaten Informationen unterscheiden, die „richtige“ Behandlungseinrichtung finden, über Finanzierungsfragen und damit zusammenhängende Rechte und Pflichten informiert sein (vgl. Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen 2002, S. 257 ff.), ihre Rechte als Patienten kennen und individuell und kollektiv aktiv vertreten (vgl. Hart 2003, 330 ff.) und sich in einem zunehmend marktwirtschaftlich organisierten System zurechtfinden.
BMC health services research, 2007
The political objective in many countries worldwide is to give better consideration to the intere... more The political objective in many countries worldwide is to give better consideration to the interests of patients within the health system. The establishment of a federal government commissioner for the issues of patients in the health system in Germany in 2004 is part of these endeavours. The structure and field of activities of this institution has been unique so far. This study investigates for the first time the inquiries the commissioner receives from the public. A 33% sampling (n = 850) of the written inquiries (correspondence and e-mails) addressed to the commissioner in the first six months of the year 2005 (n = 2580) was investigated. In a procedure comprising combined qualitative and quantitative levels, the material was thematically encoded and the inquiries allocated to the resulting categories (multiple nominations). The results are presented in descriptive form and investigated especially with respect to sex and age-specific differences. The interdependences between the...
Social Science & Medicine, 2007
The World Health Organisation (WHO) concept of responsiveness has been defined as a measure of ho... more The World Health Organisation (WHO) concept of responsiveness has been defined as a measure of how well the health system responds to the population's legitimate expectations of non-health aspects of health care provision. It comprises eight domains: dignity, prompt attention, autonomy, choice of health care provider, clear communication, confidentiality, quality of basic amenities, and access to social support networks. The concept is of particular relevance to mental health care systems because of the specific dependency and vulnerability of their users. We tested its applicability to mental health care with five focus groups of experienced mental health care users in Hannover, Germany. The focus groups revealed 492 statements about users' expectations in mental health care. Most concerned attention (115), dignity (108) and autonomy (86). The quotations were assigned to the eight responsiveness domains. In addition, the domain of prompt attention was extended and renamed attention, and the new domain continuity was created. The findings correspond with the literature on health care expectations of non-mental health patients, but differ slightly from the results of a WHO study on overall health care responsiveness. The need for widening the concept of continuity and extending the attention domain reflects the nature of mental health care of providing predominately long-term care. Our analysis indicates the feasibility of the responsiveness concept (if altered as proposed) as a tool for assessing the quality of mental health service from the users' point of view. It should also be further developed to quantitatively evaluate mental health care systems and to benchmark system performance.
Public Health Forum, 2007
Die gesundheitliche Versorgung a¨lterer, chronisch kranker und multimorbider Menschen in Deutschl... more Die gesundheitliche Versorgung a¨lterer, chronisch kranker und multimorbider Menschen in Deutschland ist defizita¨r. Die Versorgungs-abla¨ufe und -strukturen sind unzureichend auf den Versorgungsbedarf dieser Zielgruppe ausgerichtet, was nicht zuletzt an starren Barrieren zwischen den beteiligten Berufsgruppen, Fachdisziplinen, Institutionen und Diensten liegt. In Anbetracht der demografischen Entwicklung, die mit einem zunehmenden Anteil hochaltriger Menschen mit ihren alterstypischen gesundheitlichen Problemen einhergeht, ist es entscheidend, die gesundheitliche Versorgung besser an die tatsa¨chlichen Bedu¨rfnisse der Betroffenen anzupassen (Dierks und Schaeffer, 2006;. Obwohl die Gruppe der Hochbetagten mittlerweile auch in der Versorgungsforschung wahrgenommen wird (Mayer und
Patient Education and Counseling, 2013
European Journal of General Practice, 2010
Setting health and treatment priorities is necessary when caring for multiple and complex patient... more Setting health and treatment priorities is necessary when caring for multiple and complex patient issues. This is already done in the doctor-patient consultation-yet implicitly rather than explicitly. The aim of this European General Practice Network workshop was to advance a consultation approach that deals with shared priority setting. The workshop was divided into three parts: (1) how to gain a comprehensive health overview for patients with multiple problems as a basis for priority setting; (2) how to establish priorities considering patient and doctor perspectives; and (3) how to practice a communication style that achieves shared priority setting. The workshop participants preferred to gain information on patients' health status using documentations from patient records rather than conducting systematic assessments. The group emphasized that medical as well as everyday life problems need to be considered when determining priorities, a procedure that requires time and resources not readily available in daily practice. Existing skills for person-centred communication with patients should be applied in order to agree on priorities. Overall it became apparent how challenging it is to arrange and prioritize an array of health problems in a consultation with patients. Existing concepts augmented by innovative systematic methods may be the way forward.
BMC Health Services Research
Background: Evidence-based information is a precondition for informed decision-making and partici... more Background: Evidence-based information is a precondition for informed decision-making and participation in health. There are several recommendations and definitions available on the generation and assessment of so called evidence-based health information for patients and consumers (EBHI). They stress the importance of objectively informing people about benefits and harms and any uncertainties in health-related procedures. There are also studies on the comprehensibility, relevance and user-friendliness of these informational materials. But to date there has been little research on the perceptions and cognitive reactions of users or lay people towards EBHI. The aim of our study is to define the spectrum of consumers' reaction patterns to written EBHI in order to gain a deeper understanding of their comprehension and assumptions, as well as their informational needs and expectations.