Neue Wege in der Versorgung von Patienten mitfunktionellen Syndromen – Interdisziplinäre Gruppen­behandlung in der Hausarztpraxis: Eine qualitative Studie^[*]

Zusammenfassung

Schnittstellenprobleme behindern die kooperative Versorgung funktioneller Syndrome. Die speziALL-Studie untersuchte eine störungsorientierte Gruppenintervention durch Psychosomatiker und Hausarzt in dessen Praxis. Mit der Frage ihrer konkreten Zusammenarbeit analysierte unsere qualitative Studie Freitextantworten zur gemeinsamen Gruppenleitung von allen 18 Interventionsärzten. Aus Hausarzt-Sicht sollten 20-min strukturierte Vor- und Nachbesprechungen alle Sitzungen begleiten. Funktion der Vorbesprechungen sei: Distanz zum Alltag gewinnen, sich auf die Gruppe und aufeinander einstimmen, die Sitzung inhaltlich vorbereiten. Funktion der Nachbesprechungen sei: Austausch, Reflextion der Sitzung, Planung der Weiterbehandlung. Dem Psychosomatiker wurden die Rollen Gruppenleiter und Experte zugeschrieben. Sich selbst sahen die Hausärzte als Bezugsperson des Patienten, Bindeglied zwischen den Ebenen und Kotherapeuten. Zentral erschien eine gelingende Rollenaufteilung.

Abstract

Interface problems between health care sectors hinder collaborative care in functional syndromes. The speciAL trial investigated a disorder-oriented group intervention conducted by the general practitioner (GP) and a psychosomatic specialist (PS) in the GP’s office. To evaluate the GP-PS cooperation, our qualitative study analysed free text statements about collaborative group leading of all 18 intervention GPs. In the GPs’ view, all sessions should structuredly be prepared and reviewed together for 20 min. Functions of the preparatory communication were gaining distance from daily business, attunement to the group and to each other, and preparing for the session topics. Functions of the communication after the sessions were professional exchange, reflection of the session and further treatment planning. The GPs saw the PS’s role as a group leader and expert, their own role as a reference person for the patient, a link between all dimensions and a cotherapist. Crucial seemed a succeeding role splitting.

Schlüsselwörter

somatoforme Störungen - kooperative Versorgung - gemeinsame Versorgung - interdisziplinäre Gruppenintervention - qualitative Forschung

Keywords

somatoform disorders - collaborative care - shared care - interdisciplinary group intervention - qualitative research

*

^* Gabriele Kirsch ist gleichberechtigte Erstautorin.

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