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GP care

Subproject IV "Self-management in GP care"

Project goals

  • Implementation of a collaboration between nursing staff and GPs in SHI-accredited physician care
  • Setting up measures to promote self-management to enable patients to deal with the illness/symptoms more easily
  • Improvement of quality of life of patients with symptoms from the spectrum of anxiety, depressive and somatoform disorders
  • Substantial reduction of burdens caused by the psychological symptoms
  • Avoidance of the symptoms becoming chronic, with subsequent inpatient admission

Project running time
The project is running for 4 years, from January 2011 to December 2014. The intervention period in the framework of the pilot trial in the GP practice comprises 24 months.

Background of the investigation
Whether and how well patients deal with their psychological symptoms depends decisively on the therapeutic, educational, and other illness- and symptom-supporting offers that are available to the patient. The utilisation of the GP due to psychological symptoms is high. The worries and needs of a patient with burdens from the anxiety-depression-somatoform spectrum can barely be discussed in detail in the day-to-day running of the practice. Added to this is the waiting time for psychotherapeutic treatment.
Project components
Current-state analysis: By means of focus groups of GPs and practice assistants, we conduct a qualitative survey of the perspectives of the focus group participants regarding the type and scope of GP care of patients with psychological burdens. Nursing staff receive standardised training to provide self-management offers for patients with psychological burdens. In this respect, the concern is with low-threshold help or support offers, which can be integrated into outpatient GP care.
For GPs and professional nursing staff, joint case conferences are set up in order to discuss difficult situations.
Collaborations are realised with other project partners in the "Network for Mental Health" of the health metropolis of Hamburg.

Project evaluation
The acceptance of self-management measures in patients with psychological burdens is examined.
The development of the psychological burden / impairment is documented.
The patients' satisfaction with the care offers provided by the nursing staff is measured though direct survey.
Through the project-accompanying data collection, problems in the collaboration of GPs, medical assistants and nursing staff are recorded.
The quality of cooperation between the nursing staff and GPs is measured and evaluated in a qualitative manner through focus groups.

Project management

Prof. Dr. Martin Scherer
m.scherer@uke.de

Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf (UKE)

Project staff

Dr. Egina Puschmann (Research assistant)  
e.puschmann@uke.de

Dr. Thomas Zimmermann (
Research assistant)       
t.zimmermann@uke.de

Grit Bäter
g.baeter@uke.de

Svandje Carstens
s.carstens@uke.de

Martin Ebersbach
m.ebersbach@uke.de

Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf (UKE)

Contact person

Prof. Dr. Martin Scherer

Martinistr. 52
20246 Hamburg
Tel.: +49-40-7410-52400
Fax.: +49-40-7410-53681

m.scherer@uke.de

Presentations psychenet Symposium 2015

"Selbstmanagementförderung durch Pflegekräfte" Dr. Thomas Zimmermann (UKE)

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"Interdisziplinäre Kooperation bei Depression im höheren Lebensalter – German IMPACT" Prof. Dr. Wilhelm Niebling (Universitätsklinikum Freiburg)

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"Monitoring psychischer Belastungen in der Hausarztpraxis – PRoMPT-Projekt" Prof. Dr. Jochen Gensichen (Universitätsklinikum Jena)

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Poster

Poster Symposium 2012

German version

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Poster "Informationen für die Bevölkerung"

German version

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Hauptergebnisse

Collaborative nurse-led self-management support for primary care patients with anxiety, depressive or somatic symptoms: Cluster-randomised controlled trial (findings of the SMADS study)

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Publications

Härter, M., Kentgens, M., Brandes, A., Bock, T., Dirmaier, J., Erzberger, M., Fürstenberg, W., Hillebrandt, B., Karow, A., Knesebeck, O., König, H.H., Löwe, B., Meyer, H.J., Romer, G., Rouhiainen, T., Scherer, M., Thomasius, R., Watzke, B., Wegscheider, K. & Lambert, M. (2012). Rationale and content of psychenet: the Hamburg Network for Mental Health. European Archive of Psychiatry and Clinical Neuroscience. Advance online publication. doi:10.1007/s00406-012-0359-y. Pubmed

Porzelt, S., Zimmermann, T., Ernst, A., Puschmann, E., Scherer, M. (2016). Wie Pflegekräfte in der hausärztlichen Versorgung Patienten mit psychischen Beschwerden gezielt unterstützen können. Pflegewissenschaft, 18, 7-8, 355-361.

Zimmermann, T., Puschmann, E., Bäter, G., Carstens, S. & Scherer, M. (2012). Selbstmanagement stärken bei psychosozialen Belastungen: Ein neues Modell der Zusammenarbeit zwischen Hausärzt/innen und psychosozial geschulten Pflegekräften. Die Kerbe – Forum der Sozialpsychiatrie, 4, 24-27. Link

Zimmermann, T., Puschmann, E., Ebersbach, M., Daubmann, A. & Scherer, M. (2014). Effectiveness of a primary care based complex intervention to promote self-management in patients presenting psychiatric symptoms: study protocol of a cluster-randomized controlled trial. BMC Psychiatry 14, 2. pubmed

Zimmermann, T., Puschmann, E., Porzelt, S., Ebersbach, M., Ernst, A., Thomsen, P. & Scherer, M. (2015). Selbstmanagementförderung in der hausärztlichen Versorgung - der Zusammenhang zwischen Veränderungsmotivation, Selbstwirksamkeit und psychischer Belastung vor Beginn der Intervention. Psychiatrische Praxis 42, Supplement 1, S44-S48.

Zimmermann, T., Puschmann, E., Porzelt, S., Ernst, A., Wiese, B., Daubmann, A., van den Bussche, H., Scherer, M. (2016). Collaborative nurse-led self-management support for primary care patients with anxiety, depressive or somatic symptoms: Cluster-randomised controlled trial (findings of the SMADS study). International Journal of Nursing Studies, 63, 11, 101-111. Link

Congresses:

Puschmann, E. , Zimmermann, T., van den Bussche, H. & Scherer, M. (2011). Selbstmanagementförderung bei Patienten mit Angst, Depression oder somatoformen Störungen in der hausärztlichen Versorgung durch Kooperation zwischen Hausärzten und Pflegekräften. 45. Kongress der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin, 22.-24. September 2011, Salzburg, Deutschland. Link

Baeter, G., Puschmann, E. , Carstens, S., van den Bussche, H., Scherer, M. & Zimmermann, T. (2012).  Selbstmanagementförderung in der hausärztlichen Versorgung durch eine qualifizierte Beratungsassistenz. 46. Kongress der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin, 20.-22. September 2012, Rostock, Deutschland.

Puschmann, E., Zimmermann, T., Carstens, S., Baeter, G., van den Bussche, H. & Scherer, M., (2012). Engpass Psychotherapie- Alternative Angebote für Patienten mit Symptomen der Angst, Depression und Somatoformen Störungen. 46. Kongress der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin, 20.-22. September 2012, Rostock, Deutschland.