Söllner W, Stix P, Stein B, Franz M, Lampe A, Herzog T
Klinik für Psychosomatik und Psychotherapeutische Medizin, Klinikum Nürnberg, Prof. Ernst-Nathan-Strasse 1, D-90419 Nürnberg, Deutschland.
Wien Med Wochenschr. 2002;152(19-20):528-34. doi: 10.1046/j.1563-258x.2002.02093.x.
Besides the integrated psychosomatic models in various medical specialities (e.g. Internal medicine, Obstetrics and Gynaecology or Paediatrics), specific models of cooperation in the form of consultation-liaison (C-L) service between specialised psychosomatic-psychotherapeutic departments and other medical departments play a crucial role in providing psychosomatic care to patients. The concept 'liaison' expresses a particularly close form of cooperative activity, going far beyond the classical model of consultation services. In this context, the psychosomatic consultant has not only a fixed organised presence in the provision of patient care, he/she also participates in case discussions, hospital rounds, ward discussions and continuing education programmes of the 'partner' department. Thus, the liaison service is not only patient-centred, but also team-centred. Such consultation-liaison services, in Austria, were first established at the University Hospitals. As a consequence of laws regulating psychotherapeutic care, according to which such care is to be offered in general hospitals, increasingly C-L services are becoming part of regular care provision in more and more hospitals. Consensus groups, international as well as in German-speaking countries, are currently working on establishing quality standards in the area of psychosomatic C-L services. A working group of the scientific medical representatives has recently published guidelines for the structure, process and results of quality control. A second group, of the European Association of Consultation Liaison Psychiatry and Psychosomatics, is currently working on guidelines for training consultation-liaison service providers. In the present article, an overview of these projects will be presented and the results discussed against the background of the specific health policy situation in Austria.
除了各医学专科(如内科、妇产科或儿科)中的综合身心医学模式外,专门的身心治疗科室与其他医学科室之间以会诊-联络(C-L)服务形式开展的特定合作模式,在为患者提供身心护理方面发挥着关键作用。“联络”这一概念体现了一种特别紧密的合作活动形式,远远超出了传统会诊服务模式。在这种情况下,身心医学顾问不仅在患者护理工作中有固定的组织存在,还参与“伙伴”科室的病例讨论、医院查房、病房讨论和继续教育项目。因此,联络服务不仅以患者为中心,还以团队为中心。在奥地利,此类会诊-联络服务最初是在大学医院设立的。由于规范心理治疗护理的法律规定此类护理应在综合医院提供,越来越多的医院中,会诊-联络服务正日益成为常规护理的一部分。国际以及德语国家的共识小组目前正在致力于制定身心会诊-联络服务领域的质量标准。科学医学代表的一个工作组最近发布了质量控制的结构、流程和结果指南。欧洲会诊联络精神病学和身心医学协会的第二个小组目前正在制定会诊-联络服务提供者培训指南。在本文中,将对这些项目进行概述,并结合奥地利特定的卫生政策情况对结果进行讨论。