[Patient self-help, user perspective and health services research].

Patient's individual responsibility, self-help and active co-operation are essential for the health care system. This paper presents a synopsis of research in self-help groups and self-help organizations. Studies provide evidence that self-help initiatives are an important contribution to population health. Especially self-help groups increase mutual aid and social support, knowledge about the disease and its consequences and possibilities for changing attitudes of the group members and their social environment. They disburden primary networks and families and reinforce an 'intelligent' utilization of professional health care services. There has been as yet hardly any systematic investigation of the activities of self-help organizations, except from counseling services. Self-help groups and organizations increasingly receive financial support from the social security system and have increasingly become part of the health care system. However, the co-operation between self-help initiatives and the professional health care system is characterized by an imbalance between laymen and experts. Given these results, self-help, user perspective and the health-related behavior of laymen should obtain more significance in the conceptualization and definitions of health services research.