Nüchtern Elisabeth, Gansweid Barbara, Gerber Hans, von Mittelstaedt Gert
ehem. Medizinischer Dienst der Krankenversicherung Baden-Württemberg, Fachbereich Allgemeine Sozialmedizin, Karlsruhe.
Medizinischer Dienst der Krankenversicherung Westfalen-Lippe, Leiterin des Fachreferates Pflege, Leiterin der Sozialmedizinischen Expertengruppe ,,Pflege'' der MDK-Gemeinschaft, Bielefeld.
Gesundheitswesen. 2017 Jan;79(1):37-41. doi: 10.1055/s-0042-108583. Epub 2016 Jun 29.
By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their successful cooperation.
通过《加强长期护理第二法案》，将引入长期护理依赖的新概念，自2017年起生效。根据第十一社会法典的长期护理依赖将得到更广泛的定义。因此，德国社会医学与预防协会“实践与康复中的社会医学”部门的“护理”工作组，在研究了长期护理依赖定义和预防的社会医学视角后，公布了他们的研究结果。基于国际功能、残疾和健康分类（ICF），从社会医学角度系统地考虑了长期护理依赖的定义和预防策略，因为长期护理依赖意味着一种特定的残疾状况。当前和新的长期护理依赖概念都聚焦于活动受限。社会医学视角考虑了健康状况及其对日常活动的影响，以及个人和环境因素之间的相互作用。从这个角度可以系统地确定预防和康复方面的社会福利措施，以对抗长期护理依赖的发展和恶化。参考ICF有助于不同专业之间的交流。长期护理依赖的新“分级”将允许进行参照ICF的国际“转换”。社会医学领域的专家以及护理人员、护理研究者的共同目标是，需要护理的人能够以自主和自我决定的方式参与到对他们来说重要的生活的诸多方面。社会医学对长期护理依赖的观点，对所有相关职业群体及其成功合作来说都是至关重要的。
