Schwarz Julian, Bechdolf Andreas, Hirschmeier Constance, Hochwarter Stefan, Holthoff-Detto Vjera, Mühlensiepen Felix, Richter Christoph, Rout Sandeep, Weinmann Stefan, Heinze Martin, von Peter Sebastian
Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Immanuel Klinik Rüdersdorf.
Kliniken für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser der Charité - Universitätsmedizin Berlin.
Psychiatr Prax. 2021 May;48(4):193-200. doi: 10.1055/a-1274-3662. Epub 2020 Dec 11.
The obstacles to implementation of a German variation of psychiatric Home-Treatment (HT), called "Inpatient Equivalent Home-Treatment" (IEHT) are examined.
43 employees from 11 psychiatric hospitals in the federal states of Berlin and Brandenburg were questioned using interviews and focus groups. A thematic analysis was conducted using the socio-institutional theoretical model.
At system-level, implementation is hampered by an inadequate service definition, staff shortages, as well as performance assessments by health insurances. This leads to reluctant implementation at hospital-level with insufficient staffing of the teams. Other barriers include a lack of mobile devices for documentation and team communication. At the level of employees, poor information, and cooperation as well as unclear assignment of tasks are impeding factors.
For a more needs-oriented, flexible, and nationwide introduction of HT according to IEHT, improvements to the underlying framework conditions and further research addressing efficacy, effectiveness and implementation are necessary.
研究德国一种名为“住院等效家庭治疗”（IEHT）的精神科家庭治疗模式实施过程中的障碍。
通过访谈和焦点小组对来自柏林和勃兰登堡联邦州11家精神病医院的43名员工进行了询问。使用社会制度理论模型进行了主题分析。
在系统层面，服务定义不充分、人员短缺以及医疗保险的绩效评估阻碍了实施。这导致医院层面实施不力，团队人员配备不足。其他障碍包括缺乏用于记录和团队沟通的移动设备。在员工层面，信息不畅、合作不佳以及任务分配不明确是阻碍因素。
为了根据IEHT更以需求为导向、灵活且在全国范围内引入家庭治疗，有必要改善基础框架条件，并进一步开展关于疗效、有效性和实施的研究。
