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Erschienen in: Pädiatrie & Pädologie 1/2014

01.10.2014 | Leitthema

Therapie als Partizipationschance

verfasst von: Prof. Dr. C. Popow

Erschienen in: Pädiatrie & Pädologie | Sonderheft 1/2014

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Zusammenfassung

Partizipation [“shared decision making“ (SDM)], die Teilhabe an medizinischen Entscheidungen, welche die eigene Person oder anvertraute Personen betreffen, ist ein Menschenrecht. In Abhängigkeit von der Einsichts-, Urteils- und Entscheidungsfähigkeit steht es jedem Menschen zu. Es beinhaltet das Recht auf entsprechende verständliche Information und auch das Recht bzw. die Pflicht, auf der Grundlage dieser Information Entscheidungen über diagnostische und therapeutische Maßnahmen (mit) zu treffen. Informierte und mitentscheidende Patienten verfügen über bessere Behandlungsgrundlagen, da der individuelle medizinische Hintergrund verständlicher wird. Sie erzielen auch bessere Behandlungsergebnisse, da sie besser motiviert sind, notwendige medizinische Maßnahmen wie Medikamenteneinnahmen auch längerfristig zu tolerieren. Partizipation bedeutet auch eine Chance, durch Wissen und Verantwortung das Krankheitsgeschehen positiv und sinnvoll zu erleben. Der relativ geringe Mehraufwand für die Informationsarbeit und die Entscheidungsunterstützung rechnet sich sowohl hinsichtlich der Arzt-Patienten-Beziehung als auch in Bezug auf Behandlungsmotivation, -sicherheit und -ergebnis. Wir stellen Partizipationsmodelle und -ergebnisse vor, u. a. aus der Onkologie, Hals-Nasen-Ohren-Heilkunde und Diabetologie. Die spärlichen Studien zeigen, dass Ärzte und Patienten wenig über SDM informiert sind: Trotz vorhandener Richtlinien, z. B. des National Collaborating Centre for Primary Care, sind nur etwa 10 % der Patienten im Sinne des SDM in die medizinischen Entscheidungsprozesse einbezogen. Partizipation kann und sollte gelernt und von den Patienten als selbstverständliches Recht verlangt werden.
Fußnoten
1
„Assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child“ und „be provided the opportunity to be heard“.
 
2
„The child shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds“.
 
3
„Das schlimmste Unrecht ist die Missachtung der Würde. … Da wird jemand abgelehnt, weil ihm angeblich etwas fehlt, weil er anders ist, zu wenig geeignet, daher mit Fug und Recht minderprivilegiert. Aber niemand darf als zweitklassig eingestuft werden. Das ist unerträglich. Es ist legitim, sich dagegen aufzulehnen“ [3].
 
4
„Participation is adults listening to children“.
 
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Metadaten
Titel
Therapie als Partizipationschance
verfasst von
Prof. Dr. C. Popow
Publikationsdatum
01.10.2014
Verlag
Springer Vienna
Erschienen in
Pädiatrie & Pädologie / Ausgabe Sonderheft 1/2014
Print ISSN: 0030-9338
Elektronische ISSN: 1613-7558
DOI
https://doi.org/10.1007/s00608-014-0181-z