Das Gesundheitswesen , Thieme Verlag Heft 5-2024, Jahrgang 86) ISSN 1439-4421 Seite(n) 362 bis 370 DOI: 10.1055/a-2106-9717 CareLit-Dokument-Nr: 318600 |
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Zusammenfassung Ziel der Studie Ziel dieser Untersuchung war es, die derzeitigen Versorgungs- und Kontrollstrukturen für Patient*innen mit äthyltoxischer Leberzirrhose in der Vorbereitung auf eine Lebertransplantation (LTX) an deutschen Transplantationszentren zu erfassen. Es sollten zudem die damit einhergehenden Barrieren sowie die Sicht der Behandler*innen auf Verbesserungsmöglichkeiten für die Versorgung der Patient*innengruppe analysiert werden. Methodik In einem explorativen, deskriptiven, qualitativen Design wurden 11 Interviews mit Behandler*innen aus 10 der 22 deutschen LTX-Zentren geführt und inhaltsanalytisch ausgewertet. Ergebnisse Es zeigten sich deutliche Unterschiede in den Versorgungs- und Kontrollstrukturen der einzelnen Zentren. In das Behandlungskonzept integrierte suchttherapeutische Angebote gab es nicht an allen Zentren. Strukturelle Barrieren entstanden durch eine unzureichende Finanzierung und personelle Ausstattung. Behandler*innen wünschten sich erweiterte Behandlungsangebote sowie vereinheitlichte Behandlungskonzepte. Schlussfolgerungen Es zeigte sich Handlungsbedarf sowohl im Bereich der Strukturen der einzelnen LTX-Zentren als auch übergreifend auf Systemebene. Diese Ergebnisse könnten unter Berücksichtigung aktueller suchtmedizinischer Erkenntnisse als Grundlage zur Entwicklung von Behandlungskonzepten und -empfehlungen zur Optimierung der Versorgung vor LTX dienen. Abstract Objective The aim of this study was to record the current care and control structures in place for patients with ethyltoxic liver cirrhosis while being prepared for a liver transplant (LTX) at German transplant centers. In addition, it was also intended to analyze the associated barriers as well as the view of the practitioners on ways to improve care of this patient group. Methods In an exploratory descriptive qualitative design, 11 interviews with practitioners from 10 of the 22 German LTX centers were conducted and analyzed using qualitative content analysis. Results There were considerable differences in the care and control structures in place at the LTX centers. Addiction therapy counseling or treatment were not integrated into the treatment concept at all centers. Structural barriers arose from insufficient funding and staffing. Practitioners recommended expansion of treatment options as well as standardizing treatment concepts. Discussion The results of our study point to a need for action both in the area of the structures of the individual LTX centers and overall at the system level. Taking into account current standards of addiction medicine, our results could serve as a basis for the development of treatment concepts and recommendations for optimizing standard care before LTX. 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