[Strategies for classification of rehabilitation clinics based on structural equality]. / Strategien zur Taxonomie von Rehabilitationskliniken auf der Basis von Strukturgleichheit.

Comparison between clinics is a basic part of most quality assurance programmes. The classification of structurally similar clinics is a prerequisite for enabling comparisons between clinics according to quality criteria. As a part of the programme point 1 "structural quality" of the Pension insurance quality assurance programme in medical rehabilitation, a procedure was developed to classify clinics into structurally similar groups. For this purpose the data of the structure survey of the quality assurance programme was used. The first step was to check whether existing classification systems could be used, which made the need for a new classification procedure apparent. The 942 participating clinics were clustered according to a successive differentiation system employing only quality-neutral criteria, e.g., the indication group, the number of different indications, the part of AHB, number of beds, and the therapeutic focus. Further differentiation beyond indication group was necessary for the indications orthopaedics, cardiology, psychosomatics, addiction and neurology. The procedure is demonstrated using the indications orthopaedics and cardiology as examples.

[Concept definition in medical rehabilitation: an instrument for quality assurance]. / Konzepterfassung in der medizinischen Rehabilitation: Ein Instrument der Qualitätssicherung.

A survey of organizational aspects of rehabilitation clinics was part of the Pension Insurance quality assurance programme in medical rehabilitation. The goal of this survey was to strengthen the awareness for these organizational dimensions and to initiate discussion with the goal of optimizing the efficiency of the clinical working process. For the structured description of various conceptual aspects a questionnaire "Dokumentationsbogen-Konzepte" was developed and its appropriateness for the indication groups orthopaedics, cardiology and psychosomatics was examined. The focus of this examination was development of different possibilities to give feedback to the clinics. The questionnaire was appropriate for the description of conceptual aspects. Differences both between and within the indication groups were discovered. The instrument can be used in the quality assurance process.

[Partnership relations of parents and parent-child relations of physical abuse and sexual abuse experiences in childhood from the viewpoint of young adults. Further results of the Hamburg Study (II)]. / Die Partnerbeziehung der Eltern und die Eltern-Kind-Beziehung bei körperlichen Misshandlungen und sexuellen Missbrauchserfahrungen in der Kindheit aus der Sicht junger Erwachsener. Weitere Ergebnisse der Hamburger Studie (Teil II).

616 women and 452 men responded to the extensive questionnaire on body and sexual experiences in childhood of the Hamburg Study. 23% of the women and 4% of the men have been classified as sexually abused, 28% of the women and 14% of the men as physically maltreated. Beside testing group differences, the main purpose of this study was to test, which variables would predict sexual abuse and physical maltreatment in multivariate analysis. In the first part of the study, the relevance of socioeconomic and family factors for the prediction of sexual abuse and physical maltreatment have been presented. In this part, the relevance of the relationship between the parents and of the parent-child relationship are discussed. Multivariate analysis demonstrate the importance to differentiate between the early childhood and the time of elementary school. Especially in the group of sexually abused and physically maltreated children we found a deterioration of the socioeconomic circumstances over time as well as of the quality of the relationship between the parents, both of whom may be related to each other. With regard to the parent-child relationship, the Parental Bonding Instrument (Parker 1975) and questions to rewards and punishments were presented. Especially in the groups of sexually abused children, lack of demarcation and intense control were univariate significant. Lack of welfare has been of importance in the multivariate models for the prediction of physical maltreatment. Rewards and appreciations were rare in the groups of physically maltreated children but especially frequent in sexually abused children. The importance of further research on specific problems of sexual abuse and physical maltreatment is discussed.

[Social and familial aspects in physical abuse and sexual abuse experiences in childhood from the viewpoint of young adults. Selected results of the Hamburg Study (1)]. / Soziale und familiäre Gegebenheiten bei körperlichen Misshandlungen und sexuellen Missbrauchserfahrungen in der Kindheit aus der Sicht junger Erwachsener. Ausgewählte Ergebnisse der Hamburger Studie (Teil 1).

The basic assumption of this investigation is that sexual abuse and physical maltreatment should not be investigated in isolation. Young adults have been asked to participate in a study on body and sexual experiences in childhood. It was tested how sexually abused and/or physically maltreated women and men differentiate from those without this experiences. 23% out of 616 women were classified as sexually abused and 28% as physically maltreated. 4% of the 452 men were allocated as sexually abused and 14% as physical maltreated. Aside from assessing group differences, the main purpose of this study was to test which variables would predict sexual abuse and physical maltreatment in multivariate analysis. In this part of the study, the relevance of socioeconomic and family factors for the statistical prediction of sexual abuse and physical maltreatment in multivariate analysis are presented.