RESUMO
BACKGROUND: In Germany around 1 Million working and commuting accidents per year are officially registered. Since several years this number is constantly at this high level, only just since the appearance of the actual Covid pandemia significantly lower because of lockdowns and increase of homeoffice workplaces. OBJECTIVE: To ensure the professional care of psychotraumatic sequelae of work-related injuries, in 2012 new regulations were introduced by the DGUV, the national umbrella organization of the German statutory health insurances. This healthcare reform (named "Psychotherapeutenverfahren", verbally translated: psychotherapists' procedure) is looked at 10 years later. Is the new regulation accepted by the surgeons' community? What case constellations can be observed? MATERIAL AND METHODS: The use of this new instrument among trauma surgeons was evaluated by national data for the complete years 2013-2021. Additionally, we include regional data and case reports from a multidisciplinary medical facility including trauma surgery and psychiatry, located in Güstrow (Northeast Germany). RESULTS: Nationwide the percentage of psychotherapy amongst the regular treatment has doubled between 2013 and 2021 from 0.47 to 0.96%. DISCUSSION: Looking at the first 10 years of its clinical implementation, the new German psychotherapy regulation is apparently well accepted by the accident insurance consultants. As data from population based studies are not available, the actual percentage of psychological sequelae of accidents in this cases is not known yet. So there is further need of research and training in this interdisciplinary field to ensure appropriate treatment of victims of work-related accidents. The integration of psychotraumatological facts in the educational agendas of accident insurance consultants has already started.
Assuntos
COVID-19 , Seguro de Acidentes , Humanos , Consultores , Controle de Doenças Transmissíveis , PsicoterapiaRESUMO
A telephone-based psychological counselling service was implemented and evaluated in four regional offices of the German statutory accident insurance in healthcare and welfare services (BGW). Insurance employees/caseworkers, psychotherapists, and insured persons were asked to rate the counselling service in terms of their experiences and satisfaction. 15.5% of all insured persons initially contacted made use of the counselling service. Those using the service reported a slightly higher level of psychological distress, were less likely to be able to work 3 months after using the service and were more likely to attend a subsequent psychotherapy session. Telephone-based counselling by psychotherapists was rated as helpful by most insured persons. Caseworkers and psychotherapists also rated the concept favorably. All in all, the implementation can be regarded as successful. In a next step, the approach should be evaluated regarding its efficacy in a randomized, controlled trial.
Assuntos
Aconselhamento , Seguro de Acidentes , Psicoterapia , Acidentes , Alemanha , Humanos , Projetos Piloto , Telemedicina , TelefoneRESUMO
Violence in the workplace is a widespread problem that manifests itself in very different forms. The consequences for victims and companies are equally diverse. Sexual harassment is a special form of violence at the workplace. Violence may come from external perpetrators (attacks on cashiers) or from persons inside a company or establishment (colleagues, patients, people in care). Statutory accident insurance institutions in Germany (UV, "Unfallversicherungsträger") receive approximately 16,000 occupational injury reports per year that resulted from violence and led to extended incapacity to work. The numbers are increasing steadily. Particularly affected by violence are people working in healthcare and social welfare. Both psychological and physical violence can lead to severe disorders such as post-traumatic stress disorder (PTSD). To avoid violence, technical, organisational, and personal protective measures are needed. The training of de-escalation officers in the areas affected can be helpful. For victims of psychological and physical violence in the workplace, the UV offers special psychotherapeutic support and recommends the training of first-aiders.