This study evaluates the prevalence of chronic pain, intensity of pain, activity limitation, and pain-related diagnoses in German general practices. In 40 general practices, up to 50 consecutive patients presenting to general practitioners GP for routine medical consultation were questioned, and those reporting pain that lasted for more than 3 months received a questionnaire referring to intensity of pain and activity limitations. GPs received a questionnaire asking about the duration of treatment and diagnoses. Three hundred forty-six out of 1, questioned patients suffered from pain that lasted for more than 3 months a point prevalence of
You are free to copy, distribute and transmit the work, provided the original author and source are credited. This article has been cited by other articles in PMC. Three elements of the course are presented to illustrate this approach: First, a unit on Islam and Medicine, as important parts of the local immigrant community are Muslims.
The third element consists of a unit with specialized social workers form outside the university, who provide direct insights into the living conditions and health problems of local immigrant communities. Introduction Immigration and ethnic diversity have become central characteristics of German society today.
But also in rural areas, ethnic diversity is a social reality that can no longer be ignored. In the medical field, awareness for the particular needs and problems of, for example, foreign labour workers and refugees is not a novelty.
Already in the s, physicians where concerned about the medical consequences of especially hard labour conditions, social exclusion, cultural isolation and the difficulties of physician-patient-communication across barriers of culture and language [ 2 ], [ 3 ], [ 4 ].
However, systematic attention for ethnic diversity and health at large is a rather recent phenomenon in Germany. Only since the beginning of the broad public debates on immigration and the integration of migrants in the first years of the new millennium, these issues gained momentum also in the medical field.
Significant efforts were made, for example, in epidemiology, health monitoring and regarding problems of access to and quality of care [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ]. Observations in this field are frequently framed by notions like culture, ethnicity or migration background, though without adequate consideration of the complex theoretical questions behind and of the pitfalls of an unreflecting use of these categories in the field of medicine and health.
Serious cooperation with social and cultural anthropology is scarce [ 12 ], [ 13 ]. In medical education, issues of culture and ethnic diversity are almost absent until today.
Only two medical schools in Germany are currently offering courses dedicated to ethnic diversity: From a theoretical perspective, the shortcomings of such a fairly simplistic concept of culture are obvious: Moreover, empirical evidence shows that despite common assumptions, the actual way migrants conduct their lives in Germany — including cultural values, religious orientation and identity — is rather independent of ethnic categories and ancestry.
More important are social and economic conditions as well as education, biographic factors including the individual migration history and social support [ 22 ].
Medical studies and statements that are based on improperly defined ethnic or cultural categories, and fail to address social, economic, medical and other relevant aspects adequately, even contribute to the reification of false ethnic boundaries and the stereotype thinking in medicine and beyond [ 25 ].
The complex dynamics between culture, ethnicity and healthcare have to be addressed in a far more differentiated way.
Yet what can this way be? How can theoretical critique be translated into positive action and especially into teaching modalities for future physicians?
A core aspect of anthropological understandings of culture is that it is not a single factor but a multilayered set of potential modes to perceive, to understand and to evaluate all issues of everyday life including pain, disease, healing and medical devices [ 11 ], [ 12 ], [ 26 ].
Culture is acquired throughout lifetime and is constantly developing based on personal as well as collective experiences in the course of all perpetual social interactions. Even ethnic identity is shaped only in the context of social relations, namely in the dynamics of belonging and differentiation, and can thus change depending on time, place and social context [ 21 ].
Not only in case of severe disease or near death, many people, independent of ethnicity, develop a renewed interest in religious and spiritual issues even after decades of a rather secular lifestyle. Against this background, a second aspect of the anthropological understanding of culture, that outside of professional anthropology is often neglected, gains in importance: Ethnography is the key methodology of cultural and social anthropology and features huge potential for improving in-depth-understanding in health service research at large [ 27 ].
Characteristic is the combination of a holistic approach of observation and analysis with a critical attitude towards generalizing statements about ethnic groups or cultural traits.
Since generalized statements about the culture of individuals or ethnic groups are impossible, the ethnographic approach is indispensable. Instead of reducing the situation of a sick person to an abstract disease category, it tries for a comprehensive view and for identifying — as precisely as needed — the different aspects involved social, economic, bureaucratic, etc.
Moreover, ethnography includes a critical attitude towards all kind of supposedly natural and self-evident categories within and without biomedicine like disease classifications, concepts of body and illness, or ethnic boundaries and subjects them to analysis both historically and cross-culturally [ 28 ], [ 29 ], [ 30 ].
There is no need for physicians and other health care providers to become anthropologists, yet the adoption of an ethnographic perspective is necessary for at least getting closer to the real needs and living conditions of the people concerned.
And despite the huge gap that apparently separates medicine from anthropology and qualitative research methods, this kind of a clinically adapted ethnographic approach is not strange to medicine at all. However, the line between both is blurred and it depends on the disposition and abilities of the individual physician to advance in ethnography as far as the individual case demands.
Think global, teach local To support future physicians in the development of an ethnographic perspective in health care is the primary goal of the educational program in culture and healthcare at Giessen Medical School.
In various ways, students are encouraged to have a closer look at different issues that are discussed in regard to ethnic diversity, migration and health today.Nehmen stadt soltau frauen männer kostenlos kennenlernen 26 erfahrungen es dann singles deutschland statistisches bundesamt schon.
Bogenhausen realisiert auch kontakt mit einer person oder urlaub single mit kind in deutschland stadt. The scenarios resemble the situation in Germany, giving data for the present as well as future parametrizations and making it available to a larger public for the evaluation of smart grid optimization and control algorithms.
Ältere Menschen in Deutschland und der EU, - BMFSFJ Beschaffung“ Mit knapp einem Drittel macht diese Altersgruppe inzwischen den größten Anteil der Single-Haushalte aus. berichtete das Statistische Bundesamt.
Mit anderen Worten: 15,9 Millionen Singles gibt es in Von Hamburg bis München, von Berlin bis Köln – wie die. Der Anteil der Singlehaushalte in Deutschland liegt bei 37,2 %; damit leben 17,1 % der Bevölkerung allein. Von diesen 13,4 Millionen Personen sind nur 17,6 % jünger als 30 Jahre.
42,0 % von ihnen leben in Großstädten mit mindestens Einwohnern. Wie das Statistische Bundesamt anhand der Ergebnisse des Zensus weiter mitteilt, . Statistiken zum Thema Singles In den vergangenen zwanzig Jahren ist die Anzahl der Single-Haushalte in Deutschland kontinuierlich gestiegen.
Besonders der Männeranteil bei den jüngeren Singles (bis 49 Jahre) ist auffällig hoch. Bei beiden Geschlechtern sind die Gründe für die Partnerlosigkeit allerdings ganz unterschiedlich.
Get this from a library! Fachserie / Reihe 3, Haushalte und Familien: Ergebnisse des Mikrozensus.. [Deutschland. Statistisches Bundesamt.].