Der Fußball als heilige Kuh - Dopingmotivationen und Problemwahrnehmungen

Im Fußball wird irrtümlich davon ausgegangen, in diesem Mannschaftssport würde sich Doping nicht lohnen. Ebenso wie die professionellen Kraft-/Ausdauersportler unterliegen Fußballer jedoch ähnlichen Hochkosten- und Konkurrenzsituationen, in denen Doping eine probate Strategie der Vorteilsnahme und Nachteilsvermeidung sein kann. Nur wird dieses Problem aufgrund machtpolitischer Interessen augenscheinlich weniger öffentlich verhandelt. Dementsprechend wird in diesem Beitrag auf der Basis entdeckter Dopingfälle erklärt, dass Doping auch ein fußballtypisches Phänomen ist. Dazu werden zum einen kontextuelle Gelegenheitsstrukturen und Risikopotentiale aufgegriffen, die Dopinghandeln zur Folge haben können. Zum anderen wird deutlich gemacht, warum bewusst jene Mittel und Maßnahmen der verbotenen Leistungssteigerung negiert werden

Doping im Spitzensport als soziales Problem : Ursachen und Folgen eines gesellschaftlichen Diskurses

Aus soziologischer Sicht ist die Entscheidung zum Doping typischerweise kein individuelles Fehlverhalten, sondern ein Produkt des exorbitanten Anspruchsniveaus in der modernen Spitzensportlandschaft. Dabei erscheint die verdeckte Strategie des Dopings höchst profitabel, weil alle am Sport beteiligten Akteure Nutznießer sportlicher Erfolge sind. Entgegen dieser Logik wird Doping öffentlich bagatellisiert, negiert, personalisiert und moralisiert. Diese scheinbare Paradoxie führt zu der Frage, wie, warum und mit welchen Folgen die gegenwärtige Problemdebatte um Doping geführt wird. Den Leser erwartet eine systematische Darlegung der wirkenden Gesetzmäßigkeiten, denen die Akteure aus Medien, Politik, Wirtschaft, Wissenschaft und Sport in ihren Aussagen zum Doping folgen. Dazu werden die Diskrepanzen zwischen den gesetzten sozialen Standards und den strukturellen Bedingungen im medial-industriellen Sportkomplex erklärt sowie mögliche Folgen für die Dopingbekämpfung aufgezeigt. Verl.-Inf

Waiting time, communication quality, and patient satisfaction: An analysis of moderating influences on the relationship between perceived waiting time and the satisfaction of breast cancer patients during their inpatient stay

Objective: Waiting time has been consistently found to be a significant predictor of patient dissatisfaction. The aim of this study is to examine whether positive communication experiences with health care providers could moderate the negative relationship between waiting time and patient satisfaction. Methods: Data from a sample of 4626 breast cancer patients in Germany during their inpatient stay were analyzed. Multilevel logistic regression models were estimated in order to examine whether health literacy-sensitive communication (HL-COM) moderates the negative effects of perceived long waiting times on satisfaction. The models were adjusted for sociodemographic and clinical information and personality. Results: Patients who perceived long waiting times were significantly less likely to be satisfied with treatment and with their hospital. Among patients who experienced high HL-COM, the negative relationship between perceived waiting time and satisfaction disappeared, with minimal differences in satisfaction between those who perceived waiting long and those who did not. Conclusion: While waiting time persists as a significant predictor of satisfaction, this study finds that positive communication experiences with health care providers could potentially alleviate negative effects of long waiting time. Practice implications: Along with the ongoing efforts to reduce waiting time, the improvement of health literacy-sensitive communication could be instrumental in patients' overall inpatient assessment. (c) 2019 Elsevier B.V. All rights reserved

Differences in Perceived Waiting Time by Health Insurance Type in the Inpatient Sector: An Analysis of Patients With Breast Cancer in Germany

Although the relationship between health insurance and waiting time has been established in the ambulatory sector in Germany, research in the inpatient sector is limited. This study aims to contribute to previous work through analyzing differences in perceived waiting time by health insurance type during the inpatient stays of patients with breast cancer in Germany. This study utilizes cross-sectional data from 2017 of patients with breast cancer (N = 4626) who underwent primary breast cancer surgery in a certified breast care center in Germany. Results from multilevel logistic regression models indicate a significant effect of health insurance status on perceived waiting time, net of other relevant factors (patient's sociodemographic background, Union for International Cancer Control stage, grading, self-reported and classified health, type of surgery, and chemotherapy). Patients with statutory insurance were significantly more likely than privately insured patients to report long waiting times for examinations/procedures, discharge, and to speak with the physician. There were no significant differences in waiting time for nursing staff between private and statutory insurance holders. Results align with previous findings in the ambulatory sector and suggest a private health insurance advantage, with private patients receiving priority to some health care services. Disparities in health care accessibility and quality need to continue to be addressed and discussed, as well as the impact of health insurance type on other indicators of health

A salutogenic model predicting the need for psycho-oncological care and its utilisation-The role of generalised resistance resources and sense of coherence

Objective Although many cancer patients experience psychological distress, not all affected patients utilise psycho-oncological care. We aim to examine the role of generalised resistance resources (GRRs) and sense of coherence (SOC) in predicting cancer patient needs for psycho-oncological care and its utilisation. A salutogenic prediction model was conceptualised and statistically tested. Methods Survey data (response rate 88.94%) from 2270 breast cancer patients one year after treatment in one of 88 certified hospitals in North Rhine-Westphalia, Germany, were analysed. Structural Equation Modelling analysis was performed. Results 21.6% of patients (n = 485;N = 2249) felt they currently needed psycho-oncological care, of which 61.6% currently utilised it (n = 299,N = 485). 42.2% (n = 953,N = 2259) had the need for psycho-oncological care in the previous 12 months, of which 58.0% (n = 553,N = 953) utilised it. Several GRRs directly predict the need for psycho-oncological care and SOC, as well as indirectly predict the utilisation of psycho-oncological care. Past utilisation significantly affects current need and utilisation. The model shows good model fit. Conclusions Generalised resistance resources and SOC affect the utilisation of psycho-oncological care. Therefore, measuring key GRRs and SOC during cancer treatment should be integrated into patient care as a salutogenic approach, to identify resources and vulnerabilities on an individual level

Cancer patients' experiences and preferences when receiving bad news: a qualitative study

Purpose Receiving a cancer diagnosis significantly impacts patients' lives, and how the bad news is delivered influences patients' trajectory, psychosocial adjustment and openness to psycho-oncological support. We explored how patients' experiences, reactions and preferences were when receiving the news and which optimization recommendations can be made. Methods We conducted an exploratory qualitative study with patients who enrolled in the new integrated cross-sectoral psycho-oncological care programme 'isPO', being enrolled 12 months post-diagnosis. Data on the main issue (i.e. perception of the moment when the diagnosis is received) were collected via telephone interviews that were fully audiotaped and transcribed. Two independent coders conducted inductive content analyses using MAXQDA. Results Out of 38 approached patients, 23 cancer patients with 13 different tumour entities participated. They had a mean age of 54.2 (SD 16.2); n = 17 (74%) were female. Three major themes with 14 corresponding subthemes emerged: (1) patients' experiences with the bad news delivery, including setting, mode, preparation and perceived needs; (2) patients' reactions to the bad news, such as shock, fear and helplessness, disbelief and denial, anger and feeling of injustice, thankfulness and depression; and (3) patients' receiving preferences, including psycho-oncological support, addressing informational needs, needs-driven comprehensive support and a competent multidisciplinary support team. Conclusions The quality of bad news delivery and addressing patients' needs should be strongly considered by physicians. We recommend integrating patients' perspective on the quality management processes of breaking bad news. For providing needs-centred high-quality care, applying existing guidelines and acquiring patient-centred communication skills are central