[Interim results for the Patients' Rights Act and Infection Protection Act]. / Zwischenbilanz Patientenrechtegesetz und Infektionsschutzgesetz.

BACKGROUND: The Patient Rights Act has converted court rulings into legal paragraphs. Two new aspects have been introduced: the duty to hand over a copy of the signed written consent form to the patient (in which detailed recommendations are offered) and the obligation of a thorough documentation of findings and treatments within patient files. In addition the legislators, through the Joint Federal Committee (Gemeinsamer Bundesausschuss, GBA) have made the introduction of clinical risk management mandatory. The Infection Protection Act and its regulations have elevated the prerequisites of hygiene within hospitals and private practices with a parallel increase in liability. RESULTS AND DISCUSSION: Both laws and regulations offer no reference as to who (and to what extent) is financially responsible for the excessive increase in personnel costs, which are as yet not included in the German diagnosis-related groups (G-DRG) system. Despite all additional measures within the area of risk management, mistakes (avoidable or unavoidable) will nevertheless occur. In order to avoid longstanding legal battles the authors recommend an open and rapid communication with the patient and family. The wall of silence should be a thing of the past.

[Humor therapy in the depressed elderly: results of an empirical study]. / Humortherapie bei alten Menschen mit einer Depression: Ergebnisse einer empirischen Untersuchung.

BACKGROUND: Positive effects of humor on older patients with depressive symptoms have been repeatedly reported. Empirical evidence, however, is rare. We investigated the effects of a standardized humor therapy group in a clinical context especially for older depressed patients. PATIENTS AND METHODS: For this purpose, an experimental group with treatment (52 patients participating in the humor group) was compared to a control group with no specific treatment (38 patients); all 90 participants had clinical depressive symptoms according to ICD-10 classification. Questionnaires (among them GDS, SF-12, State-Trait Cheerfulness Inventory, Satisfaction with Life Scale) were administered at two time points (pre- and post-treatment). RESULTS: From pre- to post-measurement, significant improvements could be shown only in the experimental group for resilience and satisfaction with life (p<0.05). Analyses of the subgroups with at least medium to severe depression showed further significant effects for cheerfulness, seriousness, bad mood, and satisfaction with life (p<0.05). These severely affected patients seemed to profit best from humor therapy. CONCLUSION: Our results indicate the efficacy of this specific therapeutic intervention for older depressed patients.