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„In Ruhe krank sein dürfen“. Bedürfnisse und Bedarfe von kranken, obdachlosen, drogenabhängigen Frauen und Männern in einer Krankenwohnung in Köln. Ansätze einer Substantive Grounded Theory. Anhang-Supplement zur Inaugural-Dissertation

“Allowed being sick in peace”. Needs and requirements of at Cologne, Germany. Projections of a substantive grounded theory. Sick, homeless, drug-addicted women and men of illegal drugs in a half-way infirmary. Addendum-Supplement of the Inaugural-Dissertation

  • „In Ruhe krank sein dürfen“. Ausgangspunkt der hier vorliegenden Untersuchung war die Frage nach der Bewältigung von Krankheit und Kranksein durch obdachlose, von illegalen Drogen abhängigen Frauen und Männern in einer KrWo. Die Untersuchung verfolgte auf der Basis einer offenen, explorativen Fragestellung zu ergründen, was, wie und wann hilfreich und nützlich für die Kranken ist. Das Ziel, unter Anwendung der qualitativen, hypothesengenerierenden GTM und qualitativen Feldforschung einen Beitrag zur Theoriebildung zu leisten und Empfehlungen für die Praxis im Umgang mit den Kranken abzuleiten, wurde verfolgt. Anhand von Untersuchungsdaten aus der KrWo konnte eine erste erklärende Beschreibung der Nutzer erarbeitet werden. Die entwickelten theoretischen Konzepte bzw. Hypothesen sind auf den Kontext der untersuchten KrWo begrenzt, die Untersuchung verfolgt keinen Anspruch auf Repräsentativität. Es wurde gegenstandsgegründet so-wohl ein heuristisches Instrument zur Einschätzung von Desaffiliationen in der Lebenslage des Sujets erarbeitet, zudem zwei durch die Kranken und im Vergleich mit der Literatur validierte Straßendrogenkreisläufe erklärend beschrieben. Als zentrales Phänomen evolvierte in der Krankenwohnung das Ergebnis als Endpunkt dieser Arbeit „In Ruhe krank sein dürfen“. Entsprechend der Herangehensweise der GTM wurden einige Ursachen, Bedingungen, Strategien und Konsequenzen sowie prozessbezogenen Aspekte herausgearbeitet und in hypothetischen Modellteilen dargestellt. Aus den Handlungserfahrungen konnten Empfehlungen für die Praxis im Umgang mit kranken, obdachlosen Abhängigen illegaler Drogen abgeleitet werden.
  • “Allowed being sick in peace”. Needs and requirements of sick, homeless, drug-addicted women and men of illegal drugs in a half-way infirmary at Cologne, Germany. Projections of a substantive grounded theory. The background of this study is a newly established infirmary for sick, homeless, drug-dependent (misery addiction) women and men starting October 2008. The study with data collection lasted all in all 38 months from October 2008 up to December 2011. Subjects of interest (group of inquest) were the users of the infirmary (n = 190) and their surrounding network in the help system (conditional matrix) of Cologne City. Two principles of work of staff were accompanying drug work and the virtue of undesigned encounter (Guardini). The central research question was: How do sick, homeless, drug-dependent (of illegal drugs) women and men cope with sickness and ailment in an infirmary? As a methodological framework, grounded theory methodology in the style of Strauss/Corbin was applied and combined with the field research (study) according to Girtler. Data collection methods consisted of open participative observation (Girtler), ero-epic interviews (Girtler) with the intoxicated users of the infirmary, open participating ob-servation in the infirmary, team and network. Further data collection con-sisted of the demographic and health data as well as the diseases of all the users of the infirmary, a journal of occurrences in the infirmary, which have brought change in rules and regulations on the base of the formal log book of everyday occurrences, special events and general observations. This all has been documented in a research diary. The local help network in Cologne was visited. Additional visits and comparison of 7 similar establishments in Germany were accomplished. Follow-up history profiles, catamnesis of the 18 auditory interviewed persons were done and a glossary of terms of the local drug scene collected. The theoretical sampling for the auditory interview of the users of the infirmary has been done accordingly to the methodology. 17:15 hours transcribed interview material has been analysed. The sensitising concepts were sociology of exclusion/inclusion, sociology of deviant human behavior, caritas science, and diaconal sci-ence as an integral part of theology and addiction research. The coding process was partially as in GTM, sometimes delayed due to the availability of subjects of inquest and the specific life situations of the infirm. The pro-cess of data analysis was done in constant comparison through forming contrasts and drawing up codes and categories. Some results from the descriptive data (n = 190): main users were advanced drug users, male ≥ 36 years 71.36 % and female ≥ 36 years 56.57 %. All in their different drug use trajectory of mostly opioid 63.30% and poly drug use, parallel consumption 15.84 %. Other activating drugs like cocaine and ampheta-mines were not in base consumption, only sometimes as accompanying drug use. The diseases and ailments according to ICD-10 diagnosis system, not requiring immediate hospital admission, consisted of: skin diseases (132) 27 %, lung diseases (117) 24 %, diseases of muscle and skeleton (62) 13 % and gastrointestinal diseases (38) 8 %. Psychiatric diseases as comorbidity were approximated with more than 20.00 %. From the biographic data and in comparison with literature and oral valida-tion with the sick users of the infirmary, a heuristic model has been drawn, with zones from exclusiveness, normalcy, precariousness, marginality up to exclusion as a social death. This to assess the approximate extent of disaffiliation from different life dimensions: person, living space, family, work/leisure, (misery/survival) delinquency, disease/nursing care needs, addiction and values/religion. Through data analysis, a life-world-circuit of street addict/junkie has been drawn up and validated with the users of the infirmary. It consists of a “small (street) drug circuit” with drug purchase including acquisition stress, prosecution stress; drug consumption with prosecution stress; avoiding withdrawal/getting high with prosecution stress; sourcing stress (money and drug), prosecution stress; legal and illegal acquisition of money incl. (misery/survival) prostitution with acquisition stress, prosecution stress and survival stress. And a “grand (street) drug circuit” consisting of homelessness; jobless-ness; reduction of social contacts to drug related contacts; disease (acute/chronic), survival stress; craving; (misery) delinquency, prosecution stress; drug arrest; [small drug circuit under the additional circumstances of incarceration], detoxification, withdrawal, drug addiction rehabilitation (treatment); return into homelessness. Some recommendations in dealing and assisting the users of the infirmary in recovery from their diseases and drug addiction have been drawn up.

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Author:Peter Schiffer
Advisor:Frank Weidner
Document Type:Doctoral Thesis
Date of Publication (online):2014/06/30
Date of final exam:2014/05/15
Release Date:2014/06/30
Tag:Drogenabhängig; Illegale Drogen; Krank sein; Krankenwohnung; Obdachlos; substantive groundet theory
drug-addicted women and men; half-way infirmary; homeless; illegal drugs; sick; substantive grounded theory
GND Keyword:Drogenabhängiger; Kranker; Köln; Obdachloser; Wohnung
DDC-Class:300 Sozialwissenschaften / 300 Sozialwissenschaften, Soziologie, Anthropologie
University:Philosophisch-Theologische Hochschule Vallendar
Licence (German):License LogoCreative Commons - Namensnennung, Nicht kommerziell, Keine Bearbeitung