[Practice recommendations for work-related medical rehabilitation in psychosomatic rehabilitation facilities - results of a Delphi process].

Abstract

In a recently completed randomized controlled trial, we found that work-related medical rehabilitation (WMR) was implemented very differently in rehabilitation facilities. Its additional effects were particularly evident when the emphasis on work-related issues was clearly communicated to participants. We therefore developed practice recommendations for a structured further development of WMR in psychosomatic rehabilitation facilities.In a two-stage Delphi process, 119 recommendations were evaluated by various experts including people who had received psychosomatic WMR. The assessment of the strength of consensus followed the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF). The results of the first round were discussed with the participants before the second round.A total of 19 and 17 individuals participated in the respective votes. In the second Delphi round, 80 recommendations achieved strong consensus (74.8%) and 24 recommendations achieved consensus (22.4%). Two recommendations received majority approval. One recommendation was rejected by a majority. We reformulated the 106 remaining recommendations according to the AWMF recommendations in order to express the strength of consensus ("is to", "should", "can").The strong consensus on around three quarters of all practice recommendations suggests that the final assessment of the different groups involved was similar. The large number of recommendations that achieved strong consensus indicates the complexity of the intervention. A regular review of the practice recommendations is advisable.