Rehabilitation最新文献

{"title":"[Comprehension and Perspectives of the Need for Medical Rehabilitation - Results of a German Online Survey].","authors":"André Golla,&nbsp;Susanne Saal,&nbsp;Gabriele Meyer,&nbsp;Thomas Frese,&nbsp;Rafael Mikolajczyk,&nbsp;Matthias Richter,&nbsp;Jan Schildmann,&nbsp;Anke Steckelberg,&nbsp;Wilfried Mau","doi":"10.1055/a-1998-6673","DOIUrl":"https://doi.org/10.1055/a-1998-6673","url":null,"abstract":"<p><strong>Background: </strong>In Germany, medical rehabilitation usually requires an application of the persons in need. Therefore, these persons have to understand what rehabilitation is and in what case they need this type of health care service. In addition to people with health problems, their close persons (e. g. family members) should also have rehabilitation-related knowledge. Since there is only limited data on the perspective towards medical rehabilitation services, a survey was conducted.</p><p><strong>Method: </strong>In September 2020, we invited 2,401 registered participants (age: 18-79 years) of a population-based online panel study to participate in an online survey. The cross-sectional survey asked about the understanding of need, subjective information as well as attitudes and expectations towards medical rehabilitation services. We analysed the data descriptively, taking into account the participants' rehabilitation experience and health impairment. In a subgroup analysis, the potential factors influencing the subjective need for rehabilitation were tested using logistic regression.</p><p><strong>Results: </strong>Data from 1,464 persons (Ø age: 52.5±14.5 years; 55% non-male) were analysed, 44% of the participants considered themselves to be \"rather well\" or \"very well\" informed about medical rehabilitation. The majority associated a need for rehabilitation with the access requirements related to service providers. In case of an emerging need for rehabilitation, family doctors would be the first point of contact. The participants mainly had function-oriented expectations of rehabilitation services and a majority prefer inpatient rehabilitation if necessary. Among 383 persons with long lasting and pronounced health-related impairment, the concrete individual need for rehabilitation was associated by a higher subjective degree of impairment as well as their own previous rehabilitation experience and rehabilitation experience in their personal social environment.</p><p><strong>Conclusion: </strong>Despite an overall good understanding of the need for rehabilitation, different rehabilitation views were found in certain population groups. In order to improve the general understanding of rehabilitation in the public and particularly in close persons, adequate dissemination of low-threshold, population-based rehabilitation information is recommended.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"62 4","pages":"197-206"},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deutsche Gesellschaft für Rehabilitationswissenschaften e. V.\u0000 (DGRW)","authors":"U. Worringen, J. Lindenmeyer, H. Vogel, Axel Kobelt-Pönicke, D. Küch, B. Muschalla","doi":"10.1055/a-2095-6733","DOIUrl":"https://doi.org/10.1055/a-2095-6733","url":null,"abstract":"Die Reform des Psychotherapeutengesetzes im Jahr 2019 hat für\u0000 Psycholog*innen die Erlangung der Approbation und Fachkunde in\u0000 Psychotherapie grundlegend geändert. Darüber hinaus wurden\u0000 zwischenzeitlich mit den Bereichsweiterbildungen Sozialmedizin für\u0000 Psychotherapeut*innen, Spezielle Schmerzpsychotherapie und Spezielle\u0000 Psychotherapie bei Diabetes drei für die medizinische Rehabilitation\u0000 bedeutsame Bereichsweiterbildungen geschaffen. Der Artikel stellt den neuen\u0000 Approbationsstudiengang sowie die Anforderungen an die Gebiets- und\u0000 Bereichsweiterbildungen vor. Diskutiert werden Chancen und Herausforderungen, die\u0000 sich hieraus für Rehabilitationseinrichtungen ergeben. Abschließend\u0000 werden konkrete Hinweise zur Umsetzung und den damit verbundenen finanziellen\u0000 Aufwendungen gegeben.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45010312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk-Adjustment of Return to Work After Medical Rehabilitation: Methodical Advancements in Quality Assurance of the German Pension Insurance].","authors":"Sarah Leinberger,&nbsp;Christian Hetzel,&nbsp;Rainer Kaluscha","doi":"10.1055/a-1998-6574","DOIUrl":"https://doi.org/10.1055/a-1998-6574","url":null,"abstract":"<p><strong>Purpose: </strong>Besides the quality of life, patients' return to work is one of the most important treatment results of medical rehabilitation paid by the German Pension Insurance. In order to be able to use the return to work as a quality indicator for medical rehabilitation, a risk adjustment strategy for pre-existing characteristics of patients, rehabilitation departments and labour markets had to be developed.</p><p><strong>Methods: </strong>Multiple regression analyses and cross validation were used to develop a risk adjustment strategy, which mathematically compensates the influence of confounders and thus allows for appropriate comparisons between rehabilitation departments regarding patients' return to work after medical rehabilitation. Under the inclusion of experts, the number of employment days in the first and second year after medical rehabilitation were chosen as an appropriate operationalization of return to work. Methodological challenges in the development of the risk adjustment strategy were the identification of a suitable regression method for the distribution of the dependent variable, modelling the multilevel structure of the data appropriately and selecting relevant confounders for return to work. A user-friendly way of communicating the results was developed.</p><p><strong>Results: </strong>The fractional logit regression was chosen as an appropriate regression method to model the U-shaped distribution of the employment days. Low intraclass correlations indicate that the multilevel structure of the data (cross-classified labour market regions and rehabilitation departments) is statistically negligible. Potential confounding factors were theoretically preselected (medical experts were involved for medical parameters) and tested for their prognostic relevance in each indication area using backwards selection. Cross validations proved the risk adjustment strategy to be stable. Adjustment results were displayed in a user-friendly report, including the users' perspective (focus groups and interviews).</p><p><strong>Conclusions: </strong>The developed risk adjustment strategy allows for adequate comparisons between rehabilitation departments and thus enables a quality assessment of treatment results. Methodological challenges, decisions and limitations are discussed in details throughout this paper.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"62 4","pages":"225-231"},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10355906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUTB: Forschungsbericht deutet auf Wirksamkeit der Beratung\u0000 hin","authors":"","doi":"10.1055/a-2119-1817","DOIUrl":"https://doi.org/10.1055/a-2119-1817","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46034867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"World Congress der ISPRM in Cartagena","authors":"","doi":"10.1055/a-2119-1787","DOIUrl":"https://doi.org/10.1055/a-2119-1787","url":null,"abstract":"Vom 5. bis 8. Juni 2023 fand in Cartagena (Kolumbien) der 17. World Congress der\u0000 International Society of Physical and Rehabilitation Medicine (ISPRM) statt. 1885\u0000 Teilnehmerinnen und Teilnehmer hörten in den vier Tagen etwa 700\u0000 Beiträge in rund 200 Sessions. Der Kongress startete mit Vorträgen\u0000 von Antony Duttine, Rehabilitation Technical Lead der World Health Organization\u0000 (WHO), und Prof. Walter Frontera, School of Medicine der University of Puerto Rico\u0000 und Herausgeber des American Journal of Physical Medicine and Rehabilitation. Antony\u0000 Duttine skizzierte die aktuellen Bemühungen der WHO, die rehabilitative\u0000 Versorgung weltweit in den Gesundheits- und Sozialsystemen zu verankern. Prof.\u0000 Walter Frontera fasste in seinem Vortrag den Wissenschaftsstand zu gesundem Altern\u0000 und Langlebigkeit zusammen und präsentierte zahlreiche Studien, die die\u0000 Effekte von Trainingstherapie, insbesondere Krafttraining, auch in hohem Alter\u0000 zeigen.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44724072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liebe Leserinnen, liebe Leser.","authors":"Axel Schlitt","doi":"10.1055/a-2099-4792","DOIUrl":"https://doi.org/10.1055/a-2099-4792","url":null,"abstract":"wahrscheinlich „können Sie es nicht mehr hören“, aber leider beschäftigt mich das Thema nach wie vor:","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"62 4","pages":"187"},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verbände befürchten\u0000 Versorgungsdefizite in\u0000 Außerklinischer Intensivpflege","authors":"","doi":"10.1055/a-2119-1700","DOIUrl":"https://doi.org/10.1055/a-2119-1700","url":null,"abstract":"Die Fachverbände für Menschen mit Behinderung warnen in einem\u0000 Schreiben an Bundesgesundheitsminister Prof. Dr. Karl Lauterbach vom 7. Juni 2023\u0000 davor, dass aufgrund der Änderung der Anspruchsgrundlage für\u0000 Außerklinische Intensivpflege durch das Intensivpflege- und\u0000 Rehabilitationsstärkungsgesetz (IPReG) bald lebensgefährdende\u0000 Versorgungsdefizite bei beatmeten und trachealkanülierten Versicherten\u0000 drohten. Nach ihrer Einschätzung werden die strukturellen Voraussetzungen\u0000 für eine Versorgung Intensivpflegebedürftiger nach § 37c SGB\u0000 V („Außerklinische Intensivpflege“) bis zum Ablauf der\u0000 bestehenden Übergangsfrist am 30. Oktober nicht erfüllt sein.\u0000 Zurzeit sind nach Angaben der Fachverbände (Stand: Juni 2023) in der\u0000 Arztsuche des Nationalen Gesundheitsportals nur etwa 200 zur Potenzialerhebung\u0000 befugte Fachärztinnen und -ärzte und ca. 300 zur Verordnung befugte\u0000 Hausärztinnen und -ärzte gelistet. Dies reiche bei weitem nicht aus,\u0000 die bundesweit etwa 18 000 beatmeten oder trachealkanülierten\u0000 Versicherten zu versorgen. Die Fachverbände fordern den Gesundheitsminister\u0000 daher auf, die Frist um zwei Jahre zu verlängern.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47046988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pulmonary Rehabilitation].","authors":"Tessa Schneeberger,&nbsp;Gaffar Abdullayev,&nbsp;Andreas Rembert Koczulla","doi":"10.1055/a-2043-6767","DOIUrl":"https://doi.org/10.1055/a-2043-6767","url":null,"abstract":"<p><p>Reduced exercise capacity, skeletal muscle dysfunction, and a physically inactive lifestyle are linked with symptoms of fatigue and dyspnea in people suffering from chronic lung disease. Numerous such extrapulmonary manifestations have been identified as treatable aspects of pulmonary rehabilitation (PR). PR is an extensive personalized non-pharmaceutical intervention, encompassing, but not limited to, exercise training, respiratory therapy, and education. The content and goals of a PR-program are based on a comprehensive patient assessment at the time of rehabilitation admission, with personalized therapies provided by a multidisciplinary team of healthcare professionals. This article provides an overview of PR including possible indications, therapy contents (e. g. exercise training, respiratory therapy), and evidence (COPD, interstitial lung disease, COVID-19). Finally, options for pulmonary rehabilitation maintenance services in Germany are presented.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"62 4","pages":"232-247"},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10008687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impairment due to Contextual Factors: External Assessment and Self-Assessment of Rehabilitants in Psychosomatic Rehabilitation].","authors":"Ines Passier,&nbsp;Axel Kobelt-Pönicke","doi":"10.1055/a-1964-7362","DOIUrl":"10.1055/a-1964-7362","url":null,"abstract":"<p><strong>Objectives: </strong>In addition to an existing external assessment tool for the ICF-based assessment of the impairment of rehabilitation patients due to environmental and personal contextual factors, a self-assessment tool was developed and used for rehabilitation patients in a psychosomatic rehabilitation clinic. The aim was to compare the assessment of the impairment by contextual factors rated by the external assessment and by the rehabilitation patients on the other hand. Furthermore, the aim of the study was to obtain initial indications of the applicability of the newly designed self-evaluation instrument.</p><p><strong>Method: </strong>A sample of N=103 rehabilitation patients was examined via both the external and the self-evaluation tools. A comparative evaluation of the assessment of the external assessor and the rehabilitants' assessments was carried out using measures of assessor agreement (Cohen's Kappa, percentual agreement). The results were set in relation to the data of the routine assessment of the rehabilitation facility (Eta-Coefficient).</p><p><strong>Results: </strong>The external assessor and the rehabilitants get to different results in their assessment of the extent of impairment by individual contextual factors. For eight of the 15 context factors, there was only a moderate degree of agreement between the assessors (Cohen's Kappa). The percentage of non-agreement between rating of the external assessor and self-assessment lies between approx. 20% and up to approx. 40% of the cases for the majority of the context factors. Whether or not there is an impairment across all contextual factors (overall measure) was answered non-concordantly in just under a third of the cases. Mostly moderate correlations were found between the context factors classified as particularly relevant in the self-evaluation tool and scales of psychometric survey (e. g. BDI-II). This result provides a first indication of the convergent validity of the self-report tool.</p><p><strong>Conclusion: </strong>More attention should be paid to a supplementary assessment of impairment by contextual factors via the rehabilitation patient's self-assessment in addition to the external assessment. There is a need for further research with regard to the development of the self-assessment tool presented.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"62 4","pages":"216-224"},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9994364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution der WHA zur Stärkung der\u0000 Rehabilitation","authors":"","doi":"10.1055/a-2119-1752","DOIUrl":"https://doi.org/10.1055/a-2119-1752","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46785420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}