RehabilitationPub Date : 2023-04-01DOI: 10.1055/a-2041-4097
{"title":"Menschen mit Behinderungen im Homeoffice","authors":"","doi":"10.1055/a-2041-4097","DOIUrl":"https://doi.org/10.1055/a-2041-4097","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45703278","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}
RehabilitationPub Date : 2023-04-01DOI: 10.1055/a-2041-3908
{"title":"Bericht des BMAS zum Bundesteilhabegesetz","authors":"","doi":"10.1055/a-2041-3908","DOIUrl":"https://doi.org/10.1055/a-2041-3908","url":null,"abstract":"Das Bundesministerium für Arbeit und Soziales (BMAS) informiert in einem Ende\u0000 Dezember 2022 vorgelegten Bericht (Bundestagsdrucksache 20/5150)\u0000 über die Umsetzung des Bundesteilhabegesetzes (BTHG). In dem\u0000 „Bericht zum Stand und zu den Ergebnissen der Maßnahmen nach Artikel\u0000 25 Absatz 2 bis 4 des Bundesteilhabegesetzes“ werden die Ausgangslage, die\u0000 Untersuchungsergebnisse und die Verlängerung von vier\u0000 Begleitmaßnahmen zum BTHG behandelt: Umsetzungsbegleitung BTHG,\u0000 Wirkungsprognose, Evaluation modellhafte Erprobung und Finanzuntersuchung. Die\u0000 umfangreichen Einzelberichte zu den Maßnahmen sind als Anlagen im Dokument\u0000 enthalten.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42571247","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}
RehabilitationPub Date : 2023-04-01DOI: 10.1055/a-1839-5048
Beate Muschalla, Michael Jöbges
{"title":"[Patienten mit komorbiden somatischen und psychischen Erkrankungen haben ähnliche Fähigkeitsbeeinträchtigen wie Patienten mit psychischen Erkrankungen].","authors":"Beate Muschalla, Michael Jöbges","doi":"10.1055/a-1839-5048","DOIUrl":"https://doi.org/10.1055/a-1839-5048","url":null,"abstract":"<p><strong>Objectives: </strong>In patients with somatic illness and additional mental disorder, not only motor or sensory functions may be impaired, but also psychological capacities. These become more and more important for work ability in our modern working world. There are presently no data about the type and distribution of psychological capacity impairments in patients with comorbid somatic and mental disorders. These data are however important for estimation of diagnostic and therapy requirements.</p><p><strong>Methods: </strong>402 orthopedic, cardiological, and neurological patients with additional mental disorders were investigated with a structured clinical assessment for mental disorders (MINI) and psychological capacity impairments (Mini-ICF-APP).</p><p><strong>Results: </strong>In all three somatic indications at least half of the comorbid patients had any clinically relevant psychological capacity impairment. Neurological patients (67%) and orthopedic patients (72%) were more often affected than cardiological patients (50.5%). Orthopedic patients are slightly more impaired in self-care; neurological and orthopedic patients are more impaired in mobility; and cardiological patients are less impaired in assertiveness.</p><p><strong>Conclusion: </strong>In comparison of all three somatic patient groups with mental disorders the number of psychological capacity impairments is similar. In contrast to patients with mental disorders only (i. e. those without somatic comorbidity), the psychological impairment quality in comorbid patients may be influenced by the somatic illness. The data from this study are important in order to estimate diagnostic and therapeutic needs, such as capacity training or compensation of psychological capacity impairments.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/e4/10-1055-a-1839-5048.PMC10089765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-1726-6845
Marco Streibelt, Pia Zollmann, Lisa Rasch, Jana Schimichowski, Sandra Schmitz
{"title":"[Work Participation after Multimodal Rehabilitation due to Neurological Diseases - Representative Analyses Using Routine Data of the German Pension Insurance].","authors":"Marco Streibelt, Pia Zollmann, Lisa Rasch, Jana Schimichowski, Sandra Schmitz","doi":"10.1055/a-1726-6845","DOIUrl":"https://doi.org/10.1055/a-1726-6845","url":null,"abstract":"<p><strong>Purpose: </strong>There is little representative evidence for the German rehabilitation system on occupational reintegration after medical rehabilitation. For persons who have undergone rehabilitation on behalf of the German Pension Insurance (GPI) due to a neurological disease, it is therefore important to determine (a) what socio-medical risks exist prior to rehabilitation, (b) how well persons were able to participate in working life after rehabilitation, and (c) what conditions determine the work participation.</p><p><strong>Methods: </strong>The study is conducted on the basis of the GPI's database of rehabilitation statistics. Included were all persons, who completed medical rehabilitation in 2016 due to a neurological disease. The analyses were carried out for the entire group and also in a differentiated manner for the 2 main diseases, cerebrovascular diseases (CD) and multiple sclerosis (MS). Work participation was operationalized both via a monthly status variable until 24 months after rehabilitation and as a rate of all persons who were employed at the 12 and 24 months follow up and in the 3 months before, respectively. To analyse the factors influencing stable work participation, multiple logistic regression models with stepwise inclusion were calculated separately for the rates after 12 and 24 months.</p><p><strong>Results: </strong>A total of 42,230 data sets were included in the analysis (CD: n=18,368, 44%; MS: n=6,343, 15%). Patients with neurological diseases were 50 years old on average, 43% were female. We found that approximately15% of patients reported no absenteeism, whereas 17% stated an absence leave of six months or more in the year prior to rehabilitation. Mental and cardiovascular comorbidity was documented in 31 and 44% of the cases respectively. Nearly 48% of patients with CD returned to work two years after rehabilitation. For MS patients, the percentage was slightly higher at 54%. The amount of sick leave of the rehabilitated individual, their gross/net income prior to rehabilitation as well their work capacity prior to admission were the three strongest influencing factors on their return to the labour market.</p><p><strong>Conclusion: </strong>About half of all persons with neurological diseases return to sustainable work after medical rehabilitation in Germany. The amount of sick leave and the income before rehabilitation are determining factors as to whether the person will return to work. The analysis provides representative data on occupational reintegration after medical rehabilitation due to a neurological disease for the first time.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10711594","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}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-1903-4483
Barbara Seebacher, Mike C Horton, Markus Reindl, Christian Brenneis, Rainer Ehling, Florian Deisenhammer, Roger J Mills
{"title":"[Psychometric Evaluation of the 'German Neurological Fatigue Index for Multiple Sclerosis (NFI-MS-G)' in a Sample of Rehabilitation Patients with Multiple Sclerosis].","authors":"Barbara Seebacher, Mike C Horton, Markus Reindl, Christian Brenneis, Rainer Ehling, Florian Deisenhammer, Roger J Mills","doi":"10.1055/a-1903-4483","DOIUrl":"https://doi.org/10.1055/a-1903-4483","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to provide a patient-reported outcome measure for people with multiple sclerosis (MS) comprehensively reflecting the construct of fatigue and developed upon the assumptions of the Rasch model. The Neurological Fatigue Index - Multiple Sclerosis (NFI-MS) is based on both a medical and patient-described symptom framework of fatigue and has been validated. Therefore, in this study the German version of the NFI-MS (NFI-MS-G) consisting of a physical and cognitive subscale and a summary scale was validated.</p><p><strong>Method: </strong>In this bi-centre-study, 309 people with MS undergoing outpatient rehabilitation or being≥2 months before or after their inpatient rehabilitation completed the German NFI-MS-G twice within 14-21 days together with other questionnaires. Correlation with established questionnaires and Rasch analysis were used for its validation. Additionally, psychometric properties of known-groups validity, internal consistency, test-retest reliability, measurement precision and readability were tested. Finally, the English NFI-MS and German NFI-MS-G were compared with each other to equate the language versions.</p><p><strong>Results: </strong>The NFI-MS-G showed good internal construct validity, convergent and known-groups validity and internal consistency (Cronbach's alpha 0.84-0.93). The physical subscale showed minor local dependencies between items 1 and 7, 2 and 3 and 4 to 6, that could be treated by combining the respective items to testlets. Unidimensionality was found for the physical and cognitive subscales but not for the summary scale. Replacing the summary scale, a 2-domains subtest measuring the higher-order construct of fatigue was created. Good test-retest reliability (Lin's concordance correlation coefficient of 0.86-0.90) and low floor and ceiling effects were demonstrated. The NFI-MS-G was found easily readable and invariant across groups of gender, age, disease duration, timepoint and centre.</p><p><strong>Conclusion: </strong>The German version of the NFI-MS comprehensively represents the construct of fatigue and has adequate psychometric properties. The German version differs from the English original version with respect to a lack of unidimensionality of the summary scale and minor local dependencies of the physical subscale that could be canceled out using a testlet analysis.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/a4/10-1055-a-1903-4483.PMC9925291.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9265502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-1987-9345
Christoph Reimertz, Sebastian Benner, Reinhard Hoffmann
{"title":"[Inpatient and Outpatient Treatment in the German Social Accident Insurance].","authors":"Christoph Reimertz, Sebastian Benner, Reinhard Hoffmann","doi":"10.1055/a-1987-9345","DOIUrl":"https://doi.org/10.1055/a-1987-9345","url":null,"abstract":"<p><p>It is one objective of German Social Accident Insurance (DGUV) to restore the health and performance of insured persons after an accident \"using all appropriate methods\". Because of the legal requirements, possible rehabilitation may greatly differ from that provided by sickness or pension insurance. This article provides an overview of the available treatments after accidents at work and the rehabilitation phase in which they may be used.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10716291","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}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-1710-0964
Jasmin Haenel, Silke Wittmar, Isabel Wuensche, Bernhard Borgetto
{"title":"[Germany-Wide Survey on Networking and Cooperation Between Rehabilitation and Self-Help (VERS 2.0): An Overview of Opinions, Contacts and Cooperation of Rehabilitation Institutions in View of Self-Help].","authors":"Jasmin Haenel, Silke Wittmar, Isabel Wuensche, Bernhard Borgetto","doi":"10.1055/a-1710-0964","DOIUrl":"https://doi.org/10.1055/a-1710-0964","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to present opinions and knowledge of rehabilitation facilities in Germany about self-help (SH) and to identify initial structures and contacts in the networking of rehabilitation and SH.</p><p><strong>Methods: </strong>The study is a quantitative observational study. The data were collected cross-sectionally by means of an online survey. Rehabilitation facilities in Germany were included. The convenience sample was collected using different approaches. The questionnaire is based on the survey on \"Cooperation and networking of rehabilitation facilities and self-help groups/self-help organisations\" (VERS) conducted by the University of Freiburg in 2002.</p><p><strong>Results: </strong>101 rehabilitation facilities across all 16 German federal states took part in the survey. The survey revealed a positive attitude towards SH and a high proportion of rehabilitation facilities that regularly inform about SH (76.2%) and maintain contacts with self-help associations/self-help clearing houses (74.3%). Information deficits regarding the specific experiences of self-help associations, the working and organisational forms of SH as well as the support opportunities of SH became apparent.</p><p><strong>Conclusion: </strong>To strengthen the networking of rehabilitation and SH, information gaps should be closed and transparency and structural conditions for cooperation should be created. The stronger integration of knowledge about SH in educational structures in the health sector, which is desired by the institutions, can be purposeful in the future.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10700927","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}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-2002-5840
{"title":"Neue Leitlinien","authors":"","doi":"10.1055/a-2002-5840","DOIUrl":"https://doi.org/10.1055/a-2002-5840","url":null,"abstract":"Im letzten Quartal 2022 wurden mehrere Leitlinien aktualisiert. Die S3-Leitlinie Unipolare Depression ist Teil des Programms für Nationale Versorgungsleitlinien. Neu sind u. a. Empfehlungen zu Maßnahmen beim Nichtansprechen von Psychotherapie, zur Indikationsstellung für Rehabilitation sowie für Leistungen zur Teilhabe am Arbeitsleben, zur Arbeitsfähigkeit und zur Nutzung von Online-Programmen in der Therapie. Ergänzend wurde auch eine laienverständliche Patientenleitlinie veröffentlicht. Auch die S3-Leitline Chronische koronare Herzerkrankung (KHK) ist Teil des Programms für Nationale Versorgungsleitlinien. Neu in der aktualisierten Version sind Entscheidungshilfen für Patientinnen und Patienten, die damit aktiver in den Therapieprozess eingebunden werden sollen. Angepasst wurden zudem Empfehlungen zur Gewichtsstabilisierung sowie zum Einsatz von ACE-Hemmern und Betablockern. Darüber hinaus wird empfohlen, dass alle Patientinnen und Patienten nach ST-Hebungsinfarkt (STEMI), Nicht-ST-Hebungsinfarkt (NSTEMI) und koronarer Bypass-Operation eine Rehabilitation innerhalb weniger Tagen beginnen sollen. Die aktualisierte S3-Leitline Endometriumkarzinom ist Teil des Leitlinienprogramms Onkologie. Neu sind u. a. mehrere molekulare Klassifikationen, Algorithmen zur Durchführung von Therapie und Diagnostik sowie die Empfehlung der Einführung eines geriatrischen Assessments vor Operationen oder Chemotherapie. Die Information und Beratung zur medizinischen Rehabilitation sind mit starkem Konsens in der Leitlinie verankert. Weitere Empfehlungen zur Rehabilitation finden sich im Kapitel 11.4 der Leitlinie. Alle benannten Leitlinien stehen im Leitlinienregister der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) zum Download zur Verfügung (https://register.awmf.org/de/start).","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136297960","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}
RehabilitationPub Date : 2023-02-01DOI: 10.1055/a-2002-5701
{"title":"Erfurter Erklärung für einen inklusiven\u0000 Arbeitsmarkt","authors":"","doi":"10.1055/a-2002-5701","DOIUrl":"https://doi.org/10.1055/a-2002-5701","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49142595","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}