Rehabilitation最新文献

{"title":"[Need for Action and Research in Psychosomatic and Orthopaedic Rehabilitation from the Point of View of Rehabilitants and Individuals who work in Rehabilitative Care].","authors":"Lisa Ann Baumann,&nbsp;Natalie Schüz,&nbsp;Aike Hessel,&nbsp;Sina Obiedzinski,&nbsp;Anna Levke Brütt","doi":"10.1055/a-2028-5963","DOIUrl":"10.1055/a-2028-5963","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the need for practical action and research in psychosomatic and orthopaedic rehabilitation from the perspective of rehabilitants and individuals who work in rehabilitative care.</p><p><strong>Methods: </strong>The project was divided into an identification and a prioritization phase. In the identification phase, 3872 former rehabilitants, 235 employees from three rehabilitation clinics and 31 employees of the German Pension Insurance Oldenburg-Bremen (DRV OL-HB) were invited to participate in a written survey. The participants were asked to name relevant needs for action and research for psychosomatic and orthopaedic rehabilitation. The answers were evaluated qualitatively using an inductively developed coding system. Practical fields of action and research questions were formulated from the categories of the coding system. In the prioritization phase, the identified needs were ranked. For this purpose, 32 rehabilitants were invited to a prioritization workshop and 152 rehabilitants, 239 clinic employees and 37 employees of the DRV OL-HB to a two-round written Delphi survey. The resulting prioritized lists from both methods were combined into a top 10 list.</p><p><strong>Results: </strong>In the identification phase, 217 rehabilitants, 32 clinic employees and 13 employees of the DRV OL-HB participated in the survey, in the prioritization phase, 75 rehabilitants, 33 clinic employees and 8 employees of the DRV OL-HB in both survey rounds of the Delphi survey, and 11 rehabilitants in the prioritization workshop. A need for practical action primarily in the implementation of holistic and individual rehabilitation, in quality assurance and in the education and participation of rehabilitants was identified, as also a need for research primarily on access to rehabilitation, structures in the rehabilitation setting (e. g., inter-agency cooperation), the design of rehabilitative interventions (more individualized, more suitable for everyday life), and the motivation of rehabilitants.</p><p><strong>Conclusion: </strong>The identified needs for action and research include many topics that have already been identified as problems in previous research projects and by various actors in rehabilitation. In the future, there needs to be increased focus on the development of strategies for dealing with and solving the identified needs, as well as on the implementation of these strategies.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/b4/10-1055-a-2028-5963.PMC10581817.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9074755","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}

{"title":"Importance of Health Policy and Systems Research for Strengthening Rehabilitation in Health Systems.","authors":"Walter R Frontera,&nbsp;Wouter DeGroote,&nbsp;Abdul Ghaffar","doi":"10.1055/a-2154-9546","DOIUrl":"10.1055/a-2154-9546","url":null,"abstract":"During the last few decades, the field of rehabilitation has experienced substantial development, growth, and acceptance. Rehabilitation addresses the impact of a health condition on a person’s everyday life by optimizing their functioning and reducing their experience of disability. Rehabilitation expands the focus of health beyond preventative and curative care to ensure people with a health condition can remain as independent as possible and participate in education, work, and meaningful life roles.1 A definition of rehabilitation for research purposes has been recently published.2 Scientific and clinical research have generated a body of knowledge that strongly supports the use of many rehabilitation interventions with positive outcomes in various populations and health conditions. We also have now a better understanding of the growing global need, demand, and recognition of rehabilitation around the world. For example, it has been estimated that 2.41 billion people in the world could benefit from rehabilitation services. This means that at least one in every three persons in the world needs rehabilitation at some point during the course of their disease or injury.3 This figure has most likely increased because of the COVID-19 pandemic. The need for rehabilitation increased by 63% between 1990 and 2017 because of the aging population, the increasing prevalence of noncommunicable health conditions, and the shifting epidemiological profile in most countries.3 Finally, according to the 2022 global report on health equity for persons with disabilities, approximately 1.3 billion people or 16% of the world’s population has moderate to severe levels of disability associated with the underlying health conditions and impairments.4 Now more than ever before, it is crucial that rehabilitation is available and accessible to populations globally according to their needs. The important contribution of rehabilitation to the functioning, including social and occupational participation and well-being of populations worldwide, can no longer be denied or delayed. Rehabilitation is critical for the attainment of the United Nations Sustainable Development Goal 3, Ensure healthy lives and promote well-being for all at all ages.5 Notwithstanding the foregoing arguments, there continues to be a high unmet need for rehabilitation globally, with some low- and middle-income countries reporting unmet needs up to 50% of those who could benefit from rehabilitation. Rehabilitation services are not accessible to many people around the world.6 Many of those in need do not have access because of the failure, at least partially, to effectively plan for rehabilitation services. Many nations and health systems have not implemented policy measures that recognize rehabilitation as an essential component of universal health coverage7,8 Health policy, planning, and decision making for rehabilitation often require more local evidence to adequately plan, finance, implement,and monitor","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/64/10-1055-a-2154-9546.PMC10581780.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240910","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}

{"title":"Arbeitsmarktsituation schwerbehinderter Menschen","authors":"","doi":"10.1055/a-2154-5231","DOIUrl":"https://doi.org/10.1055/a-2154-5231","url":null,"abstract":"Die Bundesagentur für Arbeit befasst sich in einer Ausgabe der Berichtsserie „Blickpunkt Arbeitsmarkt“ vom Mai 2023 mit der Arbeitsmarktsituation schwerbehinderter Menschen im Jahr 2022. Aus den ausgewerteten Daten geht hervor, dass auch 2022 die Erwerbsquote bei schwerbehinderten Personen (49,8 %) deutlich niedriger war als bei nicht-schwerbehinderten Menschen (78,7 %). Die Zahl der sozialversicherungspflichtig beschäftigten schwerbehinderten Menschen hat seit Jahren beständig zugenommen, stagniert aber seit dem Coronajahr 2020. Anders als bei den älteren und den jüngeren schwerbehinderten Menschen ist die Beschäftigung in der Altersgruppe der 25- bis 55-Jährigen seit 2015 rückläufig. Neben der Erwerbsbeteiligung schwerbehinderter Menschen, ihrer Beschäftigungssituation und der Erfüllung der Beschäftigungspflicht von Arbeitgebern untersucht der Bericht auch die Arbeitslosigkeit schwerbehinderter Menschen. Diese unterliegt im Vergleich mit Nicht-Schwerbehinderten weniger der Konjunktur, dafür mehr der Demografie und rechtlichen Rahmenbedingungen. Das letzte Kapitel gibt Einblick in die Inanspruchnahme und Wirksamkeit der Instrumente der Arbeitsmarktpolitik wie z. B. berufliche Weiterbildung und berufliche Rehabilitation für die Personengruppe. Die BA stellt fest, dass der Einsatz arbeitsmarktpolitischer Maßnahmen für schwerbehinderte Menschen 2022 rückläufig war. Der Bericht (PDF) ist auf statistik.arbeitsagentur.de -&gt; Statistiken: Themen im Fokus -&gt; Menschen mit Behinderungen zu finden.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811474","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":"SVR-Gutachten 2023 zur Resilienz des Gesundheitssystems","authors":"","doi":"10.1055/a-2154-5082","DOIUrl":"https://doi.org/10.1055/a-2154-5082","url":null,"abstract":"Anlässlich der Krisen der letzten Jahre – v. a. der SARS-CoV-2-Pandemie, der Flutkatastrophe an Ahr und Erft und wiederholter Hitzewellen – befasst sich der Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen (SVR) in seinem Gutachten 2023 „Resilienz im Gesundheitswesen“ intensiv mit der potenziellen Gefährdung des deutschen Gesundheitssystems durch Extremsituationen und mit Wegen zur Bewältigung künftiger Krisen. Die aus seiner Sicht lange Zeit verbreitete Selbstwahrnehmung, Deutschland sei dank seines ausdifferenzierten Gesundheitssystems auch auf unvorhergesehene Entwicklungen sehr gut vorbereitet, hält er für trügerisch. Der Sachverständigenrat schätzt das Gesundheitssystem vielmehr als komplex, fragil und wenig anpassungsfähig ein. Schon zu normalen Zeiten leide es an einer unzulänglichen Koordination zwischen Bund, Ländern und Kommunen, einer defizitären Digitalisierung und einem unverhältnismäßigen Datenschutzverständnis. Auf Pandemien, Folgen des Klimawandels oder andere Krisen sei es nicht hinreichend vorbereitet. Der SVR fordert daher, die strukturelle Widerstandsfähigkeit des Systems zu stärken. Da krisenartige Herausforderungen verschiedene Lebensbereiche gleichzeitig betreffen können, empfiehlt er einen „All-Gefahren-Ansatz“. Außerdem müsse Gesundheit als übergreifendes Prinzip in allen Politikbereichen gestärkt werden („Health in all policies“). Dazu müsse die verantwortliche Datennutzung dringend vereinfacht werden.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811245","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":"Neuer Kennzahlenvergleich zu Entwicklungen in der EGH","authors":"","doi":"10.1055/a-2154-5109","DOIUrl":"https://doi.org/10.1055/a-2154-5109","url":null,"abstract":"Die Bundesarbeitsgemeinschaft der überörtlichen Träger der Sozialhilfe und der Eingliederungshilfe (BAGÜS) hat ihren Kennzahlenvergleich Eingliederungshilfe 2023 veröffentlicht. Die BAGÜS bezweckt mit dem Bericht, die Fachöffentlichkeit über bundesweite Trends und Entwicklungen in der Eingliederungshilfe (EGH) zu informieren und für die Leistungsträger steuerungsrelevante Struktur-, Fall- und Finanzdaten bereitzustellen. Gegenstand des Kennzahlenberichts sind Entwicklungen in den Bereichen Wohnen, Tagesförderstätten und (mit Einschränkungen) Werkstätten für behinderte Menschen (WfbM) im Jahr 2021 im Vergleich zu 2020.","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811482","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":"[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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":"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":null,"pages":null},"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":"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":null,"pages":null},"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}