Rehabilitation最新文献

{"title":"[Rehabilitation after pulmonary Embolism].","authors":"Roland Nebel, Birna Bjarnason-Wehrens, Thomas Schmidt","doi":"10.1055/a-2615-6956","DOIUrl":"10.1055/a-2615-6956","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is the third most common cause of cardiovascular death worldwide, with a suspected high number of unreported cases. If left untreated, the mortality rate ranges from 25-30%. With treatment, it decreases to approximately 8% after one year.In addition to the acute thromboembolic event PE can have far-reaching long-term health and personal consequences for the patient including limitations in physical performance, psychosocial effects and significant impairments in health-related quality of life. There is also a significant risk of an embolism recurrence. Furthermore, chronic thromboembolic pulmonary hypertension (CTEPH) or post-pulmonary embolism syndrome (PPS) can develop.The goals of a long-term follow-up strategy - including cardiac rehabilitation (CR) - are to prevent recurrences, achieve sustained improvements in physical performance, and reduce dyspnea in patients with limitations often caused by general muscular deconditioning. Another key objective is to sustainably improve quality of life, with impacts on personal, family, and professional environment.Although PE is common, structured follow-up and rehabilitation programs are largely lacking. In contrast to other cardiovascular conditions, such as myocardial infarction, post-PE care is typically limited to a few follow-up appointments. A stronger scientific evidence base, clearly defined care pathways, and interdisciplinary CR are needed.This article presents the current state of research on CR after a PE event and highlights the specific characteristics and considerations relevant to this setting.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"65 1","pages":"61-72"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229824","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":"[Intersectoral coordination of complex chronic diseases: Evaluation of a project of stroke case managers in East Westphalia-Lippe].","authors":"Juliane Andrea Düvel, Sophie Wanders, Svenja Elkenkamp, Wolfgang Greiner","doi":"10.1055/a-2663-0279","DOIUrl":"10.1055/a-2663-0279","url":null,"abstract":"<p><p>Stroke remains one of the leading causes of premature mortality or long-term disability. Hospital and rehabilitation treatment are meanwhile at a high level. Ensuring successful treatment and reducing the consequences can only be achieved with tailored long-term healthcare in the outpatient sector. The aim of the study described here was to prevent 30% of all stroke recurrences by implementing case management.The main evaluation of the intervention was conducted as a quasi-experimental study and was based on claims data. In addition, non-comparative analyses based on primary medical data and health-related quality of life as well as a process evaluation were carried out. All comparative outcomes were test-based. In addition, the three central outcomes of recurrence, mortality and costs were analyzed using regression methods. The primary data was analysed by using descriptive statistics. The process evaluation was carried out in a two-step process using qualitative expert interviews and a related quantitative questionnaire to measure physician acceptance.1,167 patients per intervention group (IG) and control group ( CG) were included in the final analysis. No significant influence of the intervention on the risk of stroke recurrence or mortality was determined (p>0.05). For the secondary outcome costs, the study groups differed significantly in favour of the controls (p<0.05). In addition, the IG had a significantly higher chance of receiving guideline-based secondary pharmaceutical prevention (p<0.05). The primary data indicated an increase in health-related quality of life over the study period. The physicians reported good integration of the stroke case managers into the care structures.A widespread adoption of the STROKE OWL intervention in standard healthcare cannot be recommended based on current findings. The results indicate that for successful integration into standard care, the study population should be selected more specifically and target groups that could particularly benefit from individual case management should be addressed in line with the core principle of case management.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"39-49"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088154","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":"[Correction: Workplace problems and basic beliefs among mentally stressed employees of the Blaufeuer counseling: A mixed methods approach].","authors":"Christian Gerlich, Janina Myrczik, Onur Erdem Ucar, Silvan Renz, Beate Lieb, Katharina Mühlich, Heiner Vogel, Uwe Krähnke, Michael Schuler","doi":"10.1055/a-2820-5762","DOIUrl":"10.1055/a-2820-5762","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"65 1","pages":"e1"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367366","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":"[Workplace problems and basic beliefs among mentally stressed employees of the Blaufeuer counseling: A mixed methods approach].","authors":"Christian Gerlich, Janina Myrczik, Onur Erdem Ucar, Silvan Renz, Beate Lieb, Katharina Mühlich, Heiner Vogel, Uwe Krähnke, Michael Schuler","doi":"10.1055/a-2768-2215","DOIUrl":"10.1055/a-2768-2215","url":null,"abstract":"<p><p>The SEMpsych project offered the \"Blaufeuer\" counselling service for people with psychological impairments and work-related stress. Firstly, this study investigated whether the recognisably high variability in the work-related problem areas can be explained by statistically and quantitatively determinable profile types. Secondly, it was investigated whether typical patterns of individual problem constellations in the course of life and habitual imprints (latent basic convictions) of Blaufeuer counselling participants, which are associated with psychological stress, can be reconstructed in their interaction.A convergent-parallel mixed methods approach was used. A latent profile analysis (LPA) was carried out statistically and quantitatively with 457 participants in the Blaufeuer programme. Qualitatively, 16 guided individual interviews were analysed using a combination of grounded theory and narrative analysis.The LPA revealed seven profiles of characteristic work and occupational problems. The qualitative analysis identified six latent basic beliefs and individual problem constellations that can contribute to the description of vulnerability risks.Both typifications provide guidance for the high variability of work-related stressors. Specifically, the qualitative findings show the necessity to consider latent basic beliefs as well as individual life events and everyday stresses in addition to the types of work-related stressors for counselling.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"65 1","pages":"11-20"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229864","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":"[Cross-sectoral coaching for individuals with health impairments and at high risk of permanent work disability: Results of a process evaluation].","authors":"Lea Remus, Marei Grope, Stella Lemke, Matthias Bethge","doi":"10.1055/a-2641-4843","DOIUrl":"10.1055/a-2641-4843","url":null,"abstract":"<p><p>An innovative case management intervention in the city of Hamburg provides an open facility for individuals at high risk of permanent work disability, offering tailored guidance and support, regardless of the nature and extent of needs and legal jurisdiction. The intervention aims on preserving or restoring employability and preventing chronicity of illnesses or impending disability. Our process evaluation examined the implementation of the intervention.Data were collected in 2021 as part of a mixed-methods study. A questionnaire survey was conducted at the start and after 12 months to analyze changes in health status, employment, and satisfaction with the intervention. Additionally, semi-structured, problem-centered interviews were conducted with stakeholders and participants to analyze the dose given and dose received. We also examined the population reached.Out of 145 eligible participants, 56% completed the initial questionnaire, and 28% successfully filled out the second questionnaire. Over 85% of the participants remained employed within a year. The Work Ability Score increased by an average of two points (p=0.001, n=36). There was a significant decrease in depression and anxiety scores. Participants expressed high satisfaction with all of the intervention components. Nine stakeholders and four participants were interviewed about the dose given and dose received. Stakeholders named services focusing on health and social stabilization to maintain of employability. This was intended to be realized through a cross-sectoral, low-threshold, and coordinating counseling approach. The participants mentioned support to ensure their employability and the opportunities for professional reorientation as offers.A new intervention was implemented to provide support for individuals with health impairments and at high risk of permanent work disability. Despite high initial levels of depression and anxiety, case management support had a positive impact. The Work Ability Score significantly improved. It was observed that the participants' employment situations were largely stabilized. The project will continue and be evaluated through a mixed-methods observational study (https://www.hgua-hamburg.de/).</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"30-38"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661011","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":"[Partipants and non-participants with different diagnoses in a post-rehabilitative case management program: a comparison].","authors":"Denise Walther, Matthias Morfeld, Axel Kobelt-Poenicke","doi":"10.1055/a-2733-7234","DOIUrl":"10.1055/a-2733-7234","url":null,"abstract":"<p><p>Patients covered by the German Pension Insurance Braunschweig-Hannover (DRV BS-H) are offered participation in a case management program after completing medical rehabiliation. The aim of the present study was to compare and identify differences along several parameters between those who took up the offer of CM and those who refused participation in this program.For this cross-sectional study, between 2021 and 2023, members of the DRV BS-H with a recommendation for CM were included in a retrospective survey, that contained items on their disease burden, professional situation and work ability as well as on the evaluation of the medical rehabilitation undergone and the CM. Non-participants were also asked about the reasons for their refusal to particpate. In addition, administrative data of the DRV BS-H were used as a supplement. Group comparison was executed with t-test, Chi²-tests and Mann-Whitney U tests. Predictors were determined using binary logistic regression. Satisfaction with the CM and the reasons for refusal were evaluated descriptively.In many aspects, significant differences were found between participants and non-participants although the effects were mainly small. Non-participants were more likely to suffer from mental illness. They generally considered themselves to be in poorer health, were less likely to be employed and had a poorer prognosis regarding work ability. Participants experienced better outcomes from the retrospective evaluation of medical rehabilitation than non-participants. The evaluation of the CM was consistently positive. The most common reason for rejecting participation in CM was a wish to find a solution themselves. A performance level of less than six hours during the last professional activity increased the probability of participation in CM; however, the regression model had a very low explanatory power.The CM of DRV BS-H is an offer taken up by patients with diverse diagnoses after completing medical rehabilitation, and can be considered as a suitable service for members with complex support needs.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":"21-29"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769970","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":"[Family coaching to promote behavior modification in children and adolescents with obesity undergoing inpatient rehabilitation and in their carers: A feasibility study].","authors":"Evita Ausner, Petra Hampel","doi":"10.1055/a-2775-3138","DOIUrl":"https://doi.org/10.1055/a-2775-3138","url":null,"abstract":"<p><p>This study examined the acceptance, feasibility, and sustainability of an individualized family coaching intervention designed to promote behavior modification among children and adolescents with obesity and persons accompanying them during inpatient rehabilitation. The primary aim was to enhance motivation for behavior modification in both patients and their accompanying persons, and to improve the sustainability of rehabilitation outcomes by increasing the involvement of the accompanying persons.This qualitative study was conducted within a single-group pre-post-follow-up design. The study included 31 patients (ages 10-13, 61% female, BMI percentile≥97) and their caregivers. The intervention consisted of three 60-minute family coaching sessions based on the principles of Motivational Interviewing. Thirteen post-intervention focus group interviews with experts, accompanying persons, and patients as well as coaching protocols were analyzed using qualitative content analysis.The coaching was positively evaluated by all participants. Experts perceived that supplementary family coaching helped reduce resistance within families and foster greater personal responsibility compared to group education alone. The accompanying persons reported improved communication with their children and clearer goal setting. Patients appreciated the opportunity to address difficult topics, such as obesity-related behaviors and family conflicts. In the course of the coaching, the accompanying persons demonstrated increasing levels of mobilizing change talk and active engagement. Patients showed an increased intention for behavior change in the course of the coaching.The qualitative findings support the acceptance and feasibility of family coaching in inpatient rehabilitation settings. Implementing a standardized coaching approach could help to sustain rehabilitation outcomes in pediatric obesity. However, sustainable integration requires structural adjustments to ensure frictionless implementation within rehabilitation routines. Future controlled studies should investigate the short- and long-term rehabilitation success of family coaching.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068556","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":"[Return to Work after Vocational Rehabilitation during the COVID-19 Pandemic: A Retrospective Cohort Study].","authors":"Mathis Elling, Nadine Sänger, Betje Schwarz, Christian Hetzel","doi":"10.1055/a-2755-0938","DOIUrl":"https://doi.org/10.1055/a-2755-0938","url":null,"abstract":"<p><p>The aim of this study was to examine how the COVID-19 pandemic affected return to work (RTW) after vocational rehabilitation. Particular attention was paid to whether pandemic-related changes in the likelihood of RTW could be observed overall and in relation to individual vulnerability characteristics.The study was based on administrative data from the German Pension Insurance (n=28,779; 2018-2021). Three cohorts were included in the analysis: a reference cohort (rehabilitation and RTW before the pandemic), pandemic cohort 1 (RTW during the pandemic), and pandemic cohort 2 (rehabilitation and RTW during the pandemic). The probability of RTW was analyzed first descriptively and then again using logistic regression models, with adjustments made for relevant covariates. Additionally, interactions between the cohort variable and vulnerability characteristics (i. e., previous receipt of unemployment benefits I or II) were examined.Descriptive results showed lower RTW rates in both pandemic cohorts compared to the reference cohort. After adjustment, the decline was less pronounced, indicating the importance of individual characteristics and contextual factors - particularly labor market conditions. In the adjusted model, no statistically significant difference remained for pandemic cohort 1 relative to the reference cohort, whereas the gap for pandemic cohort 2 was reduced but not fully eliminated. Interaction analyses further indicated that barriers to RTW were amplified under pandemic conditions: rehabilitees with prior unemployment saw a further decrease in predicted probabilities of RTW in pandemic cohort 2 compared to before the pandemic.Overall, pandemic-related conditions made the transition back to working life after vocational rehabilitation more difficult. Individuals with pre-existing labor market disadvantages were particularly affected, pointing to an intensification of social inequalities under crisis conditions. To counteract such effects in the future, stronger linkages between vocational rehabilitation and labor market integration should be established.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794552","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":"[Utilisation of medical rehabilitation depending on occupational qualification among older employees: a cross-sectional study based on the 4th wave of the lidA-study].","authors":"Jean-Baptist du Prel, Patrick Brzoska, Diana Wahidie, Jürgen Breckenkamp","doi":"10.1055/a-2748-4740","DOIUrl":"https://doi.org/10.1055/a-2748-4740","url":null,"abstract":"<p><p>Older employees make up a large proportion of the labour force in Germany. Medical rehabilitation can help to keep them healthy in working life. The study examines the extent to which the utilisation of rehabilitation services by employees over the age of 50 differs depending on their occupational qualification.The data set consisted of 6,953 socially insured employees born in 1959, 1965 or 1971 from the fourth wave of the lidA cohort study (\"leben in der Arbeit\") 2022/2023. A cross-sectional analysis was conducted to determine whether they had utilised rehabilitation services in the last four years depending on their occupational qualification. In the multiple logistic regression analysis, adjustments were made for demographic characteristics, subjective health, work stress, physical workloads, work-privacy conflict and caregiving for relatives. Potential selection effects in recruitment and follow-up were addressed using combined longitudinal and cross-sectional weighting. In addition to odds ratios, average marginal effects were calculated.17.5% of older employees had undergone medical rehabilitation (13.1% inpatient, 4.4% outpatient). Low-skilled workers (OR: 1.28; 95% CI: 1.05-1.57) and medium-skilled workers (OR: 1.45; 95% CI: 1.19-1.77) had a higher chance of utilising rehabilitation services than high-skilled workers. High work stress (OR: 1.23; 95% CI: 1.04-1.46) and poor health (OR: 2.75; 95% CI: 2.40-3.16) were associated with a higher likelihood of utilising rehabilitation services, younger age (OR: 0.75; 95% CI: 0.63-0.89), female gender (OR: 0.81; 95% CI: 0.71-0.94) and a first-generation migration background (OR: 0.72; 95% CI: 0.58-0.90) were associated with a lower chance of utilising rehabilitation services.Rehabilitation utilisation depends on occupational qualification, as expected among the low-skilled. Subjective health explains a large part of the higher probability of utilisation of rehabilitation services in this group compared to the high-skilled. Compared to high-skilled individuals, medium-skilled and low-skilled older employees had a similarly high chance of utilising rehabilitation services. Future research should therefore examine the relationship between the need for and utilisation of medical rehabilitation services depending on the level of occupational qualification, taking other factors into account.</p>","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769934","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":"Rehabilitation braucht Wissenschaft – jetzt die Weichen stellen.","authors":"Rembert Koczulla","doi":"10.1055/a-2718-6852","DOIUrl":"https://doi.org/10.1055/a-2718-6852","url":null,"abstract":"","PeriodicalId":54504,"journal":{"name":"Rehabilitation","volume":"64 6","pages":"313"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726743","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}