[Job-Related Health Check for Employees Aged 45 and Older: Is there a Need for Carers?]
High levels of physical and psychological stresses experienced by those in the care profession can have a negative impact on their health. The pilot project "Health Check for Carers in the region of Karlsruhe" offered nurses aged 45 and above - based on their self-assessed ability to work using the Work Ability Index (WAI) - the opportunity to participate in a job-related health check, based on their work ability index result. This study looks at the occupational and health situation of older carers, the (subjective) need for a Ü45 health check and draws a comparison between particpants and non-participants.
[Work-Related Rehabilitation of Patients with Inflammatory Bowel Disease- Results of a Feasibility Study]
Despite the increasing importance of occupational rehabilitation in chronic diseases, its role in the medical rehabilitation of patients with inflammatory bowel disease (IBD) is still limited. The aim of this study was to test a work-related concept for IBD patients with work-related problems and its acceptance by patients and rehabilitation staff. Improvements in work-related and psychosocial parameters of rehabilitants should be determined.
[Vascular rehabilitation for patients with peripheral arterial occlusive disease]
Compared to patients with coronary heart disease, patients with PAD have a poorer attitude towards general practitioners with regard to the frequency of prescribing rehabilitative measures and controlling risk factors. The patients themselves do not perceive the increased cardiovascular risk and thus the need for lifestyle changes and compliance to the same extent as patients with coronary heart disease.The "Rehabilitation clinic with vascular expertise" certificate defines the criteria for fulfilling the specific structural and process requirements for vascular medicine.Due to the paradigm shift and the increasing importance of conservative therapy for patients with intermittent claudication, vascular rehabilitation can be the start of or support for the implementation of conservative therapy and thus ensure long-term patient compliance with regard to the implementation of drug therapy, lifestyle changes and the sustainability of gait training. For hospitalized patients, vascular rehabilitation closes the gap to more sustainable aftercare.Increasing demand will promote the development of vascular medical rehabilitation and increase awareness on the part of payers. This process is being scientifically monitored.The goal should be a care structure for patients with PAD that is regulated on an outpatient basis as part of a separate or adapted DMP program, that includes the quality standards of the "Interdisciplinary Vascular Centers" on an inpatient basis and that includes vascular medical rehabilitation with subordinate vascular sports groups.From the point of view of rehabilitation, the aim is for vascular rehabilitation to be recognized as an independent specialist area by the payers.
[Measuring Attitudes towards Health Services Research among Representatives of German Rehabilitation Facilities: The REHA-KNOWS Study]
The REHA-KNOWS study explores the perceptions of practice representatives of rehabilitation facilities in Southwest Germany regarding (healthcare) research and shows benefits and barriers in knowledge transfer from the perspective of practice. For this purpose, an instrument with 12 5-level items was developed, which is exploratively examined in this paper. The instrument includes statements on the benefits, costs and added value of rehabilitation research projects as well as on the framework conditions in the facilities. Between March and May 2023, data were collected from representatives of 206 rehabilitation facilities in Baden-Wuerttemberg and Saarland using an online questionnaire.
[Expectations and Perceptions of Medical Rehabilitation in Times of Pandemic from the Perspective of Individuals in Need of Rehabilitation and Rehabilitation Patients - A Qualitative Study]
Over the past four years, medical rehabilitation providers and their staff have developed strategies to adapt to a new reality of care during the COVID-19 pandemic. The aim of this qualitative survey was to assess patients' expectations from and perceptions of rehabilitation in times of pandemic. The results can contribute to the development of recommendations on how pandemic-related challenges in rehabilitative care can be overcome.
[Results of a Survey Regarding the Implementation of Work-Related Medical Rehabilitation for Patients with Musculoskeletal Disorders: Evaluation and Training of Work-Related Functional Capacity]
Although work-related medical rehabilitation (WMR) has been established as a component of the rehabilitative care system for some time, particularly in patients with musculoskeletal disorders, studies indicated strong heterogeneity regarding the implementation of the guideline for WMR in Germany. This study is the first to examine the implementation of work-related functional capacity training and the preceding work-related diagnostics based on a nationwide survey of WMR health care professionals.
[Position paper from the "Climate and Sustainability" working group in the German Society for Rehabilitation Sciences]
The "Climate and Sustainability" working group of the German Society for Rehabilitation Sciences was founded in March 2023. The members represent research, practice, and service providers in rehabilitation. The aim is to make rehabilitation in Germany sustainable and to focus on climate protection and the health consequences of climate change. Dealing with these issues should become the new social norm for all stakeholders in rehabilitation. Therefore, existing knowledge is used, and new findings are developed that are passed on directly to and support the quality-assured transformation in the facilities. The focus of current activities is on two fields of action: promoting climate protection through the ecological transformation of rehabilitation facilities and promoting climate resilience through further development of rehabilitation services and social medicine. Activities to date include specialist publications and research, statements and submissions, events, and training courses as well as dissemination, networking, and public relations work to establish sustainability concepts in rehabilitation.
[Work Participation after Medical Rehabilitation due to Mental Disorders: Representative Analyses Using Routine Data of the German Pension Insurance]
The particular relevance of mental disorders for society and the economy is highlighted in the context of work participation. Based on representative routine data from the pension insurance from 2017, the aim of the study was to describe a group of psychosomatic rehabilitation patients recruited on the basis of selected characteristics, examine the return to work (RTW) rates, to assess individual progression after rehabilitation and to identify possible influencing factors.
[Quality Criteria of Qualitative Studies in Rehabilitation Research]
Considering the variety of research questions, perspectives, and disciplines involved, qualitative studies have become an integral part of rehabilitation sciences. To ensure and estimate their quality and thus the significance of their results, criteria are needed for both researchers and recipients. Due to the specific nature and the heterogeneity of qualitative research approaches, there is still disagreement regarding appropriate universally valid quality criteria. In this article, core criteria that can be used to plan, conduct and receive qualitative studies are presented and discussed with reference to national rehabilitation research. For this purpose, the specific characteristics of rehabilitation research are taken into account and the application of quality criteria is illustrated using concrete examples from the research practice of rehabilitation sciences.
[Measuring Disability in Participation Survey and Social Reporting]
The "Representative Survey on the Participation of People with Disabilities" (Participation Survey), commissioned by the German Federal Ministry of Labour and Social Affairs, aims to work in conjunction with participation reporting to assess the social participation of people with disabilities. Both the participation reporting and the Participation Survey claim to operationalize impairment and disability in accordance with the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO). A critical analysis of the measurement concept reveals methodological problems: 1) The measurement concept is not consistently ICF-oriented because it does not clearly conceptualize impairments, does not adequately take into consideration environmental factors in the determination of disability and sees impairment as causal for disability. 2) Distinction made between impairment and disability is mainly pragmatic, without any coherent conceptual justification. 3) The chosen operationalization cannot ensure the desired international comparability. In order to achieve a stronger ICF orientation and better international comparability, it is proposed in this study to integrate the "Model Disability Survey", developed by the WHO and the World Bank, into the German Participation Survey's data collection tools. An alternative measurement proposal, which can be implemented with the available data, is to categorize groups solely according to the severity of impairment, forgoing the a priori distinction between impairment and disability. This approach embraces the fundamental idea of the ICF, which views disability as a situational rather than a personal characteristic.
[What is the Impact of Early Rehabilitation and Rehabilitation Management on Outcome after Polytrauma?]
Patients with polytrauma and other severe musculoskeletal injuries often suffer from permanently impaired functionality and quality of life. This results in long-term damage with high costs for the social system. A narrative review will show the impact of targeted coordination in the rehabilitation process from early rehabilitation to long-term case management on patients with severe musculoskeletal injuries. A systematic database search of MEDLINE and the Cochrane Library identified studies of multiple injuries that compared the outcome of early rehabilitation and rehabilitation management with other types of care. Studies of predominantly neurologic injury types, soldiers, and mild injury types with an ISS less than 9 or AIS less than 3 were excluded. Four studies were included and analyzed. They looked at functionality, quality of life, psychological impairment, and costs. While treatment and total costs were higher for early rehabilitation and rehabilitation management, no better results for improved function, psychological condition and quality of life could be demonstrated in the group comparison. An effect estimate is possible due to small group differences and the small number of individual studies included. There are insufficient studies to draw conclusions about the effectiveness of the early interventions. Future studies are needed that take into greater account structures of standard care and national differences in social security systems, as well as the chosen rehabilitation management interventions.
[Vocational Rehabilitation in Times of the Covid-19 Pandemic]
The Covid-19 pandemic has posed new challenges to actors in vocational rehabilitation (VR) for people with disabilities. In this study, we were interested in the following: How did actors like service providers and financers of VR (here: German Federal Employment Agency (FEA)) experience the Covid-19 pandemic, which process changes and delays have occurred, and what impact will this possibly have on the future of vocational rehabilitation for people with disabilities?
[Prediction of Utilization of Psychological Support During Vocational Rehabilitation]
Comprehensive psychological support is a distinctive feature of vocational retraining centers, pivotal in stabilizing the health of the rehabilitants, reducing dropout rates and facilitating return to work. For optimal resource planning within the vocational retraining centers, and thereby ensuring the best possible psychological support during vocational rehabilitation, it is crucial to be able to estimate the number of appointments of the rehabilitants in advance. Even though routine data is available, predictions using regression analysis have not been undertaken previously.
[Results of a Survey Regarding the Implementation of Work-Related Medical Rehabilitation for Patients with Musculoskeletal Disorders: Identification of a Need and the Assessment of Work Demands]
Research indicates that the implementation of work-related medical rehabilitation (WMR) is characterized by pronounced heterogeneity and that the requirements defined by the German Pension Insurance are not consistently met. The study aimed to investigate the implementation of the WMR guideline in patients with musculoskeletal disorders with regard to the identification of a need for WMR as well as the assessment of the individual demands of work.
[Self-assessed use and provision of assistive devices in individuals with hereditary ataxia at the interface between development in childhood and adolescence and symptom progression]
Assistive devices are essential in neuropediatrics, but the database on the self-assessed use by and supply of medical aids to those affected with hereditary ataxia is small. The present work aims to examine the individual perspective of those affected by the use and supply of aids and to discuss them in the field of tension between physiological and psychosocial development and symptom progression.
Virtual Reality Mental Health Interventions in Geriatric Care for Functional or Well-being Enhancement - A Scoping Review
It has become common to use Virtual Reality (VR) for mental health interventions; however, its use in care of the elederly is limited, especially regarding mood and well-being. In this review, we summarize the results of current VR-based mental health interventions for this population.
[Return to Work after Cancer - a Systematic Review of Predictors in Germany]
More than one third of cancer survivors are of working age. Return to work (RTW) with and after cancer treatment is therefore an important issue for this group - but this is often accompanied with many challenges. The aim of this systematic review was to identify predictors of RTW after cancer from the literature specifically for Germany and to place these factors chronologically in the oncological course of treatment.
[Validated German PROMs for People with Major Amputation of the Lower Extremity - A Narrative Review Based on the Final Report of the LEAD and COMPASS Initiative of the ISPO]
Patient-reported outcome measures (PROMs) play an important role in the rehabilitation of people with major limb amputations. Patient-completed questionnaires help collect specific constructs on this patient population. The COMPASS and LEAD initiatives, carried out by the International Society for Prosthetics and Orthotics (ISPO), underscore the importance of regularly collecting high-quality PROMs. These are essential for the evaluation of rehabilitation needs, progress, and success. In the final report of ISPO's major international initiative, PROMs recommendations of the expert panel are tabulated. In Table 3.2 of the report, ISPO lists n=12 PROMs that were included in the narrow consensus process were considered to be of acceptable quality, and therefore recommended. The aim of this systematic review was to specifically search for these recommended PROMS regarding their availability in a German and validated version in order to identify potential gaps. All PROMs that were available in a German and validated version were then examined further with regard to the quality of the validation study, using the checklist of COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Through a systematic literature search, six validated German-language versions were found. Only four of these met the quality standards of the COSMIN checklist sufficiently. Overall, this review shows serious gaps in the availability in the German language of validated versions of PROMs used internationally and recommended as standard by the ISPO. This gap needs to be closed by guideline-oriented translation and subsequent validation studies in order to be able to offer and collect the PROMS recommended by the ISPO also for German-speaking patient populations.
[Not Available]
In order to treat and research the development, progression, therapy and prevention of cardiological and psychosomatic disorders and their interactions, the field of psychocardiology has been established in recent years and now offers several treatment options.The well-known somatic risk factors for cardiovascular diseases such as smoking, diabetes mellitus, arterial hypertension and acquired or congenital lipid metabolism disorders, lack of exercise, malnutrition and sleep-related disorders are often related to psychosocial risk factors. Conversely, mental illnesses such as depression and post-traumatic stress disorder can also be viewed as independent risk factors for cardiovascular diseases.Somatic illnesses can, in turn, result in significant psychological reactions that have a severely negative impact on the course of the disease, participation and quality of life.In addition to the scientific research into these connections, psychocardiology offers a clinical specialty that questions, diagnoses and provides treatment for psychosocial connections in cardiovascular patients.The aim of this article is primarily to convey clinical and practical aspects of psychocardiology and the most important psychological comorbidities in connection with heart disease. In addition, it should be shown which therapeutic offers are available in the medical care structures and how therapy can be carried out. Psychotherapy and exercise therapy are preferred for the treatment of these comorbid disorders. The possibility of psychopharmacological therapy for cardiovascular patients is also presented, especially because of possible problematic medication interactions.
[The National Competency-Based Catalogue of Learning Objectives for Medicine 2.0 for the subject Physical and Rehabilitative Medicine, Naturopathic Medicine. Consensus of Scientific Medical Societies]
The learning objectives in the current cross-sectional subject "Rehabilitation, Physical Medicine, Naturopathic Medicine" have been revised as part of the further development of the National Competency-Based Catalogue of Learning Objectives for Medicine (NKLM) to its new version 2.0. Since the NKLM is designed as an interdisciplinary catalogue, a subject assignment seemed necessary from the point of view of various stakeholders. Thus, the German Association of Scientific Medical Societies (AWMF) and the German medical faculties initiated a subject assignment process. The assignment process for the subject "Physical and Rehabilitative Medicine, Naturopathic Medicine" (PRM-NHV; according to the subject list of the first draft of the planned novel medical license regulations from 2020) is presented in this paper.
[Oncological Rehabilitation for Breast Cancer]
As a result of increasingly individualized and multimodal therapy, prognosis of breast cancer has improved significantly over the last years. However, multimodal treatment and the use of new medications can lead to a variety of somatic, sometimes new, side effects such as fatigue, polyneuropathy or autoimmune toxicities. This and the oncological diagnosis lead to a high level of psychological distress in the women affected and often to subsequent psychological disorders (sleep/anxiety disorders, depression, ...). Both the diverse complaints after oncological therapy and the increasingly improved overall prognosis underline the importance of multimodal rehabilitation concepts to improve quality of life and successful professional reintegration.In the following, these secondary disorders after breast cancer, their multimodal therapy and their significance for social-medical performance assessment are presented in more detail.