Rehabilitation最新文献

As part of the AUT-1A project, 123 employers were surveyed by questionnaires about their experiences with the employment of autistic employees. The aim was to identify the factors that promote and hinder employment. The study indicates that the vocational qualification in vocational training centers (BBW) has a positive effect on sustainable employment of people with autism spectrum diagnosis (ASD), but the support for companies is not sufficient yet. Also, a lack of education regarding autism-friendly environmental design as well as a lack of education about the diagnosis autism of the direct colleagues could be worked out.

Purpose: The aim of this study was to measure the status of digitalization and the opportunities and challenges for rehabilitation facilities connected to telematics infrastructure.

Methods: A partially standardized online survey of all providers of rehabilitation facilities in Bavaria (n=33) was carried out. The questionnaire with 36 questions included a scale based on the Electronic Medical Record Adoption Model (EMRAM).

Results: The level of digitization was reported as level 0 in 70% of the rehabilitation facilities (level model to 7). The transmission of patient-related data (incoming and outgoing) is often analogue, whereas the processing within the facility is already predominantly digital in many cases. When connecting to the telematics infrastructure, installation, training of staff and adaptation of work organization required quite a bit of effort.

Conclusion: Changes in the legal-financial situation in Germany open up new opportunities for increased digitalization of rehabilitation facilities. Hurdles are related to IT security requirements, staff training, and the low level of digitalization in hospitals, among doctors, and patients, which make digital data transmission difficult.

Background: Not only the severity of an injury, but also bio-psycho-social factors affect health-related quality of life and participation in social life after severe musculoskeletal injuries.

Methods: Multicentre prospective longitudinal study with follow-up up to 78 weeks after discharge from inpatient trauma rehabilitation. Data were collected using a comprehensive assessment tool. Quality of life was assessed using the EQ-5D-5L, return to work by patients' self-reports and routine data of health insurances. Analyses of the association between quality of life and return to work, change over time in quality of life compared to the general German population and multivariate analyses to predict quality of life were conducted.

Result: Of 612 study participants (444 men (72.5%); M=48.5 years; SD 12.0), 502 (82.0%) returned to work 78 weeks after discharge from inpatient rehabilitation. Quality of life improved during rehabilitation treatment from 50.18 to 64.50 (mean of visual analogue scale of EQ-5D-5L) and slightly to 69.38 78 weeks after discharge from inpatient trauma rehabilitation. EQ-5D index was below the values of the general population. In total, 18 factors were selected to predict quality of life 78 weeks after discharge from inpatient trauma rehabilitation. Among others, pain at rest and suspected anxiety disorder at admission had a very strong effect on quality of life. Contextual factors such as therapies after acute care and self-efficacy also had an effect on quality of life 78 weeks after discharge from inpatient rehabilitation.

Conclusion: Bio-psycho-social factors affect long-term quality of life of patients with musculoskeletal injuries. Already at the time of discharge from acute treatment and even more at the beginning of inpatient rehabilitation, decisions can be made in order to achieve the best possible quality of life for those affected.

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.