[Developing the Integration-Oriented Participation Into Working Life].

[Developing the integration-oriented participation into working life].

Rehabilitation (Stuttg). 2013 Apr; 52(2): 126-31
Gödecker-Geenen N, Riedel HP, Keck T

The pilot project RehaFuturReal of the Deutsche Rentenversicherung Westfalen (DRV) has been in progress since 1st April, 2011 and constitutes the implementation of the results of the na-tionwide development process RehaFutur in the consultation practice of the DRV Westfalen. In order to achieve and secure employability, this pilot project aims at sustained implementation of improved individualisation, flexibility and orientation towards integration, in the framework of the rehabilitation process. The participants are mostly recruited (75%) from different fields of medical rehabilitation (foremost orthopaedy, cardiology). They all meet the 3 selection criteria, which are present employment, current problems concerning occupational integration as well as a demand for occupational rehabilitation. They all have received support and guidance by individualised and structured rehab-management. The average age of the participants was 47.3 years (age range: 33-57 years), which is a rather old age for occupational rehabilitation. In spite of enduring physical disadvantages (83%), it turned out, that the participants had a high level of motivation concerning occupational rehabilitation services and the continuation of their employment, By offering intensive consultation and support, as well as accompanying vocational training, an occupational perspective either with the old employer or with a new employer could be reached for a large number of participants (74%). In the framework of close cooperation between the funding social security institutions, the vocational training institutions, the employers and the receivers of the services, a network has been created, which allows individualised, modularised and flexible integration solutions. In line with the pilot project RehaFuturReal of DRV Westfalen it became apparent, that in order to make occupational rehabilitation future-proof and sustainable, the already developed concepts should be transferred in actual acts of implementation consequently and interdisciplinary. HubMed – rehab

[Patient goals for medical rehabilitation – overview of the current state of research in Germany].

Rehabilitation (Stuttg). 2013 Apr; 52(2): 75-85
Buchholz I, Kohlmann T

It is widely known that goals and goal agreement are important components of a modern approach to medical rehabilitation. The present work gives an overview of the current state of research regarding patient goals for medical rehabilitation by reviewing relevant German pub-lications between 2000 and 2010. This review focused on (1) data collection methods of rehabilitation goals, (2) patient goals, and (3) agreement between the goals of patients and their clinicians.A search strategy combining electronic databases and hand search was applied. A priori inclusion and exclusion criteria were applied. A self-developed goal-catalogue was used to synthesize the literature.A total of 20 publications were included, 11 of which explored both patient and clinicians perspectives. ad (1): Only 4 goal-assessment instruments in the field of medical rehabilitation exist, but none has been established as a standard. The instruments differ in how differentiate they depict different goals areas. ad (2): The goal structure of medical rehabilitation patients corresponds to the respective indications. The 3 top goals in all patient groups included physical and/or psychosocial objectives. Information and occupational goals are rarely represented among the 3 top goals mentioned. ad (3): Patients have more numerous as well as differing goals then their treating clinicians. Goals of physical functions (e. g., enhancement of stamina) and superior rehabilitation goals (e. g., return to work) have the best agreement. Mental and maintenance goals are more frequently mentioned by the patients while pain and symptom-related goals are more frequently mentioned by the doctors. There are indication-specific differences for goals regarding information.Rehabilitation goals are highly valuable in the rehabilitation process. Finding only 20 relevant publications, generalizability of study results is limited. Due to high variability in methodological approach and presentation of results, comparisons of results across studies reviewed are severely limited. Developing survey standards and using uniform metrics could contribute to standardizing study endpoints. The goals of patients and clinicians are formed in individual life or work contexts, which are influenced by numerous factors (e. g., knowledge, illness/health concepts, assumptions regarding rehabilitation treatment), representing individual expertise that complement one another. Since compatible goals are essential for successful rehabilitation treatment, an exchange of goals and expectations as well as the establishment of joint target agreements should precede any rehabilitation programme. HubMed – rehab

[Rehabilitation goals of rehabilitants].

Rehabilitation (Stuttg). 2013 Apr; 52(2): 74
Schliehe F

HubMed – rehab

[Mobile geriatric rehabilitation in functionally severely impaired patients : Investigations on effectiveness.]

Z Gerontol Geriatr. 2013 Apr 26;
Schulz R, Knauf W, Püllen R

INTRODUCTION: Mobile geriatric rehabilitation is an outpatient rehabilitative treatment in which a multidisciplinary team treats elderly patients at home. This kind of treatment has been performed in rare cases in Germany but there are no data available on the effectiveness in patients with severe cognitive and functional impairment. MATERIAL AND METHODS: In a retrospective study design the data of all patients who had participated in mobile geriatric rehabilitation between 1 September 2009 and 23 May 2011 were evaluated. Before treatment a comprehensive geriatric assessment was performed and after treatment an assessment of mobility and activities of daily living (ADL). After 6 months a random sample of 20 patients were contacted by telephone to check the ADL. RESULTS: A total of 87 patients were treated between 1 September 2009 and 23 May 2011. The median age was 83 years and 56?% of the patients lived in nursing homes. Only 24?% of the patients had MMSE scores >?23 points, 77 patients completed the treatment with an assessment and in these patients the ADL could be improved significantly (Barthel index at the beginning 36.2 points and on completion 50.9 points, p?HubMed – rehab