Die Rehabilitation
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Rehabilitation, Physical Medicine, Naturopathic Treatment (Querschnittsbereich Q-12) was introduced as a compulsory interdisciplinary subject in the revised Federal Medical Licensing Regulations (Approbationsordnung für Arzte) in October 2003. This offered the opportunity to increase the students' interest in rehabilitation-related issues and to integrate current evidence of rehabilitation research. The implementation of the Q-12 in the German medical faculties was investigated by yearly questionnaires during a three-year-period. ⋯ During the three examinations, major differences concerning the implementation of Q-12 were found between the faculties. Therefore, it is recommended that all faculties verify whether they adequately cover the joint educational objectives recommended for Q-12 by two German scientific societies. Furthermore, the more frequent application of up-to-date practice-oriented teaching and examination methods, an intensified implementation of Q-12-related issues in teaching specific indications, the completion of curricula, enhanced offer of compulsory election subjects related to Q-12 issues, continued scientific investigations and symposia/workshops concerning the promotion of Q-12-related teaching as well as the generation and exchange of teaching and examination materials are recommended.
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Review Comparative Study
[Current appraisal of external quality assurance procedures in geriatric rehabilitation].
Seven standardized external quality assurance (QA) procedures are currently being applied in geriatric rehabilitation in Germany. Five of these procedures are case-based (Gemidas, GiB-DAT, KODAS, EVA-Reha, Evaluation Procedures of the Medical Review Board of Saxony), and two are institution-based (Quality Seal for Geriatric Rehabilitation in Rhineland-Palatinate, Quality Seal for Geriatrics BAG KGE). The institution-based procedures focus on the quality dimensions "structure" and "process", whereas the case-based procedures mainly focus on the collection of administrative data, and to a limited extent on the quality dimensions "outcomes" and "patient satisfaction". ⋯ In most procedures, data processing and analysis are performed independently of the participating service providers but only partly independently of the agency responsible for the procedure and the whole group of service providers. In the case-based procedures, risk adjustment techniques are not routinely applied in comparisons between institutions. Attempts to implement standardised QA procedures in geriatric rehabilitation may be based on existing procedures and should use this appraisal for developing them further, however taking more into account QA aspects specific to geriatrics.
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The WHODAS II (World Health Organization Disability Assessment Schedule II) is a questionnaire derived from the ICF classification system (International Classification of Functioning, Disability and Health) for the evaluation of disabilities and handicaps. Data on its validity and reliability with respect to the consequences of stroke are largely lacking. The present study aimed at measurements of reliability of the WHODAS II in its application to stroke patients and their closest others. ⋯ Our results demonstrate that the WHODAS II is a reliable instrument for the assessment of stroke patients, both as a self- and an observer-rating questionnaire. Whereas the correspondence between patient and relative may be disparate with respect to single items - especially those not directly observable -, subscale and total scores seem to allow predictions based on observer judgements. The assessment of stroke patients' disabilities and handicaps through relatives' judgements with the WHODAS II scales is reliable.