Die Rehabilitation
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Randomized Controlled Trial
[Development of a standardized back school for in-patient orthopaedic rehabilitation].
Medical rehabilitation in Germany is still lacking in patient education programmes that meet certain quality requirements such as the use of manuals, patient-oriented didactics, and evaluations of effectiveness. For patients with chronic low back pain, no standardized and evaluated back school programme has so far been available for routine use. In this paper, we demonstrate the development of a quality-assured back school based on a health-education programme of the German statutory pension insurance scheme. ⋯ Furthermore, small to medium effects were also observed among some secondary outcomes, such as motivation to physical activity, pain beliefs and pain intensity. After the programme's medium- and long-term effects have been demonstrated, it will be recommended for implementation in medical rehabilitation. The manual meets the requirements that allow for a successful transfer into clinical practice.
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Controlled Clinical Trial
[Patients with chronic low back pain: the impact of psychosocial features].
Chronic low back pain (CLBP) is often associated with clinical and subclinical levels of psychological problems. A higher stage of chronicity is associated with an increase in co-existing psychological disorders. Previous programmes of inpatient orthopaedic rehabilitation reveal little evidence of sustained rehabilitation effects, a finding which may be attributable to the absence of specific psychological treatment during the programme. ⋯ The new programme with a cognitive-behavioural depression management training revealed beneficial effects on mental health in the mid-term and on depressive symptoms in the long-term. However, the effects need to be further improved by after-care programmes.
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Due to specifications in Social Code Book IX and increasing ICF orientation, occupation-related treatment gains importance in medical rehabilitation. The quick and easy identification of patients in need of occupational rehabilitation requires adequate screening instruments. The present study was funded by the Federal Ministry of Education and Research and the German Pension Fund within a programme that focussed on "Work-related orientation within medical rehabilitation and occupational rehabilitation". The study aimed at the development and validation of a "Screening instrument work and occupation (SIBAR)". ⋯ The reliability of SIBAR was satisfying to good. Depending on the external criterion and subsample included the validity of SIBAR was good to very good respective. The agreement between subjective need for occupation-related treatment and the report by clinicians reaches 63%. Yet there is no generally accepted definition of need. For different indications, significant differences occur regarding a need for rehabilitation, which are hardly related to any personal characteristics. In comparison with other screening-instruments, SIBAR supplies a better prognostic estimation of early retirement. CONCLUSION AND FUTURE RESEARCH: The concept of SIBAR meets the methodical requirements for a screening instrument. SIBAR can serve as a generic instrument addressing various demands. It is reliable, valid, short, easy to comprehend, and capable of representing subsequent occupational reintegration and a need for occupation-related treatment.
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Behavioural interventions in chronically ill adolescents aim to improve disease-related self-management. The study presents a short questionnaire for examining the self-management strategies in paediatric patients with obesity, asthma, type I diabetes or atopic eczema. ⋯ This questionnaire can be used as an instrument for self-management strategies in chronically ill adolescents. The responsiveness (change score) and validity have to be further investigated.