Die Rehabilitation
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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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Work-related interventions have become an integral part of medical rehabilitation programmes on behalf of the German Pension Fund. Studies showed concordantly that work-related medical rehabilitation measures should focus on patients with extensive work-related problems. Therefore the identification of such problems has to be an integral part of effective work-related interventions in medical rehabilitation. Adequate screening instruments do exist, but publications regarding their psychometric quality across indications are still missing. ⋯ SIMBO-C can be characterised as a valid and reliable instrument for identification of patients with extensive work-related problems. This study in particular outlines the ability of the SIMBO-C to make predictions about problematic developments, which qualifies it as an instrument to be implemented at an early point of time in the rehabilitation process.
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The pilot phase of the rehabilitation guideline for patients with breast cancer of the German Pension Fund was accompanied by a user survey. This survey allowed oncological rehabilitation centres to comment on the guideline and to suggest changes. ⋯ At the end of the pilot phase the guideline will be revised where necessary, taking the rehabilitation centres' feedback into account. The Pension Insurance considers the guideline for the rehabilitation of patients with breast cancer an important addition to the quality assurance programme. According to the survey's results the guideline is generally accepted and realisable.
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In the context of medical rehabilitation quality assurance, the use of screening procedures aims at specifically screening for rehabilitative cases that might be affected by quality problems. These may then be subjected to more elaborate quality management procedures. In the study presented, a criteria-based screening checklist designed to tap potential quality problems among rehabilitative cases in the German statutory accident insurance medical rehabilitation system was evaluated regarding its validity and suitability for routine use. ⋯ The instrument's potential of introducing the accident insurance administrators' expertise and knowledge into medical rehabilitation quality management strategies is highlighted. Further research on methodological aspects of the instrument as well as its content features is warranted. Starting points for modifications are outlined.