The aim of this paper is to outline a current trend in inpatient medical rehabilitation in Germany, i.e. vocationally oriented medical rehabilitation (VOMR). Since employment-related demands and challenges pose a potential source of strain regarding employees' health and work ability, rehabilitative treatment in Germany is increasingly geared towards including work-related issues in diagnostics and therapy. To date, German rehabilitation research and practice have focussed primarily on the development of screening instruments for identifying vocational problems, interface management and inter-sectoral cooperation and the specification and standardisation of vocationally oriented interventions and programmes (e.g. work hardening, group interventions). Further developments in VOMR should examine the varying needs of patients for work-related interventions as well as the neglect of specific subgroups of patients (e.g. long-term unemployed) and topics (e.g. interference between work and other life domains).
The reliability of the manual seemed acceptable in the context of existing research data and is in line with existing peer review research outcomes. Nevertheless, the concordance is limited and requires optimisation. Starting points for improvement can be seen in a systematic training and regular user meetings of the peers involved.
Vocational orientation in medical rehabilitation has become an important issue in rehabilitation science and practice in Germany. Although a variety of vocationally oriented interventions has been developed in recent years, there is still a lack of consensus with regard to the definition of specific types of interventions as well as relevant criteria (e. g., methods; instruments; duration/frequency; patient groups). Building on preliminary definitions, basic types of vocationally oriented measures/interventions were conceptually modified and refined in the context of a consensual process. 39 experts of various professions were contacted during a 2-stage Delphi survey to evaluate existing definitions of vocationally oriented interventions using key questions. Standardized descriptions of 5 vocationally oriented basic interventions were specified in cooperation with an interdisciplinary panel of experts. Descriptions were published in a workbook and a homepage for researchers and clinicians, which also contain information on the implementation of measures into rehabilitative care as well as good practice examples. The media developed in this project may contribute to the transfer of research results on vocationally oriented rehabilitation into health care practice.
There is a need for existing group programs in VOMR to be further manualized, evaluated and published. More patient education programs focusing on work-related issues should be developed specifically for relevant indications.
Background. Medical rehabilitation increasingly considers occupational issues as determinants of health and work ability. Information on work-related rehabilitation concepts should therefore be made available to healthcare professionals. Objective. To revise a website providing healthcare professionals in medical rehabilitation facilities with information on work-related concepts in terms of updating existing information and including new topics, based on recommendations from implementation research. Method. The modification process included a questionnaire survey of medical rehabilitation centers (n = 28); two workshops with experts from rehabilitation centers, health payers, and research institutions (n = 14); the selection of new topics and revision of existing text modules based on expert consensus; and an update of good practice descriptions of work-related measures. Results. Health payers' requirements, workplace descriptions, and practical implementation aids were added as new topics. The database of good practice examples was extended to 63 descriptions. Information on introductory concepts was rewritten and supplemented by current data. Diagnostic tools were updated by including additional assessments. Conclusions. Recommendations from implementation research such as assessing user needs and including expert knowledge may serve as a useful starting point for the dissemination of information on work-related medical rehabilitation into practice. Web-based information tools such as the website presented here can be quickly adapted to current evidence and changes in medicolegal regulations.
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