Buchholz I, Kohlmann T
Institut für Community Medicine, Universitätsmedizin Greifswald.
Rehabilitation (Stuttg). 2014 Apr;53(2):102-9. doi: 10.1055/s-0033-1349141. Epub 2013 Dec 9.
In a multicenter study, patients of the German statutory insurance were encouraged to deal with their own rehabilitation goals using a questionnaire sent in advance of rehabilitation. How patients and physicians assess the benefits and practicability of this method should, in particular, be examined.
In a randomized controlled study a questionnaire, based on the preparation booklet of the DRV Bund, was sent by the German statutory insurance to 2782 rehabilitation patients (n(ortho)=1406, n(onco)714, n(psy)=662). For the intervention group, the questionnaire included, in addition to general information about rehabilitation goals, free text fields for the formulation of own goals. Patients were asked to bring the completed questionnaire to the admission interview. At the end of rehabilitation, satisfaction with participation in the goal-setting process and perceived usefulness of information on rehabilitation goals were captured. The doctors/psychologists responded to standardized items regarding various aspects of utility and practicability of the questionnaire.
34% of the targeted rehabilitation patients brought the completed questionnaire to the admission interview. For most of the rehabilitation patients goal setting is important; 31.4% reported the information obtained to rehabilitation goals to be very, and 62.9% particularly helpful. For practitioners, the questionnaire is likely to orient rehabilitation patients to rehabilitation goals: they reported that 56.6% of the patients reflected about their goals and that 50% were more familiar with the subject. Physicians rated the handling and integration of the questionnaire into the interview, its format and layout as well as its benefits more positively than the surveyed psychologists. These were more optimistic about the ability of rehabilitation patients to answer the questionnaire (62.5%, physicians 47.2%) and define own goals (77.8%, physicians 41.7%).
The applied questionnaire has been well accepted by the majority of rehabilitation patients and practitioners as well as was judged to be practical and useful in important aspects. A comprehensive implementation of the questionnaire proves to be promising, particularly in the context of oncological and orthopedic rehabilitation. To increase the return of the questionnaire, alternative delivery options should be explored in future. Against the background that rehabilitation patients and practitioners of psychosomatic medicine perceived the questionnaire as less helpful, it is also prudent to investigate whether indication-specific implementation strategies would be advantageous.
在一项多中心研究中,德国法定医疗保险鼓励患者通过在康复前发送的问卷来确定自己的康复目标。尤其应研究患者和医生如何评估这种方法的益处和实用性。
在一项随机对照研究中,德国法定医疗保险根据DRV Bund的准备手册,向2782名康复患者(n(骨科)=1406,n(肿瘤)=714,n(心理)=662)发送了一份问卷。对于干预组,问卷除了包含有关康复目标的一般信息外,还设有填写个人目标的自由文本字段。患者被要求在入院面谈时带上填好的问卷。在康复结束时,收集了患者对参与目标设定过程的满意度以及对康复目标信息的感知有用性。医生/心理学家回答了关于问卷实用性和可行性各个方面的标准化问题。
34%的目标康复患者在入院面谈时带上了填好的问卷。对于大多数康复患者来说,设定目标很重要;31.4%的患者表示所获得的康复目标信息非常有帮助,62.9%的患者表示特别有帮助。对于从业者来说,问卷可能会引导康复患者关注康复目标:他们报告说,56.6%的患者思考了自己的目标,50%的患者对该主题更加熟悉。与接受调查的心理学家相比,医生对问卷在面谈中的处理和整合、格式和布局以及益处的评价更为积极。心理学家对康复患者回答问卷的能力(62.5%,医生为47.2%)和确定个人目标的能力(77.8%,医生为41.7%)更为乐观。
所应用的问卷得到了大多数康复患者和从业者的认可,并且在重要方面被认为是实用和有用的。全面实施该问卷被证明是有前景的,特别是在肿瘤和骨科康复的背景下。为了提高问卷的回收率,未来应探索其他发放方式。鉴于身心医学的康复患者和从业者认为问卷帮助较小,研究特定适应症的实施策略是否有利也是明智的。