Vogel Martin, Walther Anna Lena, Deck Ruth
Mühlenbergklinik Holsteinische Schweiz, Bad Malente.
Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck.
Rehabilitation (Stuttg). 2017 Dec;56(6):379-388. doi: 10.1055/s-0043-111614. Epub 2017 Jul 31.
Many patients are discharged from the rehabilitation clinic with a restored working ability, but are often unemployed or there is a mismatch between their skills and the job requirements. Those patients often feel to be left alone with their problems regarding their adequate occupational reintegration and wish to be supported over the course of stationary rehabilitation in terms of socio-legal and social-medical issues. The randomized controlled trial investigated if a 12 month telephone aftercare conducted by staff of the social service has a positive influence on occupational reintegration. Patients with severe limitations of work-related functioning were recruited in one rehabilitation center and randomized at the end of rehabilitation. The intervention group (N=171) received a telephone aftercare for 12 month by staff of the social service, the control group (N=162) received the standard aftercare recommendation. The risk of an unsuccessful occupational reintegration was operationalized by means of 3 items, which where summed up to a risk index. The evaluation of the aftercare was conducted by written survey on 3 measurement points. Overall 333 patients were included in the study. 45% (N=152) of the sample were female, the mean age was 50 years. 12 month after rehabilitation 71% (N=120) of patients from the intervention group stated to be employed. In the control group the proportion amounts to 68% (N=110; p=0.074, CI -0.0718; 0.1252). The control group has a significant higher risk constellation according to the risk score for occupational reintegration as the intervention group. The risk score shows significant advantages for patients in the intervention group. The risk of a non-successful reintegration 12 month after rehabilitation was significant lower in the intervention group. All further occupational and health related outcomes indicate only moderate differences. These should be considered against the background of the low-threshold intervention. The telephone aftercare by staff of the social service was rated as very helpful by most of the patients in the intervention group.
许多患者从康复诊所出院时恢复了工作能力，但往往失业，或者其技能与工作要求不匹配。这些患者常常觉得在职业重新融入方面只能独自面对问题，希望在住院康复过程中能在社会法律和社会医疗问题上得到支持。这项随机对照试验调查了社会服务人员进行的为期12个月的电话随访是否对职业重新融入有积极影响。在一个康复中心招募了工作相关功能严重受限的患者，并在康复结束时进行随机分组。干预组（N = 171）接受社会服务人员为期12个月的电话随访，对照组（N = 162）接受标准的随访建议。通过3个项目将职业重新融入不成功的风险进行量化，这3个项目汇总为一个风险指数。通过在3个测量点进行书面调查对随访进行评估。该研究共纳入333名患者。样本中45%（N = 152）为女性，平均年龄为50岁。康复12个月后，干预组71%（N = 120）的患者表示已就业。对照组这一比例为68%（N = 110；p = 0.074，CI -0.0718；0.1252）。根据职业重新融入风险评分，对照组的风险组合显著高于干预组。风险评分显示干预组患者有显著优势。康复12个月后，干预组职业重新融入不成功的风险显著更低。所有其他与职业和健康相关的结果仅显示出适度差异。在低门槛干预的背景下应考虑这些差异。干预组的大多数患者认为社会服务人员的电话随访非常有帮助。
