Heßling A, Brandes I, Dierks M-L, Leniger T
Dr. Becker Neurozentrum Niedersachsen, Am Freibad 5, 49152, Bad Essen, Deutschland.
Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover, Deutschland.
Nervenarzt. 2018 Feb;89(2):169-177. doi: 10.1007/s00115-017-0430-z.
Severe restrictions of work ability (SRWA) as a condition for participation in neurological work-related medical rehabilitation (WMR) have not been adequately described up to now. Similarly, the applicability of the screening instrument SIMBO-C for evaluating SRWA in neurological rehabilitation has not yet been answered conclusively.
Determination of clinical and anamnestic characteristics of neurological SRWA and assessment of the applicability of the screening instrument SIMBO-C in neurological WMR.
For the identification of SRWA clinical and anamnestic characteristics of 344 rehabilitants were routinely collected. The clinically and anamnestically determined SRWA was described quantitatively and content-analytically and correlated with SIMBO-C.
Of the rehabilitants 66% exhibited SRWA. Apart from the established characteristics of SRWA further person and disease-specific factors were found. The SIMBO-C score was significantly higher in the group with SRWA compared to the group without SRWA (45.6 ± 18.9 vs. 31.5 ± 12.5, p < 0.001); however, 31% of the group with SRWA and 50% of the group without SRWA demonstrated a SIMBO-C score ≤ 36 points and thereby a large overlap. The profile of the clinical and anamnestic characteristics in the group with SRWA was homogeneous, regardless of the SIMBO-C score.
The characteristics of neurological SRWA are mainly qualitatively shaped and may only partly be identified by SIMBO-C. A combined quantitative and qualitative approach is necessary in neurological WMR.
作为参与神经科与工作相关的医学康复(WMR)的条件,工作能力严重受限(SRWA)至今尚未得到充分描述。同样,用于评估神经康复中SRWA的筛查工具SIMBO-C的适用性也尚未得到最终解答。
确定神经科SRWA的临床和既往史特征,并评估筛查工具SIMBO-C在神经科WMR中的适用性。
为了确定SRWA,常规收集了344名康复患者的临床和既往史特征。对临床和既往史确定的SRWA进行了定量和内容分析描述,并与SIMBO-C进行了相关性分析。
66%的康复患者表现出SRWA。除了已确定的SRWA特征外,还发现了其他与个人和疾病相关的因素。与无SRWA组相比,有SRWA组的SIMBO-C评分显著更高(45.6±18.9对31.5±12.5,p<0.001);然而,有SRWA组的31%和无SRWA组的50%的SIMBO-C评分≤36分,因此存在很大重叠。无论SIMBO-C评分如何,有SRWA组的临床和既往史特征分布是均匀的。
神经科SRWA的特征主要是定性的,SIMBO-C只能部分识别。在神经科WMR中,需要采用定量和定性相结合的方法。