Giesler Jürgen M, Klindtworth Katharina, Nebe Angelika, Glattacker Manuela
Sektion Versorgungsforschung und Rehabilitationsforschung, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg.
Deutsche Rentenversicherung Bund, Berlin.
Rehabilitation (Stuttg). 2020 Apr;59(2):112-119. doi: 10.1055/a-0965-0977. Epub 2019 Aug 13.
Although there is evidence on the efficacy of multi-disciplinary rehabilitation in the case of MS, use of inpatient rehabilitation by patients with MS in Germany is comparatively low. Therefore, it was the aim of this study to determine potential barriers and facilitators of inpatient rehabilitation use as perceived by patients with MS.
Based on an extensive preliminary qualitative study a questionnaire was developed that addressed potential determinants of inpatient rehabilitation use by means of 45 items. Data were obtained mainly online from 590 patients with MS. Data analysis primarily included descriptive statistics.
Patients' expectations regarding rehabilitation in the case of MS strongly focus on structural components of a rehabilitation clinic's quality and on participating in treatment decisions in the rehab setting. Barriers to MS-rehabilitation use are perceived to exist in terms of insufficient information on the scope and process of rehabilitation, insufficient support from physicians with respect to applying for rehabilitation and a lack of clarity with respect to the criteria upon which applications will be decided. A smaller proportion of respondents also consider family- and vocation-related factors as barriers to making use of MS-rehabilitation.
Based on these findings, recommendations may be derived that may help reduce barriers to the use of inpatient rehabilitation by patients with MS. These include providing and improving information on the aims, interventions and effects of MS rehabilitation, information on how to apply for medical rehabilitation and the criteria on which applications are decided upon, as well as strengthening the role of the outpatient medical specialist.
尽管有证据表明多学科康复对多发性硬化症患者有效，但德国多发性硬化症患者对住院康复的利用率相对较低。因此，本研究的目的是确定多发性硬化症患者所感知到的住院康复使用的潜在障碍和促进因素。
基于广泛的初步定性研究，开发了一份问卷，通过45个项目来探讨住院康复使用的潜在决定因素。主要通过在线方式从590名多发性硬化症患者那里获取数据。数据分析主要包括描述性统计。
多发性硬化症患者对康复的期望主要集中在康复诊所质量的结构组成部分以及在康复环境中参与治疗决策。人们认为，在康复范围和过程的信息不足、医生在申请康复方面的支持不足以及申请决定标准不明确等方面存在多发性硬化症康复使用的障碍。一小部分受访者还将家庭和职业相关因素视为利用多发性硬化症康复的障碍。
基于这些发现，可以得出一些建议，这些建议可能有助于减少多发性硬化症患者使用住院康复的障碍。这些建议包括提供和改进有关多发性硬化症康复的目标、干预措施和效果的信息，有关如何申请医疗康复以及申请决定标准的信息，以及加强门诊医疗专家的作用。
