Bühne David, Hetzel Christian, Elling Mathis, Alles Torsten
Institut für Qualitätssicherung in Prävention und Rehabilitation GmbH an der Deutschen Sporthochschule Köln.
Rehabilitation (Stuttg). 2024 Dec;63(6):367-375. doi: 10.1055/a-2388-5775. Epub 2024 Oct 15.
Although work-related medical rehabilitation (WMR) has been established as a component of the rehabilitative care system for some time, particularly in patients with musculoskeletal disorders, studies indicated strong heterogeneity regarding the implementation of the guideline for WMR in Germany. This study is the first to examine the implementation of work-related functional capacity training and the preceding work-related diagnostics based on a nationwide survey of WMR health care professionals.
Rehabilitation facilities (n=317) authorized to carry out WMR in patients with musculoskeletal disorders were invited to participate in a nationwide survey. 86 of 317 facilities responded to the self-developed questionnaire and met the inclusion criteria.
67% of the WMR facilities described a systematic use of functional capacity evaluation (FCE) at the beginning of rehabilitation in at least 50% of the rehabilitants. 70% stated that they systematically matched abilities and work demands. Furthermore, 57% reported that profile comparisons were used to tailor training of work-related functional capacity. The training itself was provided to at least every second rehabilitant with a total duration of 360 minutes or more in about every second facility. The FCE procedures and the work-related functional capacity training were primarily carried out by occupational therapists.
Work-related diagnostics and the work-related functional capacity training are often but not yet always implemented in line with the guideline for WMR. Promoting interdisciplinarity seems to be a promising approach regarding the further development of WMR.
尽管工作相关的医学康复(WMR)作为康复护理系统的一个组成部分已经确立了一段时间,特别是在肌肉骨骼疾病患者中,但研究表明德国WMR指南的实施存在很大异质性。本研究首次基于对WMR医疗保健专业人员的全国性调查,考察工作相关功能能力训练及之前的工作相关诊断的实施情况。
邀请了317家被授权为肌肉骨骼疾病患者开展WMR的康复机构参与全国性调查。317家机构中的86家回复了自行编制的问卷并符合纳入标准。
67%的WMR机构表示,在至少50%的康复患者中,在康复开始时系统地使用了功能能力评估(FCE)。70%表示他们系统地匹配了能力和工作需求。此外,57%报告使用了概况比较来定制工作相关功能能力的训练。在大约每两家机构中,至少每第二名康复患者接受了训练,总时长为360分钟或更长。FCE程序和工作相关功能能力训练主要由职业治疗师进行。
工作相关诊断和工作相关功能能力训练通常但并非总是按照WMR指南实施。促进跨学科性似乎是WMR进一步发展的一个有前景的方法。