TY - JOUR A1 - Bethge, M. A1 - Gutenbrunner, C. A1 - Neuderth, Silke T1 - Work Ability Index predicts application for disability pensions after work-related medical rehabilitation for chronic back pain JF - ACRM - Archives of Physical Medicine and Rehabilitation N2 - Abstract Objective To determine whether the Work Ability Index (WAI), a short 7-item self-report questionnaire addressing issues of perceived disability, impairment, and expectations for resuming work, predicts application for disability pension, recommendations for further treatment, and other adverse work-related criteria in patients with chronic back pain after rehabilitation. Design Cohort study with 3-month follow-up. Setting Seven inpatient rehabilitation centers. Participants Patients (N=294; 168 women; mean age, 49.9y) with chronic back pain. Intervention The WAI was completed at the beginning of rehabilitation. All patients were treated according to the German rehabilitation guidelines for chronic back pain and work-related medical rehabilitation. Main Outcome Measure Application for disability pension, as assessed by a postal questionnaire 3 months after discharge. Results Receiver operating characteristic curve analysis of the association between the WAI at baseline and subsequent application for disability pension revealed an area under the curve of .80 (95% confidence interval [CI], .62–.97). Youden index was highest when the WAI cutoff value was ≤20 points (sensitivity, 72.7%; specificity, 82.2%; total correct classification, 81.7%). After adjusting for age and sex, persons with a baseline WAI score of ≤20 points had 15.6 times (95% CI, 3.6–68.2) higher odds of subsequent application for disability pension, 4.9 times (95% CI, 1.5–16.8) higher odds of unemployment, and 6 times (95% CI, 2.4–15.2) higher odds of long-term sick leave at follow-up. Conclusions The WAI could help rehabilitation professionals identify patients with back pain with a high risk of a subsequent application for disability pension. Y1 - 2013 U6 - https://doi.org/10.1016/j.apmr.2013.05.003 VL - 94 IS - 11 SP - 2262 EP - 2268 ER - TY - JOUR A1 - Schwarz, B. A1 - Neuderth, Silke A1 - Gutenbrunner, C. A1 - Bethge, M. T1 - Multiprofessional teamwork in work-related medical rehabilitation for patients with chronic musculoskeletal disorders JF - Journal of Rehabilitation Medicine N2 - Objective: Systematic reviews indicate the effectiveness of multimodal rehabilitation. In Germany this has been shown, in particular, for work-related medical rehabilitation. A recently published guideline on work-related medical rehabilitation supports the dissemination of these programmes. The feasibility of this guideline was examined in a multicentre study. This paper presents findings on the relevance of multiprofessional teamwork for the implementation of successful work-related medical rehabilitation. Methods: Focus groups were conducted with 7 inpatient orthopaedic rehabilitation teams and examined using qualitative content analysis. Results: Multiprofessional teamwork emerged inductively as a meaningful theme. All teams described multiprofessional teamwork as a work-related medical rehabilitation success factor, referring to its relevance for holistic treatment of multifactorially impaired patients. Although similar indicators of successful multiprofessional teamwork were named, the teams realized multiprofessional teamwork differently. We found 3 team types, corresponding to multidisciplinary, interdisciplinary and transdisciplinary team models. These types and models constitute a continuum of collaborative practice, which seems to be affected by context-related factors. Conclusion: The significance of multiprofessional teamwork for successful multimodal rehabilitation was underlined. Indicators of ideal multiprofessional teamwork and contextual facilitators were specified. The contingency approach to teamwork, as well as the assumption of multiprofessional teamwork as a continuum of collaborative practice, is supported. Stronger consideration of multiprofessional teamwork in the work-related medical rehabilitation guideline is indicated. Y1 - 2015 U6 - https://doi.org/10.2340/16501977-1893 VL - 47 IS - 1 SP - 58 EP - 65 ER - TY - JOUR A1 - Rückriegel, S.M. A1 - Baron, M. A1 - Domschke, K. A1 - Neuderth, Silke A1 - Kunze, E. A1 - Keßler, A.F. A1 - Nickl, R. A1 - Westermair, T. A1 - Ernestus, R.-I. T1 - Trauma- and distress-associated mental illness symptoms in close relatives of patients with severe traumatic brain injury and high-grade subarachnoid hemorrhage JF - Acta Neurochirurgica N2 - Background Close relatives (CR) of patients with severe traumatic brain injury (TBI) and high-grade subarachnoid hemorrhage (SAH) suffer extraordinary distress during the treatment: Distress may lead to persisting mental illness symptoms within the spectrum of post-traumatic stress disorder (PTSD), anxiety disorders, and depression. The primary goal of this study was to determine the prevalence and severity of these symptoms in CR. The secondary goal was identification of associated factors. Method Standardized interviews were conducted with 53 CR (mean age of 57.7 ± 11.4 years) of patients with TBI °III (n = 27) and high-grade SAH H&H °III–V (n = 26) between 5 and 15 months after the event. The interviews contained a battery of surveys to quantify symptoms of PTSD, anxiety disorders, and depression, i.e., Impact of Event Scale (IES-R), 36-item Short-Form General Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS). Fixed and modifiable possibly influencing factors were correlated. Results Twenty-eight CR (53 %) showed IES-R scores indicating a probable diagnosis of PTSD. Twenty-five CR (47 %) showed an increased anxiety score and 18 (34 %) an increased depression score using HADS. Mean physical component summary of SF-36 was not abnormal (49.1 ± 9.1), whereas mean mental component summary was under average (41.0 ± 13.2), indicating a decreased quality of life caused by mental effects. Perception of the interaction quality with the medical staff and involvement into medical decisions correlated negatively with severity of mental illness symptoms. Evasive coping strategies were highly significantly associated with symptoms. Conclusions This study quantifies an extraordinarily high prevalence of mental illness symptoms in CR of patients with critical acquired brain injury due to SAH and TBI. Modifiable factors were associated with severity of mental illness symptoms. Prospective studies testing efficiency of early psychotherapeutic interventions are needed. Y1 - 2015 U6 - https://doi.org/10.1007/s00701-015-2470-0 VL - 159 IS - 8 SP - 1329 EP - 1336 ER - TY - JOUR A1 - Lukasczik, M. A1 - Gerlich, C. A1 - Neuderth, Silke A1 - Schuler, M. A1 - Dlugosch, G. A1 - Faller, H. T1 - Stress and Resources in Women Attending an Inpatient Prevention/Rehabilitation Measure for Parents: Secondary Analysis of Quality Assurance Data JF - Open Journal of Medical Psychology N2 - Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associations of gains in a psychosocial resource (parenting self-efficacy) and two types of stressors experienced by mothers at the start of treatment (parenting hassles, depressive symptoms) with general life satisfaction and satisfaction with health at the end of treatment were explored. Structural equation modeling was applied to data from N = 1724 female patients. Potential resource-stressor interactions were tested using the Latent Moderated Structural Equations approach. Results showed that parenting hassles were negatively associated with general life satisfaction and satisfaction with health while self-efficacy gains were weakly positively correlated with both variables. No interaction of parenting hassles and self-efficacy gains was found. Depressive symptoms were negatively associated with both satisfaction measures. In these models, self-efficacy gains were not substantially correlated with life satisfaction, but showed a small association with satisfaction with health. There was no significant interaction of depressive symptoms and self-efficacy gains. The findings imply that interventions for distressed mothers—as exemplarily illustrated by this inpatient setting—should focus on identifying and reducing initial stressors as these may continue to impair mothers’ subjective health despite gains in parenting-related resources. Y1 - 2015 U6 - https://doi.org/10.4236/ojmp.2015.42003 VL - 4 IS - 2 - April SP - 23 EP - 34 ER - TY - JOUR A1 - Lukasczik, M. A1 - Gerlich, C. A1 - Neuderth, Silke T1 - Patients’ perceived involvement in vocationally oriented medical rehabilitation and its associations with satisfaction and motivation to deal with work-related issues during rehabilitation JF - International journal of behavioural & healthcare research N2 - Little is known about the degree of involvement in treatment-related decision-making experienced by patients in work-related medical rehabilitative programs. It was investigated whether subgroups of patients in vocationally oriented medical rehabilitation (VOMR) can be distinguished regarding their degree of perceived participatory involvement and whether different degrees of perceived involvement during the consultation were associated with the motivation to deal with work-related problems and the satisfaction with treatment decision-making, the doctor-patient interaction and overall treatment. Data from a previous study including 283 orthopaedic rehabilitation patients were re-analysed. Latent class analysis yielded four types of perceived involvement (shared decision-making; patient-centred interaction with vs. without involvement in decision-making; no involvement). Higher involvement was associated with higher satisfaction, but not with the motivation to deal with work-related issues. Perceived involvement can be regarded as a helpful tool in promoting patient-centeredness in work-related medical rehabilitation. The lack of associations with motivation necessitates further research. Y1 - 2015 U6 - https://doi.org/10.1504/IJBHR.2015.071466 VL - 5 IS - 1-2 SP - 25 EP - 40 PB - Inderscience Publishers (IEL) ER - TY - JOUR A1 - Bethge, M. A1 - Schwarz, B. A1 - Neuderth, Silke T1 - Medizinisch-beruflich orientierte Rehabilitation bei muskuloskelettalen Erkrankungen JF - B&G Bewegungstherapie und Gesundheitssport N2 - Die medizinisch-beruflich orientierte Rehabilitation ist durch eine verstärkte Berücksichtigung von Arbeitsanforderungen und der dafür notwendigen Fähigkeiten charakterisiert. Dies betrifft den gesamten Rehabilitationsprozess (Zugang, Diagnostik, Therapie, Nachsorge). Randomisiert kontrollierte Studien zeigen, dass medizinisch-beruflich orientierte Rehabilitationsprogramme die beruflichen Teilhabechancen erhöhen und Arbeitsunfähigkeitszeiten reduzieren. Eine wesentliche Herausforderung bleibt die interinstitutionelle Zusammenarbeit der am Wiedereingliederungsprozess beteiligten Akteure. N2 - Die medizinisch-beruflich orientierte Rehabilitation ist durch eine verstärkte Berücksichtigung von Arbeitsanforderungen und der dafür notwendigen Fähigkeiten charakterisiert. Dies betrifft den gesamten Rehabilitationsprozess (Zugang, Diagnostik, Therapie, Nachsorge). Randomisiert kontrollierte Studien zeigen, dass medizinisch-beruflich orientierte Rehabilitationsprogramme die beruflichen Teilhabechancen erhöhen und Arbeitsunfähigkeitszeiten reduzieren. Eine wesentliche Herausforderung bleibt die interinstitutionelle Zusammenarbeit der am Wiedereingliederungsprozess beteiligten Akteure. Y1 - 2015 U6 - https://doi.org/10.1055/s-0035-1558526 VL - 31 IS - 6 SP - 250 EP - 254 PB - Thieme ER - TY - JOUR A1 - Eckel, J. A1 - Merod, R. A1 - Vogel, H. A1 - Neuderth, Silke T1 - Einsatz von Schauspielpatienten in den "Psych-"Fächern des Medizinstudiums – Verwendungsmöglichkeiten in der Psychotherapieausbildung? T1 - Use of Standardized Patients in the Psycho-Social Subjects of Medical Studies – Applicability of Standardized Patients in Postgraduate Psychotherapy Training Curricula? JF - PPmP Psychotherapie - Psychosomatik - Medizinische Psychologie N2 - Aufgrund des erfolgreichen Einsatzes von Schauspielpatienten (SP) im Studium der Humanmedizin werden Einsatzmöglichkeiten von SP im Rahmen der Psychotherapieausbildung auf Basis einer systematischen Literaturrecherche (Recherchezeitraum: 1982–2011) zu SP-Einsätzen in den Fächern Psychotherapie, Medizinische Psychologie, Psychosomatik und Psychiatrie geprüft. Im Ergebnis zeigt sich, dass SP vor allem zu den Themen Gesprächsführung, Anamnesetraining und psychopathologische Befunderhebung eingesetzt werden und hauptsächlich Patienten mit affektiven Störungen, neurotischen sowie Belastungs- und somatoformen Störungen und Schizophrenie, schizotypen und wahnhaften Störungen porträtieren. Hinsichtlich der Kriterien „subjektiver Lerneffekt“, „Zufriedenheit“ und „Authentizität“ werden SP-Einsätze überwiegend positiv bewertet. Die Befunde deuten somit darauf hin, dass die Psychotherapieausbildung von der Verwendung von SP zu Übungszwecken oder im Rahmen einer kompetenzorientierten Prüfungsform profitieren könnte. N2 - Due to the successful use of standardized patients (SPs) in medical studies, possible fields of application for SPs in postgraduate psychotherapy training were examined on the basis of a systematic literature research (ranging from 1982 to 2011) on the use of SPs in the fields of psychotherapy, medical psychology, psychosomatic medicine, and psychiatry. The results show that SPs are used predominantly for teaching communication and counseling techniques, history taking, and assessment of psychopathology and are commonly used to portray patients with affective disorders, neurotic, stress and somatoform disorders and schizophrenia, as well as schizotypal and delusional disorders. The use of SPs is generally rated positively with regard to subjective learning effects, satisfaction, and authenticity. Hence, the results suggest that postgraduate psychotherapy training curricula might benefit from the implementation of SPs. Y1 - 2014 U6 - https://doi.org/10.1055/s-0033-1347210 VL - 64 IS - 1 SP - 5 EP - 11 PB - Thieme ER - TY - JOUR A1 - Eckel, J. A1 - Alpers, G.W. A1 - Merod, R. A1 - Vogel, H. A1 - Neuderth, Silke T1 - Einsatzmöglichkeiten von SchauspielpatientInnen in der Psychotherapieausbildung. Ergebnisse von ExpertInnen¬befragungen JF - VPP Verhaltenstherapie & psychosoziale Praxis Y1 - 2014 SN - 0721-7234 VL - 46 IS - 2 SP - 393 EP - 413 PB - DGVT ER - TY - JOUR A1 - Bethge, M. A1 - Löffler, S. A1 - Schwarz, B. A1 - Vogel, H. A1 - Schwarze, M. A1 - Neuderth, Silke T1 - Gelingt die Umsetzung des Anforderungsprofils zur Durchführung der medizinisch-beruflich orientierten Rehabilitation? T1 - Is the Guideline for Work-Related Medical Rehabilitation Successfully Implemented? JF - Die Rehabilitation N2 - Hintergrund: Das Anforderungsprofil zur Durchführung der medizinisch-beruflich orientierten Rehabilitation (MBOR) im Auftrag der Deutschen Rentenversicherung beschreibt Standards für berufsorientierte Kernmaßnahmen in der medizinischen Rehabilitation. Wir überprüften, wie die Umsetzung der Inhalte und des empfohlenen Leistungsumfangs gelang und welche Veränderungseffekte mit der Umsetzung assoziiert ­waren. Methoden: Die Umsetzung des Anforderungsprofils wurde in 7 stationären orthopädischen Rehabilitationseinrichtungen mittels schriftlicher Patientenbefragungen am Rehabilitationsbeginn und Rehabilitationsende sowie 3 Monate nach Abschluss der Rehabilitation untersucht. Zusätzlich wurden aus den ärztlichen Entlassungsberichten die durchgeführten therapeutischen Leistungen extrahiert. Ergebnisse: Der empfohlene Umfang der Sozialberatung und der berufsbezogenen Gruppen wurde erreicht. Diskrepanzen gab es zum empfohlenen Umfang des Arbeitsplatztrainings. Die standardisierte Mittelwertdifferenz (SMD) der Arbeitsunfähigkeitsdauer vor und 3 Monate nach der Rehabilitation entsprach einer nahezu moderaten Verringerung (SMD=0,47; 95%-KI: 0,28–0,66). 5 zusätzliche Stunden berufsorientierter Therapien gingen mit einer Verringerung der Arbeitsunfähigkeitsdauer um 1,2 Wochen einher (95%-KI: −2,38 bis −0,03). Schlussfolgerungen: Das Anforderungsprofil wurde weitgehend erfolgreich umgesetzt und setzt wichtige Standards für den Ausbau der MBOR. Die flächendeckende Umsetzung des MBOR-Anforderungsprofils bedarf einer kontinuierlichen Qualitätssicherung, die zeitnahe Rückmeldungen über den erreichten Umsetzungsgrad ermöglicht. N2 - Background: The guideline for work-related medical rehabilitation (WMR) in responsibility of the German Pension Insurance describes standards of work-related measures in medical rehabilitation. We investigated if contents and recommended amount of treatment were successfully implemented and which improvements were associated with the implementation. Methods: Implementation of the WMR guideline was evaluated at 7 inpatient orthopaedic rehabilitation centres. Patients completed ques­tionnaires at beginning of rehabilitation, at dis­charge and 3 months after discharge. Details ­regarding the treatments provided were extracted from the standardised discharge report. Results: The recommended amount of social counselling and work-related psychosocial ther­apy measures were appropriate. However, there were discrepancies regarding the recommended amount of functional capacity training. The standardised mean difference (SMD) between baseline and 3-month follow-up sick leave duration indicated an almost medium-sized effect (SMD=0.47; 95% CI: 0.28–0.66). An additional 5 h of work-related therapy was associated with a 1.2-week decrease in sick leave duration (95% CI: −2.38 to −0.03). Conclusion: The guideline was for the most part successfully implemented and sets important standards for the roll-out of WMR. The na­tionwide implementation of the WMR guideline requires a continuous quality assurance that ­enables promptly feedback about the achieved implementation level. Y1 - 2014 U6 - https://doi.org/10.1055/s-0033-1353192 VL - 53 IS - 03 SP - 184 EP - 190 PB - Thieme ER - TY - CHAP A1 - Heß, V. A1 - Meng, K. A1 - Schulte, T. A1 - Neuderth, Silke A1 - Faller, H. A1 - Schuler, M. T1 - Nicht-geäußerte psychosoziale Bedürfnisse von Krebspatienten im Aufnahmegespräch der Rehabilitation: Prävalenz, Zusammenhänge und Prädiktoren T2 - 29. Rehabilitationswissen-schaftliches Kolloquium. DRV-Schriften 120, S. 178-180 Y1 - 2020 UR - https://www.deutsche-rentenversicherung.de/DRV/DE/Experten/Reha-Wissenschaften/Wissensaustausch_Veranstaltungen/Reha-Kolloquium/Reha-Kolloquium-alte/alte_kolloquien_index.html UR - https://www.researchgate.net/publication/343850838_Nicht-geausserte_psychosoziale_Bedurfnisse_von_Krebspatienten_im_Aufnahmegesprach_der_Rehabilitation_Pravalenz_Zusammenhange_und_Pradiktoren SP - 178 EP - 180 ER -