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Dr. Ruth Deck

Universitätsklinikum Schleswig-Holstein 
(Campus Lübeck) 
Institut für Sozialmedizin 
Ratzeburger Allee 160 (Haus 50)
23562 Lübeck

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Rehabilitation aftercare – Optimisation and transfer of the new creed (NaSo 2)

Project leader:

Dr. Ruth Deck, Universität zu Lübeck, Institut für Sozialmedizin

 

The project "Rehabilitation aftercare – Optimisation and transfer of the new creed" (abbreviation NASO 2) is directly connected to the Project "Rehabilitation aftercare – A 'new creed' for rehabilitation clinics", which was also funded by the German Pension Insurers Association and the German Federal Ministry for Education and Research (running time 01.01.2008 – 31.12.2010, henceforth referred to as NASO 1). Both projects are based on the conviction that rehab aftercare needs to be a central component of medical rehabilitation as the problems of chronically ill persons cannot be solved within a three-week inpatient or outpatient rehabilitation. With the new creed, in NASO 1, a long-term aftercare strategy was developed, implemented and evaluated, which focuses on physical activity and personal initiative. The overriding goal is to improve long-term rehabilitation effects.

 

Starting from the NASO 1 results, the project NASO 2 pursues three central goals, which should each be achieved in their own subproject.

 

Subproject A: Optimisation of the new creed

In order to develop an optimised strategy of aftercare which should guarantee a better fit to the needs of rehabilitees and clinic employees, qualitative interviews with rehabilitees ("creed non-responders" of the intervention group from NASO 1) and clinic employees who participated in the implementation of the aftercare programme were conducted. The results of the qualitative surveys formed the basis for the revision of the study materials (information sheets, observation book, activity diaries etc.). Where necessary, additional study materials (e.g. feedback letters regarding the activity diaries) were compiled.

 

The results available from NASO 1 highlighted that rehabilitees show great differences in terms of their impairments at the beginning of rehab. For NASO 2, for this reason, a more flexible rehab and aftercare strategy was developed: Rehabilitees with relevant impairments in the parameters functional capacity (FFbH-R) and social participation (IMET) received, over a period of 12 months after the end of inpatient rehab, a clearly more comprehensive support (activity diaries and feedback letters) than rehabilitees without relevant impairments.

 

NASO 2 will be evaluated in a prospective controlled longitudinal study (written survey at three measurement time points: beginning of rehab, end of rehab, 12 months after end of rehab). The intervention takes places in two rehab clinics (orthopaedics). In total, 150 rehabilitees with relevant impairments and 100 rehabilitees without relevant impairments should be included in the study. For the comparison with rehabilitees who receive a standard rehabilitation (usual care), 360 data sets of the control group from Credo1 are available.

 

Subproject B: 24-month follow-up

In this subproject, using a written follow-up survey, it will be examined whether the positive effects of the aftercare strategy can also be demonstrated 24 months after the end of rehab. Included in the study are all participants of the 12-month follow-up from NASO 1 (IG=166, CG=368).

 

Subproject C: Transfer psychosomatics

The aftercare program was developed for the indication area of chronic back pain and has so far been applied exclusively in this field. In this subproject, the practicability and usefulness of this need creed will be tested in the framework of psychosomatic rehabilitation (indications F32, F33 and F40 – depressive illnesses).

 

Together with the employees of the rehab clinic, the materials will be adapted. The feasibility of the transfer and the effects of the intervention will be checked in a mono-centric longitudinal study (written survey at three measurement time points: beginning of rehab, end of rehab, 4 months after end of rehab). In this part of the study, a total of 150 rehabilitees will be recruited, which corresponds to a net sample of N=120. As the control group (historical control), data will be drawn from the Quality Community of Schleswig-Holstein.

 

The project is funded by the DRV Bund with a running time of 3 years (beginning 1/2011).

 

Cooperation partners

 

1 A relevant impairment is only indicated if the rehabilitee reaches a total score of <80 on the FFbH-R and a total score of >10 on the IMET.




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