Patient-oriented training practice in orthopaedic rehabilitation through dissemination of an evaluated training program
Dr. Karin Meng, Dipl.-Psych. Anja Schultze, Prof. Dr. Dr. Hermann Faller.
Universität Würzburg, Arbeitsbereich Rehabilitationswissenschaften
in cooperation with:
Prof. Dr. Klaus Pfeifer, Stefan Peters. Universität Erlangen-Nürnberg, Institut für Sportwissenschaft
Prof. Dr. Jürgen Wasem, Dr. Dr. Anja Neumann. Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
Funding period: 01.01.2011 – 31.12.2013
Background
An approach to foster a patient-oriented training practice in medical rehabilitation is the dissemination of evaluated training programs. Studies show that their implementation represents a challenge for routine clinical practice and is frequently not entirely successful. Programs are only partially implemented or modified, which calls their effectiveness in routine practice into question. Studies on the comparison of implementation strategies and on proving the effectiveness in routine application are largely lacking for training programs in medical rehabilitation.
With the Curriculum Back School, a patient-oriented standardised training program is available which has proven to be effective in a randomised control group study (http://www.psychotherapie.uni-wuerzburg.de/forschung/projekte-koop_12.html). A dissemination in orthopaedic rehabilitation clinics can be recommended.
Aims and research questions
The aim of the project is to (A) check the effectiveness and costs of implementation strategies for the dissemination of a training program "Curriculum Back School" (implementation effectiveness) and (B) evaluate the training effectiveness in routine application (effectiveness) in terms of a patient-oriented training practice, the patient outcome as well as the cost effectiveness (efficiency).
Main research questions: (A) With which implementation strategy – train-the-trainer seminar or implementation guidelines on the manual – can a better implementation of the training be achieved regarding contents and patient-oriented didactics as well as a higher patient satisfaction? (B) After a dissemination of a standard training in routine practice, can better training effects be achieved after the rehabilitation in the short, medium and long term?
Study design/Methods
Effectiveness study (B) with integrated dissemination study (A)
(A) Dissemination study in 10 rehab clinics (approx. 130 trainers, 300 patients, 30 training programs) with quantitative and qualitative structural and needs analysis, process and outcome research).
(B) Multi-centre quasi-experimental control group study with 4 measurement time points (beginning of rehab, end of rehab, 6-month and 12-month follow-up) and 540 back pain patients (healing process; ICD-10: M51, M53, M54) from 4 of the 10 clinics.
Publication
- Meng, K., Schultze, A., Peters, S., Worringen, U., Pfeifer, K., Faller, H. (2012). Wie ist die Struktur- und Bedarfssituation von orthopädischen Rehabilitationskliniken zur Einführung eines standardisierten Schulungsprogramms? DRV-Schriften, 98, 164-166.
Cooperating clinics
- Argentalklinik Isny-Neutrauchburg
- Asklepios Klinik Bad Abbach
- Klinik Bad Wörishofen, DRV Schwaben
- MediClin Reha-Zentrum Spreewald
- RECURO Rehabilitations- & Präventionszentrum Bad Kissingen
- Rehaklinik Höhenblick, RehaZentren der Deutschen Rentenversicherung BW gGmbH
- Rehazentrum Bad Bocklet
- Reha-Zentrum Schömberg, Klinik Schwarzwald
- Sana Rheumazentrum, Rheinland-Pfalz AG
- Simssee Klinik GmbH
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