[Empirically derived recommendations for measuring patient-reported change in rehabilitation studies]. / Empirisch gestützte Empfehlungen für die patientenberichtete Veränderungsmessung in der medizinischen Rehabilitation.

Diverse methods are available for evaluation of (medical) interventions. In each case one has to decide on a specific method. Our aim was to analyze typical problems involved in the measurement of change. Different methods are delineated, and their specific pros and cons are set out. Subsequently, empirically derived recommendations are outlined on which method should be employed for which problem and under which circumstances. A characteristic of rehab treatment is that as a rule a multitude of problems are addressed, and accordingly, treatment goals are heterogenic. Straightforward recommendations for one or the other method cannot be given.

[Quality assurance and total quality management in residential home care]. / Qualitätssicherung und Qualitätsmanagement in der stationären Altenpflege.

Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.

[Questioning of relatives--potentials for the internal quality management in institutions caring for the elderly]. / Angehörigenbefragungen - Potenziale für das interne Qualitätsmanagement in Altenpflegeeinrichtungen.

The German care quality assurance law ("Pflege-Qualitätssicherungs-Gesetz", PQsG) calls for internal quality management in residential care facilities. Empirical surveys with residents, their relatives and employees are essential to get transparency and to assess the quality of service. Within the scope of the present study more than 1400 relatives of residents of 31 residential care institutions were surveyed. Therefore in preliminary studies a questionnaire for the relatives was developed, which collects data concerning quality aspects on various aspects (for example care, staff, medical care, cooperation with relatives). On the average, relatives judged the quality of the institutions as good. The overall mean of 2.2 (scale values between 1.8 ["administration/management"] and 2.5 ["care"]) reveals a positive aspect, but there is substantial variation between institutions. Empirical surveys are important tools for internal quality management. Among other things, their results can be used as input for specific quality circle work and thus for continuous improvement. Used continually in the sense of a routine-monitoring system, surveys can also serve to evaluate quality management procedures.

Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (Swiss Multicentre Study).

In this multicentre intervention study, we compared an integrated group treatment program which combines psychological and education methods into a more active training approach, with the traditional individual approach of physiotherapy and physical procedures for sub-chronic and chronic low back pain. Our 411 patients had a 4-week inpatient treatment: 243 patients in an experimental program and 168 in a traditional program. Outcomes of 283 patients were assessed 3 months and 1 year after entry. The dropout rate was 31.1%. Both conditions demonstrated favourable initial effects on functional and psychological parameters, but the integrated approach showed better long-term results for work rehabilitation than the traditional approach. The most successful patients (n = 58) were younger and had a higher educational level in comparison to the unsuccessful subgroup (n = 71). The main conclusion is that an integrated approach promoting self control and behaviour change through educational measures achieves better long-term results than the traditional individual physiotherapy approach.

[Freiburg/Bad Säckingen Scientific Rehabilitation Research Group]. / Rehabilitationswissenschaftlicher Forschungsverbund Freiburg/Bad Säckingen.

The Freiburg/Bad Säckingen Rehabilitation Research Network aims on problem solutions in rehabilitation in Germany. The core concept of the Research Group is "goal orientation in diagnosis, therapy and evaluation". This concept refers to both individual goals of patients and structural measures. The 13 projects of the Research Group deal with topics such as "specific communication problems in rehabilitation", "differential indication", "health economics", "methods", and "intervention and evaluation". To establish a long-term internal network in the Research Group and to facilitate intensive communication and co-operation between the various university-based and non-university-based institutions of rehabilitation in the Research Group area, Project Management and Methodological Support Offices were created.