Abstract
This study is aimed at identifying the impact of a team-based train-the-trainer program (TTT-P) to enhance healthcare professional (HCP) skills in patient education during medical rehabilitation. Focusing on patient-reported outcomes, a prospective, sequential two-cohort study was conducted in the fields of psychosomatic and oncological rehabilitation. Two hundred fifteen patients were evaluated before (Cohort 1) and 196 post implementation of TTT-P (Cohort 2). Patients of both cohorts completed validated questionnaires on self-management (heiQ®), general self-efficacy (GSE scale), and quality of life (WHOQOL-Bref) at the beginning, at the end, and at the 6-month follow-up to analyze short- and intermediate-term effects. Analyses were conducted separately for the psychosomatic and oncological setting. Results showed that TTT-P had no impact on patient outcomes in both rehabilitation settings. Patients did report positive outcomes as a result of the whole inpatient rehabilitation programs, though effects at follow-up were mostly small to medium size. Concerning self-management competencies, cancer patients gained less benefit during rehabilitation than psychosomatic patients. In conclusion, TTT-P did not result in measurable improvements at the patient level, likely because of the limited nature of the intervention. However, these populations of rehabilitants took benefit from participating in a multimodal rehabilitation program, of which patient education is one part.
Highlights
Chronic illnesses have great impact on the patients’ lives, regarding both physical and mental health
This study is aimed at identifying the impact of a team-based train-the-trainer program (TTT-P) to enhance healthcare professional (HCP) skills in patient education during medical rehabilitation
Data collection started in April 2014, and the follow-up for Cohort 2 was completed in August 2017
Summary
Chronic illnesses have great impact on the patients’ lives, regarding both physical and mental health. Patient selfmanagement has been proposed to be an effective strategy to manage the chronic effects of illness, i.e., in cancer [1]. Selfmanagement of the disease, empowerment in making informed choices, development of coping strategies, and modification of health behavior are important goals of patient education interventions [2, 3]. Meta-analyses found patient education to be an effective and cost-saving approach [4,5,6]. In the context of medical rehabilitation, effectiveness of standardized patient education programs has been evaluated for various medical conditions, i.e., heart failure, asthma, chronical back pain, or fibromyalgia [7,8,9]. Delivering quality patient education demands specific knowledge on medical conditions and their treatment, models of health psychology, and factors determining health-related behavior [10]. Patient educators need specific didactical qualification and have to coordinate and organize patient education programs within their health organization [11]
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