Abstract
BackgroundMental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation.MethodsVocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up.DiscussionWe expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation.Trial registrationInternational Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202)
Highlights
Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries
The clinical staff of the four rehabilitation centers conducting the inpatient Gesundheitstraining Stressbewältigung am Arbeitsplatz (GSA) program and introducing the internetbased aftercare to the patients consists of social education workers, psychologists and psychotherapists, all experienced in vocational stress management and psychological group training
In this study we evaluate the acceptance and efficacy of an internet-based aftercare program for three different indications of medical rehabilitation, with the following hypotheses: 1. We expect that taking part in the internet-based aftercare program helps stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping with conflicts at the workplace
Summary
Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Sick leave and premature pension are rising constantly in most high-income countries because of mental disorders [1,2,3]. One third of the patients in medical rehabilitation and technologies, and interpersonal conflicts in the workplace, may lead to a relapse of symptoms and, to an incapacity for work or premature pension. Only a limited number of patients are assumed to have access and to use immediate aftercare following inpatient medical rehabilitation [20]. Sibold and colleagues [21] reported that the most frequently given reasons for non-participation in aftercare programs included incompatibility with duties at work (70.7%), too much time investment (46.5%) and poor access to the outpatient rehabilitation facility (34.1%). Travelling time proved to be a significant negative predictor for participation
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