Abstract
BackgroundAs inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. However, previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants.ObjectiveThe aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic Web-based aftercare program GSA (Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace])-Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus, and to determine helpfulness of the intervention and satisfaction of the participants as well as improvement in quality of life and mental health status of the regular users of GSA-Online plus.MethodsGSA-Online plus was prescribed by physicians at termination of orthopedic psychosomatic inpatient rehabilitation. Participants’ use of the program, work-related attitudes, distress, and quality of life were assessed on the Web.ResultsIn 2 rehabilitation centers, 4.4% (112/2562) of rehabilitants got a recommendation for GSA-Online plus during inpatient rehabilitation. Compared with usual person aftercare, the Web-based aftercare program was rarely recommended by physicians. Recommendations were made more frequently in psychosomatic (69/1172, 5.9%) than orthopedic (43/1389, 3.1%) rehabilitation (χ21=11.845, P=.001, Cramér V=−0.068) and to younger patients (P=.004, d=0.28) with longer inpatient treatment duration (P<.001, r=−0.12) and extended sick leaves before inpatient medical rehabilitation (P=.004; Cramér V=0.072). Following recommendation, 77% (86/112) of rehabilitants participated in Web-based aftercare. Completers (50/86, 58%) reported statistically significant improvements between discharge of inpatient treatment and the end of the aftercare program for subjective work ability (P=.02, d=0.41), perceived stress (P=.01, d=−0.38), functioning (P=.002, d=−0.60), and life satisfaction (P=.008, d=0.42).ConclusionsPhysicians’ recommendations of Web-based aftercare are well accepted by patients who derive considerable benefits from participation. However, a low rate of prescription compared with other usual aftercare options points to barriers among physicians to prescribing Web-based aftercare.
Highlights
IntroductionWork-related stress, as observed in one-third of the German population [1], is an important risk factor for common mental disorders [2]
Occupational Stress and Work-Related Medical RehabilitationWork-related stress, as observed in one-third of the German population [1], is an important risk factor for common mental disorders [2]
We developed a Web-based transdiagnostic aftercare program (GSA-Online; Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace]) that aimed at improving vocational reintegration of rehabilitants after long-term sickness absence
Summary
Work-related stress, as observed in one-third of the German population [1], is an important risk factor for common mental disorders [2]. Participation in a graded return to work program reduced the relative risk of permanent work disability by about 40% as well as the time of welfare benefits owing to sickness absence compared with matched controls [7]. Participation in aftercare programs following inpatient medical rehabilitation is low because of long waiting times, the lack of local aftercare providers, or incompatibility with family or work commitments [8,9]. As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. Previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants
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