Medical Rehabilitation Patients Research Articles

Assessment of the quality of life in complex medical rehabilitation of patients at the stage of chemoradiotherapy for head and neck cancer

BACKGROUND: At the stage of chemoradiotherapy of malignant neoplasms of the head and neck, in 90% of cases, the development of radiation dermatitis and mucositis is observed. The resulting acute radiation reactions negatively affect not only the quality of life of the patient, but also the planned treatment. A multidisciplinary approach with the inclusion of basic treatment, physical therapy, physical factors, psychological correction, and nutritional support is an effective strategy for improving the patient's quality of life at this stage of treatment. AIM: To assess the quality of life of patients in complex medical rehabilitation who underwent chemoradiotherapy for malignant neoplasms of the head and neck. MATERIALS AND METHODS: An interventional prospective randomized study was conducted with the participation of 60 patients with malignant neoplasms of the oral cavity, larynx, oropharynx, larynx undergoing chemoradiotherapy. The main group (n=30) received a course of medical rehabilitation: exposure to low-temperature argon plasma, general magnetic therapy, physical therapy, training on the support reaction on a barefoot platform, nutritional support and classes with a medical psychologist. In patients of the comparison group (n=30), plasma exposure was not included in the rehabilitation course. The effect of chemoradiotherapy for head and neck cancer on the patient's quality of life was assessed by the severity of pain syndrome, physical functioning, and limitations of daily activities using Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS) techniques, a questionnaire developed by C.D. Spielberger and adapted by Y.L. Khanin, the SF-36 questionnaire. RESULTS: After a course of chemoradiotherapy, patients began to complain of pain, burning in the mouth, complaints of dry mouth, pain when swallowing, eating, limited mouth opening, redness and peeling of the skin, voice changes, difficulty falling asleep, frequent awakenings at night, embarrassment of one’s appearance. In patients of both groups, there was a decrease in the level of reactive and personal anxiety, the increased level of anxiety and depression decreased by the end of the course of chemoradiotherapy with a decrease in indicators after 6 months. Despite the increase in pain intensity during chemoradiation treatment, an increase in vital activity indicator was recorded, as well as an indicator of self-assessment of one’s health by the end of the course of chemoradiation treatment. CONCLUSION: The resulting radiation mucositis and epidermitis at the stage of chemoradiotherapy for head and neck cancer lead to physical and psychological limitations, worsening the patient's quality of life, which determines the need to accompany this stage of treatment with comprehensive medical rehabilitation. The study of the dynamics of the parameters of the quality of life of patients is the basis for the selection of individual rehabilitation treatment programs.

Communication Strategy for Medical Rehabilitation Installation Hj. Anna Lasmanah Hospital in Reducing Patient Drop Out Rates During the Covid 19 Pandemic

The Covid 19 pandemic that started in March 2020 gave birth to the New Habit Adaptation (IMR) policy. This situation created massive panic/alertness, including in the Medical Rehabilitation Installation at RSUD Hj. Anna Lasmanah Banjarnegara. This new rule makes the DO (Drop Out) number of Medical Rehab patients (a term for patients in the Medical Rehabilitation Installation) increase sharply and/or the number of patient visits for therapy has decreased drastically. For this reason, a communication strategy is very important to overcome this problem. This research approach uses qualitative research with constructivism paradigm. Researchers conducted in-depth observations at the Medical Rehabilitation Installation with data obtained through informant interviews. Selection of informants by purposive sampling to obtain information about the characteristics of medical rehabilitation patients. The method used in this research is a case study which aims to explain one or a number of decisions. From this research, the formulation of the right communication strategy will be produced to be applied in hospitals during a pandemic. This model of communication strategy in the form of innovation can be used as input in making appropriate hospital policies according to the sender of the message and the target audience.

Patients' Health Literacy in Rehabilitation: Comparison between the Estimation of Patients and Health Care Professionals.

The term health literacy (HL) comprises the handling of health information and disease-specific and generic self-management skills, especially relevant for patients with chronic conditions. Health care professionals (HCPs) should correctly identify patients’ communication needs and their HL levels. Therefore, the aims of the study were (1) to determine inpatient medical rehabilitation patients’ HL based on self-assessment, (2) to evaluate changes from admission to discharge, (3) to identify HCPs estimation of patients’ HL, and (4) to compare the estimated patient HL by patients and HCPs. A combined cross-sectional and longitudinal study was conducted in an orthopedic rehabilitation center in Germany. The multidimensional Health Literacy Questionnaire (HLQ) was filled in by patients (admission, discharge). An adapted version was administered to HCPs (n = 32) in order to assess HL of individual patients. Data from 287 patients were used for the longitudinal analysis, and comparison was based on n = 278 cases with at least two HL estimations. The results showed a significant increase in HL in five of nine scales with small effect sizes. Moreover, HCPs mostly provided higher scores than patients, and agreement was poor to fair. Differences between the HL estimation might lead to communication problems, and communication training could be useful.

Health Status Stability of Patients in a Medical Rehabilitation Program: What Are the Roles of Time, Physical Fitness Level, and Self-efficacy?

BackgroundIndividuals’ physical and mental health, as well as their chances of returning to work after their ability to work is damaged, can be addressed by medical rehabilitation.AimThis study investigated the developmental trends of mental and physical health among patients in medical rehabilitation and the roles of self-efficacy and physical fitness in the development of mental and physical health.DesignA longitudinal design that included four time-point measurements across 15 months.SettingA medical rehabilitation center in Germany.PopulationParticipants included 201 patients who were recruited from a medical rehabilitation center.MethodsTo objectively measure physical fitness (lung functioning), oxygen reabsorption at anaerobic threshold (VO2AT) was used, along with several self-report scales.ResultsWe found a nonlinear change in mental health among medical rehabilitation patients. The results underscored the importance of medical rehabilitation for patients’ mental health over time. In addition, patients’ physical health was stable over time. The initial level of physical fitness (VO2AT) positively predicted their mental health and kept the trend more stable. Self-efficacy appeared to have a positive relationship with mental health after rehabilitation treatment.ConclusionsThis study revealed a nonlinear change in mental health among medical rehabilitation patients. Self-efficacy was positively related to mental health, and the initial level of physical fitness positively predicted the level of mental health after rehabilitation treatment.Clinical RehabilitationMore attention could be given to physical capacity and self-efficacy for improving and maintaining rehabilitants’ mental health.

Application of altitude chamber adaptation as a component of the medical rehabilitation patients after COVID-19

<h3></h3> На современном этапе отсутствует информация о применении гипобарической барокамерной адаптации как в виде отдельного компонента реабилитации, так и в сочетании с курсом цитофлавина у пациентов после COVID-19 на амбулаторном и домашнем этапах медицинской реабилитации. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Изучить эффективность одно- и двухкомпонентного курсов гипобарической барокамерной адаптации на амбулаторном и домашнем этапах медицинской реабилитации пациентов после перенесенной пневмонии COVID-19. <h3>МАТЕРИАЛЫ И МЕТОДЫ</h3> В исследование включены 255 пациентов после перенесенной пневмонии COVID-19. Однокомпонентный курс реабилитации методом гипобарической барокамерной адаптации прошли 155 пациентов, средний возраст 53,0 [45,0; 60,0] года. На амбулаторном и домашнем этапах медицинской реабилитации двухкомпонентный курс, включавший гипобарическую адаптацию и прием цитофлавина, прошли 100 пациентов, средний возраст 54,0 [45,0; 59,5] года. Были проанализированы результаты функциональных проб, оценки по шкалам, характеризующим качество жизни и психологическое состояние пациентов до курса реабилитации, через 10 сут и 3 мес после окончания курса. <h3>РЕЗУЛЬТАТЫ</h3> Применение одно- и двухкомпонентного курсов способствовало повышению показателей пробы Штанге и динамометрии. После курса реабилитации улучшились показатели Госпитальной шкалы тревоги и депрессии, шкалы Шульте, шкалы оценки влияния травматического события, шкалы качества жизни EQ-5D. Полученные результаты статистически значимо отличались после курса реабилитации от исходных значений и сохранили свое отличие через 3 мес наблюдения. Эффективность двухкомпонентного курса была статистически значимо выше по сравнению с однокомпонентным курсом. <h3>ВЫВОДЫ</h3> Показана устойчивая пролонгированная эффективность одно- и двухкомпонентного курсов гипобарической барокамерной адаптации у пациентов после COVID-19 на амбулаторном и домашнем этапах медицинской реабилитации. Добавление цитофлавина способствовало усилению реабилитационного эффекта гипобарической барокамерной адаптации. Полученные данные необходимо учитывать при разработке комплексных программ медицинской реабилитации на амбулаторном и домашнем этапах реабилитации пациентов после COVID-19.

Suicidal behavior in patients with dementia

203 patients were examined, including 75 with dementia at Alzheimer’s disease (AD), 73 with vascular dementia (VD) and 60 patients with mixed dementia (MD). Patients were divided into main and control group by the factor of presence/absence of signs of suicidal behavior (intentions, attempts, thoughts, anti-vital mood, statements). Among patients with AD, 36 patients were the main group, 39 were the control group; at VD 39 patients were main group, 34 were control group; in mixed dementia, 30 patients were included in the main group, 30 patients were in the control group. It has been found that in 56 % of cases with dementia due to Alzheimer’s disease, in 65 % with vascular dementia and 56 % with mixed dementia of the clinical picture, suicidal behavior (SB) is observed. The complex of factors of SB risk/anti- risk and suicide-genesis mechanisms in dementia, that became the targets for development of differentiated program for medical and psychological rehabilitation and prevention (MPRP) patients with SB in dementia were distinguished. The suicide-genesis concept in dementia which determines the mechanisms of the formation of suicidal behavior under the influence of clinical and intra-personal indexes, was worked out. Accounting the formation mechanisms and SB predictors, special features of clinical and psychopathological, clinical and phenomenological SB demonstration in various types of dementia the complex and differentiated MPRP program and SB prevention, realized on the basis of complex approach including usage of psychopharmacological, psychotherapeutic, psychoeducational psychosocial actions was worked out and tested. The result of the developed system testing proved its high efficiency, which is supported by the positive dynamics of clinical and psychopathological indexes of suicide status and level of independence in the everyday life of patients with SB in dementia.

Correlation of Fugl-Meyer Assesment Score with Barthel Index and Functional Independence Measure in Patients with Stroke

Background: The prevention of stroke morbidities that is oriented to the approach of functional performance improve is expected improve the productivity of post-stroke patients. One of the tools to measure the physical performance is Fugl-Meyer Assessment (FMA) scale, while the recommended tests to measure interpedency level are Barthel Index (BI) and Functional Independence Measure (FIM). Method: This study was conducted on 20 outpatient stroke patients in Medical Rehabilitation Installation of Dr. Soetomo General Hospital Surabaya, Indonesia. FMA, BI and FIM examination were performed in all subjects. Results: The authors obtained the correlation coefficient value with r=0.816 and therefore a high positive correlation was found between the total score of FMA and BI, while the correlation coefficient value between the total score of FMA and FIM showed r of 0.728. Thus, the author concluded that there was a positive correlation between the total score of FMA and FIM. The sub-domains FMA-UE, FMA-LE and FMA Balance were highly correlated with BI and FIM. This implied that physical performance measured using FMA could describe the interdependency level of stroke patients in doing ADL. Conclusion: Physical performance (based on Fugl-Meyer Assessment) was positively correlated with the interdependency level of BI and FIM of inpatient stroke patients in Medical Rehabilitation Dr. Soetomo General Hospital Surabaya.

Predictors for Loneliness Perceived by the Interviewer or the Individual: Findings from Limited Disability Pensioners and Medical Rehabilitation Patients

Loneliness can be seen as indicator of social participation which is a major concern of the UN Convention on the Rights of Persons with Disabilities. Temporary disability pensioners and medical rehabilitants are persons with disabilities, whose rights should be empowered. Moreover, loneliness is a major burden for the individual and finding ways to overcome loneliness are accordingly required. Previous research has shown that different socio-demographic characteristics, life-satisfaction and social support interrelate with loneliness. The aim of the present study was to replicate findings with two computer-assisted telephone interview studies with individuals insured with a local pension fund. While study 1 recruited N = 453 disability pensioners (mean age=50.4 years, 53.5 % female) and assessed their loneliness with the typical self-report measured by directly asking, study 2 recruited N = 1,044 patients in a medical rehabilitation (mean age=49.5 years, 36 % female) and used the reports of their interviewers without asking the study participants directly about their loneliness. In both studies, more life-satisfaction was significantly associated with less loneliness (beta=-.41 and -.23). However, only in the interviewer-rated study, higher social support was related to less loneliness (beta=-.16). Sex differences were found in the interviewer-rated study (women were rated as lonelier, beta=.11), while an interrelation with age was only found if self-reports were used in terms of younger disability pensioners reported more loneliness (beta=-.24). The findings open options for counseling to also improve self-reported life-satisfaction. While interviewers rate female interviewees as lonelier than men, interventions should not forget about men as they report equal loneliness if controlled for other variables. The results replicate that health and life-satisfaction are imperative and addressable to decrease loneliness. This should be researched further and used for interventions.

Effects of nationwide implementation of work-related medical rehabilitation in Germany: propensity score matched analysis

ObjectivesSince 2014, the Federal German Pension Insurance has approved several departments to implement work-related medical rehabilitation programmes across Germany. Our cohort study was launched to assess the effects of work-related...

Using Volume-Based Tube Feeding to Increase Nutrient Delivery in Patients on a Rehabilitation Unit.

The purpose of this study was to determine whether volume-based tube feeding (VBTF) increased nutrient delivery to patients in a rehabilitation unit. A cohort study with a prospective group and a historical control group was used as the study design. The intervention was VBTF, a change from the standard hourly rate-based enteral nutrition. Data were collected on 70 rehabilitation patients. Data on the control group (n = 35) were collected through retrospective chart review of rate-based tube-fed patients. Data on the VBTF intervention group (n = 35) were collected prospectively after implementation of VBTF in the inpatient medical rehabilitation unit at University of Utah Health. The results showed patients in the VBTF group received 82% of their prescribed feed whereas rate-based patients received 70%. VBTF appears to increase the amount of nutrition inpatient medical rehabilitation patients receive, which may help with the intensive therapy sessions these patients must undergo.

Health Beliefs and Association with Physical Activity and Cognition in Medical Rehabilitation Patients

(1) To validate Health Beliefs Model in general rehabilitation population. (2) To explicate the relationship between the revised health beliefs factor model with pre-illness physical activity and post-illness physical and cognitive rehabilitation outcomes.

From evidence to practice: Improving work participation outcomes by work-related medical rehabilitation in patients with chronic musculoskeletal diseases

In Germany, work-related medical rehabilitation programs were developed for patients with musculoskeletal disorders to improve work participation outcomes. Randomized controlled trials have shown that return-to-work rates can be increased by about 20 points compared to common medical rehabilitation programs. Since 2014, the Federal German Pension Insurance has approved several work-related rehabilitation departments to implement these new rehabilitation programs. Our study was launched to assess the effects of work-related medical rehabilitation under real-life conditions. Participants received either a common or a work-related medical rehabilitation program. Propensity score matching was used to identify controls that were comparable to work-related medical rehabilitation patients. Effects were assessed by patient-reported outcome measures 10 months after completing the rehabilitation program. We included 1282 patients (mean age: 52.4 years; 75.3% women). Work-related medical rehabilitation increased stable return-to-work (OR = 1.42; 95% CI: 1.02 to 1.96) and self-rated work ability ( b = 0.38; 95% CI: 0.05 to 0.72) compared to common medical rehabilitation. Participants of work-related medical rehabilitation had also less depressive symptoms and fear of movement, and they reported better self-management skills. Subgroup analyses showed that the effect on stable return-to-work depended on the prior risk of not returning to work and the dose received as rated by the participants. Only persons with a high initial risk of not returning to work and a high dose received benefited from work-related medical rehabilitation. In this subgroup, i.e. high risk and high dose received, the absolute risk difference was about 20 points in favor of work-related medical rehabilitation. Implementation of work-related medical rehabilitation in German rehabilitation centers affected work participation outcomes. Our effectiveness study showed that the results from randomized controlled trials can be also achieved under real-life conditions. However, effectiveness is moderated by the population reached and the dose received.

LIFE QUALITY AMONG ELDERLY WITH OBESITY IN OUTPATIENT CLINIC, DR. SOETOMO HOSPITAL, SURABAYA

Obesity is one of the chronic diseases that may have significant impact and affect the quality of life, especially in elderly who already have multidimensional problems. This study aimed to provide information about the influence of obesity in elderly on every component of his quality of life by using the SF-36 quality of life. This study was conducted on 105 patients in outpatient Medical Rehabilitation, Geriatrics and Diabetes at Dr. Soetomo Hospital, Surabaya. Patients aged 60-75 years, consisting of 62 men and 43 women. The number of patients with obesity was 49 persons (46.7%) with an average body mass index (BMI) of 27.16 kg / m2. Whereas, non-obese patients were 56 persons (53.3%) with an average BMI of 21.23 kg/m2. In conclusion, there was no significant difference in the SF-36 life quality of obesity and non-obesity groups after being analyzed using t-test.

Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study

ObjectiveTo investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. DesignCross-sectional observation study. SettingNeurology, orthopedic, and cardiology rehabilitation clinics. ParticipantsPatients (N=1610; age, 18–65y) with work anxieties. InterventionsNot applicable. Main Outcome MeasuresPatients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non–work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. ResultsApproximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. ConclusionsAbout a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave.

Experiences, attitudes and possibilities for improvement concerning the cooperation between occupational physicians, rehabilitation physicians and general practitioners in Germany from the perspectives of the medical groups and rehabilitation patients – a protocol for a qualitative study

IntroductionRehabilitation measures for patients in the working age primarily aim at maintaining employability, restoring fitness for work or timely return to work (RTW). To facilitate RTW after long sick leave...

Cardiorehabilitation organization in Russia. The results of the pilot project "Development of the system of rehabilitation of patients with cardiovascular diseases in medical institutions of the Russian Federation"

Goal. The pilot project to organize or conduct performance improvement of existing structural units in specific hospitals (LU) Russia to provide rehabilitative care for patients with cardiovascular diseases in three stages under the current "Procedure for the provision of medical care for patients in medical rehabilitation", to introduce in practice these units tested scientifically sound approaches, forms and methods of cardio-rehabilitation, and try to create some patients routing algorithm. Material and methods. The pilot project includes 17 of the medical institutions of 13 regions of Russian Federation. Single special cards that allow to evaluate the appropriate order on the medical rehabilitation provided rehabilitation assistance to cardiac patients, a multidisciplinary team involved in the provision of rehabilitation assistance, staffing and equipping MI To analyze the effectiveness of organizational models in cardiorehabilitation MI have been developed. Special cards consisted of three sections, each of which allows you to evaluate the effectiveness of each of the three stages cardiorehabilitation: Stage I - unit intensive care unit (BRIT), and a specialized cardiology department; Stage II - stationary cardiorehabilitation department; Stage III - patient department cardiorehabilitation. The article presents the results of a three-year analysis from January 2013 to December 2015. Results. The pilot project was organized with the cardiorehabilitational help stage I in 10 DR, II stage - a 10-LU and Phase III - 7 DR. By 2015, almost all of Latvia to provide assistance in cardiorehabilitational area, multidisciplinary teams consisting of a cardiologist, cardiologist, rehabilitator, medical physical culture (physical therapy) specialist, physical therapy instructor-methodologist, psychotherapist, clinical psychologist, physiotherapist were formed. They were provided and equipped with facilities to practice physical therapy, room for educational schools. Home rehabilitation process BRIT has reduced the patient's stay in the bed of 0.7 days (2013 to 2015) and for 1 day in the cardiology department. On average, 67% of patients with acute myocardial infarction (AMI) were translated into Phase II cardiorehabilitaяtion in which they have become actively involved in the physical rehabilitation program, which is based on a classic exercise therapy, dosage walking in the room, physical training on simulators. Each MI educational schools were organized for patients actively pursued discussions with the relatives. Special complexity of the project has caused the organization phase III cardiorehabilitation. The project is currently ongoing. Conclusion. The analysis of the organization of a three-stage kardioreabilitatsionnoy care system with AMI patients considering the use of staffing, equipment and methodology, according to the current normative law, showed a significant increase in recreational activities created by multidisciplinary teams in all three stages of cardio-rehabilitation, increasing the number of used rehabilitation methods and improve the quality of their performance, as well as demonstrated safety of the proposed principles of physical rehabilitation, according to Russian clinical guidelines "Acute myocardial infarction with ST-segment elevation ECG: rehabilitation and secondary prevention", in the framework of the proposed organizational models cardiorehabilitation.

Requirements of stroke patients in medical and social rehabilitation and modern technologies of its implementation (according to foreign literature)

There is presented the analysis of the incidence rate and outcomes of different types of strokes. Depending on the level of average income per capita, these indices have significant differences, which should determine the strategy of medical care, prevention and rehabilitation. The basic element contributing to the restoration of brain structure and functional capabilities of the brain after lesions of the different character, is the phenomenon of neuroplasticity. Neuroplasticity varies widely depending on the location of the lesion and the time elapsed since the end of the impact of the damaging factor. In addition to traditional methods of rehabilitation, more and more attention of scientists is attracted to new technologies associated with both the development of the technical devices used for recovery of cognitive and motor functions, as well as with the improvement of the organization of the rehabilitation process. Out of technological innovations in the review there are presented games controlled by the movement (gesture), including the Nintendo Wii and Xbox Kinect, brain-computer interfaces, wearable robotic gait control system. The organization of the management of rehabilitation process by the patient can play a major role in the enhancement of the motivation in patients. Just the combination of the mobilization of intact functions, and the patient’s motivation with the use of high clinically tested technologies can ensure the success of rehabilitation.

Work-related medical rehabilitation in patients with musculoskeletal disorders: the protocol of a propensity score matched effectiveness study (EVA-WMR, DRKS00009780).

BackgroundMusculoskeletal disorders are one of the most important causes of work disability. Various rehabilitation services and return-to-work programs have been developed in order to reduce sickness absence and increase sustainable return-to-work. As the effects of conventional medical rehabilitation programs on sickness absence duration were shown to be slight, work-related medical rehabilitation programs have been developed and tested. While such studies proved the efficacy of work-related medical rehabilitation compared with conventional medical rehabilitation in well-conducted randomized controlled trials, its effectiveness under real-life conditions has yet to be proved.Methods/DesignThe cohort study will be performed under real-life conditions with two parallel groups. Participants will receive either a conventional or a work-related medical rehabilitation program. Propensity score matching will be used to identify controls that are comparable to treated work-related medical rehabilitation patients. Over a period of three months, about 18,000 insured patients with permission to undergo a musculoskeletal rehabilitation program will be contacted. Of these, 15,000 will receive a conventional and 3,000 a work-related medical rehabilitation. We expect a participation rate of 40 % at baseline. Patients will be aged 18 to 65 years and have chronic musculoskeletal disorders, usually back pain. The control group will receive a conventional medical rehabilitation program without any explicit focus on work, work ability and return to work in diagnostics and therapy. The intervention group will receive a work-related medical rehabilitation program that in addition to common rehabilitation treatments contains 11 to 25 h of work-related treatment modules. Follow-up data will be assessed three and ten months after patients’ discharge from the rehabilitation center. Additionally, department characteristics will be assessed and administrative data records used. The primary outcomes are sick leave duration, stable return to work and subjective work ability. Secondary outcomes cover several dimensions of health, functioning and coping strategies.DiscussionThis study will determine the relative effectiveness of a complex, newly implemented work-related rehabilitation strategy for patients with musculoskeletal disorders.Trial registrationGerman Clinical Trials Register (DRKS00009780, February 10, 2016).

Is it a Case of “Work-Anxiety” When Patients Report Bad Workplace Characteristics and Low Work Ability?

Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.

‘Sticking to a healthy diet is easier for me when I exercise regularly’: Cognitive transfer between physical exercise and healthy nutrition

Objective: Long-term rehabilitation success depends on regular exercise and healthy nutrition. The present study introduces a new framework to explain this association on a psychosocial level. The exercise–nutrition relationship was investigated by exploring the sequential mediation of habit strength and transfer cognitions.Design: Analyses were performed at two measurement points in time (at 12 and 18 months after rehabilitation), involving 470 medical rehabilitation patients who participated in an exercise intervention.Main outcome measures: Patients filled in paper-pencil questionnaires assessing exercise (t1) and habit strength, transfer cognitions and healthy nutrition at follow-up (t2).Results: Habit strength and transfer cognitions mediated the relationship between exercise and nutrition.Conclusion: Findings suggest that habit strength and transfer cognitions are important factors underlying the relationship between exercise and nutrition.