[Health Literacy and patient education in medical rehabilitation]. / Gesundheitskompetenz in der medizinischen Rehabilitation und die Bedeutung für die Patientenschulung.

Medical rehabilitation in Germany has a long tradition. It is covered by the statutory sickness funds and pension schemes, and is aimed at the prevention of work disability and need for nursing care due to chronic conditions. Chronically ill but health-literate patients - patients capable of making good health-related decisions, or of participating strongly in this decision making - have better health outcomes. To enhance health literacy and participation, medical rehabilitation relies heavily on patient education. This article describes health literacy from the perspective of educational research, outlines the basics of learning principles, and draws conclusions for developing patient education programmes in medical rehabilitation. Implementing a constructivist learning paradigm promotes changes within the trainer team and within the rehabilitation institution - turning it into a health-literate health care organisation. Health literacy in medical rehabilitation is aimed at neither turning the patient into a physician nor replacing evidence-based recommendations through subjective preferences. Medical rehabilitation reaches patients best by using modern health education programmes based on findings from education research, theoretically founded and directed towards building competencies. Furthermore, an educationally qualified training team and a rehabilitation institution are essential in enabling formal and informal learning processes.

[Resources and self-management skills in multiple sclerosis patients - can the scale structure of the questionnaire FERUS be replicated?]. / Ressourcen und Selbstmanagementfähigkeiten bei Multiple-Sklerose-Erkrankten - Lässt sich die Skalenstruktur des Fragebogens FERUS replizieren?

BACKGROUND: To assess resources and self-management skills the generic questionnaire FERUS was developed by Jack (2007) and validated and standardized in a sample of psychosomatic patients and of healthy people. The aim of this study was the psychometric review of the FERUS with a sample of patients with Multiple Sclerosis (MS). METHODS: The dimensional structure identified by Jack was replicated in an exploratory factor analyses as well as tested in a confirmatory factor analyses and the discrimination ability of the scales was examined. RESULTS: Jack's results of the exploratory factor analyses and scale analyses were replicated essentially. After elimination of non-theory-compliant items, differentiation of the construct "motivation for change" and insertion of a second-order construct "self-management skills" a good confirmatorical model fit could be achieved. CONCLUSION: The FERUS can be used for MS patients. The consideration of optimization proposals allows higher construct validity and a more economical use of FERUS.

[Improvements in patient education from the didactical point of view]. / Impulse aus der Didaktik zur Verbesserung von Patientenschulungen.

The findings of empirical educational research and the theoretical and experiential knowledge of general didactics and specific didactics of relevant subjects are not adequately considered in the conception and implementation of patient education. The aim of this work is to screen the results of existing research about the quality of instruction, to deduce quality criteria for patient education and to discuss their benefits for the existing practice. The research on the quality of instruction was systematically investigated for this purpose. Subsequently, the 3 empirically validated quality features: "clear structure", "participant-oriented social climate" and "cognitive activation with particular attention to domain-specific components of teaching" we identified were transferred to patient education and concretized by including the theoretical and experiential knowledge of didactics. In the process several domains (conception of manuals, train-the-trainer seminars) were identified in which the quality characteristics can be tied in. The findings of empirical educational research are able to complement the existing measures for quality assurance in the area of patient education. For this purpose the identification and specification together with the possible integration of the 3 quality criteria in the area of patient education are a first step.