[Risk Factors for Disability Pensioning Caused by Mental Disorders - A Systematic Review]. / Risikofaktoren der Erwerbsminderungsberentung aufgrund psychischer Erkrankungen ­ Eine systematische Übersichtsarbeit.

Background: Meanwhile, mental disorders are the main reason for receiving a disability pension. The present study aimed at providing an overview of the German literature on characteristics and factors related to ERMD and pointing out the current state in this field of research. Revealing parameters that are accompanied by an ERMD is a precondition to prospectively prevent this trend. Methods: A systematic literature review was conducted from 2001 through to 2014. All results regarding German statutory pension insurants pensioned due to mental disorders after 2001 were included. Studies were considered if they reported 2 or more relevant results. Research design was not limited, except for excluding anonymous questionnaires. Results: 20 studies were found meeting eligibility criteria. All included studies were based on secondary analyses of data derived from the German statutory pension insurance. By means of gender-specific regression analyses the level of qualification and the geographical region were unveiled to be significant predictors of the ERMD. Basically, most reported results were descriptive or explorative. Besides various single results and evidence for interactions, frequently reported results are that: (i) female insurants get pensioned more frequently due to mental disorders than male insurants, (ii) affective disorders are the most frequent diagnoses, (iii) insurants with mental disorders are younger than insurants with somatic disorders when they get pensioned and (iv) insurants with schizophrenic disorders are younger than insurants with other mental disorders when they get pensioned. The utilisation of rehabilitative services before getting pensioned is limited at 50%. Conclusion: This work demonstrates a lack of empirical evidence of how (and what) disability risks are associated with ERMD in Germany. Furthermore, our results illustrate that a major part of the insurants do not attend rehabilitative services before their retirement, even though rehabilitation of mental illness is assumed to be effective. Future studies should hence focus on identifying disability related risk factors and barriers to using rehabilitative services in order to develop starting points for preventive and individual strategies.

Dissemination strategies and adherence predictors for web-based interventions-how efficient are patient education sessions and email reminders?

The Internet offers the potential to efficaciously deliver health interventions at a low cost and with a low threshold across any distance. However, since many web-based interventions are confronted with low use and adherence, proactive dissemination strategies are needed. We, therefore, tested the efficacy of a 1-h patient education session as part of a rehabilitation program and an email reminder 4 weeks later on the publicity and use of a web-based intervention aimed at lifestyle changes in patients with either coronary heart disease or chronic back pain (CBP) and examined adherence predictors. The website www.lebensstil-aendern.de is a cost-free, German-language website providing more than 1000 patient narratives about successful lifestyle changes. To test the efficacy of the dissemination strategies and to examine adherence predictors, we conducted a sequential controlled trial with heart and CBP patients recruited from German inpatient rehabilitation centers. The dissemination strategies were found to be efficient. Use rates, however, remained low. The email reminder and internal health locus of control emerged as notable factors in motivating patients to participate in the web-based intervention. Other factors that have been suggested to be related to nonuse, e.g. sociodemographic characteristics and medical condition, did not predict use or adherence.

[Preoperative Information: What Do Patients Want to Know?]. / Die präoperative Aufklärung: Was wünschen sich Patienten?

BACKGROUND: Aimed at supporting patient information, media forms were developed. While doing so patient views were predominantly not considered. Moreover, for one of the most common surgical procedures, herniated disk surgery, there rarely exists appropriate information material. PATIENTS AND METHODS: 29 people with experience of back pain were recruited to participate in focus group interviews, where conditions of satisfying consultations and needs regarding the design of an education film for herniated disk surgery were analysed. RESULTS: Frame conditions, desired education media and factors relating to the physician compose three complexes of general satisfaction criteria. Needs in terms of form and content design of an education film were discussed and registered in detail. CONCLUSION: Existing guidelines considering patient education are extensively consistent with patients' desires and should be implemented obligatorily. The use of audio-visual media as well as medical students' and physicians' training in soft skills requires expansion.

[The truth is in the eye of the beholder? Quality in rehabilitation from the patients' perspective]. / Die Wahrheit liegt im Auge des Betrachters? Qualität in der Rehabilitation aus Sicht der Patientinnen und Patienten.

The definition of "good" quality in health research and quality management in health care and rehabilitation are primarily based on health professionals and their associations. But laypersons, patients, and participants in rehabilitation programmes, too, develop cognitive concepts about what defines good quality in health care. Until now systematic knowledge about the role of the patients' views on quality in rehabilitation is rare. Existing data demonstrate that patients report detailed ideas about indicators and preconditions of good quality of rehabilitative care. Patients' quality concepts differ in some aspect from the quality definitions of health care professionals. There is some evidence that patients' views on quality are a necessary extension and completion of programme evaluation and of quality management. They influence usage and selection of rehabilitation facilities and programme elements and probably patient satisfaction and long-term outcomes as well. Patients' ideas could contribute to gaining a deeper understanding of patients' needs. Here, patients are experts to define challenges for long-term improvements in health and health-related behavior with regard to everyday life and related resources and barriers. Taking patients' views on the quality of rehabilitation into account could help to adapt rehabilitation features, programmes and long-term offers more adequately to patients' needs. More systematic evidence is however needed as a basis for further developments in rehabilitation programmes.

[Women and men after acute myocardial infarction: are there gender differences in participation rates in cardiac rehabilitation?]. / Frauen und Männer nach Herzinfarkt: Gibt es in Deutschland geschlechtsspezifische Unterschiede in der Inanspruchnahme rehabilitativer Leistungen?

In Germany and other countries a possibly lower programme attendance in cardiac rehabilitation of women compared to men has been critically discussed for many years. Up to now however there are only limited data related to gender-specific utilization rates and programme attendance. In a longitudinal study with three points of measurement, 496 men and 172 women after an acute myocardial infarction and their physicians were asked to complete questionnaires referring to different aspects of the medical and psychosocial situation as well as to provision of acute cardiac care and rehabilitation services. The results show that currently in Germany no gender differences exist in the use and provision of cardiac rehabilitation. Whether this apparently "fair" distribution in relation to gender can be seen as an adequate supply however is questionable in the context of different needs - especially with respect to the different psychosocial conditions of women and men.