[Compatibility of Work and Family Life of Employees in the Healthcare Sector: An Issue in Health Services Research]. / Vereinbarkeit von Familie und Beruf bei Beschäftigten im Gesundheitswesen als Handlungsfeld der Versorgungsforschung.

BACKGROUND: Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility. METHODS: A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview. RESULTS: The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas. CONCLUSIONS: There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare.

A combined planning and telephone aftercare intervention for obese patients: effects on physical activity and body weight after one year.

OBJECTIVE: Obese patients require sustained lifestyle changes to reduce their health risks. We therefore developed a combined planning and telephone aftercare intervention based on the Health Action Process Approach to enhance physical activity after inpatient rehabilitation for obesity. DESIGN: Randomized controlled trial. PATIENTS: A total of 467 obesity rehabilitation patients (55% male; mean age 48 years). METHODS: Participants were randomized to receive standard obesity rehabilitation or standard obesity rehabilitation plus the new intervention. Participants in the intervention condition planned individual physical activities they intended to perform after discharge and were followed up by 6 phone calls for 6 months. Physical activity and body weight were assessed after 6 and 12 months. RESULTS: The intervention was well accepted by participants. After 12 months, effects on physical activity, but not body weight, were found. At this point, the duration of physical activity per week was 58 min longer in the intervention group than in the control group. However, body weight was reduced to similar degrees in both groups. CONCLUSION: The intervention increased physical activity, but did not reduce body weight, compared with standard care. However, even without weight reduction, an increase in physical activity may reduce health risks in obese patients.

Effectiveness of small-group interactive education vs. lecture-based information-only programs on motivation to change and lifestyle behaviours. A prospective controlled trial of rehabilitation inpatients.

OBJECTIVE: Although patient education may promote motivation to change health behaviours, the most effective method has not yet been determined. METHODS: This prospective, controlled trial compared an interactive, patient-oriented group program with lectures providing only information. We evaluated motivational stages of change and self-reported behaviours in three domains (sports, diet, relaxation) at four times up to one year (60% complete data) among 753 German rehabilitation inpatients (mean age 50 years, 52% male) with orthopaedic (59%) or cardiologic disorders (10%) or diabetes mellitus (31%). RESULTS: We found improvements between baseline and follow up regarding each outcome (p<.001) in both groups. At the end of rehabilitation, participants of the interactive group, as compared to the lectures, showed more advanced motivation regarding diet (p<.10) and sports (p=.006). Interactive group patients reported healthier diets both after 3 months (p=0.013) and 12 months (p=0.047), more relaxation behaviours (p=.029) after 3 months and higher motivation for sports after 12 months (p=.08). CONCLUSIONS: The superior effectiveness of the interactive group was only partly confirmed. PRACTICE IMPLICATIONS: This short, 5-session interactive program may not be superior to lectures to induce major sustainable changes in motivation.