Trial document





This trial has been registered retrospectively.
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  DRKS00004843

Trial Description

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Title

Workbook: "Goal setting in medical rehabilitation".

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Trial Acronym

[---]*

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URL of the Trial

http://www.deutsche-rentenversicherung.de/Allgemein/de/Inhalt/3_Fachbereiche/01_sozialmedizin_forschung/03_reha_wissenschaften/03_forschungsfoerderung/einzelprojekte_zielvereinbarung.html

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Brief Summary in Lay Language

Goal setting between patients and clinicians at the beginning of rehabilitation is considered as a core process in rehabilitation. Therefore a consequent goal orientation and guidance of the rehabilitation process along the rehabilitation goals is consistently required by numerous parts of the German rehabilitation system. According to recent (including our own) studies however various problems regarding the practice of goal setting still exist, e.g. an active participation of patients in the process of goal setting. In cooperation with the "Deutsche Rentenversicherung Bund" and a council consisting of representatives of administration, research and as well as experts in practice and affected patients, the project “Arbeitsbuch Reha-Zielvereinbarung in der medizinischen Rehabilitation“ thus aims to develop a practically oriented workbook to support rehab clinics in their implementation of rehabilitation goals.
For this purpose a Germany-wide review of existing concepts and materials of both ambulant and stationary clinics (total 1502 Facilities) is done along with an extensive research of literature and a written survey of all council members about all relevant topics. The inventory is limited on the indications "cardiology", "orthopedics", "psychosomatic", "Neurology", "Oncology", "metabolic disorders", "Pulmonary" and"dermatology". All concepts are rated based on defined criteria that were approved by the council. Concepts that obtain approval will be integrated into the workbook. Due to its purpose the main focus lies on the practicability of the workbook. Therefore the council will rate the workbook in several steps not only with respect to its structure and content but also to its use for common practice. Finally the workbook will be tested in three clinics, adapted and its content edited for the internet.

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Brief Summary in Scientific Language

In rehabilitation practice, rehabilitation research and quality management "Goal setting in medical rehabilitation" is long seen as a central topic. However, only a few empirical studies and little evidence exist regarding the effectiveness of goal setting in medical rehabilitation.

Overall, there is only little literature about the actual procedure of goal setting in rehabilitation practice. The approaches and methods described often relate to scientific research projects and are seen as quite heterogeneously by international work. Furthermore there seems to be little agreement about what approaches, methods and elements for the process of goal setting are best qualified.

While there is a general agreement about the necessity of goal setting in the German Rehab-system, opinions about the patient´s role and the overall strategy for the development of effective goal setting differ among experts (Schliehe, 2009). Regarding the participation of patients – a central quality feature of goal setting – Holliday et al. (2005) found in a clinician-survey in Great Britian (mostly physicians in neuro rehabilitation) rehabilitation teams to quite rarely use participative approaches in clinical practice.

In the project PARZIVAR more than 90% of patients asked (N = 210) consider participation in goal setting as important. Despite that only 57% of the interviewee agreed that their physician actually participated them in the goal setting process.

In addition the deficient participation of patients in goal setting, Meyer et al. (2009) identified further problems of the goal setting practice in rehabilitation: Beside the difficulties patients have to talk about their goals and expectations they often are unable to memorize all relevant information including the topic of rehabilitation goal.
Furthermore the authors point out an aggregation of rehabilitation resulting in an increasing workload of physicians, a lack of concepts and procedures, an insufficient participation of the rehabilitation team, varying opinions regarding the necessity of an explicit and participative goal setting process as well as a growing need of training for physicians concerning communicational skills and goal setting. Most of the barriers listed could be confirmed by the IST-interview of the project PARZIVAR.
In the present project the dissemination and implementation of goal setting in practice is facilitated by a workbook that is in step with actual practice.

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Organizational Data

  •   DRKS00004843
  •   2013/04/17
  •   [---]*
  •   yes
  •   Approved
  •   378/12, Ethik-Kommission der Albert-Ludwigs-Universität Freiburg
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Secondary IDs

  •   U1111-1140-8664 
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Health Condition or Problem studied

  •   The inventory data collection and evaluation is limited explicitly to the following indications: Cardiology, orthopedics, psychosomatic medicine, neurology, oncology, metabolic diseases, respiratory medicine and dermatology.
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Interventions/Observational Groups

  •   Total of 1502 medical rehabilitation facilities were contacted for data collection, patient data were not recorded. The manual´s development is closely coordinated with the Deutsche Rentenversicherung Bund and a scientific council consisting of a total of 23 members (patient´s representatives, clinicians and scientists).
    Selection of content as well as extraction of assessment criteria for concepts of goal setting in rehabilitation are based on literature research and analysis. Additionally the current status of prevalent practice of goal setting in rehabilitation is investigated by questionnaires. Furthermore concepts and materials provided by institutes are weighted and evaluated on the basis of pre-defined criteria. When rated positively they are integrated into the workbook as “Examples of Best-Practice”.
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Characteristics

  •   Non-interventional
  •   Other
  •   Single arm study
  •   Open (masking not used)
  •   [---]*
  •   Uncontrolled/Single arm
  •   Other
  •   Single (group)
  •   N/A
  •   N/A
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Primary Outcome

Development and manualisation a practical workbook to goal setting for chronic diseases in medical rehabilitation.


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Secondary Outcome

none

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Countries of Recruitment

  •   Germany
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Locations of Recruitment

  • other 
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Recruitment

  •   Actual
  •   2012/10/30
  •   1520
  •   Monocenter trial
  •   National
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Inclusion Criteria

  •   [---]*
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  •   [---]*   [---]*
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Additional Inclusion Criteria

Inpatient or outpatient facilities that are occupied a) of the German Federal Pension Insurance lead and b) Consider the corresponding indications.

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Exclusion Criteria

none

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Addresses

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    • Universitätsklinikum Freiburg, Abteilung Qualitätsmanagement und Sozialmedizin
    • Engelbergerstrasse 21
    • 79106  Freiburg
    • Germany
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    • Institut für Rehabilitationsforschung (IfR) Klinik Münsterland, DRV Westfalen
    • Ms.  Dr. Dipl. Psych.  Susanne  Dibbelt 
    • Auf der Stöwwe 11
    • 49214  Bad Rothenfelde
    • Germany
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    • Universitätsklinikum Freiburg, Abteilung Qualitätsmanagement und Sozialmedizin
    • Ms.  Dr. Dipl. Psych.  Manuela  Glattacker 
    • Engelbergerstrasse 21
    • 79106  Freiburg im Breisgau
    • Germany
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    • Universitätsklinikum Freiburg, Abteilung Qualitätsmanagement und Sozialmedizin
    • Ms.  Katharina  Quaschning 
    • Engelbergerstrasse 21
    • 79106  Freiburg im Breisgau
    • Germany
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Sources of Monetary or Material Support

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    • Deutsche Rentenversicherung Bund, Fachbereich Reha-Wissenschaften, Ref. 0421
    • Ruhrstr. 2
    • 10709  Berlin
    • Germany
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Status

  •   Recruiting ongoing
  •   [---]*
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Trial Publications, Results and other Documents

  •   Schliehe F. Zielvereinbarungen in der medizinischen Rehabilitation. Rehabilitation 2009;48:127: Holliday RC, Antoun M, Playford ED. A survey of goal-setting methods used in rehabilitation. Neurorehabilitation and Neural Repair 2005;19(3):227-231; Meyer T, Pohontsch N, Raspe H. Zielfestlegungen in der stationären somatischen Rehabilitation - die Herausforderung bleibt. Rehabilitation 2009;48:128-134.
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* This entry means the parameter is not applicable or has not been set.