Implementierung eines psychodiagnostischen Stufenplans in der medizinischen Rehabilitation – Ergebnisse einer Pilotstudie
Abstract
STUDY AIM: A pilot study was conducted to implement and evaluate a routine gradual psycho-diagnostic programme to improve diagnostics and treatment of mental disorders in somatic rehabilitation centres. First of all, implementation strategies were acquired in trainings together with psychologists and physicians. The psycho-diagnostic programme consists of a screening instrument (PHQ-9) designed to permit time-effective detection of comorbid mental disorders. Besides evaluation of the training, the aim of the study was to analyze the extent to which it is possible to implement the routine gradual psycho-diagnostic programme in practice. Additionally, it was intended to identify beneficial and obstructive conditions for implementation. METHODOLOGY: The pilot study was conducted in two orthopaedic and one cardiological rehabilitation centre. The training was evaluated directly after its completion using a questionnaire. Three months after its implementation, the introduction of the psycho-diagnostic programme was evaluated using interviews with n=11 physicians and psychologists. RESULTS: The training was rated positively by the participants . Implementation of the entire gradual psycho-diagnostic programme was possible in one centre and to some degree in the other two. Beneficial for implementation were a frank organisational climate, sufficient time resources, and physicians' biopsychosocial understanding of disease. A dismissive attitude towards psycho-diagnostics, little communication between staff members, little perceived advantage for one's own work and fear to stigmatise patients by psychiatric diagnoses were obstructive. CONCLUSION: Essential for a successful implementation are sufficient time and personal resources, a motivation for change in staff and centre management, and a positive attitude regarding psycho-diagnostics in clinic staff. Furthermore, flexibility in implementation strategies and the opportunity to participate in the implementation process are important.
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Comorbid mental disorders are associated with lower quality of life.
“Komorbide psychische Störungen sind mit erhöhten Morbiditäts-und Mortalitätsraten [ 8 , 9 ] , erhöhten Versorgungskosten [ 10 , 11 ] sowie niedriger Compliance [ 12 , 13 ] und Lebensqualität [ 9 , 14 ] assoziiert.”
From Inanspruchnahmebereitschaft und Inanspruchnahmeverhalten von Behandlungen aufgrund psychischer Belastungen bei Patienten der somatischen Rehabilitation (2012) · cites this paper as [14]
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Salzwedel, A., Reibis, R. K., Hadzic, M., Buhlert, H., & Völler, H. (2019) · Vascular Health and Risk Management · doi:10.2147/vhrm.s216039 · Cited by 19 · see citing works
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Self-citationBaumeister, H. (2014) · Psychologische Rundschau · doi:10.1026/0033-3042/a000217 · Cited by 16 · see citing works
Self-citationMorfeld, M., & Friedrichs, A. (2010) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1188-7 · Cited by 13 · see citing works
Screening und Diagnostik komorbider psychischer Störungen bei körperlichen Erkrankungen
Reuter, K., & Härter, M. C. (2010) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1183-z · Cited by 7 · see citing works
Self-citationJahed, J., Bengel, J., & Baumeister, H. (2012) · Die Rehabilitation · doi:10.1055/s-0032-1308964 · Cited by 4 · see citing works
Self-citationDiagnostik und Indikationsstellung bei psychischen Belastungen und Störungen
Baumeister, H. (2016) · Springer eBooks · doi:10.1007/978-3-662-47972-8_4 · Cited by 2 · see citing works
Self-citationReturn to Work After a Cardiovascular Event: The Central Role of Cardiac Rehabilitation
Pacileo, M., Giallauria, F., Cuomo, G., Vallefuoco, G., Mauriello, A., Russo, V., & D’Andrea, A. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15052019 · Cited by 1 · see citing works
- Authors
- Vogel, B., Jahed, J., Bengel, J., Barth, J., Härter, M., & Baumeister, H.
- Affiliations
- University of Freiburg (DE)
- University of Bern (CH)
- University Medical Center Hamburg-Eppendorf (DE)
- Venue
- Die Rehabilitation
- Publisher
- Georg Thieme Verlag KG
- Published
- 2009-12
- Volume
- 48
- Issue
- 06
- Pages
- 361-368
- ISSN
- 0034-3536 (ISSN-L)
- 1439-1309
- OpenAlex
- W2803292299
- Cited by
- 9
- References
- 0
- Citations by year
- 2026: 1 · 2023: 1 · 2019: 1 · 2018: 1 · 2016: 1 · 2014: 1 · 2012: 1
- FWCI
- 1.82
- Type
- journal article
- Language
- de
- Open access
- closed
- Locations
- Die Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- medical rehabilitation, PHQ-9 screening, implementation barriers and facilitators, employee training, organizational climate, biopsychosocial model, orthopedic rehabilitation
- MeSH terms
- Attitude of Health Personnel, Cooperative Behavior, Germany, Health Plan Implementation, Humans, Inservice Training, Interview, Psychological, Motivation, Patient Care Team, Pilot Projects, Psychophysiologic Disorders, Surveys and Questionnaires, Referral and Consultation, Rehabilitation Centers, Somatoform Disorders, Program Evaluation, Comorbidity, Interdisciplinary Communication
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