Projektart: Eigenprojekt Studie
Medizinisch-berufliche Rehabilitation und Nachsorge in regionaler Vernetzung - eine Pilotstudie

Background and research question: For the past three years, the m&i-Fachklinik Herzogenaurach has been conducting a medical-occupational rehabilitation (MBR) procedure that differs significantly from conventional MBR procedures in a number of respects: - It is conducted on a full-day outpatient basis. - It is not conducted entirely in the clinic, but in cooperation with the Vocational Training Centre in Nuremberg as the vocational training location. - The m&i-Fachklinik Herzogenaurach has been conducting the MBR procedure for the past three years At the latest in the second half of the procedure, the vocational training location is shifted to the real workplace. The aim of an initial explorative evaluation was to evaluate the results of the measure with regard to the maintenance of gainful employment, the mental state and the remaining reserves for participation in social life. Methodology: In an initial catamnestic questionnaire-based study, it was possible to evaluate the information provided by 13 neurological rehabilitation patients who had undergone the new medical-vocational rehabilitation procedure. The cost bearer in 70 percent of the cases was the German pension insurance, the remaining cases were financed by the statutory or private accident insurance. Two thirds were men, the average age was 45, and most were between 40 and 50 years old. A quarter were blue-collar workers, among the rest (white-collar workers) half had academic jobs. The duration of the measure was 11 weeks on average. Results: In half of the participants, fulltime work capacity was not achievable; in these cases, the work contract was adapted to four hours a day (with financial compensation in the form of a partial pension). With one exception, where the employment contract was terminated by the employer despite promises to the contrary, all participants are still employed in the same company with the recommended number of hours per week. Two were transferred to other departments for restructuring reasons - not disability-related - but both perceive the new workplace as a deterioration. All get along with their work, but need more breaks. Most of them need help from colleagues, but it is usually for trivial matters. The majority say they enjoy their work as much as before the illness. Exceptions are those who have had to accept a career change or are suffering from pain. The majority have not suffered or have even improved their personal well-being as a result of returning to work. However, the well-being of one pain patient from the commercial sector has worsened. Social contacts have tended to decrease, although interest in contacts has also declined in half of the respondents. This could be an indication of fewer resources besides work. Influences of the disability on the stability of the partner relationship tend not to be reported, but the increased support of the family is necessary for the vast majority. In the evaluation of the measure, almost all report that they felt well understood and supported. One participant occasionally struggled to follow content during team meetings. The vast majority rated the involvement of the employer as useful, although only two participants who were angry about their employer's behavior could not agree with this. Conclusion: The implementation of integrated MBR according to the Herzogenaurach model takes place in the real life situation of the rehabilitant. Integration problems can thus be dealt with directly by therapy. Gradual reintegration is directly integrated into the compact procedure and accompanied by therapy, so that job adjustment can be optimized even during reintegration. The results of this first study indicate that these advantages of the new procedure are also reflected in successful and stable job reintegration. However, the prerequisite of an existing employment relationship, the possibilities and the actual interest of the employer as well as the catchment area of a full-day outpatient rehabilitation set limits to the model. Nevertheless, it is likely to be interesting in principle, at least for other metropolitan areas.