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首页> 外文期刊>Journal of Occupational Medicine and Toxicology >Fostering needs assessment and access to medical rehabilitation for patients with chronic disease and endangered work ability: protocol of a multilevel evaluation on the effectiveness and efficacy of a CME intervention for general practitioners
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Fostering needs assessment and access to medical rehabilitation for patients with chronic disease and endangered work ability: protocol of a multilevel evaluation on the effectiveness and efficacy of a CME intervention for general practitioners

机译：为慢性病和濒临危险的工作能力的患者建立需求评估和获得医疗康复的机会：针对全科医生的CME干预措施的有效性的多级评估方案

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Background Studies show that endangered work ability (EWA) can be maintained or restored through medical rehabilitation (MR). For patients, general practitioners (GP) represent an important point of access to MR in outpatient care. However, many different barriers and shortcomings hinder GPs in both timely detection of the need for MR and the recognition of its potentials for their EWA-patients. These are necessary if GPs are to adequately inform patients about MR options and successfully support applications for MR. This study describes the evaluation of a continuing medical education (CME) module designed to improve rehabilitation-related practical performance of GPs regarding a) subjective satisfaction of GPs with the CME module, b) stability of attitudes and knowledge over time regarding rehabilitation, and c) subjective and objective changes in MR-related competencies needed to support MR applications. Methods This study is an open, non-randomised, pre-post-intervention study. The intervention involves a CME module for GPs ( n =?1365) in the German state of Saxony-Anhalt on the topic of medical rehabilitation in connection with the federal German pension fund (Deutsche Rentenversicherung). The module will be initially held as regularly scheduled meetings in moderated GP quality circles (QC), and then offered as a written self-study unit. At the end it will be evaluated by the GPs. The study’s primary focus is on the organizational practice as measured by the number of approved MR applications supported by medical reports submitted by the participating GPs in the 6 months before and 6 months after the CME module. Other study aims involve measuring self-perceived competencies of GPs, as well as their attitudes towards and knowledge of rehabilitation (both upon completing the CME and 6 months later). In addition, the level of satisfaction with the CME module will be analysed among participating GPs and QC moderators (as CME facilitators). Discussion Implementing targeted CME on complex topics such as those involving barriers is possible, even promising, when using QCs and their moderators. Of particular importance is how aware moderating physicians are of the relevance of MR need detection and access. Ethics and dissemination The ethics committee of the Martin-Luther-Universit?t Halle-Wittenberg has registered this study under the number 2014–13. The study will be reported on in peer-reviewed journals and at national and international conferences. The results will be available to current and future initiatives aiming to improve detection of MR need and making MR accessible to EWEC patients needing such support to minimize the effects of chronic disease on their livess. Trial registration number German Clinical Trials Register (ID number DRKS00006188) and WHO International Clinical Trials Registry Platform, Universal Trial Number (UTN) U1111–1158-8334 .
机译：背景研究表明，可以通过医疗康复（MR）来维持或恢复濒临危险的工作能力（EWA）。对于患者而言，全科医生（GP）是门诊患者获得MR的重要方面。但是，许多不同的障碍和缺点阻碍了GP在及时发现MR的需求以及认识其EWA患者的潜力方面。如果GP要充分告知患者有关MR的选择并成功支持MR的应用，则这些是必要的。这项研究描述了一个持续医学教育（CME）模块的评估，该模块旨在提高GP的康复相关实践绩效，包括以下方面：a）GP对CME模块的主观满意度; b）长期以来对康复的态度和知识的稳定性;以及c ）支持MR应用所需的与MR相关的能力的主观和客观变化。方法：这项研究是一项开放，非随机，干预后的研究。干预涉及与德国联邦养老基金（Deutsche Rentenversicherung）有关的德国萨克森-安哈特州全科医生（n = 1365）的CME模块。该模块最初将作为定期举行的会议在中等质量的GP质量圈子（QC）中举行，然后以书面的自学单元形式提供。最后，GP将对其进行评估。这项研究的主要重点是组织实践，以参与CME模块之前6个月和之后6个月的参与GP提交的医学报告支持的已批准MR申请的数量来衡量。其他研究目标涉及测量全科医生的自我感觉能力，以及他们对康复的态度和知识（包括完成CME以及六个月后）。此外，还将在参与的GP和QC主持人（作为CME主持人）之间分析CME模块的满意度。讨论在使用QC及其主持人时，可以针对复杂的主题（例如涉及障碍的主题）实施目标CME，甚至很有希望。特别重要的是，审慎的医师如何了解MR需求检测和访问的相关性。伦理学和传播马丁·路德大学·哈雷·威登堡大学的伦理学委员会已以2014-13年的编号注册了这项研究。这项研究将在同行评审的期刊以及全国和国际会议上进行报道。该结果将提供给当前和未来的举措，旨在改善对MR需求的检测，并使需要此类支持的EWEC患者能够获得MR，以最大程度地减少慢性病对其生命的影响。试验注册号德国临床试验注册号（ID号DRKS00006188）和WHO国际临床试验注册平台，通用试验号（UTN）U1111-1158-8334。

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