JMIR Publications

ABSTRACT

Background:

As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. Previous online trials on coping with work-related stress, however, have been limited to online recruitment of study participants.

Objective:

The aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic online aftercare program GSA-(“Gesund und Stressfrei am Arbeitsplatz” [Healthy and stress-less at the workplace]) Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus and to determine helpfulness of the intervention and satisfaction of the participants as well as improvement in quality of life and mental health status of the regular users of GSA-Online plus.

Methods:

GSA-Online plus was prescribed by the physicians at termination of orthopedic, respectively psychosomatic inpatient rehabilitation. Participants’ use of the program, work-related attitudes, distress and quality of life were assessed online.

Results:

Of N = 2562 rehabilitants in two rehabilitation centers, n = 112 (4.4%) got a recommendation for GSA-Online plus during inpatient rehabilitation. Compared to usual person aftercare, the online aftercare program was rarely recommended by physicians. Recommendations were made more frequently in psychosomatic (5.9%) than orthopedic (3.1%) rehabilitation (χ21= 11.845, P = .001, Cramers V = -0.068), and to younger patients (P = .004, d = 0.28) with longer inpatient treatment duration (P < .001, r = -0.12) and extended sick-leaves before inpatient medical rehabilitation (P =.004; Cramers V = 0.072). Following recommendation, 77% of rehabilitants participated in online aftercare. Completers (58%) reported statistically significant improvements between discharge of inpatient treatment and the end of the aftercare program for subjective work ability (P = .02, d = 0.41), perceived stress (P = .01, d = 0.38), functioning (P = .002, d = -0.60) and life satisfaction (P = .008, d = 0.42).

Conclusions:

Physicians’ recommendations of online aftercare are well accepted by patients who derive considerable benefits from participation. However, a low rate of prescription compared to other usual aftercare options points to barriers among physicians to prescribing online aftercare. Clinical Trial: The trial is registered at ClinicalTrials.gov (Trial Registration number: ClinicalTrials Gov ID NCT03019718).