JMIR Publications

ABSTRACT

Background:

Patient-centeredness has become a guiding principle of delivering quality health care. Integrating self-help services in healthcare facilities through collaboration is a vital part of this, also in rehabilitation. Despite increasing efforts to promote patient-centered care in Germany, implementation remains inconsistent, and research on this is particularly limited for rehabilitation.

Objective:

This study sought to examine the patient-centeredness of rehabilitation clinics, considering the significance of self-help in their internet presence as a central source of patient information. The research objectives are thus to measure and compare the self-help orientation among rehabilitation clinics’ websites to assess which clinic criteria correlate with certain levels of self-help presentation on the clinic websites.

Methods:

A quantitative content analysis of 400 rehabilitation clinic websites was conducted as a part of the KoReS project (Self-help friendliness and cooperation with self-help among rehabilitation clinics in Germany) that is co-designed, conducted and disseminated in collaboration with public health and patient representatives. Websites were systematically screened using a newly developed 16-criteria coding instrument assessing self-help orientation. A score was formed from these criteria ranging from 0-16 points. Univariate analyses were applied to describe the score distributions. Binomial logistic regression analyses were performed to determine the self-help orientation levels of the websites based on clinic characteristics.

Results:

Approximately 61% of the clinics scored low on self-help orientation, with the majority (42%) not being self-help oriented at all. Conversely, nearly 40% of the clinic websites demonstrated high self-help orientation, with 7% of them achieving exceptional scores. On average, 4.4 (±4.1) of 16 points were reached and basic self-help orientation criteria were fulfilled by the clinics. Regression analysis revealed clinics covering the indication areas oncology (OR=2.64, P<.05), neurology (OR=2.73, P<.01) or addiction (OR=3.04, P<.001) to significantly predict higher self-help orientation scores. Facility size, sponsorship type and the number of specialist indication areas did not impact the self-help orientation of the websites overall.

Conclusions:

This is the first analysis measuring the self-help orientation of rehabilitation clinic websites and indicates that it falls short of its potential. The findings suggest that greater emphasis on self-help display and collaboration with self-help in rehabilitation is needed. It can be achieved by using the concept of self-help friendliness, integrating self-help closely into clinic missions and treatment plans and considering the criteria developed in designing clinic websites to increase patient orientation.