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.
Introduction Self-help is an important complement to medical rehabilitation for people with chronic diseases and disabilities. It contributes to stabilising rehabilitation success and further coping with disease and disability. Rehabilitation facilities are central in informing and referring patients to self-help groups. However, sustainable cooperation between rehabilitation and self-help, as can be achieved using the concept of self-help friendliness in healthcare, is rare, as is data on the cooperation situation. Methods and analysis The KoReS study will examine self-help friendliness and cooperation between rehabilitation clinics and self-help associations in Germany, applying a sequential exploratory mixedmethods design. In the first qualitative phase, problemcentred interviews and focus groups are conducted with representatives of self-help-friendly rehabilitation clinics, members of their cooperating self-help groups and staff of self-help clearinghouses involved based on a purposeful sampling. Qualitative data collected will be analysed through content analysis using MAXQDA. The findings will serve to develop a questionnaire for a quantitative second phase. Cross-sectional online studies will survey staff responsible for self-help in rehabilitation clinics nationwide, representatives of self-help groups and staff of self-help clearinghouses. Quantitative data analysis with SPSS will include descriptive statistics, correlation, subgroup and multiple regression analyses. Additionally, a content analysis of rehabilitation clinics’ websites will evaluate the visibility of self-help in their public relations. Ethics and dissemination The University Medical Center Hamburg-Eppendorf Local Psychological Ethics Committee at the Center for Psychosocial Medicine granted ethical approval (reference number LPEK-0648; 10.07.2023). Informed consent will be obtained from all participants. Results dissemination will comprise various formats such as workshops, presentations, homepages and publications for the international scientific community, rehabilitation centres, self-help organisations and the general public in Germany. For relevant stakeholders, practical guides and recommendations to implement self-help friendliness will derive from the results to strengthen patient orientation and cooperation between rehabilitation and self-help to promote the sustainability of rehabilitation processes.