title: [The development of an instrument assessing the relevance of rehabilitation outcomes for patient participation: retest reliability and descriptive results].
abstract: OBJECTIVE
  In the context of an increasing patient orientation in health care, surveying patients on the success of treatment has become highly relevant. The objective of the study was to develop and test an instrument for surveying the patients' perceptions of the participation relevance of changes in health status after inpatient medical rehabilitation with respect to various areas of life for 3 diagnoses: breast cancer, chronic ischemic heart disease, and chronic back pain.
  
  
  METHODS
  The instrument refers to certain disease-specific areas of health (e. g., mobility) with regard to which the patients are asked whether they perceived an improvement and if so, what improvement in participation had ensued as a result. A questionnaire study (measuring time points: end of rehab and 6 months after the end of rehab) was conducted in 3 samples (breast cancer: n=297, chronic ischemic heart disease: n=295, chronic back pain: n=186) to test the methodology. The share of missing values and undesirable ceiling/floor effects were assessed to analyze the distribution characteristics. In a partial sub-sample, a third measuring time point was introduced approx. 10 days after the second measuring time point, and the retest reliability of the assessment of participation relevance is determined using the ICC. We also present descriptive results relative to the participation relevance from the patient perspective.
  
  
  RESULTS
  The instrument shows good distribution characteristics for the items. Regarding retest reliability, there were satisfactory values for all diagnoses in all areas of health. The descriptive analyses showed that patients who perceived a noticeable improvement in their health status at the end of rehabilitation or 6 months after inpatient rehab generally assessed the participation relevance of this improvement in health to be "moderate" to "strong".
  
  
  CONCLUSIONS
  The concept of assessing the participation relevance from the patient perspective is a satisfactorily reliable construct. By including the subjective significance of treatment success it takes into account the concept of clinical significance from the patient's perspective, a concept which has thus far been considered only insufficiently. Results show that patients ascribe the health improvements achieved by rehabilitation a noticeable relevance for their participation.
authors.affiliation: Universitätsklinikum Freiburg, Abteilung Qualitätsmanagement und Sozialmedizin. michaela.nagl@uniklinik-freiburg.de
authors.forename: M
authors.initials: M
authors.lastname: Nagl
authors.forename: E
authors.initials: E
authors.lastname: Farin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology* / Q000534:rehabilitation*; D059026:Diagnostic Self Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010358:Patient Participation; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult