title: [Vocational inpatient and post-treatment proposals in cardiac rehabilitation patients (BERUNA): results of a randomized controlled trial].
abstract: BACKGROUND
  The “Verband Deutscher Rentenversicherungsträger (VDR)” required the intense focus on vocational rehabilitation of medical problems since the early 1990s. By integrating elements of the working environment in the structures and processes of medical rehabilitation, vocational problems can be identified early in order to take appropriate countermeasures. Posttreatment proposals off er a way to provide a reliable long-term success.
  
  
  OBJECTIVE
  The intention of this study is the implementation and the investigation of effectiveness of an intensified vocational program that integrates besides the in-patient rehabilitation post-treatment proposals as well.
  
  
  METHODS
  Cardiac rehabilitation patient occurring special vocational problems participe. The recruited patients were randomized to either the vocational program or the common cardiac rehabilitation.Primary outcome was the vocational reintegration 12 months after the end of rehabilitation.The database was collected through a query of the pension insurance accounts and questionnaires.
  
  
  RESULTS
  306 people were included to the study at the beginning of rehabilitation. Rates of response:95 % of the survey to the end of rehabilitation,77 % of the survey 6 months and 73 % of the survey 12 months after the end of rehabilitation.The sample was characterized by great interferences of their professional involvement and a high demand for vocational treatments. At the beginning of the rehabilitation 50 % of study participants intended to make an application for reduction-pension. Nevertheless, one year after the end of rehabilitation a surprisingly high rate of vocational reintegration by over 70 % in both groups (IG: 72 %, KG: 75 %, p < 0.929) was indicated.The majority of the unemployed patients at the beginning of rehabilitation remained in the unemployment (IG: 69 %, KG: 65 %, p < 0.757). The participation rate at the post-treatment proposals was 42%.
  
  
  CONCLUSIONS
  The results show that vocational programs in rehabilitation need to be revised, including with regard to the question, whether and in what way post-treatment proposals must be changed.
authors.forename: D
authors.initials: D
authors.lastname: Huber
authors.forename: N
authors.initials: N
authors.lastname: Hoerschelmann
authors.forename: E
authors.initials: E
authors.lastname: Hoberg
authors.forename: J
authors.initials: J
authors.lastname: Karoff
authors.forename: M
authors.initials: M
authors.lastname: Karoff
authors.forename: J
authors.initials: J
authors.lastname: Kittel
mesh_terms: D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult