M Morfeld

Publications (37)32.24 Total impact

• Article: Ambulante Rehabilitation in Deutschland

  M. Morfeld, A. Strahl, U. Koch
  [show abstract] [hide abstract]
  ABSTRACT: Angebot und Ausbau der ambulanten medizinischen Rehabilitation in Deutschland stellen mittlerweile einen substanziellen Baustein in der rehabilitativen Versorgung dar. In Anbetracht des demografischen Wandels und der Zunahme chronischer Erkrankungen können ambulante Einrichtungen aufgrund ihrer Flexibilität Versorgungslücken schließen und Versicherte erreichen, für die eine stationäre Rehabilitation wenig attraktiv ist beziehungsweise aus anderen Gründen nicht infrage kommt. Durch die Verankerung der medizinischen Rehabilitation im SGBV und SGBVI sowie die Einführung des SGBIX mit dem Rehabilitationsgrundsatz „ambulant vor stationär“ wurde die ambulante Rehabilitation sozialrechtlich etabliert. Heute bedeutet ambulant ein der stationären Rehabilitation anerkanntes gleichgestelltes Setting, das statt einer, zur Verkürzung oder im Anschluss an eine stationäre Rehabilitation in Betracht kommt. Im Jahr 2008 machten ambulante Leistungen einen Anteil von 11% aller Maßnahmen zur medizinischen Rehabilitation aus. Der vorliegende Beitrag stellt, ausgehend von einer historischen Entwicklung, die konzeptionellen Entwicklungen einschließlich der Rahmenempfehlungen der Bundesarbeitsgemeinschaft für Rehabilitation (BAR) dar. Die Ergebnisse der wichtigsten wissenschaftlichen Untersuchungen zur Wirksamkeit der ambulanten gegenüber der stationären Rehabilitation werden berichtet. Aufbauend darauf werden Perspektiven für eine potenzielle Weiterentwicklung der ambulanten Rehabilitation in Deutschland entwickelt. The offer and development of outpatient medical rehabilitation in Germany represents a substantial component of rehabilitative care. In consideration of demographic change and the increase of chronic illnesses, outpatient rehabilitation facilities, on account of their flexibility, can close care gaps for those who find stationary rehabilitation less attractive or not possible for other reasons. With the implementation of the “Sozialgesetzbuch” (SGB)V and SGBVI as well as the introduction of the SGBIX regarding the rehabilitation principle “outpatient before inpatient,” outpatient rehabilitation was social juridically established. Today outpatient rehabilitation means an equal setting, which can substitute inpatient rehabilitation, thus, shortening inpatient rehabilitation or it can follow inpatient rehabilitation. In 2008, outpatient services constituted 11% of all rehabilitation services. Illnesses of the muscle system, skeletal system, and connective tissue system, which are the most frequent rehabilitation indications in Germany, are treated in an outpatient setting in 17% of cases. The outpatient rehabilitation process is characterized by the close proximity to a patient’s residence and job, flexibility, and individual participation. These characteristics enable the implementation of innovative possibilities, e.g., stepwise occupational reintegration into the rehabilitation process in order to optimize rehabilitation outcome. SchlüsselwörterAmbulante medizinische Rehabilitation–Vergleich–Indikationsverteilung–Weiterentwicklung KeywordsRehabilitation–Ambulatory care–Rehabilitation outcome–Vocational rehabilitation
  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 05/2012; 54(4):420-428. · 0.66 Impact Factor
• Article: Psychische Komorbidität

  M. Morfeld, A. Friedrichs
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  ABSTRACT: Psychosoziale Komorbidität bei somatischen Erkrankungen stellt aus epidemiologischer und aus Perspektive der Versorgung ein bedeutsames Problem dar. Aus ätiologischer Sicht werden verschiedene Ebenen der Entstehung beziehungsweise Herangehensweise diskutiert. Im vorliegenden Beitrag wird exemplarisch eine Übersicht über die Prävalenz psychischer Komorbidität bei muskuloskelettalen Erkrankungen mit dem Schwerpunkt chronischer Rückenschmerz in der somatischen medizinischen Rehabilitation gegeben. Muskuloskelettale Erkrankungen sind hier – nach der Statistik der Deutschen Rentenversicherung – die wichtigste Indikation. Eine wesentliche Frage, die im Beitrag gestellt wird, ist die nach den Möglichkeiten, aber auch Herausforderungen, die sich für die medizinische Rehabilitation aus dem Umgang mit psychosozialer Komorbidität ergeben. Ausgehend von einer Beschreibung der medizinischen Rehabilitation in Deutschland, wird aus unterschiedlichen Blickwinkeln beleuchtet, welche Bedeutung psychosoziale Komorbidität in der medizinischen Rehabilitation hat und welche Möglichkeiten sich durch dieses besondere Setting für das Screening psychischer Komorbidität ergeben. Untersucht werden diese Aspekte anhand entsprechender Arbeiten aus den Jahren 2000 bis 2010 aus dem Bereich der stationären orthopädischen medizinischen Rehabilitation. Es konnten zehn Arbeiten identifiziert werden, die die medizinische Rehabilitation bei chronischen Rückenschmerzen untersuchten. Drei von diesen machten Angaben zur Prävalenz psychischer Komorbidität und thematisierten ein diagnostisches Screening. Dies soll aus einer Perspektive diskutiert werden, die potenzielle Barrieren aufseiten der Behandler, aber auch Patienten aufgreift. Weitere Aufmerksamkeit wird auf die Implementierung eines entsprechenden Screenings sowie auf die Nachsorge gerichtet. Psychosocial comorbidity in somatic disorders is considered an important problem from the epidemiological point of view as well as from the perspective of care. Therefore, the different origins or development are etiologically discussed. In this article, an overview of the prevalence of psychiatric comorbidity of musculoskeletal disorders, using chronic back pain in somatic medical rehabilitation as an example, is given. According to the statistics of the German pension insurance fund, musculoskeletal diseases are the most common indication. In this article, the opportunities and the challenges for medical rehabilitation in managing psychosocial comorbidity are discussed. Starting with the description of medical rehabilitation in Germany, the significance of psychosocial comorbidity in medical rehabilitation and the resulting opportunities arising from this special setting to screen for psychological comorbidity are examined. These aspects are discussed based on articles from 2000–2010 in the field of orthopedic inpatient medical rehabilitation. A total of ten studies, focusing on the medical rehabilitation of chronic back pain, were identified. It was found that three papers reported data on the prevalence of psychological comorbidity and addressed diagnostic screening. This is discussed from a perspective that addresses potential barriers on the part of therapists as well as the patients. More attention should be directed to implementing the appropriate screening and follow-up care. SchlüsselwörterPsychosoziale Komorbidität–Chronischer Rückenschmerz–Medizinische Rehabilitation–Screening KeywordsPsychosocial comorbidity–Chronic back pain–Medical rehabilitation–Screening
  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 05/2012; 54(1):90-97. · 0.66 Impact Factor
• Article: Messung der gesundheitsbezogenen Lebensqualität mit dem SF-8. Deutsche Normdaten aus einer repräsentativen schriftlichen Befragung

  V. Beierlein, M. Morfeld, C. Bergelt, M. Bullinger, E. Brähler
  Diagnostica 01/2012; 58:145-153. · 0.72 Impact Factor
• Chapter: Versorgung mit Rehabilitationsleistungen

  M. Morfeld, U. Koch, C. Bergelt, A. Mehnert
  01/2012: pages 909-930;
• Article: [Outpatient rehabilitation in Germany. Interim results and prospects for further development].

  M Morfeld, A Strahl, U Koch
  [show abstract] [hide abstract]
  ABSTRACT: The offer and development of outpatient medical rehabilitation in Germany represents a substantial component of rehabilitative care. In consideration of demographic change and the increase of chronic illnesses, outpatient rehabilitation facilities, on account of their flexibility, can close care gaps for those who find stationary rehabilitation less attractive or not possible for other reasons. With the implementation of the "Sozialgesetzbuch" (SGB) V and SGB VI as well as the introduction of the SGB IX regarding the rehabilitation principle "outpatient before inpatient," outpatient rehabilitation was social juridically established. Today outpatient rehabilitation means an equal setting, which can substitute inpatient rehabilitation, thus, shortening inpatient rehabilitation or it can follow inpatient rehabilitation. In 2008, outpatient services constituted 11% of all rehabilitation services. Illnesses of the muscle system, skeletal system, and connective tissue system, which are the most frequent rehabilitation indications in Germany, are treated in an outpatient setting in 17% of cases. The outpatient rehabilitation process is characterized by the close proximity to a patient's residence and job, flexibility, and individual participation. These characteristics enable the implementation of innovative possibilities, e.g., stepwise occupational reintegration into the rehabilitation process in order to optimize rehabilitation outcome.
  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 04/2011; 54(4):420-8. · 0.66 Impact Factor
• Article: [Psychological comorbidity. Diagnosis and indications for further treatment in medical rehabilitation].

  M Morfeld, A Friedrichs
  [show abstract] [hide abstract]
  ABSTRACT: Psychosocial comorbidity in somatic disorders is considered an important problem from the epidemiological point of view as well as from the perspective of care. Therefore, the different origins or development are etiologically discussed. In this article, an overview of the prevalence of psychiatric comorbidity of musculoskeletal disorders, using chronic back pain in somatic medical rehabilitation as an example, is given. According to the statistics of the German pension insurance fund, musculoskeletal diseases are the most common indication. In this article, the opportunities and the challenges for medical rehabilitation in managing psychosocial comorbidity are discussed. Starting with the description of medical rehabilitation in Germany, the significance of psychosocial comorbidity in medical rehabilitation and the resulting opportunities arising from this special setting to screen for psychological comorbidity are examined. These aspects are discussed based on articles from 2000-2010 in the field of orthopedic inpatient medical rehabilitation. A total of ten studies, focusing on the medical rehabilitation of chronic back pain, were identified. It was found that three papers reported data on the prevalence of psychological comorbidity and addressed diagnostic screening. This is discussed from a perspective that addresses potential barriers on the part of therapists as well as the patients. More attention should be directed to implementing the appropriate screening and follow-up care.
  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2011; 54(1):90-7. · 0.66 Impact Factor
• Article: [Chronic low back pain : Replication of different reaction groups].

  M Holldorf, M Morfeld, M Möller, J Höder, U Koch
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  ABSTRACT: The aim of the study was to replicate the different reaction groups: "Fröhlicher Durchhalter (FD)" who are characterised by a positive mood and endurance strategies, "Depressiver Durchhalter (DD)" with depressive mood and cognitions to hold on and "Depressiver Vermeider (DV)" who are depressed with social and physical avoidance strategies. The replication was conducted with more feasible methods than the Kiel Pain Inventory (KPI), which had been frequently used in former research. This might effectuate a superior intervention outcome. The sample (n=290) consisted of patients after their first nucleotomy at the beginning of the inpatient medical rehabilitation. Selection of the scales was based on cognitive-emotional and behavioural pain characteristics. Therefore 14 scales of generic standardised questionnaires were investigated The cluster analysis revealed two heterogeneous groups: the FD (n=203, 75.7%) and DV (n=65, 24.3%). MANOVA showed significant differences between both groups (Wilks' lambda: F (14,253)=30.97; p<.001); especially the emotional pain characteristics were relevant. The study contributes to the methodological stability of two postulated groups. Thus further research should foster the development of risk-based interventions to evaluate if these groups offer an appropriate differentiation in rehabilitation.
  Der Schmerz 08/2010; 24(4):334-41. · 0.88 Impact Factor
• Article: [Requirements of professional education for rehabilitation in human medical teaching. Position paper of the German Society of Rehabilitation Science, DGRW].

  W Mau, S Kawski, W Lay, M Morfeld, S R Schwarzkopf, A Uhlmann
  Die Rehabilitation 04/2010; 49(2):114-9. · 1.36 Impact Factor
• Article: [A comparison of multimodal programmes of patient education in the rehabilitation of chronic low back pain].

  M Morfeld, D Küch, B Greitemann, S Dibbelt, C Salewski, G H Franke, A Liebenau
  [show abstract] [hide abstract]
  ABSTRACT: There is growing evidence for the effectiveness of multimodal intervention concepts for chronic low back pain in the international literature, and accordingly several German rehabilitation programmes for the treatment of chronic low back pain patients have been developed. Focus of this paper is to describe and compare frequently used German multimodal intervention programmes for in- and outpatient rehabilitation of patients with chronic low back pain. Programmes were chosen by searching the most relevant online resources as well as the online pages of Deutsche Rentenversicherung and Zentrum Patientenschulung during September 2008. Keywords guiding the search were: Patientenschulung, Rückenschmerzen, Manual, psychologische multimodale Interventionskonzepte, Rehabilitationsprogramm, psychology, intervention, low back pain, manual and therapy. By this means, six manually supported multimodal rehabilitation programmes for the in- and outpatient therapy of patients with chronic back pain could be identified: Göttinger Rücken-Intensiv-Programm (GRIP), the psychological programme for chronic head- and low back pain, the Münchner Rücken-Intensiv-Programm (MRIP), Back to Balance, Arbeiten und Leben--Back to Balance (ALEBABA) und Rückenfit: Lebenslust statt Krankheitsfrust. These programmes are depicted and compared with regard to their potentials and limitations in supporting the rehabilitation process of patients with chronic low back pain. While comparing the programmes, a number of similarities between them can be detected, as well as pronounced differences, e. g., regarding settings and complexity. In most programmes, lack of appropriate evaluation studies and lack of aftercare turn out to be critical aspects.
  Die Rehabilitation 04/2010; 49(2):66-79. · 1.36 Impact Factor
• Source

  Available from: Gabriele Helga Franke

  Chapter: Psychometrische Prüfung des BSI

  S. Rusdorf, G. H. Franke, S. Jäger, D. Küch, H. Rossband, M. Morfeld
  01/2010: pages 299-302;
• Source

  Available from: Gabriele Helga Franke

  Article: Eignet sich das BSI-18 zur Erfassung der psychischen Belastung von nierentransplantierten Patienten?

  G. H. Franke, S. Jäger, M. Morfeld, C. Salewski, J. Reimer, A. Rensing, O. Witzke, T. Türk
  Zeitschrift für Medizinische Psychologie. 01/2010; 19(1):30-37.
• Article: Effektivität von Interventionen in der Rehabilitation bei Prostatakarzinompatienten - Ein systematischer Literaturüberblick

  A. Hergert, K. Hofreuter, H. Melchior, M. Morfeld, H. Schulz, B. Watzke, U. Koch, C. Bergelt
  Physikalische Medizin Rehabilitationsmedizin Kurortmedizin 01/2009; 19:311-325. · 0.31 Impact Factor
• Article: [Report of the first summer school on "methodological bases of rehabilitation research" September 27-29, 2007 at Magdeburg-Stendal University].

  M Morfeld, M Wirtz
  Die Rehabilitation 05/2008; 47(2):129-30. · 1.36 Impact Factor
• Article: [Social inequality as a predictor of occupational reintegration of chronic back pain patients following medical rehabilitation].

  K Hofreuter, U Koch, M Morfeld
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  ABSTRACT: The question of which factors influence return to work following medical rehabilitative measures in the case of chronic back pain is, in a social political context, of international significance. While psychosocial, socio-economic and demographic factors as well as subjective perceptions of working conditions are individually discussed, the role of social inequality has thus far received little attention. The present paper focuses on the occupational reintegration of patients with chronic dorsopathies following a medical rehabilitative intervention and aims to investigate the influence of predictor variables on successful reintegration. The re-analysis conducted was based on a three-year prospective controlled intervention study with three measurement sessions. The study comprised a sample of 289 patients aged 20 to 64 years who had undergone first-time intervertebral disc operations in the lumbar spine region. Data were collected between March 2002 and February 2005 using a standardized written questionnaire. Winkler's (1998) composite index comprising indicators of occupational position, income and education was employed as a measure of social inequality. Age and sex were also included as independent variables in a binary logistic regression analysis. Of individuals undergoing rehabilitation, those from lower social classes returned to work later than those from higher social classes. Age and sex did not prove to be significant predictors of successful return to work. The probability of successful reintegration into working life increases according to the position within the vertical structure of social class. In light of this result, it can be assumed that not only differential allocation of patients to rehabilitation interventions but also the specific contents of these interventions should be modeled on the basis of economic criteria.
  Das Gesundheitswesen 04/2008; 70(3):145-53. · 0.94 Impact Factor
• Article: [Changes of teaching in the interdisciplinary subject "rehabilitation, physical medicine, naturopathic treatment" in the German medical faculties 2004 to 2006/07].

  G Kusak, M Gülich, W Lay, M Morfeld, S R Schwarzkopf, W Mau
  [show abstract] [hide abstract]
  ABSTRACT: Rehabilitation, Physical Medicine, Naturopathic Treatment (Querschnittsbereich Q-12) was introduced as a compulsory interdisciplinary subject in the revised Federal Medical Licensing Regulations (Approbationsordnung für Arzte) in October 2003. This offered the opportunity to increase the students' interest in rehabilitation-related issues and to integrate current evidence of rehabilitation research. The implementation of the Q-12 in the German medical faculties was investigated by yearly questionnaires during a three-year-period. In 2004, 2005, and 2006/07 anonymous postal questionnaires concerning the teaching in Q-12 were sent to the 36 medical faculties in Germany. Non-responders were reminded at least once by a repeat postal questionnaire. The response rates were 67% in 2004, 72% in 2005, 50% in 2006/07, respectively. Of the 36 faculties 34 responded at least once. Ten faculties responded to all questionnaires. In a considerable number of faculties, Q-12 is being coordinated by university institutions which are not denominated as one of the subjects designated in the Q-12 title. Major differences regarding the implementation of Q-12 were found between the faculties. Further development of Q-12 faces several limitations of resources. Almost all faculties provide curricula for teaching Q 12, some of which are still incomplete. During all three examinations lecturer-centered teaching methods (lectures, seminars, other presentations) were used most frequently. POL-cases and other structured patient oriented teaching were also reported less frequently. E-learning was very rarely offered to the students. Musculoskeletal and neurological disorders were the most frequent specific indications for practice-related integration of Q-12 issues. Compulsory election subjects (Wahlpflichtfächer) related to Q-12 issues before and during the final year of the medical students, are not being offered by all faculties. The vast majority of the faculties advocate an exchange of materials for teaching and examinations. During the three examinations, major differences concerning the implementation of Q-12 were found between the faculties. Therefore, it is recommended that all faculties verify whether they adequately cover the joint educational objectives recommended for Q-12 by two German scientific societies. Furthermore, the more frequent application of up-to-date practice-oriented teaching and examination methods, an intensified implementation of Q-12-related issues in teaching specific indications, the completion of curricula, enhanced offer of compulsory election subjects related to Q-12 issues, continued scientific investigations and symposia/workshops concerning the promotion of Q-12-related teaching as well as the generation and exchange of teaching and examination materials are recommended.
  Die Rehabilitation 03/2008; 47(1):2-7. · 1.36 Impact Factor
• Article: [Expertise of current trends and future perspectives in rehabilitation research in Germany].

  U Koch, C Lehmann, M Morfeld
  Die Rehabilitation 07/2007; 46(3):127-44. · 1.36 Impact Factor
• Article: [Problem oriented learning (POL) in rehabilitation on the example of a patient with ankylosing spondylitis].

  K Horn, M Gülich, W Lay, M Morfeld, S R Schwarzkopf, W Mau
  [show abstract] [hide abstract]
  ABSTRACT: Through innovative teaching and learning methods relevant topics in rehabilitation can be conveyed effectively. Therefore, in this paper a papercase for problem-oriented learning (POL) is presented concerning rehabilitation in rheumatology, exemplified by a patient with ankylosing spondylitis. This papercase can be applied in the integrated course Rehabilitation, Physical Medicine and Naturopathic Treatment, the curricular part of teaching rehabilitation during the medical training according to the 9 (th) revision of the Federal Medical Licensing Regulations (Approbationsordnung). In addition the teaching material presented can be used in other courses, such as elective courses for non-medical professionals of the interdisciplinary rehabilitation team. First experiences gathered with the papercase in the Health and Nursing Sciences study programme of the Faculty of Medicine of Martin-Luther-University Halle-Wittenberg are reported.
  Die Rehabilitation 07/2007; 46(3):164-74. · 1.36 Impact Factor
• Article: [Organization of methodological support and cross-project research activities in multicenter research programmes - experiences of the centers for methodological support within the "rehabilitation science" research network].

  M Wirtz, M Morfeld, W Igl, M Kutschmann, R Leonhart, R Muche, G Schön
  [show abstract] [hide abstract]
  ABSTRACT: On completion of the funding period of six years within the federal programme for research in medical rehabilitation, an evaluative summary is given of the work performed and the experiences made in the cross-sectional projects offering methodological support. While specific research profiles had prevailed in each of the eight regional research networks, two institutions had been implemented with similar task assignments within all networks; i. e., (i) a central office, and (ii) a center for methodological support (CMS) had been available in order to enhance methodological research infrastructure and research quality of the clinical projects. This article outlines the support offered as well as further tasks of the CMS. Further, it is argued that organized, scientifically based methodological support and consultation should be part of any research network. Finally, a number of important aspects are discussed which should be taken into account to enhance research quality in medical rehabilitation in the future.
  Die Rehabilitation 07/2007; 46(3):145-54. · 1.36 Impact Factor
• Article: [Current teaching, learning and examination methods in medical education and potential applications in rehabilitative issues].

  S R Schwarzkopf, M Morfeld, M Gülich, W Lay, K Horn, W Mau
  [show abstract] [hide abstract]
  ABSTRACT: With introduction of the new Federal Medical Licensing Regulations (Approbationsordnung) in Germany, integrated teaching in "Rehabilitation, Physical Medicine, Naturopathic Treatment" (Querschnittsbereich Q12) has become obligatory for the first time. Furthermore, the new Regulations require the medical faculties in Germany to realize an innovative didactic orientation in teaching. This paper provides an overview of recent applications of teaching techniques and examination methods in medical education with special consideration of the new integrated course Q12 and further teaching methods related to rehabilitative issues. Problem-oriented learning (POL), problem-based learning (PBL), bedside teaching, eLearning, and the examination methods Objective Structured Clinical Examination (OSCE) and Triple Jump are in the focus. This overview is intended as the basis for subsequent publications of the Commission for Undergraduate and Postgraduate Training of the German Society of Rehabilitation Science (DGRW), which will present examples of innovative teaching material.
  Die Rehabilitation 05/2007; 46(2):64-73. · 1.36 Impact Factor
• Chapter: Beurteilung der funktionalen Gesundheit und der Kontextfaktoren (Assessmentverfahren)

  M. Morfeld, C. Bergelt, U. Koch
  01/2007: pages 20-25;