Rehabilitation for children and adolescents in Austria: A systematic analysis of evaluation methodologies

Research area: Rehabilitation and occupational therapy

Duration: April 2019 - October 2019
Suggested by: Main Association of Austrian Social Security Institutions
Language: German
Publication: LBI-HTA Project report No. 122: http://eprints.hta.lbg.ac.at/1222

Background:
The current Austrian rehabilitation plan (2016) earmarks a need for rehabilitation centres for children and adolescents across Austria in four supply regions with a total of 343 beds for children and adolescents and an additional 50 beds for parents and siblings within the family-oriented rehabilitation programme:

• Supply region 1: east (Lower Austria, Vienna, northern Burgenland)
• Supply region 2: south (Styria, Carinthia, southern Burgenland)
• Supply region 3: north (Upper Austria, Salzburg)
• Supply region 4: west (Tyrol, Vorarlberg)

The rehabilitation centres should cover 11 indication groups.

Area	Indication groups	(German) Abbreviation
Somatic area	Diseases of the musculoskeletal system and Rheumatology	BSR
	Cardiovascular diseases	HKE
	Paediatric surgical diseases	KCH
	Neurological diseases	NEU
	Neurosurgery	NC
	Pulmonary diseases	PUL
	Diseases of the metabolic and digestive system	STV
Mental Health Rehabilitation	Child and adolescent psychiatric disorders	KJP
	Developmental Disorders and Diseases for Social Paediatric Care/Paediatric Psychosomatic Diseases	ESP
Family-oriented rehabilitation	Oncology	FOR
	Stem cell transplantation

The family-oriented rehabilitation (FOR) for life-threatening diseases (e.g., oncological diseases) forms a crucial element in the construction of the rehabilitation centres. Within the FOR parents/ legal guardians and siblings are also included in the rehabilitation programme. Therefore, on the one hand, the programme aims to promote rehabilitation willingness and acceptance of the affected child for the therapeutic measures, while at the same time it helps to train parents to become co-therapists.

Aim of the project:
The aim of the project is the preparation of a subsequent evaluation of rehabilitation programmes for children and adolescents in Austria and thereby, providing an overview of evaluation methods and tools. As a result, a compendium of validated evaluation tools will be presented.

The envisaged project does not involve the detailed planning or implementation of an evaluation.

Research questions:

1. Which generic endpoints and/or outcome parameters in the field of rehabilitation for children and adolescents have been collected from reviews, evaluation reports, etc. in settings comparable to Austria?
2. Which indication-specific endpoints and/or outcome parameters in the field of rehabilitation for children and adolescents have been collected from reviews, evaluation reports, etc. in settings comparable to Austria?
3. Which measuring instruments have been used to collect the generic or the indication-specific endpoints and/or outcome parameters?
4. Which evaluation results have been achieved regarding rehabilitation programmes for children and adolescents?

Methods:
To answer the four research questions the following methods are used:

• Ad 1+3: A systematic review of evaluation methods for rehabilitation programmes for children and adolescents with the focus on generic outcomes and suitable measuring instruments (detailed description).
• Ad 2+3: A systematic review of evaluation methods for rehabilitation programmes for children and adolescents with the focus on indication-specific outcomes and suitable measuring instruments (broad overview).
• Ad 4: A systematic review of the evaluation results of rehabilitation programmes for children and adolescents in settings comparable to Austria (inpatient, generic).

In a first step, a systematic literature search on reviews and evaluation reports will be conducted.

The inclusion criteria for the systematic literature search are as follows:

Population	Children and adolescents, age 0-18 years
Intervention	Inpatient, medical rehabilitation for children and adolescents
Control	-
Outcomes	Generic (cross-indication) outcomes Indication-specific outcomes Measuring instruments for the collection of outcome parameters Evaluation results
Study design	Observational studies, reviews, evaluation reports, dissertations in German or English
Publication period	01/2000 until 05/2019

In addition to the systematic literature search, an extended hand search will be conducted and experts in the field of rehabilitation evaluation will be contacted.

Following the literature selection and investigation, the collected outcomes and measuring instruments, as well as the evaluation results will be extracted and summarised. The result will be a qualitative evidence synthesis and a compendium of validated evaluation tools.

All processing steps (literature selection, data extraction, if necessary, quality assessment) will be conducted by one researcher and monitored by a second researcher.

Time schedule:

Period	Task
April-May 2019	Scoping, project protocol, systematic literature search, literature selection, additional hand search, first contact with experts
June – July 2019	Data extraction
August – September 2019	Writing/drafting of report
October 2019	Internal and external review

References:

Gyimesi M., Fülöp, G., Ivansits S., Pochobradsky E., Stoppacher A., Kawalirek S., Maksimovic A. Rehabilitationsplan 2016. Gesundheit Österreich, Wien.

Winkler R., Piso, B. Mental Health Rehabilitation bei Kindern und Jugendlichen – Literaturübersicht zu Indikationen, Ergebnisparametern und Messinstrumenten für Evaluierungen. LBI-HTA Projektbericht Nr.: 67; 2013. Wien: Ludwig Boltzmann Institut für Health Technology Assessment.

Pammer C., Abuzahra M., Wild C. Schweregraddifferenzierung in der neurologischen und Trauma-rehabilitation Teil 1: Messinstrumente bei Schlaganfall und Schädel-Hirn-Trauma. LBI-HTA Projektbericht Nr.: 023a; 2009. Wien: Ludwig Boltzmann Institut für Health Technology Assessment.