# Assessing Self-Help Orientation Among German Rehabilitation Clinics: Website Content Analysis

## TL;DR

This study analyzed German rehabilitation clinic websites to assess how well they promote self-help, finding that most have low self-help orientation despite its importance in patient-centered care.

## Contribution

The study introduces a new 16-criteria coding instrument to measure self-help orientation on clinic websites and is the first to analyze this aspect in German rehabilitation clinics.

## Key findings

- 61% of clinics scored low on self-help orientation, with 41.8% showing none at all.
- Oncology, neurology, and addiction clinics were more likely to have higher self-help orientation scores.
- Facility size, sponsorship, and number of indication areas did not significantly affect self-help orientation.

## Abstract

Patient-centeredness has become a guiding principle of delivering quality health care. Integrating self-help services in health care facilities through collaboration is a vital part of this, specifically in rehabilitation. Despite increasing efforts to promote cooperation between rehabilitation clinics and self-help groups and organizations in Germany, implementation remains inconsistent, and research on this is particularly limited.

This study sought to examine the “self-help friendliness” (SHF) 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 as an indicator of SHF to assess which clinic criteria are associated with self-help presentation on the clinic websites.

A quantitative content analysis of 400 randomly chosen rehabilitation clinic websites was conducted as 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 to 16 points. Univariate analyses describe the score distributions. Binomial logistic regression analyses were performed to determine the self-help orientation on the websites depending on characteristics of the rehabilitation clinics (size, indication area, and sponsorship).

Of the 400 clinics, 61.0% (n=242) scored low on self-help orientation, with the majority (41.8%; n=167) not being self-help oriented at all. Conversely, 39.5% (n=158) of the clinic websites demonstrated high self-help orientation, with 7.3% (n=29) of them achieving exceptional scores. Overall, a mean 4.4 (SD 4.1) of 16 points was reached and basic self-help orientation criteria were fulfilled by the clinics. Regression analysis revealed clinics covering the indication areas: oncology (odds ratio [OR] 2.64; P=.01), neurology (OR 2.73; P=.003) 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.

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 SHF, integrating self-help closely into clinic missions and treatment plans and considering the criteria developed in designing clinic websites to increase patient orientation.