Psychosomatic Inpatient Treatment Achieves in the Medium Term Sustainable Clinical Improvement as well as a Reduction in Utilization of Medical Services-Results of a one-year follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. s784-s784
Author(s):  
J. Valdes-Stauber ◽  
S. Merath ◽  
S. Krämer
Keyword(s):  
Drop Out ◽  
Medical Services ◽  
Medium Term ◽  
Post Discharge ◽  
Doctor Visits ◽  
Drop Out Rate ◽  
One Year ◽  
Hospital Days

BackgroundThe research on sustainability of effectiveness of inpatient psychosomatic treatment is necessary for epidemiological and economic reasons as well as towards their legitimacy.Objectives and aimsTo investigate whether the achieved clinical improvement by the inpatient treatment continues one year after discharge and whether the utilization of medical services display a significant reduction post-discharge compared to the year before admission.MethodsNaturalistic 1 year follow-up study of a cohort (n = 122). Three measuring time points: T1 (discharge), T2 (6 months after discharge; drop-out rate about 33%), T3 (12 months after discharge; drop-out rate about 49%). Assessment by means of standardized tests of changes in clinical variables, self-efficacy, quality of life, and personality between discharge and one year after discharge. Utilization variables (hospital days, days of incapacity, medication and doctor visits) were compared with ranges in the year before admission.ResultsImprovements at discharge in general functionality, psychological and somatic stress, depressiveness, bitterness level, quality of life and self-efficacy remain one year after discharge sustainably. Furthermore, hospital days, days of incapacity, number of doctor visits and of prescribed drugs decreased significantly in comparison with the year prior to admission.ConclusionsInpatient psychotherapy is effective not only in short-term but also in medium-term. One year after discharge clinically improvement at discharge time-point remains stable and the utilization of medical services decreased significantly. Longer periods of observation, identification of risk groups and of resilient prognostic factors, as well as ensuring post-discharge care are necessary in order to prevent relapses and to made early interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Fresh Symptom Emergence After Intensive Behaviour Therapy

1976 ◽  
Vol 129 (4) ◽  
pp. 378-383 ◽  
Author(s):  
R. Julian Hafner
Keyword(s):  
Symptomatic Treatment ◽  
Drop Out ◽  
Treatment Programme ◽  
Behaviour Therapy ◽  
Personal Adjustment ◽  
Drop Out Rate ◽  
Wide Range ◽  
One Year

SummaryThe outcome of a standard four-day intensive symptomatic treatment programme with 39 agoraphobics is examined in relation to the incidence of fresh symptom emergence. Twenty-six patients suffered fresh symptom emergence during follow-up, and there was a significant association of fresh symptom emergence with poorer outcome at one-year follow-up. About 18 per cent of patients were adversely affected by the treatment programme, as judged on a wide range of symptoms and measures of inter- and intra-personal adjustment. Sixteen individually treated patients are then compared with the 39 group-treated patients and differences in drop-out rate are discussed.

scholarly journals Fear of Falling, Recurrence of Falls, and Quality of Life in Patients with a Low Energy Fracture—Part II of an Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 584
Author(s):  
Puck C. R. van der Vet ◽  
Jip Q. Kusen ◽  
Manuela Rohner-Spengler ◽  
Björn-Christian Link ◽  
Roderick M. Houwert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Low Energy ◽  
Activity Levels ◽  
Activity Restriction ◽  
One Year ◽  
Falls In Elderly

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.

scholarly journals Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Monticone ◽  
Igor Portoghese ◽  
Daniele Cazzaniga ◽  
Valentina Liquori ◽  
Giuseppe Marongiu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Group Differences ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
One Year ◽  
Task Oriented

Abstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF. Methods By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients’ specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05). Results Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up. Conclusions A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months. Trial registration On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552.

The twelve-month outcome of patients with neurotic illness in general practice

1981 ◽  
Vol 11 (3) ◽  
pp. 535-550 ◽  
Author(s):  
A. H. Mann ◽  
R. Jenkins ◽  
E. Belsey
Keyword(s):  
Social Life ◽  
Function Analysis ◽  
Psychiatric Morbidity ◽  
The Social ◽  
Assessment Measures ◽  
Psychiatric State ◽  
One Year

SYNOPSISOne hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.

scholarly journals 357 Factors associated with changes in health-related quality of life in children with cystic fibrosis during one-year follow-up

2017 ◽  
Vol 16 ◽  
pp. S154
Author(s):  
M. Van Horck ◽  
B. Winkens ◽  
G. Wesseling ◽  
K. de Winter-de Groot ◽  
I. De Vreede ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related ◽  
One Year

Seurantatutkimus erikoissairaanhoidon kuntoutustutkimuspotilaiden työmarkkinatilanteesta, elämänlaadusta sekä koetusta työ- ja toimintakyvystä

Kuntoutus ◽  
2021 ◽  
Vol 44 (4) ◽  
pp. 5-17
Author(s):  
Minna Savinainen ◽  
Elina Lindgren ◽  
Hannu Heikkilä
Keyword(s):  
Quality Of Life ◽  
Labor Market ◽  
Work Ability ◽  
Market Situation ◽  
Perceived Work Ability ◽  
Professional Assessment ◽  
Sickness Benefits ◽  
One Year

Työurien pidentämisessä ja työhön osallistumisen lisäämisessä oleellista on tukea myös osatyökykyisten henkilöiden työhön kiinnittymistä ja työssä jatkamista. Tutkimuksen tavoitteena oli selvittää erikoissairaanhoidon kuntoutustutkimuspotilaiden (N = 238) työmarkkinatilanteen, sairausetuuksien käytön, elämänlaadun sekä työ- ja toimintakyvyn muutoksia vuoden kuluttua kuntoutustutkimuksesta. Kuntoutustutkimuksessa olleiden osallistuminen työmarkkinoille sekä ammatilliseen kuntoutukseen lisääntyi ja samalla sairausetuuksien käyttö väheni. Potilaiden elämänlaatu, koettu terveys ja työkyky sekä itsestä huolehtiminen paranivat. Vastaavasti kognitiivinen ja fyysinen toimintakyky sekä osallisuus heikkenivät. Systemaattisella ja moniammatillisella työ- ja toimintakyvyn arvioinnilla voidaan saavuttaa vaikuttavia suunnitelmia työllistymisen edistämiseksi. Abstract Follow-up study on the labor market situation, quality of life and perceived work ability and functioning of patients of a rehabilitation outpatient clinicIn order to prolong working careers and increase participation in work, it is also important to support the attachment and continuation of people with partial ability to work. The aim of the study was to find out the changes in the labor market situation, the use of sick leave, quality of life, and work ability and functioning of the outpatient clinic of the Department of Physical Medicine and Rehabilitation (N=238) during one-year follow-up. Participation in the labor market and vocational rehabilitation of those who participated in rehabilitation increased, and at the same time the use of sickness benefits decreased. Patients’ quality of life, perceived health and work ability, and self-care improved. Correspondingly, cognitive and physical functioning as well as inclusion were impaired. Systematic and multi-professional assessment of work ability and functioning can lead to effective plans to promote employment. Keywords: rehabilitation, employment status, quality of life, work ability, functioning

scholarly journals PROGNOSTIC FACTORS OF LUMBAR DISCECTOMY RECOVERY.A PROSPECTIVE ANALYSIS

2017 ◽  
Vol 16 (4) ◽  
pp. 283-287
Author(s):  
Thiago Kolachinski Brandão ◽  
André Nunes Machado ◽  
Bruno Vieira Moter ◽  
Adriano Masayuki Yonezaki ◽  
Fabrício Hidetoshi Ueno ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Short Form ◽  
Lumbar Discectomy ◽  
Social Aspect ◽  
Prospective Analysis ◽  
Domain Functional ◽  
One Year ◽  
Short Form Health

ABSTRACT Objective: To perform a prospective analysis of the quality of life prognostic factors in patients undergoing lumbar discectomy after two years of the procedure, relating the tools Short Form Health Survey, Roland Morris, Oswestry Disability Index, and VAS. Methods: Seventy-two patients were evaluated through the questionnaires in the preoperative, and one month, six months, one year and two years in the postoperative period, being performed lumbar discectomy after failure of conservative treatment. Results: We observed an improvement in comparative analysis during follow-up regarding baseline values. Conclusion: The domains social aspect, pain, general state, emotional aspect, mental health and vitality presented an improvement from the first month after the surgery; however, the domain functional capacity only showed significant improvement after 6 months and the physical aspects only after one year. Roland-Morris and VAS scales improved after one month after surgery, but Oswestry scale showed that for the measured aspects there was only improvement after six months of surgery.

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