Kremsreiter K, Henrich G, Book K, Herschbach P, Marten-Mittag B, Dinkel A
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München.
Gesundheitswesen. 2013 May;75(5):317-20. doi: 10.1055/s-0032-1321746. Epub 2012 Aug 3.
This explorative study investigated associations among the amount of different rehabilitative interventions, based on the classification of therapeutic procedures codes (KTL), and long-term health-related quality of life in patients with cancer or rheumatoid arthritis.
3 therapeutic modules of rehabilitative interventions were defined on the basis of KTL codes: (i) somatic interventions, (ii) psychological interventions, and (iii) medical counselling. Based on a median-split, patients were classified in 2 groups with low vs. high amount of rehabilitative interventions. Health-related quality of life was assessed on admission, at discharge from rehabilitative stay, as well as 3 and 12 months after discharge using the SF-12 health survey.
166 patients with chronic arthritis and 159 patients with cancer undergoing inpatient rehabilitation were included in the analysis. Arthritis patients who received a high amount of somatic interventions showed a significant improvement in the SF-12 mental health component summary score up to 12 months after discharge (p<0.05). Cancer patients who received a high amount of psychological interventions showed higher SF-12 physical health component summary scores at 3 and 12 months follow-up (p<0.05).
The results suggest differential relationships between amount of rehabilitative interventions and long-term rehabilitation outcome in 2 different disease groups. Routine classification of rehabilitative procedures (KTL) codes can be used for analysing dose-response relationships, although open questions remain concerning the validity of KTL codes.
本探索性研究基于治疗程序编码(KTL)分类,调查了不同康复干预措施的数量与癌症或类风湿性关节炎患者长期健康相关生活质量之间的关联。
基于KTL编码定义了3个康复干预治疗模块:(i)躯体干预,(ii)心理干预,以及(iii)医学咨询。根据中位数分割法,将患者分为康复干预措施数量低与高的两组。使用SF-12健康调查在入院时、康复住院出院时以及出院后3个月和12个月评估健康相关生活质量。
166例慢性关节炎患者和159例接受住院康复的癌症患者纳入分析。接受大量躯体干预的关节炎患者在出院后长达12个月时,SF-12心理健康成分汇总评分有显著改善(p<0.05)。接受大量心理干预的癌症患者在随访3个月和12个月时,SF-12身体健康成分汇总评分更高(p<0.05)。
结果表明2个不同疾病组中康复干预措施数量与长期康复结局之间存在不同的关系。康复程序(KTL)编码的常规分类可用于分析剂量反应关系,尽管关于KTL编码的有效性仍存在未解决的问题。