von der Warth Rieka, Nau Anne, Rudolph Matthias, Bengel Jürgen, Glattacker Manuela
Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany.
Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany.
J Psychosom Res. 2022 Apr;155:110750. doi: 10.1016/j.jpsychores.2022.110750. Epub 2022 Feb 5.
Illness and treatment beliefs are important predictors of health outcomes. However, little is known about their impact on outcomes in psychosomatic rehabilitation. Thus, the aim of this study was to investigate the impact of illness and rehabilitation-related treatment beliefs in patients with mental disorders attending psychosomatic rehabilitation.
We applied a longitudinal study with two measurement points (before rehabilitation; end of rehabilitation) in a psychosomatic rehabilitation clinic. Patients with mood disorders, anxiety or fear-related disorders, stress associated disorders or bodily distress disorders were included. Using regression models, we analysed whether illness and rehabilitation-related treatment beliefs predicted the rehabilitation outcome (operationalised through "Health-49"). Illness beliefs were assessed using the IPQ-R, while treatment beliefs were assessed using the RTBQ-Psych. Analyses were conducted separately for patients with a F3 and F4 diagnosis in accordance with the ICD-10.
N = 239 patients were included, sample size per regression model ranged between n = 48 and n = 85. Mean age was 50.8 years, and n = 120 were female. Initial symptom burden was the strongest predictor in all models with 12% to 64% explained variance. Concerning illness beliefs, perceived consequences, treatment control, and cyclic timeline were negatively linked to the outcome, whereas coherence and emotional representations were shown to be positive predictors. Regarding treatment beliefs, expectations towards treatment results were positively and concerns were negatively associated predictors.
Illness and treatment beliefs are predictors of the rehabilitation outcome. Patients´ beliefs might therefore be good starting points for interventions in the context of rehabilitation.
疾病与治疗观念是健康结果的重要预测因素。然而，对于它们在身心康复中对结果的影响却知之甚少。因此，本研究的目的是调查疾病及与康复相关的治疗观念对接受身心康复的精神障碍患者的影响。
我们在一家身心康复诊所进行了一项具有两个测量点（康复前；康复结束时）的纵向研究。纳入了患有情绪障碍、焦虑或恐惧相关障碍、应激相关障碍或身体不适障碍的患者。我们使用回归模型分析疾病及与康复相关的治疗观念是否能预测康复结果（通过“健康-49”进行操作化）。使用IPQ-R评估疾病观念，使用RTBQ-Psych评估治疗观念。根据ICD-10对F3和F4诊断的患者分别进行分析。
共纳入239名患者，每个回归模型的样本量在n = 48至n = 85之间。平均年龄为50.8岁，女性有120名。在所有模型中，初始症状负担是最强的预测因素，解释方差在12%至64%之间。关于疾病观念，感知后果、治疗控制和周期性时间线与结果呈负相关，而连贯性和情感表征则是积极的预测因素。关于治疗观念，对治疗结果的期望是积极的预测因素，而担忧则是消极的预测因素。
疾病和治疗观念是康复结果的预测因素。因此，患者的观念可能是康复背景下干预措施的良好起点。
