Department of Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
BMC Psychiatry. 2022 Oct 13;22(1):642. doi: 10.1186/s12888-022-04300-8.
Stress-induced exhaustion disorder is a major challenge in Swedish working life. Despite its increase in prevalence, there is still limited knowledge about the effectiveness of different rehabilitation methods. In this study, we aim to describe the healthcare utilisation for patients with stress-induced exhaustion disorder before, during and after a multi-modal rehabilitation (MMR) programme, as well as the health-related quality of life, work ability, sick leave level and psychological measures, and their possible relations.
In this longitudinal observational study, 53 patients who were part of an MMR programme at the Stress Rehabilitation Clinic participated with survey data, and among them 43 also contributed with healthcare data. Data were collected from one year before start of MMR to one year after the end of it. The patients also answered a questionnaire at the start of, end of and at a one-year follow-up of the MMR, which included questions about health-related quality of life, work ability, clinical burnout, sick leave level, anxiety and depression.
There was a statistically significant increase in healthcare consumption during MMR, if including visits to the Stress Rehabilitation Clinic, while it decreased if excluding such visits, when comparing with before and after MMR. During the follow-up period there was a non-statistically significant (p=0.11), but still rather large difference (15.4 compared with 12.0 visits per patient), in healthcare consumption in comparison with the period before MMR, when excluding follow-up visits at the Stress Rehabilitation Clinic. Health-related quality of life was rated as poor before MMR (mean 0.59). There was a statistically significant improvement, but values were still below normal at the end of follow-up (mean 0.70). In addition, the level of sick leave, the work ability and signs of clinical burnout improved statistically significantly after MMR, but were not fully normalised at the end of follow-up. Individual healthcare consumption was related to residual health problems.
Patients with stress-induced exhaustion disorder have not reduced their healthcare consumption notably after MMR, and residual health problems remain for some patients. More studies are needed for a deeper understanding of the individual effectiveness of MMR, and also of its cost-effectiveness.
应激相关耗竭障碍是瑞典工作生活中的一个主要挑战。尽管其患病率有所增加，但对于不同康复方法的效果仍知之甚少。在这项研究中，我们旨在描述接受多模式康复（MMR）治疗前后患有应激相关耗竭障碍患者的医疗保健利用情况，以及健康相关生活质量、工作能力、病假水平和心理测量结果，并探讨它们之间可能的关系。
在这项纵向观察性研究中，53 名参加应激康复诊所 MMR 项目的患者参与了调查数据的收集，其中 43 名患者还提供了医疗保健数据。数据收集从 MMR 开始前一年到结束后一年。患者还在 MMR 开始时、结束时和结束后一年进行了一次随访，回答了关于健康相关生活质量、工作能力、临床倦怠、病假水平、焦虑和抑郁的问题。
如果包括应激康复诊所的就诊次数，那么在 MMR 期间医疗保健的使用量会出现统计学上的显著增加，而如果不包括此类就诊次数，与 MMR 前后相比则会出现下降。在随访期间，与 MMR 前相比，当排除应激康复诊所的随访就诊次数时，医疗保健的使用量仍然存在非统计学上的显著差异（p=0.11），但差异仍然较大（每位患者 15.4 次就诊，而 12.0 次就诊）。在 MMR 之前，健康相关生活质量被评定为较差（平均 0.59）。在随访结束时，有统计学上的显著改善，但仍低于正常值（平均 0.70）。此外，在 MMR 后，病假水平、工作能力和临床倦怠迹象均有统计学上的显著改善，但在随访结束时仍未完全正常化。个体医疗保健的使用量与残留健康问题有关。
应激相关耗竭障碍患者在 MMR 后并没有显著减少医疗保健的使用量，一些患者仍存在残留的健康问题。需要进一步研究，以更深入地了解 MMR 的个体效果及其成本效益。
