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《综合性多模式住院方案对新冠后综合征患者疲劳和工作能力的影响:一项前瞻性观察研究》

Effects of an integrative multimodal inpatient program on fatigue and work ability in patients with Post-COVID Syndrome-a prospective observational study.

机构信息

Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, 96049, Bamberg, Germany.

Department of Integrative Medicine, Medicinal Faculty, University of Duisburg-Essen, 96049, Bamberg, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2024 Dec;274(8):1983-1991. doi: 10.1007/s00406-024-01792-1. Epub 2024 Apr 5.

Abstract

Post-COVID syndrome (PCS) is characterized by a variety of non-specific symptoms. One of the leading symptoms is fatigue. So far, there is no evidence-based causal therapy established and treatment of PCS is primarily symptom-oriented. The Clinic for Internal and Integrative Medicine in Bamberg, Germany, offers a comprehensive multimodal integrative inpatient therapy for PCS patients. Within a prospective uncontrolled observational study, the results of N = 79 patients were analysed. Post-COVID fatigue patients were hospitalized for up to 14 days. The treatment consists of individual modules depending on the patient's needs. It includes a wide range of integrative non-pharmacological treatment modalities. Outcomes were assessed before and after the inpatient treatment as well as 6 months after discharge from the hospital. Results show that fatigue of post-COVID patients in this study (M = 76.30, SD = 10.18, N = 64) was initially significantly higher than in the subsample "women aged 60-92 years" of the general German population (M = 51.5, Schwarz et al. [Schwarz et al. in Onkologie 26:140-144, 2003]; T(63) = 19.50, p < .001). Fatigue was significantly and clinically relevant reduced directly after discharge (M = 76.21, SD = 11.38, N = 42; M = 66.57, SD = 15.55, N = 42), F(1, 41) = 19.80, p < .001, partial eta squared = .326, as well as six months after discharge (M = 65.31, SD = 17.20, N = 42), F(1, 41), p < .001, partial eta squared = .371. Additionally, self-reported ability to work (NRS, 0-10) improved significantly from admission (M = 2.54, SD = 2.23, N = 39) to discharge (M = 4.26, SD = 2.60, N = 39), F(1, 38) = 26.37, p < .001, partial eta squared = .410), as well as to six months later (M = 4.41, SD = 3.23, N = 39), F(1, 38) = 15.00, p < .001, partial eta squared = .283. The study showed that patients suffering from chronic post-COVID syndrome for several months can achieve a significant improvement in their leading fatigue symptoms and a significant improvement in the subjective assessment of their ability to work through a comprehensive two-week multimodal integrative inpatient program.

摘要

新冠后综合征(PCS)的特点是多种非特异性症状。主要症状之一是疲劳。到目前为止,还没有建立基于证据的因果治疗方法,PCS 的治疗主要是对症治疗。德国班贝格的内科和整合医学诊所为 PCS 患者提供全面的多模式整合住院治疗。在一项前瞻性非对照观察性研究中,分析了 79 名患者的结果。新冠后疲劳患者住院治疗长达 14 天。治疗包括根据患者需求而定的个体化模块。它包括广泛的整合非药物治疗方式。在住院治疗前后以及出院后 6 个月评估结果。研究结果表明,本研究中新冠后疲劳患者的疲劳程度(M=76.30,SD=10.18,N=64)明显高于一般德国人群中“60-92 岁女性”亚组(M=51.5,Schwarz 等人,[Schwarz 等人在 Onkologie 26:140-144, 2003];T(63)=19.50,p<.001)。疲劳在出院后直接显著且具有临床意义地降低(M=76.21,SD=11.38,N=42;M=66.57,SD=15.55,N=42),F(1, 41)=19.80,p<.001,部分 eta 平方=0.326,出院后 6 个月(M=65.31,SD=17.20,N=42),F(1, 41),p<.001,部分 eta 平方=0.371。此外,自我报告的工作能力(NRS,0-10)从入院(M=2.54,SD=2.23,N=39)到出院(M=4.26,SD=2.60,N=39)显著改善,F(1, 38)=26.37,p<.001,部分 eta 平方=0.410),以及 6 个月后(M=4.41,SD=3.23,N=39),F(1, 38)=15.00,p<.001,部分 eta 平方=0.283。研究表明,患有慢性新冠后综合征数月的患者可以通过全面的两周多模式整合住院治疗方案显著改善主要疲劳症状,并显著改善主观工作能力评估。

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