Gesundheitsbezogene Kontrollüberzeugung und Lebensqualität bei chronisch Kranken nach stationärer Behandlung mit Integrativer Medizin – eine Beobachtungsstudie

Abstract

Health-Related Control Belief and Quality of Life in Chronically Ill Patients after a Behavioral Intervention in an Integrative Medicine Clinic – an Observational Study Background: In 1999 the Clinic for Internal Medicine and Integrative Medicine was founded in Essen as a regular part of the German inpatient health care system. Integrative medicine (standard internal medicine, evidence-based complementary and alternative medicine combined with intensified lifestyle modification) aims to help patients with chronic illness to cope with their condition more effectively and to achieve a health-promoting lifestyle. Techniques include cognitive restructuring, the elicitation of the relaxation response, and lifestyle education. The goal is to increase health-related quality of life (QoL) as well as control beliefs and to reduce morbidity in later life. Aim: To demonstrate changes in quality of life, lifestyle, and control beliefs after a two-week hospital stay. Methods: Uncontrolled prospective observational study with 557 consecutive hospital patients. Outcome parameters were quality of life (SF36), control beliefs (GKÜ), and daily health-related behavior (nutrition, physical activity, relaxation) on admission, at discharge, as well as 3 and 6 months after discharge. Results: Weekly physical activity increases by 29%, consumption of not recommendable foods decreases by 18%. The majority of patients (57%) engage in relaxation exercises 6 months after discharge (on admission 23%). The physical sum scale (SF36) increases from 33.9 (95% KI 32.5–35.3) on admission to 37.3 (35.8–38.9) 6 months after discharge, the mental sum scale from 41.2 (39.5–42.9) to 45.1 (43.5–46.7). The ratio internal/external control belief rises from 1.17 (95% KI 1.11–1.24) to 1.32 (1.24–1.40). Pretherapeutic ratio internal/external control belief and its increase are associated with rises in QoL. Conclusions: After integrative medicine treatment a lasting increase in QoL and lifestyle changes can be achieved. Reinforcement of internal control beliefs and own competence is possible and enhances outcomes in chronically ill patients.