Die prognostische Bedeutung von ICF-Faktoren für die Umsetzung von Empfehlungen aus dem ärztlichen Entlassungsbericht nach einer stationären psychosomatischen Rehabilitation

Abstract

In this trial, the prognostic significance of ICF-related diagnostics compared to social and medical, disease-related and personal factors with regard to realization of recommendations given in the medical discharge report after the in-patient psychosomatic rehabilitation should be examined. ICF-related, social and medical, disease-related and personal prognostic factors were surveyed by questionnaires and interviews, on admission, discharge and 6 months after discharge from rehabilitation (time of catamnesis). As target criteria, realizations of recommendations from the fields of sports and exercise, psychotherapy and social medicine were chosen, they could be evaluated by telephone from N=344 participants at the time of catamnesis. For determination of relevant predictors, bivariate and multi-variate analyses were performed. 70% of patients realized the recommended sports and exercise, 45% the recommended psychotherapy and 44% a social and medical recommendation. With regard to the target criterion for the realization of recommended sports and exercise, the elevated prognostic factors had only a low prognostic value. For the prognosis of the target criterion of realizing a recommended psychotherapy, interpersonal problems and a low ability to interact in groups (Mini-ICF-APP) turned out to be relevant ICF-related predictors. Different problems (e. g., job-related conditions) appeared as relevant, ICF-related predictors concerning the realization of social and medical recommendations. Disturbances of reliability, self-evaluated by means of ICF AT-50 Psych, showed in the bivariate analyses significant correlations with the target criteria. Besides other variables, also ICF-supported attributes turned out to be suitable for the prognosis of target criteria. They should be evaluated and considered in the rehabilitation process.