[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.


OBJECTIVE
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 (GKU), 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.
Hoffmann
B
B
Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Germany. barbara.hoffmann@medizin.uni-essen.de
Moebus
S
S
Michalsen
A
A
Paul
A
A
Spahn
G
G
Dobos
G J
GJ
Jöckel
K H
KH
D001521:Behavior Therapy / Q000379:methods*; D002908:Chronic Disease / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012064:Relaxation Therapy; D016896:Treatment Outcome