[Is it possible to predict approval of medical rehabilitation by the extent of fatigue and subjective need for rehabilitation? Development, results and acceptance of a short screening].
OBJECTIVE
In earlier studies the lack of correlation between subjective need for rehabilitation of the applicant and the medically determined objective need for rehabilitation was reported again and again. The correlation between fatigue and subjective need for rehabilitation was not yet examined so far. Nevertheless fatigue is not defined sufficiently in the ICD, so interactions between chronic fatigue and somatic diseases are not taken into account appropriately. The following questions are considered: How high is the degree of chronic fatigue in insurees applying for rehabilitation? Is there a correlation between degree of fatigue and need for rehabilitation? Is it possible to predict approval of medical rehabilitation by fatigue and need for rehabilitation? How will insurees accept a screening accompanying their application for rehabilitation?


METHODS
The study is based on data of 500 (response rate 85.6%) insurees of the pension insurance Braunschweig-Hannover, who had applied for medical rehabilitation between 1/2004 and 3/2004. The screening instrument included: scales on functional activity, mobility, social support, coping (IRES), the Chalder Fatigue Scale, SCL 14, Items concerning need for rehabilitation. As statistical methods t-, chi (2)-test, correlations, covariance-analysis and regression analysis are used.


RESULTS
70.2% of the patients claiming rehabilitation reported relevant clinical symptoms of chronic fatigue. There were no differences in age, work status, motivation, or expectations of returning to work, but differences in sex. Patients with chronic fatigue met more citeria of need for rehabilitation. But the approval of medical rehabilitation could not be predicted by fatigue and need for rehabilitation. Nevertheless the acceptance of the screening was high in the insurees.


CONCLUSIONS
Patients with chronic fatigue met more criteria of need for rehabilitation. But the approval of medical rehabilitation could not be predicted by fatigue and need for rehabilitation. We assume that the reduction of activity and participation is associated with the degree of fatigue. It is discussed that the information an investigator may derive from a screening which is accepted by the insurees claiming medical rehabilitation will complete the collected clinical documents in a meaningful manner.
Kobelt
A
A
Deutsche Rentenversicherung Braunschweig-Hannover, Arztlicher Dienst, Lange Weihe 2, 30880 Laatzen. axel.kobelt@drv.bsh.de
Grosch
E
E
Wasmus
A
A
Ehlebracht-König
I
I
Schwarze
M
M
Krähling
M
M
Gutenbrunner
C
C
D000328:Adult; D000704:Analysis of Variance; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D012943:Social Security / Q000331:legislation & jurisprudence; D013223:Statistics as Topic; D011795:Surveys and Questionnaires