title: [Female patients with fibromyalgia syndrome in somatic and psychosomatic rehabilitation center - an exploratory study on access routes and differences in patient characteristics].
abstract: OBJECTIVE
  Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group.
  
  
  METHODS
  Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership.
  
  
  RESULTS
  The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership.
  
  
  CONCLUSIONS
  Our results provide initial evidence of how FMS patients access the German rehabilitation system and which of their characteristics are responsible for being assigned to a particular rehabilitation setting.
authors.affiliation: Abteilung für Qualitätsmanagement und Sozialmedizin, Universitätsklinikum Freiburg.
authors.forename: A
authors.initials: A
authors.lastname: Ullrich
authors.forename: M
authors.initials: M
authors.lastname: Glattacker
authors.forename: M
authors.initials: M
authors.lastname: Sibold
authors.forename: U T
authors.initials: UT
authors.lastname: Egle
authors.forename: I
authors.initials: I
authors.lastname: Ehlebracht-König
authors.forename: W
authors.initials: W
authors.lastname: Geigges
authors.forename: V
authors.initials: V
authors.lastname: Köllner
authors.forename: M
authors.initials: M
authors.lastname: Kruse
authors.forename: W H
authors.initials: WH
authors.lastname: Jäckel
mesh_terms: D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D014850:Waiting Lists; D016387:Women's Health / Q000706:statistics & numerical data