Adipositas, Essverhalten und Persönlichkeitsstruktur – Erfolgreiche Veränderungen im Rahmen eines mehrwöchigen stationären Rehabilitationsaufenthaltes

Zusammenfassung: In der vorliegenden Studie wurde die Effizienz und Nachhaltigkeit eines psychologisches Behandlungsprogramms für adipöse RehabilitationspatientInnen (= PatientInnen mit Herz-Kreislauf- oder/und rheumatischen Erkrankungen) an 85 Patienten mittels Analyse zum Essverhalten (FEV) und zur Persönlichkeitsstruktur mittels des Freiburger Persönlichkeits-Inventars (FPI-R) evaluiert (Prä-, Post- und Katamneseuntersuchung mit Kontrollgruppendesign). Die Ergebnisse zeigen, dass das psychologische Programm bei den adipösen RehabilitationspatientInnen (N =53) zu einer erwünschten, vorteilhaften Veränderung des Essverhaltens führte. Einerseits nahm die kognitive Kontrolle des Essverhaltens, welche für eine erfolgreiche Gewichtsreduktion notwendig ist, erheblich zu; andererseits konnten negative Komponenten, nämlich die Störbarkeit des Essverhaltens sowie das Ausmaß an erlebten Hungergefühlen, deutlich reduziert werden. Auffallend gute Wirksamkeit bei weiblichen Patienten; wenngleich bei den Männern die erlebten Hungergefühle und der BMI sich ebenfalls nach 3 Monaten signifikant verminderten. Das Behandlungsprogramm zeigte unterschiedliche Effekte zwischen Rheuma- und Herz-Kreislaufpatienten.Abstract: Efficiency and sustainability of a psychological therapy programme for obese rehabilitation in-patients with cardiovascular and/or rheumatic diseases were studied by analyses of questionnaires concerning eating behaviour (FEV) and personality structure (Freiburger Persönlichkeitsinventar – FPI-R) of 85 obese patients. In this controlled study data were collected at admission, discharge, and follow-up after 1 year.The psychological programme resulted in an intended beneficial alteration of eating behaviour of the obese patients (N = 53). On the one hand, the cognitive control of eating behaviour that is needed for successful weight reduction increased significantly. On the other hand, negative components – in fact the disturb ability of eating behaviour and the extent of sensations of hunger – could be reduced significantly with differences in male and female. The therapy especially succeeded in female patients, although the sensations of hunger and the BMI of the male patients also reduced significantly after 3 months. The therapy programme also showed different effects regarding rheumatic or cardiovascular patients

Cardiac rehabilitation in Austria: long term health-related quality of life outcomes

<p>Abstract</p> <p>Background</p> <p>The goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.</p> <p>Methods</p> <p>Patients (N = 487, 64.7% male, age 60.9 ± 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].</p> <p>Results</p> <p>All MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.</p> <p>Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.</p> <p>Conclusion</p> <p>These findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.</p