2018/03/06 by Hass, Holger G., Muthny, Fritz, Stepien, Jürgen +5
Medicine · #610 Medical sciences #Brustkrebs #HADS #IRES-24 #Medicine #Patientenschulung #breast cancer #inpatient rehabilitation #onkologische Rehabilitation #patient education
paper · doi:10.3205/ors000034
Background: Especially for oncological patients lifestyle modifications are important since an association between physical activity and improved outcomes in cancer survivors was demonstrated. Therefore, patient motivation is necessary to change longtime lifestyle habits. In this study feasibility and long-term effects of a standardized patient education program during inpatient rehabilitation were analyzed. Methods: 316 breast cancer patients (mean age 47.5 y) were randomized to the standard information program (control group/phase I: n=172) or to a standardized patient education intervention (phase II: n=144). Patients were evaluated by standardized questionnaire at T1 (start of inpatient rehabilitation), T2 (after 3 weeks/end of inpatient rehabilitation) and T3 (six months after inpatient rehabilitation) including IRES-24 and HADS questionnaire. Results: To evaluate the effects of the new patient education program a multifactorial analysis was performed (IRES-24 Score, HADS-fear/ depression value). The main effect of IRES-24 was significant depending on time (P<0.001) but not different in the study groups. For the HADS scores similarly significant effects (between d=.58 and d=.82) depending on time were documented but no effect of the intervention was seen. Conclusions: A standardized patient education program is feasible with high patient acceptance. However, an improvement of long-term effects by the new patient education intervention was not detected by IRES-24 and HADS questionnaire. Maybe due to the fact that in a complex multifactorial system like inpatient rehabilitation changes in only one therapeutic area could not lead to significant long-time effects. Today in specialized rehabilitation centers in Germany patient information and motivation is well integrated in the multimodal standard therapy maybe leading to a “ceiling effect” without significant effects of intensive education programs.