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[The Significance of Chronic Fatigue in the Post-Covid Consultation and its Consequences for Outpatient Rehabilitation in the Context of Statutory Accident Insurance].
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- Author(s): Dalichau S;Dalichau S; Kordy H; Kordy H; Klüver J; Klüver J; Brinkmeier W; Brinkmeier W; Rathmann N; Rathmann N; Yorke L; Yorke L; Kleefmann J; Kleefmann J; Möller T; Möller T
- Source:
Psychotherapie, Psychosomatik, medizinische Psychologie [Psychother Psychosom Med Psychol] 2024 Jul; Vol. 74 (7), pp. 265-275. Date of Electronic Publication: 2024 Mar 16.- Publication Type:
English Abstract; Journal Article- Language:
German - Source:
- Additional Information
- Transliterated Title: Die Bedeutung der Chronischen Fatigue in der Post-COVID-Sprechstunde und ihre Konsequenzen für die ambulante Rehabilitation im Kontext der gesetzlichen Unfallversicherung.
- Source: Publisher: Thieme Country of Publication: Germany NLM ID: 8002823 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-1058 (Electronic) Linking ISSN: 09372032 NLM ISO Abbreviation: Psychother Psychosom Med Psychol Subsets: MEDLINE
- Publication Information: Original Publication: Stuttgart ; New York : Thieme, c1980-
- Subject Terms:
- Abstract: Objective: The post-COVID consultation (PCC) is offered as part of a comprehensive range of treatment services provided by the statutory accident insurance for post-COVID patients to determine individual recommendations for further care. The aim of the study was to record the main symptoms and the associated restrictions on social and occupational participation in order to derive consequences for outpatient rehabilitation.
Method: In addition to a medical examination and a psychological consil, numerous assessments were carried out to evaluate the biopsychosocial state of health. 373 female (82.2%) and 81 male patients aged between 40 and 60 years from the professions of health and care services, education and pedagogy participated in the PCC since April 2021.
Results: Nearly all patients (98.2%) reported fatigue as a cardinal symptom of their post-COVID complaints, in combination with subjectively experienced limitations in brain functioning in over 73% of cases. The duration of the symptomatology persisted for an average of 14-15 months in both female and male insured persons. Thus, over 85% of the total sample can be classified as cases of chronic fatigue (Fatigue Scale). The severity of fatigue also proportionally affects quality of life (SF-36), feelings of anxiety and depression (HADS), psychological resilience (RS-13), and motor parameters such as maximum grip strength and endurance capacity. 54.3% of the patients also received a suspected mental diagnosis and 38.1% a recommendation for further neuropsychological diagnostics.
Conclusion: For further treatment of the leading symptom of chronic fatigue, a multimodal and interdisciplinary outpatient rehabilitation is recommended, which should be oriented towards the treatment of the diagnosis of chronic fatigue syndrome (ME/CFS) and thus in particular towards a psychoeducational and rather than a curative therapeutic approach, and should consider aftercare strategies. Confirmed mental disorders and neuropsychological deficits are to be treated in addition.
Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
(Thieme. All rights reserved.) - Contributed Indexing: Local Abstract: [Publisher, German] ZIEL: Die Post-COVID-Sprechstunde (PCS) wird im Rahmen eines umfassenden Behandlungsangebotes der gesetzlichen Unfallversicherung für Post-COVID-Patient*innen durchgeführt, um individuelle Empfehlungen für die weitere Versorgung festzulegen. Ziel der Untersuchung war die Erfassung der Hauptsymptome sowie die damit verbundenen Einschränkungen der sozialen und beruflichen Teilhabe, um Konsequenzen für die ambulante Rehabilitation abzuleiten. [Publisher, German] Neben einer ärztlichen Untersuchung sowie einem psychologischen Konsil wurden zahlreiche Assessments zur Evaluation des biopsychosozialen Gesundheitszustands durchgeführt. 373 weibliche (82,2%) und 81 männliche Patient*innen im Alter zwischen 40 und 60 Jahren aus den Berufen der Gesundheits- und Pflegedienste, der Erziehung und Pädagogik nahmen seit April 2021 an der PCS teil. [Publisher, German] Nahezu alle untersuchten Patient*innen (98,2%) gaben Fatigue als Kardinalsymptom ihrer Post-COVID-Beschwerden an, in über 73% der Fälle in Kombination mit subjektiv erlebten Einschränkungen der Hirnleistungsfähigkeit. Die Dauer der Symptomatik persistierte dabei sowohl bei den weiblichen als auch männlichen Versicherten durchschnittlich seit 14–15 Monaten. Somit sind über 85% der Gesamtstichprobe als Fälle chronischer Erschöpfung (Fatigue Skala) einzustufen. Die Schwere der Fatigue beeinflusst zudem proportional die Lebensqualität (SF-36), Gefühle von Angst und Depression (HADS), die psychische Widerstandskraft (RS-13) sowie motorische Parameter wie die maximale Greifkraft und die Ausdauerleistungsfähigkeit. 54,3% der Versicherten erhielten zudem eine psychische Verdachtsdiagnose und 38,1% die Empfehlung zu einer weiterführenden neuropsychologischen Diagnostik. [Publisher, German] Zur weiteren Behandlung des Leitsymptoms der chronischen Fatigue ist eine multimodale und interdisziplinäre ambulante Rehabilitation zu empfehlen, die sich an der Behandlung der Diagnose des Chronischen Fatiguesyndroms (ME/CFS) und somit insbesondere an einem psychoedukativen und weniger an einem kurativen Therapieansatz orientieren und Nachsorgestrategien berücksichtigen sollte. Gesicherte psychische Störungen und neuropsychologische Defizite sind begleitend zu behandeln.
- Publication Date: Date Created: 20240316 Date Completed: 20240705 Latest Revision: 20240705
- Publication Date: 20240706
- Accession Number: 10.1055/a-2266-3441
- Accession Number: 38492566
- Transliterated Title:
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