Artikel
Inpatient rehabilitation for patients wih multiple myeloma / plasmacytoma: Rehabilitation needs and effects of an integrative program Stationäre Rehabilitation für Patienten mit Multiplem Myelom / Plasmozytom: Rehabilitationsbedarf und Effekte eine integrativen Programms
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Veröffentlicht: | 20. März 2006 |
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Incidence rates for multiple myeloma (MM) / plasmacytoma in Germany are about 3.500 patients per year. Improvements in therapeutic strategies, especially in haematopoietic stem cell therapy, have led to an increase in survival times, thus making MM a chronic disease for many patients. This leads to specific rehabilitation needs requiring the identification and treatment of disease- and treatment-related functional deficits. These squeal include, for example, muscle-skeletal symptoms, renal dysfunction, or a general susceptibility to infections. In recent years the rehabilitation unit of the Tumour Biology Center, Freiburg has developed a specific program for this group. Based on a bio-psycho-social model of rehabilitation, the program includes the assessment of myeloma-specific aspects (e.g. an oncologic-orthopedic conference to optimize support for patients with osteolysis and risk of bone fractures) and more general therapeutic approaches from different professions including nursing, physiotherapy, psycho-oncology, social work or nutrition therapy in order to reduce symptoms and to enhance physical abilities, emotional well-being, social integration and overall quality of life. In a prospective clinical trial we assessed the physical and psychosocial status, as well as the individual rehabilitation goals of 28 patients. Points of measurement were at admission and at discharge from the rehabilitation clinic. Effects of the rehabilitation program were assessed using several standardized instruments, covering health-related quality of life (EORTC-QLQ-C 30; core module plus myeloma-specific module MY 24), rehabilitation status (IRES), fatigue (MFI), affective status (HADS-D), coping with illness (TSK) and physical performance status (FFB-Mot). The mean age of our study sample was 60,0 years, with a range from 43 to 84 years. The majority of patients (68%) had been undergoing autologous stem cell therapy. The heterogeneity of the study sample is reflected by great differences in physical capacity and functional status. Our data show specific positive effects of the rehabilitation program in the areas of physical performance status and activities of daily living. Furthermore, patients` individual rehabilitation goals indicate a great need for information on disease-related topics and support in coping with the chronic illness. The predictors for rehabilitation outcome will be discussed on the basis of our results.