Changes in Somatic, Behavioral, and Psychosocial Outcomes during the Inpatient Rehabilitation of Patients with Metabolic Syndrome
A Longitudinal Study of the META-Program
This study analyzed whether clinical, behavioral and psychosocial outcomes changed in patients who participate in a five weeks inpatient rehabilitation program addressing the metabolic syndrome (META-program) and whether changes were maintained at a three months follow-up.
At the beginning of the program, N=114 eligible patients consented to participate in the study. Behavioral and psychosocial outcomes were measured with standardized questionnaires at program entry, program completion and three months later. These outcome measures included eating behaviors, illness beliefs, health literacy and psychosocial health. Data analysis used t-tests for dependent samples and repeated measures ANOVAs for assessing change.
Most of the outcomes improved significantly across time with effect sizes frequently medium or larger. At program completion, this included, for example, blood pressure, fasting blood glucose and blood lipids. Improvements in self-reported eating behaviors at three months included an increase in eating and eating-related health promoting behaviors in terms of a more flexible control of one’s eating, sports, and compliance with nutrition recommendations. Illness beliefs also changed significantly: Symptom burden and concern decreased, while understanding of one’s illness increased towards the end of the program. Similarly, facets of psychosocial health also improved towards program completion. At three months follow-up, some facets of psychosocial health like somatoform disorder and depression deteriorated again slightly.
The significant and in part marked changes of the included outcomes are in line with the goals the META-program attempts to achieve. Future research on programs like the one under study here should include longer follow-up intervals and should use designs that allow interpreting observed changes as effects of participating in the program. This also would allow determining how changes in outcomes can be stabilized or even be enhanced in the long term.