[Forms of Use of Psychosomatic Rehabilitation by Patients - A Study on the Significance of the Moment of Entrance in the Rehabilitation Setting and the Dependence on the Individual Situation at Admission to Rehabilitation].

Background And Aims: As expectancies of patients and physicians in psychosomatic rehabilitation are not always congruent, we focused on the patients' subjective expectancies toward rehabilitation in relation to the perceived benefit of the treatment for return to work and on the individual forms of utilization of the therapeutic services in the setting of psychosomatic clinics. A special focus was given to the changes in the patients' evaluations and coping behaviours over a follow-up period of 18 months.

Methods: N=105 participants (F-3/F-4 Main-Diagnosis, specific vocational problems, under 3 months jobless) of 4 psychosomatic rehabilitation settings were asked for their situation at the end of the rehabilitation by means of a questionnaire. 33 patients out of the questionnaire-sample who consented to participate were interviewed for 3 times (6, 12 and 18 months after release from the clinic) by means of episodic-narrative interviewing technique.

Results: Some characteristic expectancies and modes of use of the psychosomatic rehabilitation setting by the patients could be identified. The uses of the clinics' therapeutic services by the patients are pointing to different subjective felt needs that correlate with the state of coping with the illness and other psychosocial features at the moment of entrance in the rehabilitation setting. The patients' actual situation can be identified by retrospective tracing his/her positioning on an ideal-typed trajectory of the whole illness process from the beginning of the first symptoms up to Return to work. The results give hints for more individualised and person-centred propositions in rehabilitation-settings.