Article

International Journal of Behavioral Medicine

, Volume 20, Issue 1, pp 42-51

Open Access This content is freely available online to anyone, anywhere at any time.

Long-Term Outcomes Following Vocational Rehabilitation Treatments in Patients with Prolonged Fatigue

  • Margot C. W. JoosenAffiliated withCoronel Institute of Occupational Health, Academic Medical Center, University of AmsterdamSchool of Social and Behavioral Sciences, Tilburg University
  • , Monique H. W. Frings-DresenAffiliated withCoronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam
  • , Judith K. SluiterAffiliated withCoronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam Email author 

Abstract

Background

Multi-component vocational rehabilitation (VR) provides positive short-term outcomes in patients with prolonged fatigue.

Purpose

The purpose of this study is to evaluate the long-term outcomes of Dutch multi-component VR up to 18 months after treatment.

Method

In a pre–post-study, measurements were taken before treatment (t0), after treatment (t1) and in long-term follow-ups at 6 (t2), 12 (t3) and 18 months (t4) after treatment. Primary outcomes (fatigue, work participation and workability) and secondary outcomes [physical and social functioning, mental health and heart rate variability (HRV)] were assessed over time using linear mixed models analyses. Post hoc long-term outcomes were compared with t0 and t1.

Results

Sixty patients with severe fatigue complaints participated. The primary outcomes significantly (p < 0.001) improved at follow-ups compared with t0 and showed no relapse compared with t1. Moreover, fatigue decreased (p < 0.002) whereas workability (p < 0.001) and work participation (p < 0.001) increased further after treatment (t1). The secondary outcomes, physical functioning, mental health, social functioning and HRV, improved significantly (p < 0.001, p < 0.001, p < 0.001 and p = 0.049, respectively) over the long term compared with t0. At 6-month follow-up (t2), mental health (p < 0.003) and social functioning (p = 0.003) further increased after the treatment was stopped.

Conclusion

Multi-component VR treatments seem to significantly and in a clinically relevant way decrease fatigue symptoms and improve individual functioning and work participation in patients with severe prolonged fatigue over the long term and without showing relapse.

Keywords

Biopsychosocial intervention Multi-component treatment Practice-based research Prolonged fatigue complaints Return to work Work-directed intervention