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Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise.

Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

Activities of Daily Living↗

[Evaluation of air hygiene in health resorts].

Concerning the maintenance and restoration of health in patients being subjected to health resort treatment, the spas play an important role. Therefore, legal provisions in this field establish the elimination of unfavourable environmental conditions, as air pollution, for instance. The geographical situation of a health resort exercises influences on its air quality considered in terms of hygiene. This is linked with different atmospheric and bioclimatic conditions in various regions. The major source of air pollution in a health resort is represented by housing and the communal area, by traffic on the roads and partly by industry. Instructions for measuring and evaluating of pollutants are given. Furthermore, various possibilities for improving the air quality in health resorts are mentioned.

Air Pollutants↗

[The principles of health resort treatment].

"Cures" prescribed in spas and health resorts are useful especially for patients who are chronically ill. The differences between pharmacotherapy and physiotherapy are discussed. The treatment in health resorts produces adaptations to repeated irritations, which need time, mostly four weeks. However, the changes of the function of circulatory system, lungs, metabolism etc. do not disappear after the end of the cure. To this extent, the principles of treatment in health resorts are comparable to sporting training. The days of incapacity to working are reduced to 50-60% in the following two years after a successful cure.

Chronic Disease↗

[Participants of mother-child health resort treatments].

Mother-child health-resort treatments have for many years been a major component of rehabilitative and preventive health care for women. The rising significance of health-promotion measures on the one hand, and increased attention to women's health aspects in rehabilitation and prevention on the other, have made in-depth consideration of the issues involved in target-groups, participation in and conceptual potential of mother-child programmes necessary. In a questionnaire study of n = 103 women participating in a mother-child programme, data were collected concerning their life situation, life satisfaction, psychosocial burdens and psychovegetative complaints, the expectations and needs hoped to be met by the preventive and rehabilitative programme features, as well as the motives for participating. The findings show that the life situation of the women in our study is characterized by a high degree of stress and strain, by physical complaints and dissatisfaction with life. The women clearly state the relationships they see among their current life situation, their subjective emotional state, their health behaviours, and their subjective physical status. Programme participation, on the one hand, has to do with needing a rest and easing of tension; yet on the other hand, the responding women also express a desire to confront current life themes, to find room for reconsidering attitudes, behaviours and the potential for change. Implications for shaping women-specific rehabilitative and preventive programmes are formulated on the basis of the study findings. Future studies in the field of mother-child health resort programmes should be directed at evaluating the treatment programmes available.

Adolescent↗