Satisfaction of post-COVID patients with rehabilitation, 2025, Kupferschmitt et al

Satisfaction of post-COVID patients with rehabilitation

Alexa Alica Kupferschmitt, Thilo Hinterberger, Sebastian Indin, Christoph Hermann, Jöbges Michael, Stefan Kelm, Gerhard Sütfels, Thomas H Löw, Volker Köllner

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Purpose
The most common symptoms of PCS are persistent fatigue and cognitive impairment, which significantly affect participation in work and daily life. There is increasing evidence for the effectiveness of rehabilitative treatment approaches.

Nevertheless, voices are being raised, especially in the social media, that negatively evaluate rehabilitation for PCS. The aim of this study was to objectify the subjective success of treatment and the satisfaction of inpatients with PCS with the rehabilitation.

Methods
As part of a prospective multicentre cohort study (n=1028), the subjective treatment success and patient satisfaction (ZUF-8) at the end of PCS rehabilitation were examined (PCS rehabilitation indications: Dual rehabilitation, psychosomatics, neurology and pneumology). Frequency analyses, mean value comparisons, correlation analyses and regression models were used.

Results
The subjective success of treatment was rated as good to very good across all PCS rehabilitation indications. Approximately 62% of PCS patients experienced improvement in physical symptoms, about 58% improvement in mental well-being. The general State of health and performance improved in 62% and 47% of patients, respectively. If all categories of treatment success are considered together, at least one area improved in 87.5%.

Around 90% of PCS patients would recommend rehabilitation to others or return for treatment. Comparable results also showed that the treatment met the patients' needs. The vast majority of PCS patients (around 90%) would recommend the rehabilitation programme to others or return for treatement.

Global patient satisfaction correlated to r=–0.727 (p<0.001) with the subjectively experienced psychological relief, but not with the 6-minute walking test (6MWT) as a somatic surrogate parameter. Regression analyses showed that only improvement in depression had a significant influence on patient satisfaction and subjective treatment success, but not improvement in walking distance or the socio-medical assessment (general labour market performance).

Conclusion
PCS rehabilitants were satisfied with the therapy programme across all indications examined and experienced successful treatment. The vast majority of PCS rehabilitants found a multimodal rehabilitation program to be helpful.

Link (Die Rehabilitation) [Paywall] [Full text language is German]

 

‘Evidence’ is generous. There are papers that claim it - but none of them are any good as far as I’ve seen.

‘Objectify the subjective’ is a laughable assertion. You can attempt to quantify the subjective, but it can’t be objectified. It might be a translation error, but it’s very concerning if the authors believe what they write.

If we assume a uniform distribution, that’s within the range of a coin flip.
Edit: and it ‘s a completely useless measure without a control group. And a terribly expensive intervention for so low response rates.

See above.

So satisfaction didn’t have anything to do with actual improvement! Case closed.

People are likely to report they are happy when they receive attention. Wow, what an impressive discovery.

 

You're assuming that if you followed a group that doesn't change on average, around 50% would improve and 50% would worsen? If there was an option for "no change" then the improve group would be expected to be smaller than 50%.

But anyway, this sounds about right for natural improvement:

Trajectories of the evolution of post-COVID-19 condition, up to two years after symptoms onset (2023, International Journal of Infectious Diseases)

Post-COVID-19 condition in prospective inpatient and outpatient cohorts (2025, Nature Scientific Reports)

 

Its important also to consider the patients who won't have been doing rehab. All the PEM sufferers and those far too ill be attending rehab sessions. None of those were improved and couldn't do this rehab at all but those rejects aren't ever accounted for.

 

Yes.

Good point. Would that depend on how broad the «no change» is, which would depend on the granularity of the scales used?

 

I was allowed to do rehab because they never asked about PEM. It did not go well in the end, but my 6MWT still went from 400 to 600 meters.

 

I think so. Or if it was just a vague question like "Since you started, have you improved, worsened, or no change?" it'd be hard to say what exactly the cutoff is for improve.

 

I am perhaps being unfair as I have not read the paper, but …

Examining patient satisfaction in my experience is the least useful way of evaluating an intervention. Especially if it is done relatively soon after that intervention.

The patient has had nice well meaning clinicians genuinely intending to help them and investing time and effort to develop a therapeutic relationship helping them through a very difficult period in their life. They want to believe the effort they have put in was worth while and are grateful for the clinicians goodwill.

My experience was that only very gross failures in an intervention programme are picked up by assessing satisfaction. Regardless of any real benefit, any intervention has to be really disastrous not to get a good or a very good rating.

 

This is laughable. It's like a participation trophy society. They don't understand how to evaluate patient reports, and seem content with grading their own homework on a curve.

It's been 5 years and they're still stuck with the same nonsense. It you listen to them they've basically got this fully under control. Completely imaginary depiction of reality.