Schonungslose Medizin: Der neue Umgang mit dem Kranksein

Zusammenfassung

Schonung wurde schon in der Antike in der Behandlung von Krankheiten eingesetzt und ist seitdem ein häufiger, aber in seinen Konsequenzen wenig bedachter Begleiter verschiedener Therapiestrategien. Mitte der 50er-Jahre zeigten empirische Untersuchungen erstmalig schlechtere Heilungsverläufe bei längeren postoperativen Liegezeiten und bessere Ergebnisse für eine frühzeitige Aktivierung z. B. bei Patienten mit koronarer Herzkrankheit. Inzwischen gibt es höchste Evidenz für die Effektivität von Bewegung in der Prävention und Behandlung chronischer Krankheiten bzw. für die Unwirksamkeit oder sogar negativen Folgen von Bettruhe. Trotzdem raten Ärzte ihren Patienten vielfach noch zur Einhaltung von längerer Bettruhe, was - wie in der Behandlung chronischer Schmerzen - die Prognose der Patienten verschlechtern kann. Der Artikel ist ein Plädoyer für den rationalen Umgang mit Medizin gegen den Einsatz unangebrachter medizinischer Interventionen in natürlichen Lebensbereichen am Beispiel der Schonung.

Abstract

Already in the ancient world bed rest was used in the management of illnesses. Since then it was administered frequently along with other treatment strategies, but without really considering its consequences. In the mid-fifties for the first time empirical investigations showed worsened outcomes with prolonged bed rest after surgical procedures and improved outcomes with early activation for example in patients with coronary heart disease. Up to now, there is best evidence for the effectiveness of exercise in the prevention and therapy of chronic diseases or for the inefficacy or harm of bed rest. However even medical doctors do still recommend prolonged bed rest, which may worsen patients' prognosis as it does in the management of chronic pain patients. Considering bed rest as an example, this article pleads for a rational use of medicine against the implementation of non-adequate medical interventions in normal life.

Schonung - Bettruhe - Aktivität - Medikalisierung - Disease mongering

bed rest - activity - medicalisation - disease mongering

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