CHILD-MOTHER KUR - AN EFFECTIVE SYSTEM OF MEDICAL INTERVENTION IN CHRONIC DISEASES OF CHILDREN

Institut for Gesundheit, Sport und Ernährung, Universität Bremen, Bremen, Germany

OBJECTIVE: Stresses affecting the health of children have increased significantly in the past years due to multiple social and economic changes. Whilst acute medical problems like infectious diseases have declined, the number of those with chronic disorders are rising. ,,Kur" as a system of medical intervention for children has been established for many decades in Germany, especially in the prevention and rehabilitation of chronic diseases. Sick children may attend by themselves ("children-Kur") or with their mothers ("Child-Mother Kur"). The concept of the Kur is financially well supported by the sick-funds and the social insurances and there are many anecdotal experiences from patients, the Kur institutions and physicians but currently there is a little data only to evaluate their success. This study attempts to evaluate the interventionalist concept of the Child-Mother Kur.

METHOD: Structured questionaires were posted to mothers who had accompanied their children during the period 1993 - 97 for interventions at 2 centres in the North Sea area.

RESULTS: About 50% (=1563) of questionnaires were returned. The main reasons for attending the Kur for the children were chronic infections of the upper respiratory tract, chronic bronchitis, asthma, eczema and atopic dermatitis. Results of the Kur showed a high degree of effectiveness of the concept: 93% of the mothers reported improvements in the general well-being of their children, of which 58% was ..significant improvement". The success rate was especially high in those with chronic infections of the upper respiratory tract and chronic bronchitis but was evident across all categories of illness. The duration of the improvement exceeded one year for approximately 40% of the patients and further 32% reported lasting beneficial effects between 6 and 12 months. Visits to the doctor decreased in 80% of cases following the Kur and 70% of the respondents reported decreased use of less medications. An improvement in school or kindergarten absence was noticed by 50%. Furthermore positive effects were seen in family interactions and coping strategies as well as improvements of health resources. Interestingly, the success rate was proportional to the length of the Kur with 3 week stay showing significantly less success than a 4 week Kur. The respondents mainly attributed the health improvement of their children to the North Sea climate.

CONCLUSIONS: It is evident that the intervention Kur is highly effective. It is likely that the success of the Kur intervention originates from the whole Kur concept rather than individual factors. Any interest from European partners to continue this research in a European context would be most appreciated.