Trajectories of health-related quality of life among people with a physical disability and/or chronic disease during and after rehabilitation: a longitudinal cohort study

Abstract

Purpose To identify Health-related Quality of Life (HR-QoL) trajectories in a large heterogeneous cohort of people with a physical disability and/or chronic disease during and after rehabilitation and to determine which factors before discharge are associated with longitudinal trajectory membership. Methods A total of 1100 people with a physical disability and/or chronic disease were included from the longitudinal cohort study Rehabilitation, Sports and Active lifestyle. All participants participated in a physical activity promotion programme in Dutch rehabilitation care. HR-QoL was assessed using the RAND-12 Health Status Inventory questionnaire at baseline (T0: 3–6 weeks before discharge) and at 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. A data-driven approach using Latent Class Growth Mixture modelling was used to determine HR-QoL trajectories. Multiple binomial multivariable logistic regression analyses were used to determine person-, disease- and lifestyle-related factors associated with trajectory membership. Results Three HR-QoL trajectories were identified: moderate (N = 635), high (N = 429) and recovery (N = 36). Trajectory membership was associated with person-related factors (age and body mass index), disease-related factors (perceived fatigue, perceived pain and acceptance of the disease) and one lifestyle-related factor (alcohol consumption) before discharge from rehabilitation. Conclusions Most of the people who participated in a physical activity promotion programme obtained a relatively stable but moderate HR-QoL. The identified HR-QoL trajectories among our heterogeneous cohort are disease-overarching. Our findings suggest that people in rehabilitation may benefit from person-centred advice on management of fatigue and pain (e.g. activity pacing) and the acceptance of the disability.

Long-Term Change and Predictors of Change in Physical and Mental Function after Rehabilitation: A Multi-Centre Study

“…The large variation in the literature concerning clinically important change in PCS and MCS scores (32)(33)(34), means that it is challenging to determine whether the changes were clinically important. Nevertheless, the improvements in component scores from baseline to 1 year are in line with changes seen in a 1-year functional rehabilitation trajectory study conducted in Norway (15), and similar to reported improvements in the moderate outcome category in a Dutch 1-year follow-up study (16). The current study provides new knowledge that improvement achieved at 1 year after rehabilitation seems to persist over time.…”

The Relationship Among Quality of Care, Government Social Protection Program and Quality of Life of People with Disability: Empirical Evidence from Dili Municipality

“…This implies that good quality of care leads to enhance quality of life of people with disability because quality of care is important factor in healthcare, disability services and rehabilitation. The results of this study confirms the previous empirical studies that quality of care influence significantly on quality of life of the people with disability (Zheng et al, 2014) because rehabilitation is an outcome of quality of care which directly improves quality of life of people (Seves et al, 2021). However, the result of this study is inconsistency with numerous previous empirical studies that quality of care has no significant effect on the quality of life of the people with disability (De Waele et al, 2005).…”

“…Empirical evidences from a study of QOL, perceived QOC and support, personal attitude towards disability among people with physical disability in China, showed that quality of care and support was playing a more important mediating role than PWPD's attitudes towards their own disability on the quality of life for people with disability (Zheng et al, 2014). Signifying that rehabilitation is an outcome of quality of care and more importantly improved quality of life was reported among people who received rehabilitation services compared to people with disabilities never received rehabilitation care (Seves et al, 2021). Quality of care is significant on quality of life of people with disabilities.…”

Attachment insecurity predicts outcomes in an ACT-CBT group therapy for adults in a physical rehabilitation centre

“…Albeit exploratory, results related to the impact of attachment anxiety and attachment avoidance on CID-treatment outcomes set the stage for future research in this area. Examining predictors of outcome may help tailor treatment to better meet patient needs, and help identify individuals who may be at risk of poor treatment response and an unfavourable HRQoL trajectory (Seves et al, 2021).…”