Evaluating the impact of community rehabilitation on health-related quality of life

Mr Simon Mathieson1

1Alfred Health, Caulfield, Australia

Authors: Mathieson S 1 , Wise F 1 , Harris D 2, Woolley K 1

Affiliations: 1. Alfred Health Community Rehabilitation Program, 2. Aspex Consulting

AIM: There is a significant gap in rehabilitation literature and clinical knowledge regarding the measurement and prediction of health-related quality of life (HRQOL) in Community Rehabilitation (CR) clients.

The aims of this study, therefore, were:

  1. To evaluate the changes in health-related quality of life that occurs in a community rehabilitation population.
  2. To identify which set of factors (illness-related; demographic, and psychological) best predict community rehabilitation outcome (as measured by patients’ health-related quality of life).

METHODS: In a prospective longitudinal study, 117 participants (mean age 68.4 yrs; 56% female) were recruited consecutively from clients admitted for centre-based community rehabilitation.

On admission and discharge, participants completed questionnaires measuring HRQOL, mood, and environmental barriers, in addition to completing a 6 Minute Walk (6MW) test. On admission, a Mini-Mental Status Examination and severity of illness/comorbidities was also calculated.  HRQOL domains underwent reliability analysis.

RESULTS: From admission to discharge, participants demonstrated a significant (p ≤ .01) improvement in HRQOL, as well as overall health ratings, exercise capacity, use of mobility devices and mood (all p = .000). Significant predictors of the “Independent Living” HRQOL domain on discharge included age, number of therapy encounters, number of mobility devices used and exercise capacity, accounting for 38% of variance in Independent Living scores.

SIGNIFICANCE TO ALLIED HEALTH: HRQOL was a reliable and responsive outcome measure in Community Rehabilitation patients, with improvement seen in both Quality of Life and its predictors. Future research should include study of such outcomes in the long-term, in home based rehabilitation populations and in patients with speech language deficits.