Health-related quality of life of patients with hip fracture before and after rehabilitation therapy: discrepancies between physicians' findings and patients' ratings.
OBJECTIVE
Health-related quality of life (HrQoL) is broadly accepted as an evaluation criterion of medical therapy effects. The major objectives of this work are a) measuring of the effects of rehabilitation therapy on the HrQoL of elderly patients after hip fracture, and b) study of discrepancies between the physician's findings on one hand and subjective ratings of patients on the other, and their influence on HrQoL, depression, and independence in activities of daily living.


METHODS
The study sample consisted of 95 patients surgically treated after a fall-induced hip fracture (mean age=82 years; range=61-97). Using the median as splitting criterion, ratings of patients and physicians concerning disturbance-specific functional capacity were subdivided into positive and negative. This led to separation of the sample into four subgroups: the fortunate (congruent positive ratings), satisfaction paradox (positive subjective, negative objective ratings), dissatisfaction dilemma (negative subjective, objective positive ratings), and the unfortunate (congruent negative ratings).


RESULTS
The four patient subgroups diverged in their estimations. The subgroups of the fortunate and satisfaction paradox have had the highest subjective gains in HrQoL. The subgroups of dissatisfaction dilemma and the unfortunate estimated their gains as similarly low on most of the tested scales.


CONCLUSIONS
Results stress the importance of subjective factors in processes concerning therapy evaluations and their influence on HrQoL. The objective success of therapy is not of primary importance for the extent of the HrQoL, but subjective evaluation of it is.
Papadopoulos
Costas
C
Faculty of Psychology, Institute of Clinical and Health Psychology, University of Vienna, Vienna, Austria. costas.papadopoulos@gmx.at
Jagsch
Reinhold
R
Griesser
Barbara
B
Magenheim
Elisabeth
E
Mozelt
Christine
C
Chhatwal
Christa
C
Kryspin-Exner
Ilse
I
Pils
Katharina
K
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006620:Hip Fractures / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life