title: Quality of life in rehabilitation outpatients: normal values and a comparison with the general Dutch population and psychiatric patients.
abstract: OBJECTIVE
  To provide Dutch normal values for rehabilitation outpatients with chronic pain or musculoskeletal diseases utilizing the World Health Organization Quality of Life questionnaire abbreviated version (WHOQOL-BREF) and analyse influence of diagnosis and patient characteristics on normal values and increase understanding in those values.
  
  
  METHODS
  Five hundred and forty-two outpatients were referred to a rehabilitation psychologist. Referral diagnoses were "musculoskeletal", "chronic pain", "neurological" and "miscellaneous". Comparisons between groups were made for each of the four domains of the WHOQOL-BREF (scoring range 4-20).
  
  
  RESULTS
  Domain scores of rehabilitation outpatients were physical domain 11.0 (±2.7), psychological domain 13.6 (±2.4), social domain 14.8 (±3.4) and environmental domain 14.2 (±2.2). Outpatients with chronic pain reported the lowest scores on the WHOQOL-BREF when compared to the "musculoskeletal", "neurological" and "miscellaneous" groups. Increased age, lower education, living alone and unemployment had a negative impact on WHOQOL-BREF scores. Compared to the general Dutch population, rehabilitation outpatients scored, unadjusted for age, significantly lower difference for the physical domain 4.5 [95% confidence interval (CI) 4.2; 4.8], the environment domain 1.7 (95% CI 1.5; 2.0), the psychological domain 1.1 (95% CI 0.4; 1.2) and the social domain 0.4 (95% CI 0.0; 0.8).
  
  
  CONCLUSIONS
  WHOQOL-BREF scores of rehabilitation outpatients are lower and differed significantly from normal values of a Dutch population in all four domains. Therefore, the WHOQOL-BREF can be used to measure the subjective impact of their disease or injury. The subjective impact of chronic pain was found to be particularly high.
authors.affiliation: Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. e.schrier@umcg.nl.
authors.forename: Ernst
authors.initials: E
authors.lastname: Schrier
authors.affiliation: Sinai Centre, Amersfoort, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Schrier
authors.affiliation: Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
authors.forename: Jan H B
authors.initials: JH
authors.lastname: Geertzen
authors.affiliation: Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.|Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000523:psychology; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands; D010045:Outpatients / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012016:Reference Values; D012046:Rehabilitation / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Outcome assessment; Quality of life; Rehabilitation centre; Rehabilitation outpatients