The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture.
Patients (n = 171; age range 18–100 years) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref) and the Short Musculoskeletal Function Assessment questionnaire (SMFA) at time of diagnosis (i.e., pre-injury status), 1 week, and 6 months post-fracture. Linear mixed modeling was performed.
Interaction effects of time with treatment were detected for the WHOQOL-Bref facet Overall QOL and General health (p = .002) and Physical health (p = .003). Patients did not return to their pre-injury Physical health, Psychological health, and Environment 6 months post-fracture (p < .05). No effects were found for Social relationships. The SMFA subscale Lower extremity dysfunction showed main effects for time and treatment (p < .0001) with full recovery at 6 months (p = .998). An interaction effect of time with treatment was found for Daily life consequences (p < .0001) with nonoperatively treated patients showing full recovery (p = 1.00), whereas surgically treated patients did not (p = .002).
Six months after LEF, patients still experienced impaired physical and psychological health on the WHOQOL-Bref compared to their pre-injury status. However, patients showed full recovery on SMFA Lower extremity dysfunction, indicating that the choice of the questionnaire influences the derived conclusions. LEF did not affect satisfaction with social relationships.
De Vries, J. (2001). Quality of life assessment. In A. J. J. M. Vingerhoets (Ed.), Assessment in behavorial medicine (pp. 353–370). Hove: Brunner-Routledge.
WHOQOLGroup. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41(10), 1403–1409. CrossRef
WHOQOLGroup. (1998). The World Health Organization quality of life assessment (WHOQOL): Development and general psychometric properties. Social Science and Medicine, 46(12), 1569–1585. CrossRef
WHOQOLGroup. (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23(3), 24–56. CrossRef
Bhandari, M., Busse, J. W., Hanson, B. P., Leece, P., Ayeni, O. R., & Schemitsch, E. H. (2008). Psychological distress and quality of life after orthopedic trauma: An observational study. Canadian Journal of Surgery, 51(1), 15–22. PubMedCentral
WHOQOLGroup. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychological Medicine, 28(3), 551–558. CrossRef
Van Son, M. A., Den Oudsten, B. L., Roukema, J. A., Gosens, T., Verhofstad, M. H., & De Vries, J. (2014). Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with a fracture of the upper or lower extremity. Quality of Life Research, 23(3), 917–926. doi: 10.1007/s11136-013-0529-z. CrossRefPubMed
Ackerman, I. N., Graves, S. E., Bennell, K. L., & Osborne, R. H. (2006). Evaluating quality of life in hip and knee replacement: Psychometric properties of the World Health Organization Quality of Life short version instrument. Arthritis and Rheumatism, 55(4), 583–590. doi: 10.1002/art.22107. CrossRefPubMed
van Esch, L., den Oudsten, B. L., & de Vries, J. (2011). The World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF) in women with breast problems. International Journal of Clinical and Health Psychology, 11(1), 5–22.
Hedeker, D., & Gibbons, R. D. (2006). Longitudinal data analysis. New Yersey: Wiley.
De Vries, J., & Van Heck, G. L. (1996). The Dutch version of the WHOQOOL-Bref. Tilburg: Tilburg University.
De Vries, J., & Van Heck, G. L. (2003). Dutch manual of the WHOQOL. Tilburg: Tilburg University.
Cohen, J. (1977). Statistical power analysis for the behaviourial sciences. New York: Wiley.
Watson, W. L., Ozanne-Smith, J., & Richardson, J. (2007). Retrospective baseline measurement of self-reported health status and health-related quality of life versus population norms in the evaluation of post-injury losses. Injury Prevention, 13(1), 45–50. doi: 10.1136/ip.2005.010157. CrossRefPubMedPubMedCentral
Busse, J. W., Bhandari, M., Guyatt, G. H., Heels-Ansdell, D., Kulkarni, A. V., Mandel, S., et al. (2012). Development and validation of an instrument to predict functional recovery in tibial fracture patients: the Somatic Pre-Occupation and Coping (SPOC) questionnaire. Journal of Orthopaedic Trauma, 26(6), 370–378. doi: 10.1097/BOT.0b013e31822421e2. CrossRefPubMedPubMedCentral
- The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study
M. A. C. Van Son
J. De Vries
J. A. Roukema
M. H. J. Verhofstad
B. L. Den Oudsten
- Springer International Publishing