Perceived health in hip-fracture patients: a prospective follow-up of 100 patients

Abstract

We report the impact of the treatment and rehabilitation in hip-fracture patients by using self-assessment instruments of perceived health and relate them to objective outcome assessments, such as ADL (personal hygiene/dressing), walking ability and technical complications. Subjective and objective status for 100 hip-fracture patients admitted from their own home, and rehabilitated in primary health care, were registered over 1 year after fracture. Mean age was 74, and 80% of the patients were women. Two self-assessment questionnaires: the Nottingham Health Profile (NHP part 1) and the Mood Adjective Checklist (MACL) were answered by the patients 6 and 12 months after fracture and compared with functional status (ADL, and walking ability) 4 months after fracture. Problems related to the hip fracture such as pain and physical mobility had most effect on the self-assessment questionnaire (NHP) and were in accordance with the district physiotherapists' evaluation of function. Patients with complications (resulting in nail extraction and total hip replacement) after the primary hip osteosynthesis and patients with a poor function 4 months after fracture had scores in the self-assessment questionnaires indicating a more pronounced and distressing impact of the disease. Small changes in subjective mood (MACL) were found. In an acute, curable, disease such as hip fracture the objective outcome seems as informative as the subjective evaluations of patients' self-assessment.