Change in quality of life of disabled patients after intensive inpatient rehabilitation at Siriraj Hospital

Objective: To compare the quality of life (QOL) before and after intensive rehabilitation of disabled patients and to examine the factors associated with the change in QOL. Material and Method: A retrospective chart review of 200 disabled patients who were admitted for intensive rehabilitation between 2006 and 2009. The Thai abbreviated version of World Health Organization quality of life (WHOQOL-BREF-THAI) was used to assess QOL. Demographic data, physical and psychosocial status, Modified Barthel ADL Index (BAI) were collected and analyzed for the association with WHOQOL-BREF-THAI score changes. Results: One hundred seventeen (58.5%) males and 83 (41.5%) females with mean age 55.6 (SD17.9) years old participated in this study. Various principal diagnoses were included; 112 (56%) stroke, 54 (27%) spinal cord injury and 34 (17%) other diagnoses. After the intensive rehabilitation, quality of life perception was improved in 164 (82%) disabled patients. There was significant difference in mean WHOQOL-BREF-THAI scores on admission and at discharge which were 81.3 (SD 11.2) and 85.5 (SD 11.0) respectively with the p-value < 0.001. The mean changed score was 4.2 (SD 8.0). However, four domains of QOL were improved except the social domain. The factors associated with the disabled patients who were non-improved in WHOQOL-BREF-THAI score after rehabilitation were having non-familial caregiver (OR 5.8, 95% CI 2.1 to 16.0) and joint stiffness (OR 4.1, 95% CI 1.7 to 9.9). Conclusion: Intensive inpatient rehabilitation can significantly improve quality of life in the disabled patients with various primary diagnoses. Having joint stiffness prior to rehabilitation and non-availability of familial members for taking care are the factors associated with the poor outcome in QOL perception.