Trajectories of health-related quality of life among people with a physical disability and/or chronic disease during and
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Trajectories of health‑related quality of life among people with a physical disability and/or chronic disease during and after rehabilitation: a longitudinal cohort study B. L. Seves1 · F. Hoekstra1,2,4 · F. J. Hettinga3 · R. Dekker4 · L. H. V. van der Woude1,4 · T. Hoekstra5 Accepted: 19 September 2020 © The Author(s) 2020
Abstract Purpose To identify Health-related Quality of Life (HR-QoL) trajectories in a large heterogeneous cohort of people with a physical disability and/or chronic disease during and after rehabilitation and to determine which factors before discharge are associated with longitudinal trajectory membership. Methods A total of 1100 people with a physical disability and/or chronic disease were included from the longitudinal cohort study Rehabilitation, Sports and Active lifestyle. All participants participated in a physical activity promotion programme in Dutch rehabilitation care. HR-QoL was assessed using the RAND-12 Health Status Inventory questionnaire at baseline (T0: 3–6 weeks before discharge) and at 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. A data-driven approach using Latent Class Growth Mixture modelling was used to determine HR-QoL trajectories. Multiple binomial multivariable logistic regression analyses were used to determine person-, disease- and lifestyle-related factors associated with trajectory membership. Results Three HR-QoL trajectories were identified: moderate (N = 635), high (N = 429) and recovery (N = 36). Trajectory membership was associated with person-related factors (age and body mass index), disease-related factors (perceived fatigue, perceived pain and acceptance of the disease) and one lifestyle-related factor (alcohol consumption) before discharge from rehabilitation. Conclusions Most of the people who participated in a physical activity promotion programme obtained a relatively stable but moderate HR-QoL. The identified HR-QoL trajectories among our heterogeneous cohort are disease-overarching. Our findings suggest that people in rehabilitation may benefit from person-centred advice on management of fatigue and pain (e.g. activity pacing) and the acceptance of the disability. Keywords Quality of life · Active lifestyle · Health promotion · Rehabilitation · Latent class growth (mixture) models · Activity pacing
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02647-7) contains supplementary material, which is available to authorized users. * B. L. Seves [email protected] 1
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2
School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
3
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
4
Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
5
Department of Health
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