Long-Term Change and Predictors of Change in Physical and Mental Function after Rehabilitation: A Multi-Centre Study.

OBJECTIVE: To investigate changes and predictors of change in physical and mental function over a 3-year period after rehabilitation. DESIGN: Prospective cohort. PARTICIPANTS: Patients, across diseases, living in western Norway, accepted for somatic specialized interprofessional rehabilitation (n = 984). METHODS: Physical and mental function were assessed at admittance (baseline), and after 1 and 3 years using the Medical Outcome Study Short Form 36 (SF-36). Associations between changes in SF-36 component summary scores and sense of coherence, pain, disease group (musculoskeletal, neoplasm, cardiovascular, neurological, other), exercise habits and demographic variables were analysed using linear mixed modelling. RESULTS: In the total group, mean (standard deviation) physical component summary scores improved by 2.9 (8.4) and 3.4 (9.3) points at 1 and 3 years, respectively. Mental component summary scores improved by 2.1 (9.7) and 1.6 (10.8) points. Improvement in physical component summary was significantly greater for patients with higher sense of coherence (b = 0.09, p = 0.001) and for the neoplasm disease group (b = 2.13, p = 0.046). Improvement in mental component summary was significantly greater for patients with low sense of coherence (b = -0.13, p = < 0.001) and higher level of education (b = 3.02, p = 0.0302). Interaction with age (physical component summary: b = 0.22, p = 0.039/mental component summary b = 0.51, p = 0.006) indicated larger effect at 1 year than at 3 years. CONCLUSION: Physical and mental function improved in the total study group over the 3-year period. Sense of coherence at baseline was associated with improved physical and mental function, suggesting that coping resources are important in rehabilitation.

The effect of team collaboration and continuity of care on health and disability among rehabilitation patients: a longitudinal survey-based study from western Norway.

PURPOSE: The purpose of this study was to investigate how changes in patient-rated health and disability from baseline to after rehabilitation were associated with communication and relationships in rehabilitation teams and patient-rated continuity of care. METHODS: Linear models were used to assess the associations between relational coordination [RC] and Nijmegen Continuity Questionnaire-Norwegian version [NCQ-N] with changes in the World Health Association Disability Assessment Schedule 2.0 [WHODAS 2.0] and EuroQol EQ-VAS [EQ-VAS]. To express change in WHODAS 2.0 and EQ-VAS, the model was adjusted for WHODAS 2.0 and EQ-VAS baseline scores. Analyses for possible slopes for the various diagnosis groups were performed. RESULTS: A sample of 701 patients were included in the patient cohort, followed from before rehabilitation to 1 year after a rehabilitation stay involving treatment by 15 different interprofessional teams. The analyses revealed associations between continuity of care and changes in patient-rated health, measured with EQ-VAS (all p values < 0.01). RC communication was associated with more improvement in functioning in neoplasms patient group, compared to improvement of health among included patient groups. The results revealed no associations between NCQ-N and WHODAS 2.0 global score, or between RC in the rehabilitation teams treating the patients and changes in WHODAS 2.0 global score. CONCLUSION: The current results revealed that better personal, team and cross-boundary continuity of rehabilitation care was associated with better patient health after rehabilitation at 1-year follow-up. Measures of patient experiences with different types of continuity of care may provide a promising indicator of the quality of rehabilitation care.