Disability outcome and self-assessment of disabled persons: an analysis of 506 cases
Susset, V.; Vobecky, J.; Black, R.
Archives of Physical Medicine and Rehabilitation 60(2): 50-56
1979
ISSN/ISBN: 0003-9993 PMID: 157111 Document Number: 145529
A 1 yr retrospective study in an ongoing project measured the disability outcomes, rehabilitation care provided and self-assessment of 506 disabled subjects. A structured and precoded questionnaire was developed to collect data at home, in nursing homes and chronic care hospitals. Of the 506 subjects, 475 could be classified into 9 disabling diagnostic groups. A physical and psychosocial index, and the subject's living place, were used as the objective outcome indicators. Personal attitudes of the subjects and the perception of their rehabilitation were expressed. The psychosocial and the physical index correlated (r = 0.49; df 426) for the study population. Among the groups, variables with the highest power to differentiate were related to age and severity or the extent of the physical impairment. For individuals, the most important factor of differentiation was the patient's resilience. The correlation of the self-assessment and the physical index (r = 0.36) and the psychosocial index (r = 0.39) suggested that the disabled viewed their condition rather realistically. Rehabilitation input appeared as an important outcome determinant. Psychosocial indices were significantly higher even when only partial rehabilitation services were offered (P < 0.007) and also when the subject was treated by a physiatrist (P < 0.001) in a comprehensive rehabilitation program. Three, more or less successful, subgroups were identified. When their respective rehabilitation inputs were measured, unmet needs were found more frequently in the less successful disability outcome groups.