Change in sense of coherence and health-related quality of life after injury – a prospective cohort study

Abstract

Purpose

To investigate how accidents leading to fracture affect sense of coherence and health-related quality of life 6 months later and the association between the two phenomena.

Materials and methods

A cohort study including 201 patients admitted to hospital with fractures was conducted. Data were based on structured interviewing a few days after admission and 6 months later. Sense of coherence was evaluated with a nine-item scale and health-related quality of life was examined with the subscales of Short Form-36 (SF-36).

Results

Follow-up comprised 164 patients (81.6%), mean age 47 years. Sense of coherence changed to be either stronger (43%) or weaker (41%) and was stable for 15.9% of the participants. Health-related quality of life changed positively after 6 months but did not reach normative values. Strong sense of coherence was significantly associated with the SF-36 subscales emotional role functioning, social functioning, vitality, and mental health.

Conclusions

Accidents leading to fracture can be stressful life events that could influence an individual’s sense of coherence to be stronger or weaker. The association between sense of coherence and health-related quality of life emphasises the importance of therapists supporting the patients’ personal resources and promote a salutogenic focus.

IMPLICATIONS FOR REHABILITATION

• An injury may change an individual’s sense of coherence to be stronger or weaker.

• For patients who sustain fracture, sense of coherence should be included in therapists’ analysis of personal resources and support a salutogenic perspective.

• Health-related quality of life is especially for younger individuals affected by an accident and its consequences and need a guided and meticulous rehabilitation course.

Keywords:

• Sense of coherence
• quality of life
• fractures
• bone
• cohort study

Acknowledgement

We would like to thank the participating patients for their valuable contribution to this study.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This work was supported by University College Absalon, The Danish Rheumatism Association, and Aase & Ejnar Danielsen’s Foundation.