Sense of coherence, quality of life, and function among elderly hip fracture patients

The aim was to study whether sense of coherence (SOC) had any predictive power in patients with hip fractures regarding length of stay in hospital, state of confusion and health, functional ability, quality of life, and municipal home-help service. A total of 73 patients admitted from their own homes participated (mean age 80.4 years). The patients were followed during a 4-month period. Acute confusional state was diagnosed using a Swedish version of the NEECHAM Confusion Scale. SOC and self-rated functional health status were assessed during the hospitalization period and one month after discharge; Quality of Life Index (QLI) and instrumental daily activities (SPE) were assessed four months after discharge. Focusing on the differences in outcome between persons with a stronger vs a weaker SOC, there were few significant differences in physical status between the subgroups. However, the persons with a weaker SOC stayed longer in the hospital and reported a significantly lower score on the NEECHAM Confusion Scale, as well as more discomfort and disability symptoms related to communication, mental, and emotional status. Furthermore, these persons had less favorable scores on the overall QLI and subscales respectively, and on all subscales measuring instrumental daily activities. The persons with a weaker SOC were significantly more dependent on assistance before admission to the hospital than those with a stronger SOC. The conclusions drawn from the study indicate that persons with a stronger SOC seem to cope in a better way with their situation after a hip fracture.