Factors predicting health-related quality of life after rehabilitation for femur fracture in elderly people of Hispanic origin

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Kathryn E. Roach, Committee Chair


The purpose of this study was to examine the contribution of psychological and social impairment in determining health-related quality of life in older Cuban-Americans recovering from hip fracture. The three indicators of health-related quality of life were activity limitation, social disability, and perceived health.Thirty-seven men and women over 50 with hip fracture were recruited from a comprehensive rehabilitation unit. Subjects were interviewed at the time of discharge, one week after discharge, and two months after discharge from rehabilitation, in order to assess activity limitation, social disability, and health-related quality of life. Activity limitation was measured using the SF-36 physical function subscale, the motor subscale of the Functional Independence Measure; and the Health Assessment Questionnaire. Social disability was measured using three subscales of the SF-36, and perceived health was measured using the general health subscale of the SF-36. Psychological impairment was measured using the mental health subscale of the SF-36, and social impairment was measured by interview.Data were analyzed for each of the indicators of health-related quality of life at each time point. Bivariate relationships were examined by Spearman correlations, and multivariate relationships were examined using multiple linear regression and the backward deletion process.The subjects were 83.8% female and had a mean age of 79.9 +/- 8.8 years. All of the subjects were of Hispanic origin, with 94.6% identifying themselves as Cuban. Several global findings can be inferred from the results of this study. First, psychological impairment was not significantly affected by hip fracture. Psychological impairment was associated with quality of life indicators before hip fracture, but not after hip fracture; while social impairment was associated with quality of life indicators after hip fracture, but not before hip fracture. Instrumental support and emotional support had opposite effects on indicators of health-related quality of life. The variables that influence activity limitation and perceived health two months after hip fracture interacted differently in men than in women. Finally, both psychological impairment and social impairment, but not activity limitation, were associated with perceived health after hip fracture.


Health Sciences, Rehabilitation and Therapy

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