Evaluation of quality of life at-own-risk-discharged (AOR-discharged) orthopedic patients form Hospital Universiti Sains Malaysia

Abstract

In hospital Universiti Sains Malaysia, AOR-discharged cases in orthopedic trauma is high, estimated at 13% of all AOR-discharged cases. Between 1989 to 1991, 75 patients with close and compound fractures, who had made up their mind for AOR-discharge were randomly selected and were interviewed with a questionnaire to identify the factors that influence the patient's decision for AOR-discharge. More than 6 months later, they were contacted by mail to return to the hospital for re-examination, evaluation of their quality of life, and re-counsel for compliance. Twenty-three patients responded. All of them were males and 78.3% sustained injuries in traffic accident. Fracture of femur accounted for 56.5% with a majority (95.7%) had close fractures. The line of treatment proposed were conservative for 8 and surgical for 15 patients. Reasons cited for AOR-discharge were many but a majority believed that traditional (bomoh's) treatment was superior in healing rate. The quality of life evaluation was compromised by shortening of limb disability, nagging pain, reduction or loss of earning in all of them. Of the four patients recommended for corrective surgery only one accepted with good functional outcomes. Bomoh could be an ally to modern doctors in counseling, instilling confidence and hope to the patients through prayers and non-manipulative procedures.