General and Specific Quality of Life Course of Individuals with Different Levels of Stroke Severity: A One-Year Prospective Longitudinal Study.

IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Clinical Gerontologist Pub Date : 2024-10-01 Epub Date: 2024-06-13 DOI:10.1080/07317115.2024.2366833
Marcela Aline Fernandes Braga, Iza Faria-Fortini, Kênia Kiefer Parreiras de Menezes, Jéssica Melo Santos, Nathália Aparecida Gravito Rodrigues, Edvânia Andrade de Moura Silva, Christina Danielli Coelho de Morais Faria
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Abstract

Objectives: To compare the course of generic and specific health-related quality of life (HRQOL) of individuals with stroke, and its physical, mental, and social domains, at three, six, and 12 months after hospital discharge, considering the levels of stroke severity.

Methods: This is a longitudinal study, in stroke individuals, assessed during hospital admission by the National Institutes of Health Stroke Scale (NIHSS), and divided into mild (NIHSS ≤3) or moderate/severe (NIHSS ≥4) disease. At three, six, and 12 months after hospital discharge, the individuals were assessed for generic (Short Form Health Survey-36: total score and physical and mental domains) and specific (Stroke Specific Quality of Life Scale: total score and social domain) HRQOL. A 2 × 2 repeated measures analysis of variance (ANOVA) with post-hoc was applied.

Results: 146, 122, and 103 individuals were assessed at three, six and 12 months, respectively HRQOL courses showed different behaviors according to stroke severity (3.37≤F ≤ 4.62; 0.010≤p ≤ .036). Individuals with mild stroke showed significant changes in the physical domain, with a reduction between three and six months, and an increase between six and 12. Moderate/severe individuals showed a significant increase in all HRQOL variables between three and six months, and a maintenance of values for almost all variables, except for physical domain, which improved significantly between three and six months, and got significantly worse between six and 12.

Conclusions: HRQOL during the first year after stroke showed distinct trajectories, being stroke severity an important factor in identifying stroke subjects at risk of HRQOL decline.

Clinical implications: These results demonstrate the importance of considering not only the phase of the stroke, the severity, and the general and specific HRQOL, but also the physical, social, and mainly the mental domain, which has long been neglected, when assessing this population.

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不同脑卒中严重程度患者的一般和特殊生活质量:为期一年的前瞻性纵向研究。
目的比较脑卒中患者出院后 3 个月、6 个月和 12 个月的一般和特殊健康相关生活质量(HRQOL)的变化过程,以及其身体、精神和社会领域,同时考虑脑卒中的严重程度:这是一项纵向研究,研究对象为入院时接受美国国立卫生研究院卒中量表(NIHSS)评估的卒中患者,分为轻度(NIHSS ≤3)或中度/重度(NIHSS ≥4)。在出院后的 3 个月、6 个月和 12 个月,对患者的一般 HRQOL(简表健康调查-36:总分和身体及精神领域)和特殊 HRQOL(卒中特殊生活质量量表:总分和社交领域)进行评估。采用 2 × 2 重复测量方差分析(ANOVA)和事后分析:分别对 146 人、122 人和 103 人进行了 3 个月、6 个月和 12 个月的 HRQOL 评估,根据中风严重程度的不同,HRQOL 的变化也不同(3.37≤F≤4.62;0.010≤P≤.036)。轻度脑卒中患者在体能方面有明显变化,3 到 6 个月之间有所下降,6 到 12 个月之间有所上升。中度/重度患者的所有 HRQOL 变量在 3 到 6 个月之间都有明显增加,几乎所有变量的值都保持不变,只有身体领域在 3 到 6 个月之间有明显改善,而在 6 到 12 个月之间则明显恶化:结论:中风后第一年的 HRQOL 呈现出不同的轨迹,中风严重程度是识别中风患者 HRQOL 下降风险的重要因素:这些结果表明,在评估这类人群时,不仅要考虑中风的阶段、严重程度、一般和特殊的 HRQOL,还要考虑身体、社会,主要是长期以来被忽视的精神领域。
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来源期刊
Clinical Gerontologist
Clinical Gerontologist GERIATRICS & GERONTOLOGY-PSYCHIATRY
CiteScore
6.20
自引率
25.00%
发文量
90
审稿时长
>12 weeks
期刊介绍: Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including: -adjustments to changing roles- issues related to diversity and aging- family caregiving- spirituality- cognitive and psychosocial assessment- depression, anxiety, and PTSD- Alzheimer’s disease and other neurocognitive disorders- long term care- behavioral medicine in aging- rehabilitation and education for older adults. Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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