Stroke disease-specific quality of life trajectories and their associations with caregivers' anxiety, depression, and burden in stroke population: a longitudinal, multicentre study.

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Cardiovascular Nursing Pub Date : 2024-03-12 DOI:10.1093/eurjcn/zvad054
Davide Bartoli, Agostino Brugnera, Andrea Grego, Rosaria Alvaro, Ercole Vellone, Gianluca Pucciarelli
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Abstract

Aims: The aims of this study were to: (i) test if there are clusters of stroke survivors who experience distinct trajectories of quality of life (QOL) from hospital rehabilitation discharge to 12-month follow-up; (ii) test if any sociodemographic or clinical variables predict this class membership; and (iii) examine the associations between the clusters of stroke survivors' and their caregivers' trajectories of anxiety, depression, and burden over time.

Methods and results: A total of 415 stroke survivors and their caregivers were recruited in Italy for this 1-year, longitudinal, multicentre prospective study, filling out a survey at five time points. We found two distinct trajectories of change in stroke survivors' psychological QOL (i.e. Memory, Communication, Emotion, and Participation). The first trajectory (86% of the survivors) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, while the second trajectory (14% of the survivors) comprised those who started with lower overall levels of psychological QOL and experienced a worsening or no changes at all in these dimensions up to 12-month follow-up. Very few clinical and sociodemographic variables at baseline predicted class membership. Finally, caregivers of those patients who experienced no change or a worsening in psychological QOL reported greater distress and burden over time.

Conclusion: Our results highlight the need for more tailored interventions to improve patients' psychological QOL and consequently their caregivers' well-being. This requires a shift from a stroke survivor-centred approach to a stroke survivor- and caregiver-centred one.

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脑卒中患者特定疾病的生活质量轨迹及其与照顾者焦虑、抑郁和负担的关系:一项纵向多中心研究。
目的:本研究旨在(i) 检验从康复出院到 12 个月随访期间是否存在经历不同生活质量(QOL)轨迹的中风幸存者群组;(ii) 检验是否有任何社会人口学或临床变量可预测该群组成员;(iii) 检验中风幸存者群组及其照顾者的焦虑、抑郁和负担轨迹随时间变化的关联:这项为期 1 年的纵向多中心前瞻性研究在意大利共招募了 415 名中风幸存者及其照护者,他们在五个时间点填写了调查问卷。我们发现中风幸存者的心理 QOL(即记忆、沟通、情感和参与)有两种不同的变化轨迹。第一种轨迹(86% 的幸存者)包括那些开始时心理 QOL 水平较高,并且在所有心理领域都有轻微到明显改善的幸存者,而第二种轨迹(14% 的幸存者)包括那些开始时心理 QOL 总体水平较低,并且在 12 个月的随访中这些方面的情况有所恶化或没有任何变化的幸存者。基线时的临床和社会人口学变量很少能预测患者的类别。最后,随着时间的推移,那些心理 QOL 无变化或恶化的患者的护理人员报告了更大的痛苦和负担:我们的研究结果突出表明,有必要采取更有针对性的干预措施来改善患者的心理 QOL,进而改善其照护者的福祉。这需要从以中风幸存者为中心的方法转变为以中风幸存者和照护者为中心的方法。
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来源期刊
European Journal of Cardiovascular Nursing
European Journal of Cardiovascular Nursing CARDIAC & CARDIOVASCULAR SYSTEMS-NURSING
CiteScore
5.10
自引率
10.30%
发文量
247
审稿时长
6-12 weeks
期刊介绍: The peer-reviewed journal of the European Society of Cardiology’s Council on Cardiovascular Nursing and Allied Professions (CCNAP) covering the broad field of cardiovascular nursing including chronic and acute care, cardiac rehabilitation, primary and secondary prevention, heart failure, acute coronary syndromes, interventional cardiology, cardiac care, and vascular nursing.
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