Article

Quality of life among older stroke patients in Taiwan during the first year after discharge.

School of Nursing, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan.
Journal of Clinical Nursing (impact factor: 1.12). 10/2008; 18(16):2320-8. DOI:10.1111/j.1365-2702.2008.02458.x pp.2320-8
Source: PubMed

ABSTRACT To explore the one-year poststroke trajectories in health-related quality of life and physical function in a sample of older stroke patients in Taiwan.
Health-related quality of life has repeatedly been reported as decreased in poststroke patients. The vast majority of information on the health-related quality of life of older patients after stroke is based on data collected in Western developed countries. In contrast, little is known about older stroke patients in Asian countries.
A descriptive, prospective and correlational design was used.
Older stroke survivors (n = 98) were assessed at the end of one, three, six and 12 months after hospital discharge for health-related quality of life (measured by the Medical Outcomes Study Short Form 36) and physical functioning (measured by the Chinese Barthel Index and Instrumental Activities of Daily Living Scale).
The subjects, who were 65-88 years old, performed considerably worse at 12 months after hospital discharge in social and physical functioning (means = 61.1, 54.8, respectively) than the age-matched community-dwelling norm (means = 78.7, 69.7, respectively). During the first year after discharge, subjects improved significantly on the Medical Outcomes Study Short Form 36 physical component summary scale and role limitations due to physical problems; during the first three months after discharge, they improved significantly on performance of activities of daily living and instrumental activities of daily living; and from the third to sixth month after discharge, they improved significantly in physical functioning.
The first year, especially the first three months after hospital discharge, is critical for improvements in health-related quality of life and physical functioning for older stroke survivors in Taiwan.
Older Taiwanese/Chinese people who suffer a stroke will likely benefit from interventions during the first 12 months after discharge and the most effective interventions may be earlier, during the first three months after discharge.

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    Article: Perceived wellbeing of patients one year post stroke in general practice--recommendations for quality aftercare.
    Leonie de Weerd, Wijnand A F Rutgers, Klaas H Groenier, Klaas van der Meer
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    ABSTRACT: Annually, 41,000 people in the Netherlands have strokes. This has multiple physical and psychosocial consequences. Most patients return home after discharge from hospital. Quality aftercare by general practitioners is important to support patients at home. The purpose of this study is to examine the wellbeing of patients who returned home immediately after discharge from hospital, one year post stroke, in comparison with the general Dutch population of the same age and to determine factors that could influence wellbeing. All the stroke patients from the Department of Neurology, Martini Hospital Groningen in the period November 2006 to October 2007 were included. People aged under 65 years or with haemorrhaging were excluded. All the patients (N=57) were interviewed at home using the following questionnaires: Barthel Index, SF-36, HADS, CSI and a questionnaire about their way of life. 31% of the patients in this study experienced a decrease in functional status after one year. Nevertheless, there was no significant difference between the median Barthel Index value at discharge from hospital and one year post stroke. ADL independence correlated with a better quality of life. The health-related quality of life was high. Stroke patients have almost the same quality of life as the 'average' Dutch elderly population. Where patients can no longer fully participate in society, their perceived quality of life is also lower. In this study there is an indication of a high prevalence of depression and anxiety disorders in stroke patients. This negatively affects the quality of life a year after stroke. Although caregiver strain was low for the partners of stroke patients, a reduced quality of life is correlated to greater burden. This study provides valuable insight into the wellbeing of patients living at home one year post stroke. Physical functioning and quality of life are comparable to the general population of the same age, but improvements in mental functioning can be envisaged. In addition, more attention should be paid to maintaining the patients' activities. The wellbeing of these stroke patients could be increased further if greater attention is paid to these aspects of life. This seems to be applicable to general practice.
    BMC Neurology 03/2011; 11:42. · 2.17 Impact Factor
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Keywords

12 months
 
age-matched community-dwelling norm
 
Asian countries
 
Chinese Barthel Index
 
first 12 months
 
health-related quality
 
hospital discharge
 
Instrumental Activities
 
Living Scale
 
Medical Outcomes Study Short Form 36
 
older patients
 
older stroke patients
 
Older stroke survivors
 
Older Taiwanese/Chinese people
 
one-year poststroke trajectories
 
physical function
 
physical problems
 
poststroke patients
 
role limitations
 
vast majority
 

Yea-Ing L Shyu