McMillan A S, Leung K C M, Pow E H N, Wong M C M, Li L S W, Allen P F
Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
J Oral Rehabil. 2005 Jul;32(7):495-503. doi: 10.1111/j.1365-2842.2005.01451.x.
The study aimed to investigate oral health-related quality of life (OHR-QoL) of stroke survivors on hospital discharge after rehabilitation. It was a cross-sectional study involving 43 elderly survivors of mild to moderate stroke about to be discharged from hospital after rehabilitation and a comparison group of 43 community-dwelling elderly people. The Medical Outcomes Short Form 36 (SF-36) measure, the General Oral Health Assessment Index (GOHAI) and an oral health transition scale were administered prior to a dental examination. Median SF-36 subscale scores were significantly different between groups (P < 0.05). In physical function, role-physical, role-emotional and mental health domains, stroke survivors had significantly lower scores indicating poorer health. The median GOHAI score for the stroke group was 52 and 54 for the comparison group with no significant difference between groups although more stroke survivors had difficulty speaking compared with the comparison group. About 75% of stroke survivors considered their appearance to be worse, half of them felt that speech was worse and about a third had difficulty chewing hard food compared with the pre-stroke condition (P < 0.05). Most participants were partially dentate with no significant difference in DMFT scores or prosthetic status between groups (P > 0.05). Health-related quality of life in general was significantly poorer after stroke although patients were considered physically well enough to be discharged from hospital. There was some impairment of OHR-QoL. The nature of the stroke, the hospital environment including diet, coping strategies and elderly Chinese peoples' perception of health should be taken into account when interpreting measures of health status in stroke survivors.
该研究旨在调查中风幸存者康复出院后的口腔健康相关生活质量（OHR-QoL）。这是一项横断面研究，涉及43名轻度至中度中风的老年幸存者，他们即将在康复后出院，以及一个由43名社区居住老年人组成的对照组。在进行牙科检查之前，使用了医学结果简表36（SF-36）测量、一般口腔健康评估指数（GOHAI）和口腔健康转变量表。两组之间SF-36子量表的中位数得分存在显著差异（P<0.05）。在身体功能、身体角色、情感角色和心理健康领域，中风幸存者的得分显著较低，表明健康状况较差。中风组的GOHAI中位数得分为52，对照组为54，两组之间无显著差异，尽管与对照组相比，更多中风幸存者存在言语困难。与中风前相比，约75%的中风幸存者认为自己的外貌变差，一半的人觉得言语变差，约三分之一的人咀嚼硬食物有困难（P<0.05）。大多数参与者为部分牙列缺失，两组之间的龋失补牙面数（DMFT）得分或修复状况无显著差异（P>0.05）。尽管患者被认为身体状况足以出院，但中风后总体的健康相关生活质量明显较差。OHR-QoL存在一些损害。在解释中风幸存者的健康状况测量结果时，应考虑中风的性质、包括饮食在内的医院环境、应对策略以及中国老年人的健康观念。
