Hartman-Maeir Adina, Soroker Nachum, Ring Haim, Avni Noga, Katz Noomi
School of Occupational Therapy, Hadassah and Hebrew University of Jerusalem, Israel.
Disabil Rehabil. 2007 Apr 15;29(7):559-66. doi: 10.1080/09638280600924996.
To evaluate the chronic consequences of stroke in terms of activity limitations, restricted participation and dissatisfaction from life, and the relationship between these variables, in stroke survivors living in the community one-year post onset.
A total of 56 stroke patients (mean age: 57.7) who completed an in-patient rehabilitation programme, were evaluated one-year post onset in their homes, using the following instruments: Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), a work questionnaire, Life-Satisfaction Questionnaire (Li-Sat 9) and the Geriatric Depression Scale (GDS).
One year post stroke onset the mean FIM motor score was 75.88 (max score: 91), yet more than 50% of the sample still required assistance (usually mild to moderate) in dressing, bathing and use of stairs. The majority of the sample required full assistance in some IADL domains, notably meal preparation (77%), housekeeping (70%) and laundry (82%). Only one subject returned to paid employment and the mean activity level (ACS), representing the percentage of leisure and IADL activities retained from before stroke, was 42.8%. Satisfaction ratings were generally low but varied between domains. Only 39% were satisfied from 'life as a whole'. The lowest satisfaction rates were noted for 'vocational situation' (14%), 'leisure situation' (34%) and 'ability in self-care' (43%), whereas the satisfaction rate from family life was high (84%). Significant correlations were found between overall life satisfaction scores and the overall FIM motor, IADLq, and ACS scores (Pearson r values: 0.32, 0.48 and 0.57, respectively). Activity level was found to be a significant predictor of satisfaction (p = 0.007) beyond that accounted for by demographic variables and depression.
Stroke survivors dwelling in the community demonstrate long-standing dissatisfaction one-year post onset, correlating with activity limitation and restricted participation. The findings present a compelling need for rehabilitation services with a focus on participation in IADL and leisure activities, in order to improve the satisfaction of this population.
评估中风发病一年后，社区中风幸存者在活动受限、参与受限和生活不满意方面的慢性后果，以及这些变量之间的关系。
共有56名中风患者（平均年龄：57.7岁）完成了住院康复计划，在发病一年后在家中接受评估，使用以下工具：功能独立性测量（FIM）、日常生活活动问卷（IADLq）、活动卡片分类（ACS）、工作问卷、生活满意度问卷（Li-Sat 9）和老年抑郁量表（GDS）。
中风发病一年后，FIM运动平均得分是75.88（满分：91），然而超过50%的样本在穿衣、洗澡和上下楼梯方面仍需要帮助（通常为轻度至中度）。大多数样本在一些IADL领域需要完全帮助，尤其是 meal preparation（77%）、家务（70%）和洗衣（82%）。只有一名受试者恢复了带薪工作，代表中风前保留的休闲和IADL活动百分比的平均活动水平（ACS）为42.8%。满意度评分普遍较低，但各领域有所不同。只有39%的人对“整体生活”感到满意。“职业状况”（14%）、“休闲状况”（34%）和“自我照顾能力”（43%）的满意度最低，而家庭生活的满意度较高（84%）。总体生活满意度得分与总体FIM运动、IADLq和ACS得分之间存在显著相关性（Pearson r值分别为0.32、0.48和0.57）。发现活动水平是满意度的一个重要预测因素（p = 0.007），超出了人口统计学变量和抑郁所解释的范围。
居住在社区中的中风幸存者在发病一年后表现出长期的不满，这与活动受限和参与受限相关。研究结果表明迫切需要提供以参与IADL和休闲活动为重点的康复服务，以提高这一人群的满意度。
