Arts Mark L J, Kwa Vincent I H, Dahmen Rutger
Department of Rehabilitation Medicine, Slotervaart Hospital, Amsterdam, The Netherlands.
Cerebrovasc Dis. 2008;25(6):566-71. doi: 10.1159/000132203. Epub 2008 May 16.
Many hospitalised patients with a transient ischaemic attack (TIA) or minor stroke develop subtle cognitive disorders and emotional problems a few weeks after discharge, and are dissatisfied with the care they have received, even with specialised stroke care programmes. Therefore, an individualised stroke care programme was developed to match the therapy with the personal care needs. In this pilot study we evaluated the feasibility of the rehabilitation programme, the satisfaction of stroke patients with this programme, and the factors associated with satisfaction.
Consecutive patients who were hospitalised with a TIA or minor stroke, with no apparent residual deficits, were eligible. Occupational and neuropsychological screening was applied 4-6 weeks after discharge, and therapy was provided when necessary. After 6 months, satisfaction with care (Satisfaction-With-Stroke-Care-19), was assessed as the primary outcome. Secondary outcomes were quality of life (QoL), disability, handicap, anxiety and depression.
42 patients with a TIA or minor stroke participated in the programme and the follow-up. Of all the participants, 71% were satisfied with the care they have received after discharge. Male patients were more satisfied than female patients. Dissatisfied patients were less able to perform the activities of daily living, had a lower QoL and more depressive symptoms. After regression analysis, only the Barthel Index was independently associated with satisfaction.
In this pilot study, our individualised stroke care programme seems to have improved patient satisfaction. Ability to perform daily activities is associated with satisfaction. A randomised controlled trial is needed to confirm the effectiveness of this rehabilitation programme.
许多因短暂性脑缺血发作(TIA)或轻度中风住院的患者在出院几周后会出现轻微的认知障碍和情绪问题,并且对他们所接受的护理不满意,即使是在专门的中风护理项目中。因此,制定了一项个性化的中风护理计划,以使治疗与个人护理需求相匹配。在这项试点研究中,我们评估了康复计划的可行性、中风患者对该计划的满意度以及与满意度相关的因素。
连续收治的因TIA或轻度中风住院且无明显残留缺陷的患者符合条件。出院后4 - 6周进行职业和神经心理筛查,必要时提供治疗。6个月后,将对护理的满意度(中风护理满意度-19)作为主要结局进行评估。次要结局包括生活质量(QoL)、残疾、残障、焦虑和抑郁。
42例TIA或轻度中风患者参与了该项目及随访。在所有参与者中,71%对出院后所接受的护理感到满意。男性患者比女性患者更满意。不满意的患者在日常生活活动方面能力较差生活质量较低且有更多抑郁症状。经过回归分析,只有巴氏指数与满意度独立相关。
在这项试点研究中,我们的个性化中风护理计划似乎提高了患者满意度。日常生活活动能力与满意度相关。需要进行一项随机对照试验来证实该康复计划的有效性。