Ostwald Sharon K, Swank Paul R, Khan Myrna M
Gerontological Nursing, Center on Aging, University of Texas School of Nursing, Houston, TX 77030, USA.
J Cardiovasc Nurs. 2008 Jul-Aug;23(4):371-7. doi: 10.1097/01.JCN.0000317435.29339.5d.
Stroke is the primary cause of long-term disability among older adults. This study identifies predictors of functional independence and perceived stress for stroke survivors discharged home from inpatient rehabilitation with a spousal caregiver.
Stroke survivors (N = 97) were interviewed immediately after discharge to obtain scores on the National Institutes of Health Stroke Scale, Functional Independence Measure (FIM), Stroke Impact Scale, Geriatric Depression Scale-15, Perceived Stress Scale, and Perceived Health Status. Demographic and stroke-related data were abstracted from their inpatient rehabilitation charts. Descriptive and regression analyses determined the relationships among variables and the models that best predicted functional independence and perceived stress.
Stroke survivors perceived a 50% recovery in their function upon discharge from inpatient rehabilitation. National Institutes of Health Stroke Scale, age, socioeconomic status, and number of complications predicted 63% of the variance of the total FIM score (F6,88 = 24.64; P < .0001). Total FIM, depression, and Stroke Impact Scale Emotion subscale predicted 45% of the Perceived Stress Scale score (F6,88 = 12.04; P < .0001).
Variables that predict the stroke survivors' recovery are complex as the severity of the stroke combines with demographic and economic variables and depression to predict functional independence and perceived stress. These factors need to be considered when preparing a discharge plan for stroke survivors who are discharged home from rehabilitation.
中风是老年人长期残疾的主要原因。本研究确定了从住院康复机构出院并由配偶照顾的中风幸存者功能独立和感知压力的预测因素。
对97名中风幸存者在出院后立即进行访谈，以获取其美国国立卫生研究院中风量表、功能独立性测量量表（FIM）、中风影响量表、老年抑郁量表-15、感知压力量表和感知健康状况的得分。人口统计学和中风相关数据从他们的住院康复病历中提取。描述性分析和回归分析确定了变量之间的关系以及最能预测功能独立性和感知压力的模型。
中风幸存者认为从住院康复机构出院时其功能恢复了50%。美国国立卫生研究院中风量表、年龄、社会经济地位和并发症数量预测了总FIM得分63%的方差（F6,88 = 24.64；P <.0001）。总FIM得分、抑郁得分和中风影响量表情绪子量表预测了感知压力量表得分45%的方差（F6,88 = 12.04；P <.0001）。
预测中风幸存者恢复情况的变量很复杂，因为中风的严重程度与人口统计学、经济变量以及抑郁相结合，共同预测功能独立性和感知压力。在为从康复机构出院回家的中风幸存者制定出院计划时，需要考虑这些因素。
