Visser-Meily J M Anne, Rhebergen Marloes L, Rinkel Gabriel J E, van Zandvoort Martine J, Post Marcel W M
Department of Rehabilitation and Sports Medicine, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands.
Stroke. 2009 Apr;40(4):1526-9. doi: 10.1161/STROKEAHA.108.531277. Epub 2008 Dec 18.
Many patients who survive an aneurysmal subarachnoid hemorrhage experience decreased health-related quality of life (HRQoL). Physical factors have been identified as determinants of HRQoL. We describe long-term HRQoL and assessed whether psychological symptoms and personality characteristics determine HRQoL after subarachnoid hemorrhage.
In a cross-sectional study in 141 patients living independently in the community 2 to 4 years after subarachnoid hemorrhage, we assessed whether HRQoL, evaluated by the Stroke Specific Quality of Life scale, was related to psychological symptoms (mood disorders, fatigue, and cognitive complaints), personality characteristics (neuroticism and passive coping style), demographic characteristics, and subarachnoid hemorrhage disease characteristics.
Best Stroke Specific Quality of Life scale scores were found in the physical domain and worst in the emotional and social domains. Thirty-two percent reported anxiety, 23% depression, and 67% fatigue. Mood (beta between -0.42 and -0.18), fatigue (beta between -0.40 and -0.24), and cognitive complaints (beta between -0.46 and -0.16) were strongly associated with Stroke Specific Quality of Life scale scores in multivariate regression analyses.
Depression, anxiety, and fatigue were present in a substantial proportion of patients and were strongly related to decreased HRQoL. These symptoms identified are helpful to tailor rehabilitation to the needs of patients in the chronic phase after subarachnoid hemorrhage.
许多动脉瘤性蛛网膜下腔出血幸存者的健康相关生活质量(HRQoL)下降。身体因素已被确定为HRQoL的决定因素。我们描述了长期的HRQoL,并评估了心理症状和人格特征是否决定蛛网膜下腔出血后的HRQoL。
在一项横断面研究中,对141例在蛛网膜下腔出血后2至4年独立生活在社区中的患者,我们评估了通过卒中特异性生活质量量表评估的HRQoL是否与心理症状(情绪障碍、疲劳和认知主诉)、人格特征(神经质和消极应对方式)、人口统计学特征以及蛛网膜下腔出血疾病特征相关。
卒中特异性生活质量量表得分在身体领域最佳,在情感和社会领域最差。32%的患者报告有焦虑,23%有抑郁,67%有疲劳。在多变量回归分析中,情绪(β值在-0.42至-0.18之间)、疲劳(β值在-0.40至-0.24之间)和认知主诉(β值在-0.46至-0.16之间)与卒中特异性生活质量量表得分密切相关。
相当比例的患者存在抑郁、焦虑和疲劳,且与HRQoL下降密切相关。所确定的这些症状有助于根据蛛网膜下腔出血后慢性期患者的需求调整康复方案。