Faculty of Dentistry, Periodontology and Dental Public Health, University of Hong Kong, Hong Kong SAR.
J Oral Rehabil. 2009 Apr;36(4):264-70. doi: 10.1111/j.1365-2842.2009.01941.x. Epub 2009 Feb 9.
This study aimed to assess agreement between patient and proxy assessment of patients' oral health-related quality of life (OHRQoL) during the acute stroke phase and 6 months after hospital discharge. As part of an observational longitudinal study, 161 consecutive patients hospitalized after stroke and their caregivers (CGs) were monitored during acute stroke and 6 months after hospital discharge. Patient-CG agreement of health-related quality of life as assessed by the General Oral Health Assessment Index (GOHAI) and Medical Outcomes Study 12-item Short Form (SF-12) which comprises physical (PCS-12) and mental component summaries (MCS-12) was determined by comparison and correlation analyses. Complete data were available for 65 patients and CGs. Compared with acute stroke, there were improvements in GOHAI and SF-12 scores from patient's and CG's perspective at 6-month follow-up. Caregivers overestimated the impact of stroke on MCS-12 over a period of time (P < 0.01) and underestimated the impact on GOHAI during acute stroke (P < 0.001) and on PCS-12 6 months later (P < 0.05). Patient-CG agreement was substantial to excellent during acute stroke [intra-class correlation coefficient (ICC 0.69-0.86)] and fair-to-moderate 6 months later (ICC 0.28-0.60). Agreement was adequate between patients' and CGs' assessment of patient OHRQoL during acute stroke but it was less reliable 6 months after hospital discharge. These findings suggest that proxy assessment of OHRQoL after stroke is effective in assessing stroke-related oral impairments that affect life quality without placing additional burden on stroke patients themselves to assess OHRQoL.
本研究旨在评估急性脑卒中阶段和出院后 6 个月期间，患者及其照护者（CGs）对患者口腔健康相关生活质量（OHRQoL）的评估是否一致。作为一项观察性纵向研究的一部分，161 名连续住院的脑卒中患者及其 CGs 在急性脑卒中期间和出院后 6 个月期间进行监测。通过比较和相关分析，确定了由一般口腔健康评估指数（GOHAI）和医疗结局研究 12 项简明量表（SF-12）评估的患者-CG 健康相关生活质量的一致性，SF-12 包括身体成分量表（PCS-12）和心理成分量表（MCS-12）。有 65 名患者及其 CGs 提供了完整的数据。与急性脑卒中相比，患者和 CG 在 6 个月随访时的 GOHAI 和 SF-12 评分均有所改善。在一段时间内，CG 高估了脑卒中对 MCS-12 的影响（P < 0.01），低估了脑卒中对 GOHAI 的影响（P < 0.001）和对 PCS-12 的影响（P < 0.05）。在急性脑卒中期间，患者-CG 一致性较高（组内相关系数（ICC）0.69-0.86），而在 6 个月后则为适度到中等（ICC 0.28-0.60）。在急性脑卒中期间，患者和 CG 对患者 OHRQoL 的评估具有充分的一致性，但在出院后 6 个月时，这种一致性的可靠性较低。这些发现表明，脑卒中后代理评估 OHRQoL 可有效评估影响生活质量的与脑卒中相关的口腔障碍，而不会给脑卒中患者本身带来评估 OHRQoL 的额外负担。
