Faculty of Nursing, University of Calgary, Alberta, Canada.
J Stroke Cerebrovasc Dis. 2010 Jan;19(1):10-6. doi: 10.1016/j.jstrokecerebrovasdis.2009.02.005.
Mild stroke survivors are generally discharged from acute care within a few days of the stroke event, often without rehabilitation follow-up. We aimed to examine the recovery trajectory for male patients and their wife-caregivers during the 12 months postdischarge.
A descriptive study was undertaken to examine functional outcomes, quality of life (QOL), depression, caregiver strain, and marital function in a prospective cohort of male survivors of mild stroke and their wife-caregivers during the 12 months postdischarge. Data from each point in time were summarized and repeated measures analyses undertaken. Logistic regression was used to determine which baseline demographic and biopsychosocial variables influenced or predicted marital functioning 1 year postdischarge.
A total of 38 male patients (mean age 63.4 years) and their wife-caregivers (mean age 58.5 years) were examined. The median discharge National Institutes of Health Stroke Scale score was 1.5, modified Rankin Scale score was 1.0, Barthel Index was 100.0, and Stroke Impact Scale-16v2 score was 78.5. The patients' modified Rankin Scale (function) and QOL scores improved significantly over time (F (2) = 4.583, P = .017; and F (6) = 5.632, P < .001, respectively). However, the wife-caregiver QOL scores did not change. Multivariate analysis revealed overall worsening of depression for both the patient and wife-caregivers (F (6, 32) = 3.087, P = .017) and marital function (F (6, 32) = 3.961, P = .004), although the wife-caregivers' perceptions of caregiver strain improved (F (6, 32) = 3.923, P = .007). None of the measured variables were associated with marital functioning 1 year postdischarge.
Despite improvement in patients' functional status, other patient and wife-caregiver psychosocial outcomes during the 12 months postdischarge may be negatively affected. Thus, attention needs to focus on recovery beyond functional outcomes.
轻度中风幸存者通常在中风发生后的几天内从急性护理中出院，通常没有康复随访。我们旨在研究出院后 12 个月内男性患者及其妻子照顾者的恢复轨迹。
本研究采用描述性研究，在出院后 12 个月内，检查轻度中风后男性幸存者及其妻子照顾者的功能结局、生活质量（QOL）、抑郁、照顾者负担和婚姻功能。总结每个时间点的数据，并进行重复测量分析。逻辑回归用于确定哪些基线人口统计学和生物心理社会变量会影响或预测出院后 1 年的婚姻功能。
共检查了 38 名男性患者（平均年龄 63.4 岁）及其妻子照顾者（平均年龄 58.5 岁）。出院时 NIHSS 中位数为 1.5，改良 Rankin 量表评分为 1.0，Barthel 指数为 100.0，中风影响量表-16v2 评分为 78.5。患者的改良 Rankin 量表（功能）和 QOL 评分随时间显著改善（F（2）=4.583，P=0.017；F（6）=5.632，P<.001）。然而，妻子照顾者的 QOL 评分没有变化。多变量分析显示，患者和妻子照顾者的抑郁状况总体恶化（F（6，32）=3.087，P=0.017）和婚姻功能（F（6，32）=3.961，P=0.004），尽管妻子照顾者的照顾者负担感有所改善（F（6，32）=3.923，P=0.007）。测量的变量均与出院后 1 年的婚姻功能无关。
尽管患者的功能状态有所改善，但出院后 12 个月内其他患者和妻子照顾者的心理社会结局可能会受到负面影响。因此，需要关注功能结局之外的恢复情况。
