EA, handicap et système nerveux, université Victor-Segalen Bordeaux, France.
Ann Phys Rehabil Med. 2011 Sep;54(6):376-90. doi: 10.1016/j.rehab.2011.06.002. Epub 2011 Aug 5.
Stroke is a major public health issue. Even though most hemiplegic stroke patients may obtain a good functional outcome, many remain dissatisfied with their lives. Indeed, quality of life and subjective well-being should be taken into account in any assessment of stroke survival.
To assess long-term quality of life in stroke patients (compared with healthy controls) and the corresponding determinants and predictive factors.
The patient population consisted of 80 of the 217 first-stroke survivors treated between January and June 2005 in the Clinical Neurosciences Department at Bordeaux University Hospital. After a mean follow-up period of 2 years, 24 patients were interviewed in their homes and data from the 56 others were obtained in a telephone interview. Demographic information, clinical status on admission and functional status (as assessed by Barthel Index) and depression (on the ADRS) at the time of the study visit were recorded. Quality of life was assessed by using the Sickness Impact Profile (SIP-65) and Bränholm and Fugl-Meyer's Satisfaction with Life Scale (LiSat 11). The patients' data were compared with those from 149 healthy controls.
Life satisfaction and quality of life were significantly impaired in stroke patients, compared with controls. All life domains were impaired. The worst scores were observed for independence and health-related items in the LiSat 11 and the physical and communication items in the SIP-65. Quality of life was strongly correlated with functional independence, the persistence of hemiplegia and depressive mood, which is in agreement with literature findings. Neither gender nor the initial Rankin score had a significant impact on these parameters.
DISCUSSION-CONCLUSION: Quality of life at 2 years is significantly impaired in stroke survivors and seems more difficult to predict than functional independence. However, in addition to these objective results, our interviews suggest that receiving adequate social support might be as important to patients as recovering independence.
中风是一个主要的公共卫生问题。尽管大多数偏瘫中风患者可能获得良好的功能结果，但许多人仍对他们的生活不满意。事实上，生活质量和主观幸福感应该纳入任何中风生存评估中。
评估中风患者的长期生活质量（与健康对照组相比）及其相应的决定因素和预测因素。
患者人群由 2005 年 1 月至 6 月在波尔多大学医院临床神经科治疗的 217 例首次中风幸存者中的 80 例组成。在平均 2 年的随访后，对 24 例患者进行了家庭访谈，并通过电话访谈获得了另外 56 例患者的数据。记录人口统计学信息、入院时的临床状况和功能状况（由 Barthel 指数评估）以及研究访问时的抑郁（ADRS）。使用疾病影响量表（SIP-65）和 Bränholm 和 Fugl-Meyer 的生活满意度量表（LiSat 11）评估生活质量。将患者的数据与 149 名健康对照组进行比较。
与对照组相比，中风患者的生活满意度和生活质量明显受损。所有生活领域都受到影响。LiSat 11 中独立性和健康相关项目以及 SIP-65 中的身体和沟通项目的评分最差。生活质量与功能独立性、偏瘫的持续存在和抑郁情绪密切相关，这与文献结果一致。性别和初始 Rankin 评分对这些参数均无显著影响。
讨论-结论：中风幸存者 2 年后的生活质量明显受损，似乎比功能独立性更难预测。然而，除了这些客观结果外，我们的访谈还表明，获得足够的社会支持对患者来说可能与恢复独立性一样重要。
