Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria.
Health Qual Life Outcomes. 2011 Sep 27;9:81. doi: 10.1186/1477-7525-9-81.
Various studies have reported discordant profiles of health-related quality of life (HRQOL) after stroke. The aims of this study, the first of its kind, were to determine the real impact of stroke on HRQOL across diverse cultures; and to compare HRQOL between stroke patients and healthy adults, and across stroke severity strata.
100 stroke patients and 100 apparently healthy adults (AHAs) in Nigeria; as well as 103 stroke and 50 AHAs in Germany participated. Stroke severity was measured using the National Institute of Health Stroke Scale, Stroke Levity Scale and modified Rankin scale. HRQOL was evaluated using the HRQOL In Stroke Patients (HRQOLISP) measure, a holistic multiculturally-validated measure with seven therapeutically-relevant domains distributed into two spheres.
Domains within the spiritual sphere were considered more important by stroke patients. In both countries, stroke patients significantly (0.00001 < p < 0.004) had worse HRQOL than AHAs in all domains within the physical sphere. This was not so for the spiritual sphere. Consistently, stroke severity correlated significantly with all domains in the physical sphere unlike the spiritual sphere. In diverse cultures, the correlation coefficients between HRQOL and all indices of stroke severity revealed a decremental trend from the physical domain (rho = 0.77, p < 0.00001) to the spiritual domain (rho = 0.01, p = 0.893).
Consistently, stroke elicited a decremental response across domains, with domains in the spiritual sphere being relatively stroke-resilient. The potential utility of the relatively preserved spiritual sphere in facilitating stroke rehabilitation requires evaluation in diverse cultures.
多项研究报告称，卒中后健康相关生活质量（HRQOL）的特征存在差异。本研究旨在首次确定卒中对不同文化人群 HRQOL 的实际影响；并比较卒中患者与健康成年人以及卒中严重程度分层之间的 HRQOL。
尼日利亚的 100 名卒中患者和 100 名明显健康成年人（AHAs）；以及德国的 103 名卒中患者和 50 名 AHAs 参与了本研究。卒中严重程度采用国立卫生研究院卒中量表、卒中严重程度量表和改良 Rankin 量表进行评估。HRQOL 使用卒中患者 HRQOL 量表（HRQOLISP）进行评估，这是一种整体的、多文化验证的量表，具有七个具有治疗意义的领域，分布在两个领域。
卒中患者认为精神领域的领域更重要。在两个国家中，与 AHAs 相比，所有物理领域的领域卒中患者的 HRQOL 均显著（0.00001 < p < 0.004）更差。但精神领域并非如此。一致地，卒中严重程度与物理领域的所有领域均显著相关，但与精神领域无关。在不同的文化中，HRQOL 与所有卒中严重程度指标之间的相关系数显示出从物理域（rho = 0.77，p < 0.00001）到精神域（rho = 0.01，p = 0.893）的递减趋势。
一致地，卒中在各个领域引起递减反应，而精神领域的反应相对较强。在不同的文化中，评估相对保留的精神领域在促进卒中康复方面的潜在效用是必要的。
