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中风发病两年后的生活满意度:卢森堡中风患者(Newsqol)及其家庭照顾者(Whoqol-bref)的性别、职业状况、记忆功能和生活质量的影响。

Life satisfaction two-years after stroke onset: the effects of gender, sex occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg.

机构信息

Medical Sociology, INSIDE Research Unit, University of Luxembourg, Walferdange, Luxembourg.

出版信息

BMC Neurol. 2012 Sep 25;12:105. doi: 10.1186/1471-2377-12-105.

Abstract

BACKGROUND

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective influences remain unclear. This study assessed, two years post-stroke onset, the effects of these factors on patients' LS and family caregivers' LS in Luxembourg.

METHODS

All stroke patients admitted to all hospitals in Luxembourg were identified by the 'Inspection Général de la Sécurité Sociale' using the only national system database for care expenditure reimbursement. Their diagnosis was confirmed by medical investigator. The sample included ninety four patients living at home having given consent (mean age 65.5 years) and sixty two main caregivers (mean age 59.3 years). Questionnaires were completed during face-to-face interviews. LS was assessed via European single question (range 1-10), survivors' QoL via Newsqol (11 dimensions), and caregivers' QoL via Whoqol-bref (4 domains) (range 0-100). Data were analysed using multiple regression models.

RESULTS

Two years after stroke onset, 44.7% of patients suffered from impaired sensory function, 35.1% from impaired motor function, and 31.9% from impaired memory function. Mean patient' LS was 7.1/10 (SD 1.9). It was higher in women (+12.4) and lower among unemployed socioeconomically active patients (-13.1, vs. retired people). Adjusted for sex, occupation, impaired motor and memory functions, LS positively correlated with scores of Newsqol feelings, sleep, emotion, cognition and pain dimensions (slopes 0.20 to 0.31), but did not correlate with those of caregivers' Whoqol-bref domains. Family caregiver' LS was 7.2 (SD 1.7). It was lower in those with patients suffering from impaired memory function (-12.8) as well as from feelings and emotion issues (slopes 0.22). It was associated with all caregivers' Whoqol-bref domains (physical health, psychological health, environment, and social relationships) (slopes 0.53 to 0.68).

CONCLUSIONS

Two-year post-cerebrovascular disease patient' LS was associated with gender, occupation, and impaired memory function. It correlated with feelings, sleep, emotion, cognition, and pain issues. Family caregivers of patients with impaired memory function had lower LS. Family caregiver' LS correlated with dimensions of patients' feelings (less independent, yourself, life changed, depressed, useless, less control because of stroke) and emotion (get more emotional, fear of another stroke or to become dependent on others), and with their own QoL. LS, Newsqol, and Whoqol appeared to be appropriate tools. Our findings may be useful for policy makers in relation to family and medical-social issues of stroke home-based rehabilitation.

摘要

背景

脑血管病幸存者及其家庭照顾者的生活满意度(LS)可能与社会经济因素、功能障碍、健康相关生活质量(QoL)有关,但各自的影响尚不清楚。本研究在卢森堡评估了这些因素在脑血管病发病两年后对患者 LS 和家庭照顾者 LS 的影响。

方法

卢森堡所有医院的所有脑血管病患者均由“社会保障总监察署”通过唯一的国家护理支出报销系统数据库使用“Inspection Général de la Sécurité Sociale”识别。他们的诊断由医学调查员确认。样本包括 94 名居住在家庭中并同意(平均年龄 65.5 岁)和 62 名主要照顾者(平均年龄 59.3 岁)。通过面对面访谈完成问卷调查。LS 通过欧洲单一问题(范围 1-10)进行评估,幸存者的 QoL 通过 Newsqol(11 个维度)进行评估,照顾者的 QoL 通过 Whoqol-bref(4 个领域)(范围 0-100)进行评估。使用多元回归模型分析数据。

结果

脑血管病发病两年后,44.7%的患者存在感觉功能障碍,35.1%存在运动功能障碍,31.9%存在记忆功能障碍。患者平均 LS 为 7.1/10(SD 1.9)。女性(+12.4)更高,而社会经济活跃的失业患者(-13.1,与退休人员相比)则较低。调整性别、职业、运动和记忆功能障碍后,LS 与 Newsqol 感觉、睡眠、情绪、认知和疼痛维度的评分呈正相关(斜率 0.20 至 0.31),但与照顾者 Whoqol-bref 领域的评分无关。家庭照顾者的 LS 为 7.2(SD 1.7)。患者记忆功能障碍(-12.8)以及情绪和情绪问题(斜率 0.22)的照顾者 LS 较低。它与照顾者 Whoqol-bref 的所有领域(身体健康、心理健康、环境和社会关系)相关(斜率 0.53 至 0.68)。

结论

脑血管病发病两年后患者的 LS 与性别、职业和记忆功能障碍有关。它与感觉、睡眠、情绪、认知和疼痛问题相关。记忆功能障碍患者的家庭照顾者 LS 较低。家庭照顾者的 LS 与患者的情绪(更不独立、自己、生活改变、抑郁、无用、因中风而失去更多控制)和情绪(变得更加情绪化、害怕再次中风或依赖他人)以及自己的 QoL 相关。LS、Newsqol 和 Whoqol 似乎是合适的工具。我们的研究结果可能对与家庭和医疗社会问题相关的政策制定者在脑血管病家庭康复方面有用。

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