脑卒中患者神经内康复住院治疗后健康相关生活质量的预测因素：一项前瞻性研究。
Predictors of health-related quality of life in stroke patients after neurological inpatient rehabilitation: a prospective study.
机构信息
Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuernberg, Schwabachanlage 6, 91054, Erlangen, Germany.
Clinic for Specialised In- and Outpatient Rehabilitation Medicine Herzogenaurach, Department of Neurology and Neuropsychology, In der Reuth 1, 91074, Herzogenaurach, Germany.
出版信息
Health Qual Life Outcomes. 2015 May 14;13:58. doi: 10.1186/s12955-015-0258-9.
BACKGROUND
The goal of the study was to investigate the long-term course of health-related quality of life (HRQoL) in stroke survivors during and up to 2.5 years after inpatient neurological rehabilitation and to identify predictors of HRQoL.
METHODS
HRQoL was determined in 152 stroke survivors in a single-centre prospective cohort study at four time points: upon admission to inpatient rehabilitation, at discharge, and one and 2.5 years after discharge. Their HRQoL was determined by administering the EQ-5D at all four measurement points. During inpatient rehabilitation, the SF-36 was administered in addition to the EQ-5D. Predictors were identified through multiple regression analysis.
RESULTS
During inpatient rehabilitation, the "European Index" of the EQ-5D rose significantly (p < 0.001) from 45.4 to 66.7. The change in HRQoL on the SF-36 was convergent. The HRQoL of the stroke patients living at home remained at the same level for 2.5 years following discharge. In the multiple regression analysis, the EQ-5D Index at discharge (p = 0.049), the risk of falls as defined by Runge and Rehfeld (p = 0.001), and the change in emotional quality of life on the SF-36 during inpatient rehabilitation (p = 0.048) predicted HRQoL 2.5 years following discharge.
CONCLUSION
On the basis of our results, we conclude that the long-term health-related quality of life of stroke survivors can be positively influenced by reducing the risk of falls and improving emotional well-being during neurological inpatient rehabilitation.
背景
本研究的目的是调查脑卒中幸存者在住院神经康复期间及之后 2.5 年内健康相关生活质量（HRQoL）的长期变化，并确定 HRQoL 的预测因素。
方法
在一项单中心前瞻性队列研究中，我们在四个时间点评估了 152 名脑卒中幸存者的 HRQoL：入院时、出院时、出院后 1 年和 2.5 年。在所有四个测量点均采用 EQ-5D 评估他们的 HRQoL。在住院康复期间，除了 EQ-5D 之外，还采用 SF-36 评估。通过多元回归分析确定预测因素。
结果
在住院康复期间，EQ-5D 的“欧洲指数”从 45.4 显著上升至 66.7（p<0.001）。SF-36 的 HRQoL 变化具有一致性。出院后 2.5 年内，居家生活的脑卒中患者的 HRQoL 保持在同一水平。在多元回归分析中，出院时的 EQ-5D 指数（p=0.049）、Runge 和 Rehfeld 定义的跌倒风险（p=0.001）以及住院康复期间 SF-36 中情绪健康状况的变化（p=0.048）预测了出院后 2.5 年的 HRQoL。
结论
基于我们的结果，我们得出结论，降低跌倒风险和改善神经科住院康复期间的情绪健康状况可以对脑卒中幸存者的长期健康相关生活质量产生积极影响。
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