Lee Hyejin, Lee Yuna, Choi Hyunsoo, Pyun Sung-Bom
Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea.
Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea.
Yonsei Med J. 2015 Nov;56(6):1694-702. doi: 10.3349/ymj.2015.56.6.1694.
To examine community integration and contributing factors in people with aphasia (PWA) following stroke and to investigate the relationship between community integration and quality of life (QOL).
Thirty PWA and 42 age-and education-matched control subjects were involved. Main variables were as follows: socioeconomic status, mobility, and activity of daily living (ADL) (Modified Barthel Index), language function [Frenchay Aphasia Screening Test (FAST)], depression [Geriatric Depression Scale (GDS)], Community Integration Questionnaire (CIQ) and Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). Differences between aphasia and control groups and factors affecting community integration and QOL were analyzed.
Home and social integration and productive activity were significantly decreased in the aphasia group compared to the control group; 8.5 and 18.3 points in total CIQ score, respectively. Amount of time spent outside the home and frequency of social contact were also significantly reduced in the aphasia group. Total mean score on the SAQOL-39 was 2.75±0.80 points and was significantly correlated with economic status, gait performance, ADL, depressive mood, and social domain score on the CIQ. Depression score measured by GDS was the single most important factor for the prediction of QOL, but the FAST score was significantly correlated only with the communication domain of the SAQOL-39.
Community activities of PWA were very limited, and depression was highly associated with decreased community integration and QOL. Enhancing social participation and reducing emotional distress should be emphasized for rehabilitation of PWA.
研究中风后失语症患者(PWA)的社区融入情况及相关影响因素,并调查社区融入与生活质量(QOL)之间的关系。
纳入30名PWA患者和42名年龄及教育程度匹配的对照受试者。主要变量如下:社会经济地位、活动能力以及日常生活活动(ADL)(改良巴氏指数)、语言功能[法国失语症筛查测试(FAST)]、抑郁[老年抑郁量表(GDS)]、社区融入问卷(CIQ)以及中风与失语症生活质量量表-39(SAQOL-39)。分析失语症组与对照组之间的差异以及影响社区融入和生活质量的因素。
与对照组相比,失语症组的家庭和社会融入以及生产性活动显著降低;CIQ总分分别降低8.5分和18.3分。失语症组在家外度过的时间量和社交接触频率也显著降低。SAQOL-39的总平均分是2.75±0.80分,且与经济状况、步态表现、ADL、抑郁情绪以及CIQ的社会领域得分显著相关。GDS测量的抑郁得分是预测生活质量的唯一最重要因素,但FAST得分仅与SAQOL-39的沟通领域显著相关。
PWA的社区活动非常有限,抑郁与社区融入和生活质量下降高度相关。对于PWA的康复,应强调增强社会参与和减轻情绪困扰。