Kwon Su-Yeon, Hong Sang-Eun, Kim Ee-Jin, Kim Chang-Hwan, Joa Kyung-Lim, Jung Han-Young
Department of Physical and Rehabilitation Medicine, Inha University School of Medicine, Incheon, Korea.
Ann Rehabil Med. 2016 Feb;40(1):111-9. doi: 10.5535/arm.2016.40.1.111. Epub 2016 Feb 26.
To follow up the long-term functioning in a community through assessing personal background and status based on the International Classification of Functioning, Disability and Health (ICF) after a stroke, by using a Korean version of World Health Organization Disability Assessment Scale II (K-WHODAS II).
We surveyed 146 patients diagnosed at the first-onset of acute stroke and discharged after Inha University Hospital, and 101 patients answered the K-WHODAS II survey. We analyzed the relationship of six functioning domains of K-WHODAS II with K-MMSE (Korean version of Mini-Mental State Examination) and K-MBI (Korean version of Modified Barthel Index) at admission and discharge, and personal background. All subjects were divided into five groups, according to the disease durations, to assess the functional changes and the differences of K-MMSE and K-MBI at the admission and discharge.
K-MBI and K-MMSE at admission and discharge showed no significant differences in all five groups, respectively (p>0.05), reflecting no baseline disparity for long-term follow-up. All subjects showed positive gains of K-MBI and K-MMSE at discharge (p<0.05). The six functioning domains and total scores of K-WHODAS II had decreasing trends until 3 years after the stroke onset, but rose thereafter. Higher scores of K-MBI and K-MMSE, younger age, women, working status, higher educational level, and living with a partner were correlated with lower scores of K-WHODAS II (p<0.05).
The long-term functioning after stroke was affected not only by cognitive and motor status in hospital, but also by certain kinds of personal background. K-WHODAS II may be used to monitor functioning status in a community and to assess personal backgrounds in subjects with chronic stroke.
通过使用韩国版世界卫生组织残疾评估量表II（K-WHODAS II），基于国际功能、残疾和健康分类（ICF）评估中风后的个人背景和状况，以跟踪社区中的长期功能状况。
我们对146例首次诊断为急性中风并在仁荷大学医院出院后的患者进行了调查，其中101例患者回答了K-WHODAS II调查问卷。我们分析了K-WHODAS II的六个功能领域与入院和出院时的K-MMSE（韩国版简易精神状态检查表）和K-MBI（韩国版改良巴氏指数）以及个人背景之间的关系。根据病程将所有受试者分为五组，以评估入院和出院时的功能变化以及K-MMSE和K-MBI的差异。
五组患者入院和出院时的K-MBI和K-MMSE分别均无显著差异（p>0.05），这反映了长期随访中无基线差异。所有受试者出院时K-MBI和K-MMSE均有正向改善（p<0.05）。K-WHODAS II的六个功能领域和总分在中风发作后3年呈下降趋势，但此后上升。K-MBI和K-MMSE得分较高、年龄较小、女性、工作状态、教育水平较高以及与伴侣同住与K-WHODAS II得分较低相关（p<0.05）。
中风后的长期功能不仅受住院时的认知和运动状态影响，还受某些个人背景的影响。K-WHODAS II可用于监测社区中的功能状态，并评估慢性中风患者的个人背景。
