Worrall Linda E, Hudson Kyla, Khan Asaduzzaman, Ryan Brooke, Simmons-Mackie Nina
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
Arch Phys Med Rehabil. 2017 Feb;98(2):235-240. doi: 10.1016/j.apmr.2016.06.020. Epub 2016 Jul 22.
To determine factors that contribute to living well with aphasia in the first 12 months poststroke.
Prospective longitudinal cohort study.
Hospitalized care, ambulatory care, and general community.
A referred sample of people (N=58) with a first incidence of aphasia after stroke was assessed at 3, 6, 9, and 12 months postonset. Participants were recruited through speech-language pathologists in 2 capital cities in Australia. Presence of aphasia was determined through the Western Aphasia Battery-Revised by an experienced speech-language pathologist.
Not applicable.
The main outcomes were the 5 domains of the Assessment for Living with Aphasia at 3, 6, 9, and 12 months poststroke. The independent variables included demographics, physical functioning, social network, mood, aphasia severity, and a self-rating of successfully living with aphasia at the same time points. Mixed effects modeling was used to determine which factors contributed to the trajectory of each of the 5 domains of participation, impairment, environment, personal factors, and life with aphasia.
Higher household income, larger social network size, being a woman, and having milder aphasia were positively associated with the participation domain. Graduate or postgraduate educational levels, low mood, and poor physical functioning were negatively associated with the participation domain. Factors positively associated with other domains included higher income, self-ratings of successfully living with aphasia, and aphasia severity. Low mood was consistently negatively associated with all of the domains.
Psychosocial determinants were the most significant predictors of living well with aphasia in the first 12 months postonset. Aphasia rehabilitation needs to attend more to these factors to optimize outcomes.
确定中风后12个月内有助于失语症患者良好生活的因素。
前瞻性纵向队列研究。
住院护理、门诊护理和普通社区。
对58例首次中风后发生失语症的患者进行了研究，在发病后3、6、9和12个月进行评估。参与者通过澳大利亚两个首府城市的语言病理学家招募。失语症的存在由经验丰富的语言病理学家通过西方失语症成套测验修订版确定。
不适用。
主要结局是中风后3、6、9和12个月失语症生活评估的5个领域。自变量包括人口统计学、身体功能、社交网络、情绪、失语症严重程度以及在相同时间点对成功与失语症共存的自我评估。采用混合效应模型来确定哪些因素对参与、损伤、环境、个人因素和失语症生活这5个领域的轨迹有影响。
家庭收入较高、社交网络规模较大、女性以及失语症较轻与参与领域呈正相关。研究生或更高学历、情绪低落和身体功能较差与参与领域呈负相关。与其他领域呈正相关的因素包括较高收入、对成功与失语症共存的自我评估以及失语症严重程度。情绪低落始终与所有领域呈负相关。
社会心理因素是发病后12个月内失语症患者良好生活的最重要预测因素。失语症康复需要更多关注这些因素以优化治疗效果。
