Kruisheer Elize M, Huenges Wajer Irene M C, Visser-Meily Johanna M A, Post Marcel W M
Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; National Military Rehabilitation Center Aardenburg, Doorn, The Netherlands.
Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
J Stroke Cerebrovasc Dis. 2017 May;26(5):1000-1006. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.124. Epub 2017 Jan 18.
The study aimed to investigate participation problems in patients with subarachnoid hemorrhage (SAH), and the course of participation between 3 and 12 months post-SAH, and to identify determinants of this course.
This is a prospective cohort study.
The study was done in the SAH outpatient clinic at the University Medical Center Utrecht.
Subjects included patients independent in activities of daily living who visited the SAH outpatient clinic for a routine follow-up visit 3 months after the event.
Participation was assessed using the restrictions scale of the Utrecht Scale for Evaluation of Rehabilitation-Participation at 3, 6, and 12 months post-SAH. Repeated measures analysis of variance was conducted to identify possible determinants of participation (demographic and SAH characteristics, mood, and cognition).
One hundred patients were included. Three months after SAH, the most commonly reported restrictions concerned work/unpaid work/education (70.5%), housekeeping (50.0%), and going out (45.2%). Twelve months post-SAH, patients felt most restricted in work/unpaid work/education (24.5%), housekeeping (23.5%), and chores in and around the house (16.3%). Participation scores increased significantly between 3 and 6 months, and between 3 and 12 months, post-SAH. The course of participation was associated with mood, cognition, and gender, but was in the multivariate analysis only determined by mood (F [1, 74] = 18.31, P = .000, partial eta squared: .20), showing lower participation scores at each time point for patients with mood disturbance.
Participation in functionally independent SAH patients improved over time. However, 1 out of 3 patients (34.9%) still reported one or more participation restrictions 12 months post-SAH. Mood disturbance was negatively associated with the course of participation after SAH.
本研究旨在调查蛛网膜下腔出血（SAH）患者的参与问题、SAH后3至12个月的参与过程，并确定该过程的决定因素。
这是一项前瞻性队列研究。
研究在乌得勒支大学医学中心的SAH门诊进行。
研究对象包括日常生活活动能够自理的患者，这些患者在SAH事件发生3个月后到SAH门诊进行常规随访。
在SAH后3、6和12个月，使用乌得勒支康复参与评估量表的限制量表评估参与情况。进行重复测量方差分析以确定参与的可能决定因素（人口统计学和SAH特征、情绪和认知）。
共纳入100例患者。SAH后3个月，最常报告的限制涉及工作/无薪工作/教育（70.5%）、家务（50.0%）和外出（45.2%）。SAH后12个月，患者在工作/无薪工作/教育（24.5%）、家务（23.5%）和房屋内外杂务（16.3%）方面感到限制最大。SAH后3至6个月以及3至12个月期间，参与得分显著提高。参与过程与情绪、认知和性别有关，但在多变量分析中仅由情绪决定（F[1, 74]=18.31，P=.000，偏η²：.20），表明情绪障碍患者在每个时间点的参与得分较低。
功能独立的SAH患者的参与情况随时间改善。然而，1/3的患者（34.9%）在SAH后12个月仍报告有一项或多项参与限制。情绪障碍与SAH后的参与过程呈负相关。
