Department of Health Services Research University of Liverpool Liverpool UK.
Brain Behav. 2017 Aug 13;7(9):e00778. doi: 10.1002/brb3.778. eCollection 2017 Sep.
We sought to determine stroke survivors' views on impact of stroke-related visual impairment to quality of life.
Stroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio-recorded and transcribed verbatim. A thematic approach to analysis of the qualitative data was adopted. Transcripts were systematically coded using NVivo10 software.
Thirty-five stroke survivors were interviewed across the UK: 16 females, 19 males; aged 20-75 years at stroke onset. Five qualitative themes emerged: "Formal care," "Symptoms and self," "Adaptations," "Daily life," and "Information." Where visual problems existed, they were often not immediately recognized as part of the stroke syndrome and attributed to other causes such as migraine. Many participants did not receive early vision assessment or treatment for their visual problems. Visual problems included visual field loss, double vision, and perceptual problems. Impact of visual problems included loss in confidence, being a burden to others, increased collisions/accidents, and fear of falling. They made many self-identified adaptations to compensate for visual problems: magnifiers, large print, increased lighting, use of white sticks. There was a consistent lack of support and provision of information about visual problems.
Poststroke visual impairment causes considerable impact to daily life which could be substantially improved by simple measures including early formal visual assessment, management and advice on adaptive strategies and self-management options. Improved education about poststroke visual impairment for the public and clinicians could aid earlier diagnosis of visual impairments.
我们旨在确定卒中幸存者对与卒中相关的视力障碍对生活质量的影响的看法。
招募了卒中后超过 1 年且存在视力障碍的幸存者。对半结构化的传记叙述性访谈进行了录音和逐字转录。采用主题方法对定性数据进行分析。使用 NVivo10 软件对转录本进行系统编码。
在英国共对 35 名卒中幸存者进行了访谈:16 名女性,19 名男性;卒中发作时年龄为 20-75 岁。出现了 5 个定性主题:“正式护理”、“症状和自我”、“适应”、“日常生活”和“信息”。存在视力问题时,它们通常不作为卒中综合征的一部分而立即被识别,并归因于其他原因,如偏头痛。许多参与者没有接受过早期视力评估或治疗其视力问题。视力问题包括视野丧失、复视和知觉问题。视力问题的影响包括自信心下降、成为他人的负担、增加碰撞/事故以及对跌倒的恐惧。他们对视觉问题进行了许多自我识别的适应:放大镜、大字体、增加照明、使用白色手杖。关于视觉问题,始终缺乏支持和信息提供。
卒中后视力障碍对日常生活造成了相当大的影响,通过早期进行正式的视觉评估、管理以及提供有关适应性策略和自我管理选项的建议,可以大大改善。公众和临床医生对卒中后视力障碍的教育得到改善,有助于更早地诊断视力障碍。