Törnbom Karin, Hadartz Kristin, Sunnerhagen Katharina S
Research Group for Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Research Group for Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Stroke Cerebrovasc Dis. 2018 Apr;27(4):1115-1122. doi: 10.1016/j.jstrokecerebrovasdis.2017.11.028. Epub 2017 Dec 25.
Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke.
Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy-English version (IPA-E) was used. Multivariate logistic regression models were performed using age, gender, stroke severity, and functional dependency at discharge as potential contributors to the perceived level of participation and autonomy.
A high percentage (70%-88%) evaluated their functions as fair to very good within all domains of the IPA-E at 1 year post stroke. However, around a fifth experienced their Family role as poor to very poor. Participants' functional dependency at discharge significantly influenced the outcome for the domains of Family role (odds ratio [OR] = 5.66, P < .01), Social relations (OR = 3.23, P < .03), and Autonomy indoors (OR = 3.44, P < .04) at 1 year post stroke.
Aspects of the Family role domain deserve further attention in interventions aimed at improving participation and autonomy at 1 year post stroke. The results also indicate that supporting indoor autonomy and social relations of persons with stroke during the acute rehabilitation is important to enhance participation and autonomy at 1 year post stroke.
识别预测中风后参与度和自主性长期结果的因素对于制定个性化康复干预措施至关重要。目的是描述自我评估的参与度和自主性，并探讨中风后1年与之相关的因素。
参与者包括79名（平均年龄 = 67岁）在1年随访时首次中风的患者。为了调查中风后1年的感知参与度和自主性，使用了一份自我评估问卷，即《参与和自主性影响-英文版》（IPA-E）。使用年龄、性别、中风严重程度和出院时的功能依赖程度作为感知参与度和自主性水平的潜在影响因素，进行多变量逻辑回归模型分析。
在中风后1年，高比例（70%-88%）的患者在IPA-E的所有领域中将其功能评估为“尚可”至“非常好 ”。然而，约五分之一的患者认为他们的家庭角色“差”至“非常差”。患者出院时的功能依赖程度对中风后1年的家庭角色领域（比值比[OR]=5.66，P<.01）、社会关系领域（OR=3.23，P<.03）和室内自主性领域（OR=3.44，P<.04）的结果有显著影响。
在旨在改善中风后1年参与度和自主性的干预措施中，家庭角色领域的各个方面值得进一步关注。结果还表明，在急性康复期间支持中风患者的室内自主性和社会关系对于提高中风后1年的参与度和自主性很重要。
