Chimatiro George Lameck, Rhoda Anthea J, De Wit Liesbet
Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, South Africa.
Deputy Dean Teaching and Learning, Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, South Africa.
Malawi Med J. 2018 Sep;30(3):152-158. doi: 10.4314/mmj.v30i3.4.
Stroke is the fourth leading cause of mortality and disability in Malawi. There is paucity of studies reporting on acute stroke functional outcomes, quality of life and satisfaction with care among patients with stroke. This study aimed to determine stroke outcomes and satisfaction with care in the country's central hospitals.
A descriptive cross-sectional study, recruiting 114 adult patients with stroke and their caregivers, was done. FIM, EQ-5D-5L, SASC and C-SASC were used to collect data. Univariate associations were assessed using the Kruskal-Wallis Test for categorical variables and the Wilcoxon Rank Sum Test for continuous variables.
With 79% of the original study sample taking part, there was improvement in patients' functional status at discharge compared to on admission with notable improvement in self-care (p<0.001), sphincter control (p<0.001), locomotion (p<0.001), and social cognition (p<0.001), but no significant improvement in transfers (p=1.000), and communication (p=0.865). Satisfaction with care was high, with no significant differences between males and females (p=0.415), age in years (p=0.397), and distance to the clinic (p=0.615). Satisfaction ratings were also high from caregivers' responses and their scores were not associated with age (p=0.663) or distance to the hospital (p=0.872). Quality of life was poor, most patients were either unable or had severe limitation in functional dimensions of mobility (22(28%), self-care (19(25%) and performance of usual activities (25(33%). Every additional year in age was associated with average of 0.36 decrease in quality of life score coefficient, -0.36 (95% CI: -0.63; -0.10); p=0.008.
Patients with stroke experience improvement in functional outcomes on discharge compared to on admission. Patients and caregivers were satisfied with care provision despite having poor quality of life post stroke treatment. There is need to focus proven interventions on areas of stroke care that can impact patients' quality of life in resource limited settings.
在马拉维，中风是导致死亡和残疾的第四大主要原因。关于急性中风功能结局、生活质量以及中风患者对护理满意度的研究较少。本研究旨在确定该国中心医院的中风结局及护理满意度。
开展了一项描述性横断面研究，招募了114名成年中风患者及其护理人员。使用FIM、EQ-5D-5L、SASC和C-SASC收集数据。对于分类变量，使用Kruskal-Wallis检验评估单变量关联；对于连续变量，使用Wilcoxon秩和检验进行评估。
原研究样本的79%参与其中，与入院时相比，患者出院时的功能状态有所改善，自我护理（p<0.001）、括约肌控制（p<0.001）、移动能力（p<0.001）和社会认知（p<0.001）有显著改善，但转移能力（p = 1.000）和沟通能力（p = 0.865）无显著改善。对护理的满意度较高，男性与女性之间（p = 0.415）、年龄（岁）之间（p = 0.397）以及到诊所的距离之间（p = 0.615）均无显著差异。护理人员的满意度评分也较高，且他们的得分与年龄（p = 0.663）或到医院的距离（p = 0.872）无关。生活质量较差，大多数患者在移动功能维度（22例（28%））、自我护理（19例（25%））和日常活动能力（25例（33%））方面要么无法完成，要么有严重限制。年龄每增加一岁，生活质量得分系数平均下降0.36，即-0.36（95%置信区间：-0.63；-0.10）；p = 0.008。
与入院时相比，中风患者出院时的功能结局有所改善。尽管中风治疗后的生活质量较差，但患者和护理人员对护理服务感到满意。在资源有限的环境中，需要将经过验证的干预措施集中在能够影响患者生活质量的中风护理领域。
