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卒中单元管理的卒中患者在家中生活1年后的后遗症和生活质量

Sequelae and Quality of Life in Patients Living at Home 1 Year After a Stroke Managed in Stroke Units.

作者信息

Broussy Sophie, Saillour-Glenisson Florence, García-Lorenzo B, Rouanet Francois, Lesaine Emilie, Maugeais Melanie, Aly Florence, Glize Bertrand, Salamon Roger, Sibon Igor

机构信息

Univ. Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France.

INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France.

出版信息

Front Neurol. 2019 Aug 21;10:907. doi: 10.3389/fneur.2019.00907. eCollection 2019.

Abstract

Knowledge about residual deficiencies and their consequences on daily life activities among stroke patients living at home 1-year after the initial event managed in stroke units is poor. This multi-dimensional study assessed the types of deficiencies, their frequency and the consequences that the specific stroke had upon the daily life of patients. A cross-sectional survey, assessing, using standardized scales, 1 year post-stroke disabilities, limitations of activities, participation and quality of life, was carried out by telephone interview and by mail in a sample of stroke patients who returned home after having been initially managed in a stroke unit. A total of 161 patients were included (142 able to answer the interview on their own; 19 needing a care-giver). Amongst a sub-group of the patients interviewed, 55.4% (95% Confidence Interval [47.1-63.7]) complained about pain and 60.0% (95% CI [51.4-68.6]) complained of fatigue; about 25% presented neuropsychological or neuropsychiatric disability. Whilst 87.3% (95% CI [81.7-92.9]) were independent for daily life activities, participation in every domains and quality of life scores, mainly in daily activity, pain, and anxiety subscales, were low. Despite a good 1-year post-stroke functional outcome, non-motor disabling symptoms are frequent amongst patients returned home and able to be interviewed, contributing to a low level of participation and a poor quality of life. Rehabilitation strategies focused on participation should be developed to break the vicious circle of social isolation and improve quality of life.

摘要

对于在家中生活的中风患者,在中风单元接受首次治疗1年后,关于残留缺陷及其对日常生活活动影响的了解非常匮乏。这项多维度研究评估了缺陷的类型、频率以及特定中风对患者日常生活的影响。通过电话访谈和邮件方式,对在中风单元接受首次治疗后回家的中风患者样本进行了横断面调查,使用标准化量表评估中风后1年的残疾情况、活动受限、参与度和生活质量。共纳入161名患者(142名能够自行回答访谈;19名需要护理人员协助)。在接受访谈的患者亚组中,55.4%(95%置信区间[47.1 - 63.7])抱怨疼痛,60.0%(95%置信区间[51.4 - 68.6])抱怨疲劳;约25%存在神经心理或神经精神残疾。虽然87.3%(95%置信区间[81.7 - 92.9])在日常生活活动方面能够自理,但在各个领域的参与度和生活质量得分,主要是在日常活动、疼痛和焦虑子量表方面,都很低。尽管中风后1年功能预后良好,但回家且能够接受访谈的患者中,非运动性致残症状很常见,这导致参与度低和生活质量差。应制定以参与度为重点的康复策略,以打破社会孤立的恶性循环并提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b72/6712081/395d19945095/fneur-10-00907-g0001.jpg

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