Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.
Department of Health and Care Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
Disabil Rehabil. 2021 Dec;43(26):3810-3820. doi: 10.1080/09638288.2020.1753830. Epub 2020 May 1.
To compare stroke-specific health related quality of life in two country-regions with organisational differences in subacute rehabilitation services, and to reveal whether organisational factors or individual factors impact outcome.
A prospective multicentre study with one-year follow-up of 369 first-ever stroke survivors with ischaemic or haemorrhagic stroke, recruited from stroke units in North Norway ( = 208) and Central Denmark ( = 161). The 12-domain Stroke-Specific Quality of Life scale was the primary outcome-measure.
The Norwegian participants were older than the Danish (= 69.8 vs. 66.7 years, respectively), had higher initial stroke severity, and longer stroke unit stays. Both cohorts reported more problems with cognitive, social, and emotional functioning compared to physical functioning. Two scale components were revealed. Between-country differences in the cognitive-social-mental component showed slightly better function in the Norwegian participants. Depression, anxiety, pre-stroke dependency, initial stroke severity, and older age were substantially associated to scale scores.
Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as pre-stroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services.IMPLICATIONS FOR REHABILITATIONThe stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clinically important information for the rehabilitation services.The cognitive-social-mental component and the physical health component, indicate specific functional problems which may vary across and within countries and regions with different organisation of rehabilitation services.For persons with mild to moderate stroke, longer-term functional improvements may be better optimised if the rehabilitation services particularly address cognitive, emotional, and social functioning.
比较两个在亚急性康复服务组织方面存在差异的国家-地区的特定于中风的健康相关生活质量，并揭示组织因素还是个体因素对结果有影响。
一项前瞻性多中心研究，对来自挪威北部（n=208）和丹麦中部（n=161）卒中单元的 369 名首次缺血性或出血性卒中幸存者进行了为期一年的随访。主要结果测量指标为 12 个领域的卒中特异性生活质量量表。
挪威参与者比丹麦参与者年龄更大（分别为 69.8 岁和 66.7 岁），初始卒中严重程度更高，且在卒中单元停留时间更长。两个队列在认知、社会和情感功能方面报告的问题都比身体功能多。两个量表分量被揭示出来。在认知-社会-心理分量上，国家间存在差异，挪威参与者的功能略好。抑郁、焦虑、卒中前依赖、初始卒中严重程度和年龄较大与量表评分有实质性关联。
两个国家-地区在一年后功能上的成功改善可能是通过优化长期康复服务来解决认知、情感和社会功能来实现的。卒中后一年的卒中特异性生活质量（SS-QOL）可以用个体因素来解释，如卒中前的依赖和心理健康，而不是亚急性康复服务组织的差异。
特定于中风的健康相关生活质量（SS-QOL）评估工具从患者的角度捕捉中风的多维影响，这是康复服务的重要临床信息。认知-社会-心理分量和身体健康分量，表明特定的功能问题，这些问题可能因康复服务组织不同而在不同的国家和地区有所不同。对于轻度至中度卒中患者，如果康复服务特别关注认知、情感和社会功能，那么长期的功能改善可能会得到更好的优化。
