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康复出院后脑卒中患者特定生活质量轨迹及其社会人口学和临床相关性:一项纵向、多中心研究。

Stroke disease-specific quality of life trajectories after rehabilitation discharge and their sociodemographic and clinical associations: A longitudinal, multicentre study.

机构信息

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.

出版信息

J Adv Nurs. 2021 Apr;77(4):1856-1866. doi: 10.1111/jan.14722. Epub 2020 Dec 8.

Abstract

AIM

To investigate the longitudinal growth trajectories of disease-specific quality of life (QoL) dimensions and their associations over 1 year.

DESIGN

A longitudinal design. Data were collected between February 2015-May 2017.

METHODS

Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope.

RESULTS

We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12-month follow-up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion.

CONCLUSIONS

This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables.

IMPACT

Stroke has a great impact on stroke survivors' QoL. Disease-specific QoL significantly increases from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.

摘要

目的

探讨疾病特异性生活质量(QoL)维度的纵向增长轨迹及其在 1 年内的相关性。

设计

纵向设计。数据收集于 2015 年 2 月至 2017 年 5 月之间。

方法

415 例脑卒中幸存者(平均年龄 70.6 岁;81%为缺血性脑卒中)在康复医院出院后被招募,并在 1 年内每 3 个月随访一次。使用分层线性模型(HLMs)和线性、对数、二次和三次时间斜率评估脑卒中影响量表(SIS)维度评分的变化。

结果

我们观察到大多数 SIS 维度从基线到 12 个月随访的线性和二次增加,尤其是在身体维度上。沟通维度在整个时间内保持稳定,而记忆维度仅呈线性增加。较高的身体维度得分与基线时较低的年龄、高胆固醇血症和更好的身体功能显著相关,而较高的沟通维度与较低的年龄、更好的身体功能和外周血管疾病诊断相关。更好的记忆与较低的年龄、已婚状态、更好的身体功能和左侧脑卒中相关。更好的参与与较低的年龄和更好的身体功能相关。情绪方面没有显著的相关性。

结论

本研究提供了有关脑卒中幸存者特定 QoL 轨迹及其相关变量的重要信息。

影响

脑卒中对脑卒中幸存者的 QoL 有很大的影响。疾病特异性 QoL 从基线到 12 个月随访显著增加,尤其是在身体维度上。较低的年龄、高胆固醇血症、更好的身体功能和外周血管疾病的诊断似乎与更好的 QoL 相关。通过对相关变量的分析,我们确定了更易受影响且需要更有针对性的干预措施来改善其身体、心理、情绪和社会维度的脑卒中幸存者。

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