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探索伴有沟通障碍的脑卒中幸存者生活质量的多个维度——简要报告。

Exploring dimensions of quality-of-life in survivors of stroke with communication disabilities - a brief report.

机构信息

Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.

Centre for Research Excellence in Stroke Rehabilitation, Victoria, Australia.

出版信息

Top Stroke Rehabil. 2023 Sep;30(6):603-609. doi: 10.1080/10749357.2022.2095087. Epub 2022 Jul 4.

Abstract

BACKGROUND

People with communication disabilities post-stroke have poor quality-of-life.

OBJECTIVES

We aimed to explore the association of self-reported communication disabilities with different dimensions of quality-of-life between 90 and 180 days post-stroke.

METHODS

Cross-sectional survey data were obtained between 90 and 180 days post-stroke from registrants in the Australian Stroke Clinical Registry recruited from three hospitals in Queensland. The usual follow-up survey included the EQ5D-3L. Responses to the Hospital Anxiety and Depression Scale, and extra questions (e.g. communication disabilities) were also collected. We used χ statistics to determine differences.

RESULTS

Overall, 244/647 survivors completed the survey. Respondents with communication disabilities (n = 72) more often reported moderate to extreme problems in all EQ5D-3L dimensions, than those without communication disabilities (n = 172): anxiety or depression (74% vs 40%, p < .001), pain or discomfort (58% vs 39%, p = .006), self-care (46% vs 18%, p < .001), usual activities (77% vs 49%, p < .001), and mobility (68% vs 35%, p < .001). Respondents with communication disabilities reported less fatigue (66% vs 89%, p < .001), poorer cognitive skills (thinking) (16% vs 1%, p < .001) and lower social participation (31% vs 6%, p < .001) than those without communication disabilities.

CONCLUSIONS

Survivors of stroke with communication disabilities are more negatively impacted across different dimensions of quality-of-life (as reported between 90 and 180 days post-stroke) compared to those without communication disabilities. This highlights the need for timely and on-going comprehensive multidisciplinary person-centered support.

摘要

背景

脑卒中后存在交流障碍的人群生活质量较差。

目的

本研究旨在探讨脑卒中后 90-180 天患者自我报告的交流障碍与生活质量不同维度之间的关系。

方法

本研究为横断面调查,数据来自昆士兰州 3 家医院的澳大利亚脑卒中临床登记处的注册患者,于脑卒中后 90-180 天进行常规随访调查,调查内容包括 EQ5D-3L。同时收集医院焦虑抑郁量表(HADS)的应答情况和额外问题(如交流障碍)。采用卡方检验比较两组间的差异。

结果

共有 647 例存活患者完成了调查,其中 244 例患者报告了交流障碍。与无交流障碍的患者(172 例)相比,有交流障碍的患者(72 例)在 EQ5D-3L 的所有维度中报告更多的中度至重度问题,包括焦虑或抑郁(74% vs. 40%,p < 0.001)、疼痛或不适(58% vs. 39%,p = 0.006)、自我护理(46% vs. 18%,p < 0.001)、日常活动(77% vs. 49%,p < 0.001)和行动能力(68% vs. 35%,p < 0.001)。有交流障碍的患者报告疲劳程度更低(66% vs. 89%,p < 0.001)、认知技能(思维)更差(16% vs. 1%,p < 0.001)和社会参与度更低(31% vs. 6%,p < 0.001)。

结论

与无交流障碍的患者相比,脑卒中后存在交流障碍的患者在生活质量的不同维度上受到更负面的影响(报告于脑卒中后 90-180 天)。这突出表明需要及时提供全面的、多学科的、以患者为中心的支持。

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