Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Liouying, Tainan City, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan City, Taiwan; Department of Physical Medicine and Rehabilitation, Chung San Medical University, Taichung City, Taiwan.
J Formos Med Assoc. 2023 Sep;122(9):862-871. doi: 10.1016/j.jfma.2023.05.007. Epub 2023 May 21.
This study focused on the integrated post-acute care (PAC) stage of stroke patients, and employed a retrospective study to examine the satisfaction with life quality in two groups, one that received home-based rehabilitation and one that received hospital-based rehabilitation. A secondary purpose was to analyze the correlations among the index and components concerning their quality of life (QOL) and compare the advantages and disadvantages of these two approaches to PAC.
This research was a retrospective study of 112 post-acute stroke patients. The home-based group received rehabilitation for one to two weeks, and two to four sessions per week. The hospital-based group received the rehabilitation for three to six weeks, and 15 sessions per week. The home-based group mainly received the training and guidance of daily activities at the patients' residence. The hospital-based group mainly received physical facilitation and functional training in the hospital setting.
The mean scores of QOL assessment for both groups were found to be significantly improved after intervention. Between-group comparisons showed that the hospital-based group had better improvement than the home-based group in mobility, self-care, pain/discomfort and depression/anxiety. In the home-based group, the MRS score and the participant's age can explain 39.4% of the variance of QOL scores.
The home-based rehabilitation was of lower intensity and duration than the hospital-based one, but it still achieved a significant improvement in QOL for the PAC stroke patients. The hospital-based rehabilitation offered more time and treatment sessions. Therefore hospital-based patients responded with better QOL outcomes than the home-based patients.
本研究聚焦于脑卒中患者的综合康复后期阶段，采用回顾性研究方法，比较了居家康复组和住院康复组两组患者的生活质量满意度。次要目的是分析与生活质量相关的各项指标及其组成部分之间的相关性，并比较两种康复后期治疗模式的优缺点。
本研究纳入了 112 例急性脑卒中后患者，其中居家康复组接受 1-2 周、1-2 次/周的康复治疗，住院康复组接受 3-6 周、15 次/周的康复治疗。居家康复组主要在患者家中接受日常生活活动的训练和指导，住院康复组主要在医院接受物理治疗和功能训练。
两组患者的生活质量评估评分均在干预后显著提高。组间比较显示，在移动能力、自我护理、疼痛/不适和抑郁/焦虑方面，住院康复组的改善优于居家康复组。在居家康复组中，MRS 评分和患者年龄可以解释生活质量评分变化的 39.4%。
居家康复的强度和持续时间低于住院康复，但仍能显著改善康复后期脑卒中患者的生活质量。住院康复提供了更多的时间和治疗次数，因此住院康复患者的生活质量改善情况优于居家康复患者。
