Panicker Praveen, Iype Thomas, Appireddy Ramana, Ajithan Ayana, Lijimol A S, Sasikumar Asha, Dileep R, Vijaya Nirmala, Booth Chris, Rajagopal M R
Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India.
Department of Neurology, Queens University, Queens University School of Medicine, Kingston, Ontario, Canada.
J Neurosci Rural Pract. 2024 Apr-Jun;15(2):349-356. doi: 10.25259/JNRP_7_2024. Epub 2024 Apr 3.
Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India.
Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months.
Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up.
There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.
中风幸存者在多个领域都有姑息治疗需求，但这些需求被忽视了。准确评估这些需求对于确保适当的康复和规划干预措施以提高生活质量（QoL）至关重要。我们旨在以结构化方式评估印度南部一家三级护理中心神经科服务中中风患者在各个领域的姑息治疗需求。
在六个月内招募了连续75名到神经科就诊的中风患者，并在基线时以及在1个月和3个月随访时对各个领域进行评估，包括症状负担、身体领域、日常生活活动（ADL）、精神/心理领域和生活质量。
尽管中风幸存者的传统中风损伤指标有所改善，但各个领域仍存在大量未满足的需求；在3个月随访时，98%的患者在ADL方面严重或完全依赖他人；疼痛和失眠是最常见（发生率33%）的困扰症状。存在大量与心理健康相关的问题。所采用的生活质量测量工具是中风影响评估问卷（SIAQ），这是一种新工具，以及世界卫生组织生活质量简表（WHO-QOL-BREF）。1个月时SIAQ评分显示，19名患者（42.22%）的生活质量受到严重影响，3个月随访时36名患者（80%）呈现相同趋势。WHO-BREF评分显示，在1个月随访时，27名患者（62%）未报告有良好的生活质量，32名患者（73%）对自己的健康不满意。
在印度，中风幸存者在各个领域都存在大量未满足的姑息治疗需求负担。
