Angeleri F, Angeleri V A, Foschi N, Giaquinto S, Nolfe G
Istituto delle Malattie del Sistema Nervoso, Clinica Neurologica, Università di Ancona, Italy.
Stroke. 1993 Oct;24(10):1478-83. doi: 10.1161/01.str.24.10.1478.
This study was designed to assess the quality of life after an active poststroke period of rehabilitation and to investigate the possibility of a return to a working environment for those still of working age.
The study was conducted on 180 consecutive patients affected by stroke who were hospitalized for the first time and discharged at least 1 year before the study. The group consisted of 65% men and 35% women with a mean age 65.29 years (SD, 11.22). The period between the stroke and the interview ranged from 12 to 196 months, with a mean of 37.5 months. The average Rankin score on discharge from the rehabilitation center was 2.718 (moderate handicap). The interview took place at home after consent obtained by telephone. The questionnaire included general and personal information regarding the individuals, their socioeconomic position, and scales for daily activity, depression, social activity, and stress produced in the family. The control group consisted of 167 age-matched subjects.
A close correlation was observed in all patients between depression, social activity, and stress caused to relatives. The scores on the individual scales were clearly worse than those for control subjects. The patients received approximately 5 months of rehabilitation after the stroke. Differences emerged between men and women for depression and social activities, with the women scoring worse. In reference to daily life, 70% of prestroke ability was required on average after rehabilitation. The daily activity score at the time of the interview was also strongly influenced by the discharge score. The majority of patients were retired. Of the total, 20.64% returned to work, but not always to the same job and often after readapting to new conditions. Of this population, only 31.5% were women. With regard to the population aged younger than 65 years, 21.42% returned to work. Lesions in the dominant hemisphere do not necessarily seem to rule out return to work, even if associated with aphasia. The main discriminating element was the ability to understand language. The patients were often criticized by their cohabitants; the criticisms most often raised concerned apathy, irritability, and self-centeredness. Sexual activity was depressed in almost all cases.
Despite the progress made in studying cerebral vasculopathies, patients in the aftermath of a stroke still seem to live unsatisfactorily, as they did many years ago. Useful measures include valid treatment against spasticity, psychological assistance, and greater social support.
本研究旨在评估卒中后积极康复阶段后的生活质量，并调查仍处于工作年龄的患者重返工作环境的可能性。
本研究对180例首次住院且在研究前至少已出院1年的卒中患者进行。该组中男性占65%，女性占35%，平均年龄65.29岁（标准差11.22）。卒中与访谈之间的时间间隔为12至196个月，平均为37.5个月。康复中心出院时的平均Rankin评分为2.718（中度残疾）。在通过电话征得同意后，在家中进行访谈。问卷包括有关个人的一般和个人信息、他们的社会经济地位，以及日常活动、抑郁、社交活动和家庭产生的压力量表。对照组由167名年龄匹配的受试者组成。
在所有患者中，抑郁、社交活动与给亲属造成的压力之间存在密切相关性。各个量表的得分明显低于对照组受试者。卒中后患者接受了大约5个月的康复治疗。在抑郁和社交活动方面，男性和女性之间存在差异，女性得分更差。在日常生活方面，康复后平均需要卒中前能力的70%。访谈时的日常活动得分也受到出院得分的强烈影响。大多数患者已退休。在所有患者中，20.64%重返工作岗位，但并不总是回到原来的工作，而且往往是在适应新条件之后。在这一人群中，只有31.5%是女性。对于年龄小于65岁的人群，21.42%重返工作岗位。优势半球的病变似乎不一定排除重返工作的可能性，即使伴有失语症。主要的区分因素是语言理解能力。患者经常受到同居者的批评；最常提出的批评涉及冷漠、易怒和以自我为中心。几乎在所有情况下，性活动都受到抑制。
尽管在研究脑血管疾病方面取得了进展，但卒中后的患者似乎仍像多年前一样生活得不尽人意。有用的措施包括有效的抗痉挛治疗、心理援助和更多的社会支持。
