Determinants Of Quality Of Life In Stroke Survivors After 6 Months, From Comprehensive Stroke Unit In Spain. A Longitudinal Study

886 words - 4 pages

Our results highlight the negative consequences of stroke on both the physical and mental dimensions of HRQoL as assessed using the SF-12. Moreover, we must emphasize that quality of life is lower in stroke survivors than in the general population, regardless of type of stroke (Haley et al., 2011; Monteagudo-Piqueras, et al., 2007; Schmidt et al., 2012; Vilagut et al., 2008).
Most of the studies we reviewed evaluate HRQoL beginning at the time of stroke (Castellanos-Pinedo et al., 2012; Haacke et al., 2006; Haley et al., 2011; Patel et al., 2007; Rønning & Stavem, 2008; Maa et al., 2009), but they do not take into account patient status prior to the stroke, as we do here. The cited studies observed that patients improve over time with respect to the first evaluation. However, our study clearly shows that post-stroke status is worse than baseline status prior to stroke, and that quality of life remains lower during the sub-acute phase of stroke.
Concurring with other studies (Carod-Artal et al., 2009; Castellanos-Pinedo et al., 2012; Dhamon et al., 2010; Haacke et al., 2006; Owolabi, 2010; Rønning, & Stavem, 2008), we found that initial stroke severity, functional status, and disability determine the HRQoL in stroke survivors. These factors mainly affect physical domains of HRQoL.
In our study, we examined basic activities of daily living (measured with BI) separately from instrumental activities (measured with IADL). As a result, we observe that dependency for activities of daily living affects a larger number of HRQoL domains than dependency for instrumental activities. These results are coherent with results from other studies (Haacke et al., 2006; Maa et al., 2009). An explanation may be that a decrease in social activity or dependency for certain instrumental activities (housework, money management, errands outside the home, etc.), where the patient has reasonable expectations, is less disruptive than dependency for activities of daily living, such as toilet use, dressing, walking, mobility, etc.
In line with other studies (Dhamon et al., 2010; Grubaugh et al., 2013; Haacke et al., 2006; Jönsson et al., 2005; Maa et al., 2009), we found that age seems to be a key factor, i.e. when age increases, HRQoL decreases. We also discovered that women have lower scores on some HRQoL items (Carod-Artal & Egido, 2009; Gargano & Reeves, 2007; Gray et al., 2007; Jönsson et al., 2005; Kwok et al., 2006; Patel et al., 2007; Maa et al., 2009). This is probably due to women experiencing more severe strokes at older ages, more marked comorbidity during recovery, less social support (living alone and social isolation), and a higher institutionalization rate after stroke (Reeves et al., 2008).
We observed poorer quality of life in individuals with...

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