Quality of Life of Stroke Survivors: A 1-Year Follow-Up Study
Abstract
Kwok T, Lo RS, Wong E, Wai-Kwong T, Mok V, Kai-Sing W. Quality of life of stroke survivors: a 1-year follow-up study.
Objectives
To examine the changes in and to identify determinants of health-related quality of life (HRQOL) during the first year after stroke.
Design
Prospective cohort study.
Setting
Regional university teaching hospital in China.
Participants
Chinese survivors of stroke (N=303). Patients who were previously physically handicapped were excluded.
Interventions
Not applicable.
Main Outcome Measures
Barthel Index, Lawton Instrumental Activities of Daily Living (IADL), Chinese Mini-Mental State Examination, Geriatric Depression Scale (GDS), and the abbreviated Hong Kong Chinese version of the World Health Organization Quality of Life measure domain scores at 3, 6, and 12 months after the stroke.
Results
A total of 268 (88%) subjects completed the study. HRQOL data were available in 247 (82%) subjects at 3 months. Between 3 and 12 months, there was no significant change in Barthel Index and IADL scores, but there was significant increase in GDS scores. On multivariate analysis and multilevel modeling, there was a small but significant decrease in social interaction and environment HRQOL domain scores with time. GDS score was negatively associated with all 4 domains of HRQOL, whereas the Barthel Index score was associated with physical and psychological HRQOL domains only. Female sex, nursing home residence, welfare assistance, pain in affected limbs, soft diet or tube feeding, and lack of physical exercise were associated with poorer HRQOL.
Conclusions
Environment and social interaction HRQOL may decrease after 1 year of stroke among Chinese stroke patients. Depression has a more generalized adverse effect on HRQOL than basic functional disabilities. Health care professionals should focus on treating depression; group exercises and self-help group activities may help in promoting socialization and reintegration into community life.
aDepartment of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China
bCentre for Epidemiology and Biostatistics, School of Public Health, Chinese University of Hong Kong, Shatin, Hong Kong, China
cDepartment of Psychiatry, Shatin Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China
Reprint requests to Timothy Kwok, MD, Dept of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China
Supported by the Health Services Research Fund in Hong Kong (grant no. 931012).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT