Community-Dwelling Stroke Survivors: Function Is Not the Whole Story With Quality of Life
Presented in part to the Stroke It’s Time Conference, July 7, 2006, Sydney, Australia.
Abstract
White JH, Alston MK, Marquez JL, Sweetapple AL, Pollack MR, Attia J, Levi CR, Sturm J, Whyte S. Community-dwelling stroke survivors: function is not the whole story with quality of life.
Objective
To compare function and quality of life in community-dwelling stroke survivors at 1, 3, and 5 years after stroke.
Design
A community-based, cross-sectional study of 3 retrospective cohorts.
Setting
Community-dwelling stroke survivors in Australia.
Participants
The 3 cohorts comprised 30 participants each at 1, 3, and 5 years poststroke discharge from a tertiary referral hospital.
Interventions
Not applicable.
Main Outcome Measures
Stroke severity, comorbidity, medications used, and demographic information were recorded. Poststroke function was assessed using the Modified Rankin Scale, Mini-Mental State Examination, Stroke Impact Scale, and Multidimensional Scale of Perceived Social Support.
Results
This cross-sectional study provides insights into trends in stroke survivors over time. A high proportion of stroke survivors use community services, even those who are independent with activities of daily living. Although there was little attrition in medication use over time except for warfarin, this was from a baseline of suboptimal compliance and adherence with stroke preventive therapies. Stroke survivors report high levels of perceived social support; however, emotional well-being was low overall. The data suggest that those who are independent at 1 year tend to remain independent, although this was an extrapolation from serial cross-sections and needs to be explored in a longitudinal study.
Conclusions
Stroke survivors’ function does not change significantly over time. A high proportion of survivors require community services. The development of needs-related effective long-term service delivery models is required.
aHunter Stroke Service, Hunter New England Area Health Service, New South Wales, Australia
bCommunity Stroke Team, Hunter New England Area Health Service, New South Wales, Australia
cRankin Park Centre, Hunter New England Area Health Service, New South Wales, Australia
dJohn Hunter Hospital, Hunter New England Area Health Service, New South Wales, Australia
eCentre for Clinical Epidemiology and Biostatistics, University of Newcastle, New South Wales, Australia
fGosford Hospital, Northern Sydney Central Coast Area Health Service, New South Wales, Australia.
Reprint requests to Jennifer H. White, BAppSc, Locked Bag No. 1, Hunter Region Mail Centre, NSW 2310, Australia
Supported by the Hunter Stroke Service, Hunter New England Area Health.
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 authors or upon any organization with which the authors are associated.