Determinants of quality of life in stroke survivors after 6 months, from comprehensive stroke unit in Spain. A longitudinal study
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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...
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...ference level is the patient’s status during the preceding week, we believe this information to be more relevant than information taken during the hospital stay or in the first few weeks after discharge.
The physical and mental well-being of a patient who has suffered a stroke clearly remains affected six months after the event. Stroke severity, disability, female sex, poor social support, and prior strokes have a significant negative impact on the physical and mental domains of generic HRQoL. Our results confirm that stroke has an important impact on many areas of quality of life, and they indicate that health professionals must take a more holistic and comprehensive view of the patient to improve outcomes in this disease. Future studies should investigate sex-related differences in quality of life, and the factors that give rise to these differences.