Original articleQuality of Life of Stroke Survivors: A 1-Year Follow-Up Study
Section snippets
Participants
Hong Kong has a comprehensive and almost fully publicly funded hospital-based rehabilitative service for stroke patients. From January through July 2002, a research assistant prospectively screened patients with acute stroke within 2 days of admission to the Prince of Wales Hospital (PWH)—a regional university teaching hospital with 1500 beds serving a population of 0.7 million people. Patients were included in the study if they were Chinese. Patients were excluded if the stroke had occurred
Results
During the study period, 392 patients with stroke were admitted to PWH. Of these, 303 (77%) were recruited and followed up at 3 months after stroke onset. The reasons for excluding the 89 patients were as follows: handicapped before stroke (n=24), death before 3 months (n=38), recurrence of stroke (n=14), terminal illness (n=5), non-Chinese ethnicity (n=1), unable to contact (n=4), and refusal to participate (n=3).
Of the 303 subjects, 269 (88.8%) subjects had ischemic strokes; 13 (4.3%)
Discussion
This prospective cohort study of patients during the first year of stroke showed that self-perceived HRQOL deteriorated significantly at 12 months in terms of social interactions and living environment. Depression had a negative association with all 4 domains of HRQOL, whereas decreasing disability in basic ADLs (reflected by an increasing Barthel Index score) had a positive association with physical and psychological HRQOL. Female sex, residence in a nursing home, some forms of welfare
Conclusions
Environment and social interaction HRQOL may diminish after 1 year of stroke among elderly Chinese patients. Some of the factors that are associated with HRQOL—depression, diet, exercise, and limb pain—are potentially modifiable, whereas others—sex, marital status, and poverty—are not. We recommend that all stroke patients should be followed up by a health care professional for at least 1 year. Apart from the need to control risk factors of recurrent strokes, attending doctors or nurses should
Acknowledgments
We thank Leung Kwok Fai, chief of occupational therapy, Queen Elizabeth Hospital, for his advice on research design and his training of our research assistants in administering WHOQOL-BREF (HK), and to Ashley Yu, Centre for Clinical Trials and Epidemiological Research, the Chinese University of Hong Kong, for statistical advice.
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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.