[Knowledge concerning illness, expectations and perceptions of treatment of elderly stroke patients and family caregivers--a prospective study during inpatient treatment].
Forty-five stroke patients and their 45 proxies were interviewed after the patients' hospital admission and before discharge. The topics of the interviews were disease knowledge, expectations in and judgement about therapy, estimation of functional health status (CCOP/WONCA Charts), and prognosis. The patients and proxies were also asked to name the patient's actual three most important health problems. The depressive symptomatology in the patients (geriatric depression scale) and their ADL status (Barthel Index) were evaluated on admission and before hospital discharge. The proxies' general knowledge of disease was superior compared to that of the patients. There were knowledge deficits regarding individual risk factors and secondary prevention, in particular. Information was predominantly obtained from physicians. However, an additional need for information on prognosis and prevention, in particular, was expressed by patients and proxies before hospital discharge. There was a high agreement between the patients and their proxies in mentioning the patients' actual three most important health problems, apart from psychological problems. These were mentioned only by the proxies but not by the patients themselves. Depressive symptomatology in the patients increased significantly. There were associations of depression with the level of the Barthel Index score and the patients' self-estimation of functional health status before and after the stroke. Full recovery was expected by one half of the patients, on admission. The patients' primary therapeutic goal was the ability to walk again. Their ADL status improved significantly, as measured by a mean increase in the Barthel Index score by 22 points. The patients and their proxies, as well, judged the result of treatment equally high. The proxies' total satisfaction with patient care was significantly related to their ratings of separate parts of patient care regarding nurses, therapists, and physicians, to their expectations in therapy, and the satisfaction of their own personal needs. The results of the study revealed a particular need for information on prognosis and secondary prevention of stroke. Furthermore, depression and coping with consequences of the disease should be important issues in counselling of stroke patients and their proxies. The results regarding patient and proxy satisfaction with care were of importance for internal discussion in the clinic.
von Renteln-Kruse
W
W
Reha-Zentrum Reuterstrasse Geriatrische Klinik Reuterstrasse 101 51467 Bergisch Gladbach, Germany. renteln.kruse@mkh-bgl.de
Nogaschewski
K
K
Meier-Baumgartner
H P
HP
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D002544:Cerebral Infarction / Q000523:psychology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010348:Patient Care Team; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011379:Prognosis; D012648:Self Care / Q000523:psychology; D012803:Sick Role; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation