Quality of life during and after inpatient stroke rehabilitation.
OBJECTIVE
Very limited longitudinal data are available that assess the health-related quality of life (HRQOL) of stroke survivors after discharge from inpatient rehabilitation. The purpose of this research was to assess changes in HRQOL during inpatient rehabilitation and again 6 months after discharge.


METHODS
This was a prospective study of all eligible patients admitted to an inpatient stroke rehabilitation hospital over a 3-year period. HRQOL was assessed by means of the Medical Outcomes Study 36-item Short Form (SF-36). Dependent t tests were used to compare the scores at admission and discharge and at discharge and 6 months. Changes in HRQOL were calculated for the period of admission to discharge and of discharge to the 6-month follow-up.


RESULTS
Complete data were available for 85 patients. During rehabilitation, there were improvements in all 8 domains of the SF-36, with 5 attaining statistical significance. After discharge, 3 domains continued to improve, with 1 attaining statistical significance. However, there were marked and statistically significant declines in the other 5 domains of the SF-36. Feedback was obtained from a subset of the patients as to the reasons for these declines.


CONCLUSIONS
Substantial gains in HRQOL during inpatient stroke rehabilitation may be followed by equally substantial declines in the 6 months after discharge. There is a need for longitudinal research into the HRQOL of stroke survivors and their families, as well as a need to ensure that adequate community services and support are available.
Hopman
Wilma M
WM
Clinical Research Unit, Kingston General Hospital, and the Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario K7L 2V7. hopmanw@kgh.kari.net
Verner
Jane
J
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000592:standards* / Q000706:statistics & numerical data; D017678:Sex Distribution; D018434:Sickness Impact Profile; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data