[Changes in the quality of life of cerebral stroke patients in the first year after rehabilitation].
The aim of the study was to identify and analyze significant changes in the quality of life of elderly persons in the first year after rehabilitation from cerebral stroke. Data of 138 geriatric patients investigated on admission in a stationary rehabilitation program and one year later at home were used for this analysis. Multivariate logistic modelling tested differences between first investigation and follow-up in several domains: IADL functionality, subjective well-being, locus of control, subjective coping with stroke, stroke-related quality of life, social support. Age, gender, living alone and educational status were used as control variables. Compared to first investigation, subjects on follow-up showed an increased IADL functionality (OR = 1.40) but a decline in subjective well-being (OR = 0.91) and a more external locus of control (OR = 0.57). Coping with stroke has ameliorated (OR = 1.82), while stroke-related quality of life in six life domains was more negatively presented (OR = 0.82). Marked modifications in social exchange were found: the quantity of social contacts increased (OR = 4.70), while their variety reduced (OR = 0.38), significant others became more important (OR = 7.42) while the respondents' importance as a significant person for others diminished (R = 0.20). The findings suggest that recovery in IADL functionality after rehabilitation does not ensure a subsequent improvement in the subjective well-being nor does a positive trend in coping with stroke impede declines in stroke-related quality of life. Increased social exchange, which becomes more concentrated and less reciprocal, indicates a growing need of receiving social support. The findings are commented and implications for rehabilitation are mentioned.
Lalu
R E
RE
Jella Lepman Str. 47, 81673 München, Germany. lalu@qolr.de
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010343:Patient Admission; D011788:Quality of Life / Q000523:psychology*; D012047:Rehabilitation Centers; D012803:Sick Role; D012944:Social Support; D013223:Statistics as Topic; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation