title: Agreement between patient and proxy assessments of oral health-related quality of life after stroke: an observational longitudinal study.
abstract: This study aimed to assess agreement between patient and proxy assessment of patients' oral health-related quality of life (OHRQoL) during the acute stroke phase and 6 months after hospital discharge. As part of an observational longitudinal study, 161 consecutive patients hospitalized after stroke and their caregivers (CGs) were monitored during acute stroke and 6 months after hospital discharge. Patient-CG agreement of health-related quality of life as assessed by the General Oral Health Assessment Index (GOHAI) and Medical Outcomes Study 12-item Short Form (SF-12) which comprises physical (PCS-12) and mental component summaries (MCS-12) was determined by comparison and correlation analyses. Complete data were available for 65 patients and CGs. Compared with acute stroke, there were improvements in GOHAI and SF-12 scores from patient's and CG's perspective at 6-month follow-up. Caregivers overestimated the impact of stroke on MCS-12 over a period of time (P < 0.01) and underestimated the impact on GOHAI during acute stroke (P < 0.001) and on PCS-12 6 months later (P < 0.05). Patient-CG agreement was substantial to excellent during acute stroke [intra-class correlation coefficient (ICC 0.69-0.86)] and fair-to-moderate 6 months later (ICC 0.28-0.60). Agreement was adequate between patients' and CGs' assessment of patient OHRQoL during acute stroke but it was less reliable 6 months after hospital discharge. These findings suggest that proxy assessment of OHRQoL after stroke is effective in assessing stroke-related oral impairments that affect life quality without placing additional burden on stroke patients themselves to assess OHRQoL.
authors.affiliation: Faculty of Dentistry, Periodontology and Dental Public Health, University of Hong Kong, Hong Kong SAR. mcgrathc@hkucc.hku.hk
authors.forename: C
authors.initials: C
authors.lastname: McGrath
authors.forename: A S
authors.initials: AS
authors.lastname: McMillan
authors.forename: H W
authors.initials: HW
authors.lastname: Zhu
authors.forename: L S W
authors.initials: LS
authors.lastname: Li
mesh_terms: D000368:Aged; D017028:Caregivers; D005260:Female; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009909:Oral Health / Q000592:standards*; D019727:Proxy; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000592:standards*; D020521:Stroke / Q000150:complications / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors