Stroke in the under-75S: Expectations, concerns and needs
Stroke in the under-75S: Expectations, concerns and needs
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DOI：
10.1016/j.rehab.2009.06.007
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发表时间：
2009-09-01
影响因子：
4.6
通讯作者：
Mazaux, J. -M.
中科院分区：
文献类型：
--
作者：
Jerome, D.;Dehail, P.;Mazaux, J. -M.
大多数偏瘫中风患者功能结果的研究都使用标准残疾评定量表（例如巴塞尔指数）。然而，规划援助和资源的分配需要有关这些患者的期望和需求的更多信息。研究的目的。 - 评估偏瘫患者中风后 1 至 2 年的日常生活和持家功能独立性、家庭环境的变化、技术援助和人工帮助的类型以及期望。方法。 - 法国大学医院神经血管科收治的 94 名首次记录中风的患者中，有 61 名患者连续入组。该研究仅限于 75 岁以下的患者，因为 75 岁以上的患者不遵循相同的护理网络。中风后（平均）17 个月，患者在家中接受检查或通过电话进行访谈。记录标准功能评估工具（例如巴塞尔指数和工具性日常生活活动 [IADL] 评分），以及对家庭环境以及工具和人类帮助的描述。最后，患者和护理人员被要求陈述他们的期望和需求。结果。 - 虽然只有 1 人中风后住在疗养院，但其他 23 名受访者 (34%) 需要进行家居调整或搬回家。 7 名患者（11%）在日常生活活动方面存在依赖性（Barthel 指数低于 60），11 名患者（18%）难以维持家庭活动和社区生活（IADL 评分超过 10）。尽管其余患者的功能恢复良好，但 23 例正在使用技术辅助设备，28 例需要家人或护理人员协助，其中 23 例具有完全功能独立评分。 25 名患者 (42%) 患有精神障碍诊断和统计手册（第 4 版，文本修订版，DSM IV-R）所定义的抑郁症。患者最关心的是独立性的恢复、休闲活动和经济资源。家庭成员的期望与行政事务的复杂性、信息缺乏和服务提供的延迟有关。讨论和结论。 - 对于 75 岁以下的偏瘫中风患者，标准残疾评定量表得分高并不总是意味着不需要帮助。 (C) 2009 Elsevier Masson SAS。版权所有。
Most studies of functional outcomes in hemiplegic stroke patients use standard disability rating scales (such as the Barthel Index). However, planning the allocation of assistance and resources requires additional information about these patients' expectations and needs.Aims of the study. - To assess functional independence in daily living and house holding, changes in home settings, type of technical aid and human helps, and expectations in hemiplegic patients 1 to 2 years after the stroke.Methods. - Sixty-one out of 94 patients admitted to the neurovascular unit of French university hospital for a first-ever documented stroke were consecutively enrolled. The study was restricted to patients under 75, since patients over 75 do not follow the same care network. Patients were examined at their homes or interviewed by phone 17 months (on average) after the stroke. Standard functional assessment tools (such as the Barthel Index and the instrumental activities of daily living [IADL] score) were recorded, along with descriptions of home settings and instrumental and human help. Lastly, patients and caregivers were asked to state their expectations and needs.Results. - Although only one person was living in a nursing home after the stroke, 23 (34%) of the other interviewees had needed to make home adjustments or move home. Seven patients (11%) were dependent in terms of the activities of daily living (a Barthel Index below 60) and 11 (18%) had difficulty in maintaining domestic activities and community living (an IADL score over 10). Although the remaining patients had made a good functional recovery, 23 were using technical aids and 28 needed family or caregiver assistance, including 23 patients with full functional independence scores. Twenty-five patients (42%) were suffering from depression as defined by the diagnosis and statistical manual of mental disorders (4th edition, text revision, DSM IV-R). The patients' prime concerns were related to recovery of independence, leisure activities and financial resources. Family members' expectations related to the complexity of administrative matters, lack of information and the delay in service delivery.Discussion and conclusion. - In under-75 hemiplegic stroke patients, high scores on standard disability rating scales do not always mean that no help is required. (C) 2009 Elsevier Masson SAS. All rights reserved.