Short-term changes in and predictors of participation of older adults after stroke following acute care or rehabilitation
Short-term changes in and predictors of participation of older adults after stroke following acute care or rehabilitation
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DOI：
10.1177/1545968307307116
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发表时间：
2008-05-01
影响因子：
4.2
通讯作者：
Ska, Bernadette
中科院分区：
文献类型：
--
作者：
Desrosiers, Johanne;Demers, Louise;Ska, Bernadette
背景中风可能导致日常活动和社会角色参与的限制。虽然被认为是一个重要的康复结果，但对卒中后的参与及其预测因素以及卒中后提供的服务类型的差异知之甚少。Objective.本研究的目的是：1）跟踪和比较急性护理或急性期后康复的卒中后出院回家的老年人参与的变化; 2）从出院后不久采取的身体、认知、知觉和心理能力指标中确定卒中后参与的最佳预测因素。方法.对197例老年卒中患者在急性护理（n = 86）或康复（n = 111）出院后2 - 3周（T1）、3个月（T2）和6个月（T3）的日常活动参与程度和社会角色进行了评价。在T1时评估身体、认知、感知和心理能力。结果随着时间的推移，两组的参与率都有显著增加，主要是在前3个月。参与的最佳预测因素在不同的群体之间以及在日常活动和社会角色领域之间存在差异。步行和接受中风或更少的抑郁症状是中风后参与水平的最佳预测因子。结论.出院时的参与度并不是最佳的，因为回家后参与度继续增加。心理因素在中风后参与的重要性是不可否认的。许多预测者都可以接受干预。
Background. Stroke can lead to restrictions in participation in daily activities and social roles. Although considered an important rehabilitation outcome, little is known about participation after stroke and its predictors, and about the differences associated with the types of services provided following stroke. Objective. The aims of this study were 1) to follow and compare changes in participation of older adults discharged home after stroke from acute care or postacute rehabilitation, and 2) to identify the best predictors of participation after stroke from physical, cognitive, perceptual, and psychological ability measures taken shortly after discharge. Methods. Level of participation in daily activities and social roles of 197 older adults who had a stroke was evaluated at 2 to 3 weeks (T1), 3 months (T2), and 6 months (T3) after being discharged home from acute care (n = 86) or rehabilitation (n = 111). Physical, cognitive, perceptual, and psychological abilities were assessed at T1. Results. A significant increase in participation was found over time for both groups, mainly in the first 3 months. The best predictors of participation differed between the groups and between the daily activities and social roles domains. Walking and acceptance of the stroke or fewer depressive symptoms were the best predictors of the level of participation after stroke. Conclusions. Participation was not optimal at discharge because it continued to increase after the return home. The importance of psychological factors in participation after stroke is undeniable. Many predictors are amenable to interventions.