THE INFLUENCE OF DEPRESSION, SOCIAL ACTIVITY, AND FAMILY STRESS ON FUNCTIONAL OUTCOME AFTER STROKE
THE INFLUENCE OF DEPRESSION, SOCIAL ACTIVITY, AND FAMILY STRESS ON FUNCTIONAL OUTCOME AFTER STROKE
复制标题
DOI：
10.1161/01.str.24.10.1478
复制
发表时间：
1993-10-01
期刊：
影响因子：
8.3
通讯作者：
NOLFE, G
中科院分区：
文献类型：
--
作者：
ANGELERI, F;ANGELERI, VA;NOLFE, G
背景和目的。本研究旨在评估中风后积极康复期的生活质量，并调查那些仍处于工作年龄的人重返工作环境的可能性。方法：研究对象为连续180例首次住院且在研究前至少1年出院的脑卒中患者。该组包括65%的男性和35%的女性，平均年龄为65.29岁（SD, 11.22）。中风和访谈之间的时间从12到196个月不等，平均为37.5个月。康复中心出院时平均Rankin评分为2.718分（中度残疾）。采访是在电话征得同意后在家中进行的。问卷包括个人的一般和个人信息，他们的社会经济地位，以及日常活动、抑郁、社会活动和家庭压力的量表。对照组由167名年龄相匹配的受试者组成。结果：所有患者的抑郁、社交活动和亲属压力均有密切关系。他们在个体量表上的得分明显低于对照组。患者在中风后接受了大约5个月的康复治疗。男性和女性在抑郁和社交活动方面存在差异，女性的得分更低。参考日常生活，康复后平均需要70%的中风前能力。访谈时的日常活动得分也受到出院评分的强烈影响。大多数病人已经退休。在总数中，20.64%的人重返工作岗位，但并不总是回到原来的工作岗位，而且往往是在重新适应新的环境之后。在这些人中，只有31.5%是女性。在65岁以下的人口中，21.42%的人重返工作岗位。即使与失语症有关，主控半球的病变似乎也不一定排除重返工作岗位的可能性。主要的区别因素是理解语言的能力。患者经常受到同居者的批评；最常见的批评是冷漠、易怒和以自我为中心。几乎所有病例的性行为都受到抑制。尽管对脑血管疾病的研究取得了进展，但中风后的患者似乎仍然生活得不满意，就像许多年前一样。有效的措施包括对痉挛的有效治疗、心理援助和更多的社会支持。
Background and Purpose. This study was designed to assess the quality of life after an active poststroke period of rehabilitation and to investigate the possibility of a return to a working environment for those still of working age.Methods: The study was conducted on 180 consecutive patients affected by stroke who were hospitalized for the first time and discharged at least 1 year before the study. The group consisted of 65% men and 35% women with a mean age of 65.29 years (SD, 11.22). The period between the stroke and the interview ranged from 12 to 196 months, with a mean of 37.5 months. The average Rankin score on discharge from the rehabilitation center was 2.718 (moderate handicap). The interview took place at home after consent obtained by telephone. The questionnaire included general and personal information regarding the individuals, their socioeconomic position, and scales for daily activity, depression, social activity, and stress produced in the family. The control group consisted of 167 age-matched subjects.Results: A close correlation was observed in all patients between depression, social activity, and stress caused to relatives. The scores on the individual scales were clearly worse than those for control subjects. The patients received approximately 5 months of rehabilitation after the stroke. Differences emerged between men and women for depression and social activities, with the women scoring worse. In reference to daily life, 70% of prestroke ability was required on average after rehabilitation. The daily activity score at the time of the interview was also strongly influenced by the discharge score. The majority of patients were retired. Of the total, 20.64% returned to work, but not always to the same job and often after readapting to new conditions. Of this population, only 31.5% were women. With regard to the population aged younger than 65 years, 21.42% returned to work. Lesions in the dominant hemisphere do not necessarily seem to rule out return to work, even if associated with aphasia. The main discriminating element was the ability to understand language. The patients were often criticized by their cohabitants; the criticisms most often raised concerned apathy, irritability, and self-centeredness. Sexual activity was depressed in almost all cases.Conclusions. Despite the progress made in studying cerebral vasculopathies, patients in the aftermath of a stroke still seem to live unsatisfactorily, as they did many years ago. Useful measures include valid treatment against spasticity, psychological assistance, and greater social support.