Article

This international study aims to examine the size and determinants of
the impact of stroke on five-year survivors' health-related quality of life
(HRQoL) in four different European countries. METHOD: Patients were recruited
consecutively in four European rehabilitation centers.
Five years after stroke,
the EuroQol-visual analog scale (EQ-VAS) was administered in 226 first-ever
stroke patients. Impact of stroke was determined by calculating EQ-VAS z-norm
scores (= deviation - expressed in SD - of patients' EQ-VAS level relative to
their age-and gender-matched national population norms). Determinants of EQ-VAS
z-norm scores were identified using multivariate linear regression analysis.
RESULTS: Five years post-stroke, patients' mean EQ-VAS was 63.74 (SD = 19.33).
Mean EQ-VAS z-norm score was -0.57 [95%CI: (-0.70)-(-0.42)]. Forty percent of the
patients had an EQ-VAS z-norm score <-0.75 SD; 52% had an EQ-VAS z-norm score
between -0.75 and +0.75 SD, only 8% scored >+0.75 SD. Higher patients' levels of
depression, anxiety and disability were associated with increasingly negative
EQ-VAS z-norm scores (adjusted R(2)( )=( )0.392). CONCLUSIONS: Five years after
stroke, mean HRQoL of stroke survivors showed large variability and was more than
(1/2) SD below population norm. Forty percent had a HRQoL level below, 52% on,
and 8% above population norm. The variability could only partially be explained
by the variables considered in this study. Longitudinal studies are needed to
increase our understanding of the size and determinants of the impact of stroke
on the HRQoL of long-term stroke survivors. Implications for rehabilitation The
current European concept of stroke rehabilitation is focused on the acute and
sub-acute rehabilitation phase, i.e., in the first months after stroke. The
results of this study show that at five years after stroke, the mean level of
HRQoL of stroke survivors remains below the healthy population level. This
finding shows the need for continuation of rehabilitation in the chronic phase.
At five years after stroke, higher patients' levels of depression, anxiety and
disability were associated with lower scores for HRQoL.
This finding implicates
that chronic rehabilitation programs should be multi-faceted in order to increase
long-term survivors' psychosocial outcomes.

Langue : ANGLAIS