Perceived wellbeing of patients one year post stroke in general practice - recommendations for quality aftercare

Abstract

BackgroundAnnually, 41,000 people in the Netherlands have strokes. This has multiple physical and psychosocial consequences. Most patients return home after discharge from hospital. Quality aftercare by general practitioners is important to support patients at home. The purpose of this study is to examine the wellbeing of patients who returned home immediately after discharge from hospital, one year post stroke, in comparison with the general Dutch population of the same age and to determine factors that could influence wellbeing.MethodsAll the stroke patients from the Department of Neurology, Martini Hospital Groningen in the period November 2006 to October 2007 were included. People aged under 65 years or with haemorrhaging were excluded. All the patients (N = 57) were interviewed at home using the following questionnaires: Barthel Index, SF-36, HADS, CSI and a questionnaire about their way of life.Results31% of the patients in this study experienced a decrease in functional status after one year. Nevertheless, there was no significant difference between the median Barthel Index value at discharge from hospital and one year post stroke. ADL independence correlated with a better quality of life. The health-related quality of life was high. Stroke patients have almost the same quality of life as the 'average' Dutch elderly population. Where patients can no longer fully participate in society, their perceived quality of life is also lower. In this study there is an indication of a high prevalence of depression and anxiety disorders in stroke patients. This negatively affects the quality of life a year after stroke. Although caregiver strain was low for the partners of stroke patients, a reduced quality of life is correlated to greater burden.ConclusionsThis study provides valuable insight into the wellbeing of patients living at home one year post stroke. Physical functioning and quality of life are comparable to the general population of the same age, but improvements in mental functioning can be envisaged. In addition, more attention should be paid to maintaining the patients' activities. The wellbeing of these stroke patients could be increased further if greater attention is paid to these aspects of life. This seems to be applicable to general practice.

Life satisfaction two-years after stroke onset: the effects of gender, sex occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg

“…), patients, and their families. Our findings may be useful for policy makers to understand the family and medical-social contexts of stroke over time in order to design adequate health systems [51,52]. …”

Quality of Life and Loneliness in Stroke Survivors Living in Appalachia

“…However, recently, it has been reported that nearly half of stroke survivors experienced significant negative psychological outcomes associated with stroke such as depression and that social support mediated both QoL and functional ability (Huang et al, 2010). In a Danish and Netherlands cohort, stroke survivors who experienced depression were less likely to regain their baseline QoL when compared with those who did not experience depression (De Weerd, Rutgers, Groenier, & van der Meer, 2011; Muus, Petzold, & Ringsbert, 2010). …”

“…Broadening our nursing knowledge to include studies of the negative psychological outcomes of stroke, such as anxiety(De Weerd et al, 2011), depression (De Weerd et al, 2011; Huang et al, 2010), and loneliness (Hilari et al, 2010), and enhancing our understanding of how they relate to QoL could lead to new nursing interventions that target the emotional health needs of the stroke survivor. Few studies have focused on loneliness as a specific negative psychological outcome of stroke.…”

Survival of stroke patients after introduction of the ‘Dutch Transmural Protocol TIA/CVA’

“…A stroke has considerable impact on the patient’s life and his/her family [2,3]. Stroke can cause various neurological deficits, including paralysis, loss of vision, aphasia, spatial disorder, disturbance in thinking, difficulty in swallowing and incontinence [4].…”