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Quality-of-Life and Disability in Patients with Stroke

Cerniauskaite, Milda, MSc; Quintas, Rui, MSc; Koutsogeorgou, Eleni, MA; Meucci, Paolo, MA; Sattin, Davide, PsyD; Leonardi, Matilde, MD; Raggi, Alberto, PsyD

American Journal of Physical Medicine & Rehabilitation: February 2012 - Volume 91 - Issue 13 - p S39–S47
doi: 10.1097/PHM.0b013e31823d4df7
Original Research Articles

Objective The aim of this study was to assess the impact of stroke on health-related quality-of-life (HRQoL) and disability, the relationships between the two constructs, and to what extent these two constructs are affected when perceived health state changes.

Design The World Health Organization Disability Assessment Schedule (WHO-DAS II) and the 36-Item Short-Form Health Survey (SF-36) were administered via mail to a sample of adult stroke survivors. Comparison against normative Italian values was made using one-sample t test. SF-36 and WHO-DAS II scores were compared between employed and unemployed patients and between patients self-reporting improved, unchanged, and decreased health state using analysis of variance with least significant difference post hoc test. The relationships between SF-36 and WHO-DAS II were assessed using Pearson correlation.

Results A total of 111 patients were enrolled. The SF-36 and WHO-DAS II scores of stroke patients were worse in comparison with Italian normative values. Moderate to strong correlations between all scales and the summary score of WHO-DAS II and SF-36 were found: The worse the disability is, the lower the HRQoL. Patients reporting worse health status in the previous year reported higher levels of disability and lower HRQoL. Employed persons had higher HRQoL and lower disability levels.

Conclusions The generic HRQoL instrument and disability schedule used in this study demonstrated strong relationship between these two dimensions. It also gave a more detailed picture of the aspects of disability and HRQoL that are most relevant for the persons after stroke and that should be studied further in the future research.

From the Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute “Carlo Besta” IRCCS Foundation, Milan, Italy.

All correspondence and requests for reprints should be addressed to: Milda Cerniauskaite, MSc, Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute “Carlo Besta,” Via Celoria 11, Milan 20131, Italy.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. This study was conducted within the Multidisciplinary Research Network on Health and Disability in Europe project (European Commission project funded within the Sixth Framework Programme, MRTN-CT-2006-035794).

© 2012 Lippincott Williams & Wilkins, Inc.