Most identified questionnaires reflect limitations or restrictions in one component only. These results provide valuable information on the content quality of these questionnaires for health-care providers and researchers.
Background and Purpose
We sought to clarify the way in which organized inpatient (stroke unit) care can produce reductions in case fatality and in the need for institutional care after stroke.
Methods
We performed a secondary analysis of a collaborative systematic review of all randomized trials that compared organized inpatient (stroke unit) care with contemporary conventional care. Nineteen trials were included, of which 18 (3246 patients) could provide outcome data on death, place of residence, and final functional outcome. Data were less complete (but always available for at least 12 trials; 1611 patients) for subgroup analyses examining timing and cause of death and outcomes in patients with different levels of severity of initial stroke.
Results
The reduction in case fatality of patients managed in a stroke unit setting developed between 1 and 4 weeks after the index stroke. The reduction in the odds of death was evident across all causes of death and most marked for those deaths considered to be secondary to immobility. However, data were insufficient to permit a firm conclusion. The relative increase in the number of patients discharged home from stroke units as opposed to conventional care was largely attributable to an increase in the number of patients returning home physically independent. Across the range of stroke severity, stroke unit care was associated with nonsignificant increases in the number of patients regaining independence.
Conclusions
Within the limitations of the available data, we conclude that organized inpatient stroke unit care probably benefits a wide range of stroke patients in a variety of different ways, ie, reducing death from secondary complications of stroke and reducing the need for institutional care through a reduction in disability.
In the sample studied, the strongest predictors of life satisfaction were the psychosocial variables, represented by coping strategies regarding the disease. Interventions directed at workers with WMSD that seek to promote well-being should favor coping in the most adaptive manner, going beyond the clinical realm of the disease.
Background: About half of people with multiple sclerosis (MS) have cognitive problems. Cognitive rehabilitation aims to reduce the effects of these problems in daily life. Method: This multicentre, randomized controlled trial compared the effects of cognitive rehabilitation with usual care alone. Consenting participants aged 18-69 years with MS and confirmed cognitive problems were individually randomized to cognitive rehabilitation (10 weekly group sessions) or usual care alone. The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale (MSIS-Psy) at 12 months. Secondary outcomes included everyday memory functioning and mood assessed at 6 and 12 months post-randomization. Results/Findings: A total of 449 participants were randomized with 387 (214 intervention, 173 in control) included in the primary analysis. At 12 months, mean MSIS-Psy score was 22.2 (SD 6.1) in the intervention, 23.4
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