Longitudinal Analysis of Quality of Life for Stroke Survivors Using Latent Curve Models

Abstract

Background and Purpose-For the survivors, activities of daily living, handicap, and depression have a significant impact on health-related quality of life (HRQOL). How the dynamic changes of these variables relate to HRQOL over time in the subacute phase of stroke recovery has not been investigated. The objective of this study was to study longitudinal behaviors of HRQOL of the stroke survivors in relation to the changes in activities of daily living, handicap, and depression after stroke. Methods-This was a prospective cohort study of first disabling patients with stroke. Subjects were interviewed at 3, 6, and 12 months after stroke for modified Barthel Index, London Handicap Scale, Geriatric Depression Scale, and the World Health Organization Quality of Life questionnaire (abbreviated Hong Kong version). A latent curve model was developed to analyze how the dynamic changes in activities of daily living, handicap, and depressive mood related to the changes in HRQOL. Results-Two hundred forty-seven of 303 patients (82%) followed up at 3 months after stroke could complete the quality-of-life questionnaire. Their mean age was 68.8 years. The latent curve model analysis revealed that initial physical health HRQOL was independently associated with activities of daily living, handicap, and depression. The other 3 HRQOL domain scores were primarily associated with depression only. The rates of change in all 4 domains of HRQOL were significantly and inversely associated with rate of change in the Geriatric Depression Scale only. Conclusion-Change in mood in the postacute phase of stroke recovery is the most significant determinant of change in HRQOL. More attention should be paid to the detection and management of poststroke depression.

Factors Associated With Health-Related Quality of Life After Stroke

“…7 Furthermore, an individual's perception and establishment of goals and expectations are undoubtedly influenced by personal characteristics such as optimism, psychic stability, and confidence. 36 Not only were mental and personality functions identified as powerful determinants of HRQoL already in previous studies, [37][38][39] but the relationship between HRQoL and gait as well as activities of daily living (ADL), including housework, were also identified as determinants. 40,41 This association was in the chronic phase after stroke.…”

Quality of life of individuals with stroke and their caregivers in a city of Triângulo Mineiro

“…In some international studies [14][15][16][17][18] using the WHOQOL-bref instrument, it was observed that the quality of life of an individual is greatly affected after a stroke. In the study by baune and Aljeesh…”

“…Also was concluded that all domains of quality of life are affected and those people affected need to participate in a rehabilitation program. The area most affected in the study by Pan et al 17 was physical, followed by psychological, social relationships and environment. In the bölsche et al 18 study the physical domain obtained improval during his intervention, while the social relations domain was most affected.…”

The depressive disorders during the early rehabilitation period following preceding ischemic stroke: the possibilities for the application of the enhanced external counterpulsation method

“…У больных с постинсультной депрессией от-мечено увеличение риска смертности, менее выра-женное восстановление нарушенных когнитивных и неврологических функций, увеличение продол-жительности восстановительного периода, более значимые нарушения активности в повседневной жизни, снижение качества жизни и приверженно-сти рекомендованной терапии [12,13].…”