Stroke, Vol 24, 1478-1483, Copyright © 1993 by American Heart Association
F Angeleri, VA Angeleri, N Foschi, S Giaquinto and G Nolfe
BACKGROUND AND PURPOSE: This study was designed to assess the quality of
life after an active poststroke period of rehabilitation and to investigate
the possibility of a return to a working environment for those still of
working age. METHODS: The study was conducted on 180 consecutive patients
affected by stroke who were hospitalized for the first time and discharged
at least 1 year before the study. The group consisted of 65% men and 35%
women with a mean age 65.29 years (SD, 11.22). The period between the
stroke and the interview ranged from 12 to 196 months, with a mean of 37.5
months. The average Rankin score on discharge from the rehabilitation
center was 2.718 (moderate handicap). The interview took place at home
after consent obtained by telephone. The questionnaire included general and
personal information regarding the individuals, their socioeconomic
position, and scales for daily activity, depression, social activity, and
stress produced in the family. The control group consisted of 167
age-matched subjects. RESULTS: A close correlation was observed in all
patients between depression, social activity, and stress caused to
relatives. The scores on the individual scales were clearly worse than
those for control subjects. The patients received approximately 5 months of
rehabilitation after the stroke. Differences emerged between men and women
for depression and social activities, with the women scoring worse. In
reference to daily life, 70% of prestroke ability was required on average
after rehabilitation. The daily activity score at the time of the interview
was also strongly influenced by the discharge score. The majority of
patients were retired. Of the total, 20.64% returned to work, but not
always to the same job and often after readapting to new conditions. Of
this population, only 31.5% were women. With regard to the population aged
younger than 65 years, 21.42% returned to work. Lesions in the dominant
hemisphere do not necessarily seem to rule out return to work, even if
associated with aphasia. The main discriminating element was the ability to
understand language. The patients were often criticized by their
cohabitants; the criticisms most often raised concerned apathy,
irritability, and self- centeredness. Sexual activity was depressed in
almost all cases. CONCLUSIONS: Despite the progress made in studying
cerebral vasculopathies, patients in the aftermath of a stroke still seem
to live unsatisfactorily, as they did many years ago. Useful measures
include valid treatment against spasticity, psychological assistance, and
greater social support.
ARTICLES
The influence of depression, social activity, and family stress on functional outcome after stroke
Istituto delle Malattie del Sistema Nervoso, Clinica Neurologica, Universita di Ancona, Italy.
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