Published Online
on February 13, 2003

A more recent version of this article appeared on March 1, 2003

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Submitted on September 11, 2002
Accepted on October 1, 2002

Quality of Life During and After Inpatient Stroke Rehabilitation

Wilma M. Hopman MA^* and Jane Verner MEd

From the Clinical Research Unit, Kingston General Hospital, and the Department of Community Health and Epidemiology, Queen's University (W.M.H.), and the Social Services Department, St Mary's of the Lake Hospital Site, Providence Continuing Care Centre (J.V.), Kingston, Ontario.

^* To whom correspondence should be addressed. E-mail: hopmanw{at}kgh.kari.net.

Background and Purpose--Very limited longitudinal data are available that assess the health-related quality of life (HRQOL) of stroke survivors after discharge from inpatient rehabilitation. The purpose of this research was to assess changes in HRQOL during inpatient rehabilitation and again 6 months after discharge.

Methods--This was a prospective study of all eligible patients admitted to an inpatient stroke rehabilitation hospital over a 3-year period. HRQOL was assessed by means of the Medical Outcomes Study 36-item Short Form (SF-36). Dependent t tests were used to compare the scores at admission and discharge and at discharge and 6 months. Changes in HRQOL were calculated for the period of admission to discharge and of discharge to the 6-month follow-up.

Results--Complete data were available for 85 patients. During rehabilitation, there were improvements in all 8 domains of the SF-36, with 5 attaining statistical significance. After discharge, 3 domains continued to improve, with 1 attaining statistical significance. However, there were marked and statistically significant declines in the other 5 domains of the SF-36. Feedback was obtained from a subset of the patients as to the reasons for these declines.

Conclusions--Substantial gains in HRQOL during inpatient stroke rehabilitation may be followed by equally substantial declines in the 6 months after discharge. There is a need for longitudinal research into the HRQOL of stroke survivors and their families, as well as a need to ensure that adequate community services and support are available.

Key words: outcome • quality of life • rehabilitation • stroke • stroke assessment

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