Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors

Background:Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.Methods:The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).Results:We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.Conclusions:Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.

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Discriminant Validity of the Stroke Impact Scale

Stroke ◽

10.1161/str.32.suppl_1.361-c ◽

2001 ◽

Vol 32 (suppl_1) ◽

pp. 361-361

Author(s):

Sue-Min Lai Dr ◽

Stephanie Studenski Dr ◽

Pamela W Duncan Dr ◽

Subashan Perera Dr

Keyword(s):

Quality Of Life ◽

Discriminant Validity ◽

Community Dwelling ◽

Elderly Subjects ◽

Stroke Patients ◽

P Values ◽

Post Stroke ◽

Stroke Impact Scale ◽

Impact Scale

P123 Purpose: The purpose of this study was to determine the discriminant validity of the Stroke Impact Scale (SIS) by comparing function and quality of life in stroke patients to assessments from stroke-free community dwelling elderly. Methods: The SIS was administered at 90 to 120 days post-stroke to subjects who participated in the Kansas City Stroke Registry (KCSR). The same impact scale was also administered cross-sectionally to community dwelling elderly who were recruited from primary care clinics for participation in an ongoing prospective study of health and function (Merck). All subjects were queried for responses to 64 items of the SIS including eight domains: strength, memory and thinking, emotion, communication, ADL/IADL, mobility, upper extremity, and social participation. Regression analyses were used to examine differences between stroke patients and stroke-free elderly in each of the eight SIS domains while controlling for demographics and comorbidities. Results: One hundred and sixty KCSR subjects and two hundred and forty-three subjects from the Merck study were included in the present analysis. The mean ages were 73±10.1 and 74±5.1, respectively. Gender and race were similar in both groups. The 90-days post-stroke mean Barthel ADL was 80±23 in the stroke patients. Mean scores of all 8 SIS domains were significantly lower in stroke patients than those in the stroke-free community dwelling elderly even after controlling for differences in age and comorbidities (all p values < 0.0001). Mean scores of the 7 SIS domains (except strength), even in stroke patients who had Barthel ADL > 90 at 90-days post-stroke, remained lower than those in the stroke-free community dwelling elderly (p values < 0.01). Conclusion: The SIS was able to discriminate well between stroke patients with disability and stroke-free elderly subjects. Patients who had recovered basic ADLs continued to have residual disability and impaired quality of life when compared to non-stroke patients.

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Abstract 44: Quality of Life for Younger Patients Following Lacunar Stroke: A Secondary Analysis of SPS-3

Stroke ◽

10.1161/str.51.suppl_1.44 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Adam H de Havenon ◽

Ka-Ho Wong ◽

Kirby Taylor ◽

Michael Dela Cruz ◽

Theodore Rock ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Secondary Analysis ◽

Lacunar Stroke ◽

Linear Regression Models ◽

Stroke Patients ◽

Younger Patients ◽

Student’S T ◽

One Year

Background: The long-term quality of life (QoL) effects of stroke on younger patients has not been adequately compared to older stroke patients. Methods: We included patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial, who had a lacunar stroke within the last 6 months. We divided the cohort into younger patients aged <55 years versus older patients aged ≥55. The primary outcome was a 12 domain stroke specific QoL scale (ss-QoL), measured at one year from enrollment. The ss-QoL scores range from 0-5, with higher scores indicating better QoL. We fit linear regression models to the 12 domains and their mean, and adjusted for 90-day mRS, gender, white race, history of MI, diabetes, HTN, COPD, and level of education. After identifying domains of interest, we examined specific questions within domains to compare the mean score on individual questions using Student’s t-test. Results: We included 2,542 patients with a mean (SD) age of 62.8 (10.7) and 64% were male. Younger stroke patients comprised 26.5% (673/2,542) of the cohort and had a mean (SD) ss-QoL score of 4.18 (0.75) compared to 4.24 (0.69) of the older patients, a difference which was significant in the adjusted model (p=0.015). Younger stroke patients had significantly lower scores on the following individual ss-QoL domains compared to older stroke patients: language, thinking, personality, mood, family roles, and energy (Table 1). The three questions that younger stroke patients had the most difference with older patients were “in the past week I was discouraged about my future” (young vs old, 3.7 vs 4.0, p<0.001), “…had little confidence in myself” (4.0 vs 4.3, p<0.001), and “…was irritable” (3.7 vs 3.9, p<0.001). Conclusion: After lacunar stroke, compared to older patients, younger patients score worse on stroke specific quality of life at 1-1.5 years after stroke, particularly in domains related to mood. This under-appreciated impact of stroke in the young warrants additional research.

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Abstract 2472: The Negative Impact of Spasticity on the Health-Related Quality of Life of Stroke Survivors

Stroke ◽

10.1161/str.43.suppl_1.a2472 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Patrick Gillard ◽

Heidi Sucharew ◽

Sepideh Varon ◽

Kathleen Alwell ◽

Charles Moomaw ◽

...

Keyword(s):

Quality Of Life ◽

Ischemic Stroke ◽

Negative Impact ◽

Stroke Severity ◽

Stroke Survivors ◽

Health Related Quality ◽

Stroke Patients ◽

Related Quality ◽

Health Related

Background: Spasticity can lead to numerous symptomatic and functional problems that can cause substantial disability. No published studies have quantified the independent effect spasticity has on the health-related quality of life (HRQoL) of stroke survivors. Objective: To assess the hypothesis that spasticity has a negative impact on HRQoL among stroke survivors. Design: In 2005, as part of the Greater Cincinnati/Northern Kentucky Stroke Study, a cohort of 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. Detailed in-person interviews and medical record abstractions were undertaken during the early post-stroke period to capture key information about demographics; pre-stroke level of functioning; social, family, and medical histories; medications; laboratory results; and stroke severity. Follow-up interviews at 3 months, 1 year, and 2 years gathered information on HRQoL as measured by the Short Form-12 (SF-12), EuroQol-5D (EQ-5D), and Stroke Specific Quality of Life (SSQOL). SF-12 scores are divided into mental (MCS) and physical (PCS) components that range from 0 to 100, with higher scores indicating better health. EQ-5D scores range from 0 (death) to 1 (perfect health). SSQOL scores are stroke specific and range between 0 and 5, with lower scores indicating better HRQoL. HRQoL differences between stroke survivors with and without spasticity (as reported by the patient) were cross-sectionally compared using generalized linear models, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities. Results: Of the 460 ischemic stroke patients, 328 had spasticity data available at the 3-month interview, with 54 (16%) reporting spasticity following their stroke. The patients included in the 3-month analysis had a mean age of 66 years; 49% were female, and 26% black. Patients who reported spasticity at 3 months had lower mean PCS, EQ-5D index, and SSQOL total score compared with patients without spasticity ( Table ). Similar differences in HRQoL were also observed at year 1 and year 2 (data not shown). Conclusions: We found statistically and clinically meaningful differences in HRQoL between stroke survivors with and without spasticity at 3 months, 1 year, and 2 years following stroke. Clinically, these results suggest an opportunity to improve HRQoL among stroke survivors with effective spasticity management.

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Resilience is an independent correlate of the course of quality of life in patients with first-ever ischemic stroke

International Psychogeriatrics ◽

10.1017/s1041610220000587 ◽

2020 ◽

pp. 1-9

Author(s):

Zhihui Liu ◽

Xuan Zhou ◽

Wei Zhang ◽

Lanshu Zhou

Keyword(s):

Quality Of Life ◽

Ischemic Stroke ◽

Multilevel Model ◽

Depression Scale ◽

Neurological Function ◽

Stroke Severity ◽

Stroke Patients ◽

Hospitalization Period ◽

Prospective Longitudinal

ABSTRACT Objectives: To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life. Design: A prospective longitudinal cohort study. Setting: This study was conducted in Shanghai, China. Participants: Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018. Intervention: None. Measurements: Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor–Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life. Results: Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = −.051, p = .0006), neurological function (B = −.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = −.100, p =< .0001), depression (B = −.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = −.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = −.014, p = .0273), and time (B = −.031, p < .0001). Conclusions: Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.

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Factors Predicting Quality of Life among Post-Stroke Patients Living in Community

PsycEXTRA Dataset ◽

10.1037/e570112013-027 ◽

2013 ◽

Author(s):

Kultida Panidchakul ◽

Suneerut Boonsin

Keyword(s):

Quality Of Life ◽

Stroke Patients ◽

Post Stroke

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KUALITAS HIDUP PASIEN STROKE DI POLIKLINIK RAWAT JALAN RUMAH SAKIT SWASTA YOGYAKARTA

Media Ilmu Kesehatan ◽

10.30989/mik.v7i3.274 ◽

2019 ◽

Vol 7 (3) ◽

pp. 232-237

Author(s):

Hana Larasati ◽

Theresia Titin Marlina

Keyword(s):

Quality Of Life ◽

Social Relations ◽

Hemorrhagic Stroke ◽

Poor Quality ◽

Social Dimension ◽

Stroke Patients ◽

Sampling System ◽

Post Stroke ◽

Psychological Dimension

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension. Keywords: Hemorrhagic stroke, ischemic stroke, quality of life

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Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist – The Managing Aftercare for Stroke (MAS-I) study

European Stroke Journal ◽

10.1177/2396987318771174 ◽

2018 ◽

Vol 3 (3) ◽

pp. 237-245 ◽

Cited By ~ 16

Author(s):

Benjamin Hotter ◽

Inken Padberg ◽

Andrea Liebenau ◽

Petra Knispel ◽

Sabine Heel ◽

...

Keyword(s):

Quality Of Life ◽

Caregiver Burden ◽

Unmet Needs ◽

Community Dwelling ◽

Social Needs ◽

Interquartile Range ◽

Stroke Patients ◽

Post Stroke

Introduction Detailed data on the long-term consequences and treatment of stroke are scarce. We aimed to assess the needs and disease burden of community-dwelling stroke patients and their carers and to compare their treatment to evidence-based guidelines by a stroke neurologist. Methods We invited long-term stroke patients from two previous acute clinical studies ( n = 516) in Berlin, Germany to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using the Post-Stroke Checklist and validated standard measures of: self-reported needs, quality of life, overall outcome, spasticity, pain, aphasia, cognition, depression, secondary prevention, social needs and caregiver burden. Results Fifty-seven participants (median initial National Institutes of Health Stroke Scale score 10 interquartile range 4–12.75) consented to assessment (median 41 months (interquartile range 36–50) after stroke. Modified Rankin Scale was 2 (median; interquartile range 1–3), EuroQoL index value was 0.81 (median; interquartile range 0.70–1.00). The frequencies for disabilities in the major domains were: spasticity 35%; cognition 61%; depression 20%; medication non-compliance 14%. Spasticity ( p = 0.008) and social needs ( p < 0.001) had the strongest impact on quality of life. The corresponding items in the Post-Stroke Checklist were predictive for low mood ( p < 0.001), impaired cognition ( p = 0.015), social needs ( p = 0.005) and caregiver burden ( p = 0.031). In the comprehensive interview, we identified the following needs: medical review (30%), optimization of pharmacotherapy (18%), outpatient therapy (47%) and social work input (33%). Conclusion These results suggest significant unmet needs and gaps in health and social care in long-term stroke patients. Further research to develop a comprehensive model for managing stroke aftercare is warranted. Clinical Trial Registration: clinicaltrials.gov NCT02320994.

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FP37-WE-05 Impact of insomnia on the quality of life of post-stroke patients

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(09)70466-6 ◽

2009 ◽

Vol 285 ◽

pp. S117

Author(s):

M. Sieminski ◽

K. Chwojnicki ◽

A. Ossowska ◽

L. Wierucki ◽

T. Zdrojewski ◽

...

Keyword(s):

Quality Of Life ◽

Stroke Patients ◽

Post Stroke

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Studi Epidemiologi Kualitas Hidup Penderita Paska Stroke di RSUD Propinsi Nusa Tenggara Barat

Jurnal Sains Teknologi & Lingkungan ◽

10.29303/jstl.v5i1.106 ◽

2019 ◽

Vol 5 (1) ◽

pp. 53

Author(s):

Ilsa Hunaifi ◽

Pujiarohman Pujiarohman

Keyword(s):

Quality Of Life ◽

General Hospital ◽

Normal Population ◽

Social Health ◽

Average Score ◽

Life Questionnaire ◽

Stroke Patients ◽

Cross Sectional ◽

Post Stroke

troke is a leading cause of mortality and morbidity in Indonesia. Post stroke patients has a higher disability hence results in poor quality of life compared with normal population. In Indonesia, studies related to the quality of life of post-stroke patients are scarce, so studies are required to explore the quality of life of post-stroke patients, particularly in West Nusa Tenggara. Aim of this study is to determine the epidemiology of quality of life for post-stroke patients in West Nusa Tenggara. Methods of this study is An Observational with cross-sectional design was performed in population of post-stroke patients admitted to West Nusa Tenggara General Hospital. The quality of life of post stroke patient was evaluated with SSQOL (Stroke Specific Quality of Life) questionnaire. The collected data was analyzed by the appropriate test. Result of this study is the average age of subject is 60.33±10.68 years. Hypertension is a major risk factor of stroke. The average SSQOL score is 177.02±45.75. SSQOL assesses 4 dimension are physical, functional, psychological and social health. Based on the physical dimension, the average score is 17.00, the functional dimension, the average score is 14.91, the psychological dimension, the average score is 13.17 and the social health dimension the average score is 13.44. The quality of life for post-stroke patients in West Nusa Tenggara General Hospital is good.

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