Kvalitet života i funkcionalni oporavak bolesnika nakon rehabilitacije posle prvog moždanog udara

Abstract

Introduction. Brain stroke is considered to be the third main cause of death in developed countries, the first two being cardiovascular diseases and cancer, and the second one regarding worldwide population. Objective. The aim of the research was to compare the quality of life of the patients who were treated in hospitals having a longer period of rehabilitation in spa conditions with the quality of life of the patients who did not have any rehabilitation treatment in hospitals. Methods. The method that was used is a prospective cohort study. It included 196 patients at the age of 30 to 79, all of them being the citizens of Nis district. Te cohort consisted of the patients who had had an acute brain stroke for the first time in their lives (ABS) during 2011, 2012, and 2013. The beginning of the study was defined by the date of the first ABS. The study lasted from the 1st of April 2011. until the 15th of August 2013. The control group consisted of 60 patients who did not have any rehabilitation treatment in hospital after the first ABS. The functional recovery of patients was followed by use of Barthel index (BI) and of the Modified Rankin scale (RS).The questionnaires which were used:The general questionnaire used for estimating the quality of life was the Short form SF 36 (SF-36), the specific questionnaire for examining the functional status of neurological patients who survived brain stroke were the Stroke Impact Scale (SIS), “Mini-mental state examination” (MMSE), the level of neurological damage was measured by NHSS, EQ VAS and EQ5D. The questionnaires were used four times: at the admission, 1, 3, and 6 months after the stroke. Multivariant linear regression analysis was applied. Results. ABS leads to a significant destruction and decrease of HRQOL in all of its domains. Since physical functions of patients were the weakest immediately after the acute brain stroke, and their disability was greatest at the admission , they evaluated their own health condition and their quality of life as being lowest at the admission and within the first month. At the end of the research the quality of life was significantly higher with the patients who had rehabilitation treatment in hospitals. Conclusion. The quality of life of patients after ABS is significantly damaged and lower both in the early phase of recovery and 6 months after the stroke. Six months later the patients from the experimental group had a significantly higher quality of life in comparison with those from the control one.