Original Title: Calidad de vida del paciente con ictus y de su cuidador. Pronóstico y resultados del tratamiento rehabilitador

Authors' objectives: The main aims are to analyse the effectiveness and efficiency of the rehabilitation treatment following a stroke and to determine those variables that have the greatest influence on the functional recuperation and their destination on being discharged from hospital. On the other hand, evaluate the quality of life of disabled patients following a stroke, and the burden and quality of life of their main caregivers.

Authors' results and conclusions: Forty-five point two percent of the 241 patients included were found to be in a situation of total dependency on admission and 12.8 % on being discharged from hospital. The average stay was 37.1 ± 22.8 days and the effectiveness was 32.5± 20.4 points on the BI and efficiency was 1.25 ± 1.24. The variable that had a greater influence on effectiveness was the BI on admission and the severity of the neurological deficits (p less-than 0.001) had the greater influence on efficiency. Eighty-one point five percent returned to their homes following hospitalisation. The probability of destination to a nursing home is 3 and 2.71 times greater in patients with total dependency and with high comorbidity, respectively. The variables most closely associated with destination on discharge are marital status, social risk and BI (p less-than 0.001). One hundred and nineteen caregivers were included in the study with an average age of 59; women represented 74 %. Stroke patients perceive a drop in their quality of life greater than their caregivers and both perceive a deterioration in comparison with the general population. The quality of life of patients is affected to a greater degree the worse their functional situation, the greater their neurological deficit, if there is depression and when the gender is female. Caregivers perceive an average burden of 48.26 on the Zarit scale, which is greater in women. The physical component of the quality of life of the caregiver is affected more the worse the functional status of the patient is and if he/she has problems of swallowing. The mental component is affected the greater the age of the patient and when the patient cared for is a woman. CONCLUSIONS There are numerous variables that influence the results of the rehabilitating treatment following a stroke, and it is therefore necessary to make an overall evaluation of the patients with disability following a stroke that allows doctors to predict the recovery of the patient, the aims of the treatment and to carry out a destination plan on discharge. Moreover, the disability of stroke patients affects their quality of life, both in their physical and mental component, and in the quality of life and burden of their main caregiver. By identifying the variables that have the greatest influence on the burden of the caregiver and the quality of life of the patient may allow strategies to be created to partially compensate this situation.

Authors' methods: All the patients admitted to the Rehabilitation Services of the two hospitals of the Basque Health Service (Osakidetza) for eight months following a stroke were included. The evaluation was performed on admission, on discharge from hospital, and six months following the stroke and included sociodemographic data, social risk (Gijon scale), comorbidity (Charlson Index), neurological severity (NIHSS), functional variation by means of the Barthel Index (BI), effectiveness, efficiency and the destination on discharge. Six months following the stroke, an assessment was also made of the burden for the caregiver based on the Zarit scale, the quality of life of the patient and caregiver based the SF36 questionnaire, and these were compared with data on the general population of the Basque Country, and a questionnaire of the specific quality of life for stroke (ECVI 38. The analysis was made by applying a linear model and logistical regression models.

Project Status: Completed

Year Published: 2013

URL for published report: https://www.euskadi.eus/contenidos/informacion/2013_osteba_publicacion/es_def/adjuntos/Informe%20D-13-06.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>