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Trajectories of health-related quality of life after stroke: results from a one-year prospective cohort study.

Abstract：

PURPOSE:To identify trajectories of physical and psychosocial health-related quality of life (HRQoL) from two months to one-year post stroke and to determine the factors that are associated with trajectory membership. METHOD:Multicenter prospective cohort study in which 351 stroke patients were followed up at 2, 6, and 12 months post stroke. Latent class growth mixture modeling was used to determine trajectories of physical and psychosocial HRQoL. Multinomial regression analyses were performed to predict trajectory membership. Potential predictors were demographic, stroke-related, and psychological factors. RESULTS:Four trajectories were identified for both physical and psychosocial HRQoL: high, low, recovery, and decline. Comparing the low and recovery trajectories, the groups with low HRQoL were more likely to have higher scores for neuroticism. Comparison of the decline and high trajectories yielded the following predictors of physical HRQoL: discharged to a rehabilitation setting, less acceptance and more neuroticism, pessimism, helplessness, and passive coping. Predictors of psychosocial HRQoL were: discharged to a rehabilitation setting, less self-efficacy, and proactive coping, and more helplessness and passive coping. CONCLUSIONS:The present study identified four distinct trajectories of physical and psychosocial HRQoL. The findings indicate that psychological factors are the most important factors in identifying stroke patients at risk of unfavorable HRQoL trajectories. Using these factors will help to identify vulnerable patients and guide rehabilitation in the early stages post stroke. Implications for rehabilitation Clinicians should be aware that health-related quality of life follows distinct trajectories stable high, stable low, recovery, or decline, after onset of stroke. Determining relevant psychological factors, in particular helplessness and passive coping, in stroke patients early after stroke is important because these are predictors of unfavorable health-related quality of life trajectories.

journal_name

Disabil Rehabil

journal_title

Disability and rehabilitation

authors

van Mierlo M,van Heugten C,Post MWM,Hoekstra T,Visser-Meily A

doi

10.1080/09638288.2017.1292320

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

997-1006

issue

eissn

0963-8288

issn

1464-5165

journal_volume

pub_type

杂志文章

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Trajectories of health-related quality of life after stroke: results from a one-year prospective cohort study.