Relationship Between Disability and Health‐Related Quality of Life and Caregiver Burden in Patients With Upper Limb Poststroke Spasticity

Wiley - Tập 4 Số 1 - Trang 4-10 - 2012
Quan V. Quan V., Allison Allison, Patrick J. Patrick J., Sepideh F. Sepideh F., Amanda M. Amanda M., Catherine C. Catherine C., Elie P. Elie P.

Tóm tắt

ObjectiveTo evaluate the relationship between disability and both health‐related quality of life (HRQoL) and caregiver burden in patients with upper limb poststroke spasticity.DesignMulticenter open‐label study.SettingThirty‐five sites in North America.ParticipantsPatients (N = 279) with upper limb poststroke spasticity.MethodsPost hoc analyses of data from an open‐label study were performed to estimate HRQoL and caregiver burden at study baseline across levels of disability in 4 problem domains: hygiene, dressing, limb posture, and pain. Disability severity in these areas was determined by using the 4‐point Disability Assessment Scale rated by the physicians.Main Outcome MeasurementsHRQoL measured by the patient‐reported EuroQol 5 Dimensions questionnaire and the Stroke‐Adapted Sickness Impact Profile and caregiver burden.ResultsAt study baseline, increasing disability in the hygiene, dressing, and pain domains of the Disability Assessment Scale was associated with diminishing HRQoL scores (P < .002) measured by the EuroQol 5 Dimensions. By using the Stroke‐Adapted Sickness Impact Profile, greater disability scores in all problem domains were significantly associated with higher overall dysfunction scores (P ≤ .05). Within the physical dimension of the Stroke‐Adapted Sickness Impact Profile, significant associations also were observed in all domains. At baseline, caregiver burden was significantly related to increasing levels of hygiene and dressing domain severity (P ≤ .05). Caregiver assistance requirement increased from approximately 9.0‐28.2 hours per week in the hygiene domain and 3.3‐32.1 hours per week in the dressing domain as disability increased from “none” to “severe.”ConclusionsIn patients with upper limb poststroke spasticity, increasing disability in the hygiene, dressing, and pain domains of the Disability Assessment Scale were associated with diminishing HRQoL. Furthermore, these patients required caregiver assistance proportionally related to the severity of their disability in the hygiene and dressing domains.

Tài liệu tham khảo

10.1161/CIRCULATIONAHA.108.191259 10.1161/01.STR.0000105386.05173.5E 10.1191/0269215502cr512oa Royal College of Physisicans.Spasticity in adults: Management using botulinum toxinhttp://www rcplondon ac uk/pubs/contents/6988a14a‐1179‐4071‐8f56‐dc2a865f0a43 pdf2009 Accessed August 5 2010 Exel N.J., 2004, Assessment of post‐stroke quality of life in cost‐effectiveness studies: The usefulness of the Barthel Index and the EuroQoL‐5D, Qual Life Res, 13, 427, 10.1023/B:QURE.0000018496.02968.50 10.1053/apmr.2002.33984 10.1161/01.STR.0000141977.18520.3b 10.1016/j.apmr.2008.01.007 10.1161/STROKEAHA.108.544346 10.1097/00005650-199711000-00002 10.1161/01.STR.28.11.2155 10.1161/01.STR.19.9.1101 10.1161/01.STR.27.9.1467 10.1161/01.STR.31.8.2004 Food and Drug Administration.Guidance for industry patient‐reported outcome measures: Use in medical product development to support labeling claimshttp://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM193282.pdf Accessed April 1 2011 10.1053/apmr.2002.35474 EuroQol Group.EQ‐5D User Guide: basic information on how to use EQ‐5Dhttp://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/User_Guide_v2_March_2009.pdf Accessed October 21 2011 10.1097/00005650-200503000-00003 10.1161/CIRCULATIONAHA.107.752006 10.1186/1477-7525-5-70 10.1186/1477-7525-4-71 10.1161/01.STR.32.6.1425 10.1097/01.mlr.0000172050.67085.4f