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ORIJINAL ARAŞTIRMA

İnmeli Hastaların Sağlıkla İlişkili Yaşam Kalitesiyle İlgili Faktörler
Factors Associated with Health-Related Quality of Life of Patients with Stroke
Received Date : 18 Feb 2023
Accepted Date : 13 Nov 2023
Available Online : 17 Nov 2023
Doi: 10.31609/jpmrs.2023-96197 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2024;27(2):89-95.
ÖZET
Amaç: İnme, dünya çapında en sık görülen nörolojik hastalıktır. İnme geçirenler günlük yaşam aktivitelerinde güçlük çekerler. Sağlıkla ilişkili yaşam kalitesi (SİYK) inmenin etkisiyle olumsuz etkilenmektedir. Bu çalışma, inmeli hastalarda sağlıkla ilgili yaşam kalitesini incelemeyi ve inme sonrası yaşam kalitesini öngören değişkenleri belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Hastaların kognitif durumlarını değerlendirmek için Mini Mental Test kullanıldı. Fonksiyonel durum ve günlük yaşam aktiviteleri Barthel İndeksi, Rivermead Mobilite İndeksi ve İnme Etki Ölçeği 3.0 (İEÖ 3.0) ile değerlendirildi. Hastanın duygudurumu Beck Depresyon Ölçeği ile sorgulandı. Yaşam kalitesi ile ilişkili faktörleri belirlemek için Pearson korelasyonu, bağımsız örneklem t-testi, tek yönlü varyans analizi ve regresyon analizi kullanıldı. Bulgular: Çalışmaya yaş ortalaması 62,33±10,47 (37-80) yıl olan 71 (%47,3) kadın, 79 (%52,7) erkek olmak üzere toplam 150 inme hastası katıldı. İnme sonrası süre ile İEÖ alt başlıkları (hafıza, ruh hâli, iletişim, günlük yaşam aktivitesi, mobilite, sosyal katılım, iyileşme) ve toplam skorları arasında pozitif korelasyon vardı (sırasıyla p=0,033, p=0,020, p=0,043, p=0,007, p=0,004, p=0,020, p=0,016 ve p=0,11). Sol hemiplejili hastalarda İEÖ-iletişim alt başlığında anlamlı fark saptandı (p=0,031). İEÖ-ruh hâli alt başlığı, çalışma durumuyla pozitif olarak ilişkiliydi (p=0,035). Sonuç: İnmeli hastalarda fonksiyonel bağımsızlık ve mobilite düzeyinin artmasıyla SİYK artmakta, depresyonda SİYK azalmaktadır. Şiddetli bağımlılık, dil bozukluğu, ileri yaş, hemorajik inme ve sol taraflı lezyonlar daha düşük SİYK ile ilişkilendirildi. Daha yüksek eğitim seviyesi daha yüksek yaşam kalitesi ile ilişkilendirildi.
ABSTRACT
Objective: Stroke is the most common neurological disease worldwide. Stroke survivors have difficulties in activities of daily living. Health-related quality of life (HRQOL) is adversely affected due to the impact of stroke. This study aims to examine HRQOL in stroke patients and identify variables predicting post-stroke quality of life. Material and Methods: Mini Mental Test was used to evaluate the cognitive status of patients. Functional status and activities of daily living were assessed with Barthel Index, Rivermead Mobility Index, and Stroke Impact Scale 3.0 (SIS 3.0). The patient’s mood status was questioned with Beck Depression Scale. Pearson correlation, independent sample t-test, one-way analysis of variance, and regression analysis were used to identify the factors associated with quality of life. Results: A total of 150 stroke patients, 71 (47.3%) women and 79 (52.7%) men, with a mean age of 62.33±10.47 (37-80) years participated in the study. Duration after stroke was positively correlated with memory, mood, communication, daily living activities, mobility, social participation, improvement, and total scores of SIS (respectively p=0.033, p=0.020, p=0.043, p=0.007, p=0.004, p=0.020, p=0.016 and p=0.11). A significant difference was detected in the SIS-communication subheading in patients with left hemiplegia (p=0.031). The SIS-mood subheading was positively associated with employment status (p=0.035). Conclusion: HRQOL increases with the increase in functional independence and mobility level in stroke patients, and HRQOL decreases in depression. Severe addiction, severe language impairment, advanced age, hemorrhagic stroke, and leftsided lesions were associated with lower HRQOL. Higher education level was associated with higher quality of life.
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