İnmeli hastalarda yaşam kalitesini etkileyen faktörler
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Date
2010
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Publisher
Trakya Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
İnme önemli bir sağlık sorunudur ve nörolojik hastalıklar içerisinde en sık görülen hastalık grubunu oluşturmaktadır. Ortalama yaşam süresinin artmasına paralel olarak inme görülme sıklığı artmıştır. Son yıllardaki tanı ve tedavideki gelişmeler sonucunda inmeye bağlı ölüm oranı azalmış, rehabilitasyona ihtiyacı olan hasta sayısı artmıştır. İnme sonrası gelişen sorunlar, hayatın fiziksel, psikolojik ve sosyal boyutlarında ciddi defisitlere yol açarak yaşam kalitesinde önemli ölçüde azalmaya neden olur. Bu çalışmanın amacı da inmeli hastalarda iyileştirilmesi rehabilitasyonun temel hedeflerinden biri olan yaşam kalitesini etkileyen faktörleri belirlemektir. Çalışmaya Trakya Üniversitesi Tıp Fakültesi Nöroloji servisinde klinik ve radyolojik olarak inme tanısı almış 111 hasta alındı, çalışmayı 97 hasta tamamladı. Hastaların klinik durumları değerlendirme yapmaya uygun olduğunda ilk muayeneleri yapıldı. Hastalar muayenelerinden 1 ve 3 ay sonra tekrar aynı fakültenin rehabilitasyon kliniğinde değerlendirildi. Demografik verileri, hastalığı ile ilgili bilgileri ve yaşam kalitesini etkileyebileceğini düşündüğümüz bulgular araştırıldı. Fonksiyonel durum, Barthel İndeksi ile, ambulasyon Fonksiyonel Ambulasyon Skoru ile, kognitif değerlendirme Mini Mental Test ile, ihmal sendromu Yıldız Silme Testi ile, depresyon Beck Depresyon Ölçeği ile değerlendirildi. Yaşam kalitesi de kısa Form-36? ve inmeye özgü bir yaşam kalitesi ölçeği olan İnme Etki Ölçeği 3.0 versiyonu ile değerlendirildi. Yaşam kalitesine etkiyen faktörler lineer regresyon analizi kullanılarak saptandı. Hastaların yaşam kalitelerinin başlangıçtan 3. aya olumlu yönde değiştiği bulundu. Yaşın, cinsiyetin, dominant ekstremitenin tutulumunun, kognitif fonksiyonların, ambulasyonun, konuşma bozukluğunun ve depresyonun yaşam kalitesi ölçeklerinin her ikisinin de farklı alt birimlerini farklı şekilde etkilediği tespit edildi. Bazı demografik ve hastalıkla ilişkili faktörler, inmede yaşam kalitesini kötüleştirme potansiyeli taşırlar. Bu konuda bilinçli olmak, rehabilitasyon çalışmalarına yön verme açısından önemli olabilir.
Abstract
Stroke causes an important health problem and is the most frequent neurological disorder. Stroke incidence has increased in concordance with the increase in the mean life time. The death rate has decreased, so the rehabilitation need has increased as a consequence of improvements in diagnosis and treatment of stroke. Post stroke health problems cause serious deficits in pysical, psychological and social dimensions of life and lead to deteriorations in life quality. Our goal of this study was to determine the factors that effect quality of life, the improvement of which is the main aim of rehabilitation efforts, in stroke patients. One hundred eleven patients who were diagnosed clinically and radiologically as having stroke in Trakya University Medical Faculty Neurology Department were included in the study. Of these patients 97 could complete the whole study period. The first evaluation of the patients were performed when their clinical status reached a clinically stable status. The second and the third evaluations were made after 1 and 3 months, consecutively in the Rehabilitation Clinic of the same hospital. Demografic and disease related factors along with findings which could impare life quality were investigated. Functional status were assessed by Barthel Index, ambulation by Functional Ambulation Score, cognitive status by Mini Mental Test, neglect syndrome by Star Erasing Test and depression by Beck Depression Scale. Quality of life was evaluated by Short Form-36? and a stroke-spesific outcome measure named ?Stoke Impack Scala 3.0? version. Factors having effect on life quality were determined using linear regression analysis. It has been found that quality of life improved from the begining to the thirth month. We found that age, gender, dominant extremity involvement, cognitive functions, ambulation, speech disorder and depression all have effects in various subitems of the two life quality measurement instruments. Some demographic and disease related factors have potential to deteriorate life quality in stroke. The awareness in this point may carry importance to give direction to rehabilitation efforts.
Abstract
Stroke causes an important health problem and is the most frequent neurological disorder. Stroke incidence has increased in concordance with the increase in the mean life time. The death rate has decreased, so the rehabilitation need has increased as a consequence of improvements in diagnosis and treatment of stroke. Post stroke health problems cause serious deficits in pysical, psychological and social dimensions of life and lead to deteriorations in life quality. Our goal of this study was to determine the factors that effect quality of life, the improvement of which is the main aim of rehabilitation efforts, in stroke patients. One hundred eleven patients who were diagnosed clinically and radiologically as having stroke in Trakya University Medical Faculty Neurology Department were included in the study. Of these patients 97 could complete the whole study period. The first evaluation of the patients were performed when their clinical status reached a clinically stable status. The second and the third evaluations were made after 1 and 3 months, consecutively in the Rehabilitation Clinic of the same hospital. Demografic and disease related factors along with findings which could impare life quality were investigated. Functional status were assessed by Barthel Index, ambulation by Functional Ambulation Score, cognitive status by Mini Mental Test, neglect syndrome by Star Erasing Test and depression by Beck Depression Scale. Quality of life was evaluated by Short Form-36? and a stroke-spesific outcome measure named ?Stoke Impack Scala 3.0? version. Factors having effect on life quality were determined using linear regression analysis. It has been found that quality of life improved from the begining to the thirth month. We found that age, gender, dominant extremity involvement, cognitive functions, ambulation, speech disorder and depression all have effects in various subitems of the two life quality measurement instruments. Some demographic and disease related factors have potential to deteriorate life quality in stroke. The awareness in this point may carry importance to give direction to rehabilitation efforts.
Description
Tıpta Uzmanlık Tezi
Keywords
İnme, Yaşam Kalitesi, İnme Etki Ölçeği, Stroke, Quality of Life, Stroke Impact Scala
