1
|
Quality of life of HIV-negative, previously healthy individuals following cryptococcal meningoencephalitis. Sci Rep 2021; 11:3673. [PMID: 33574462 PMCID: PMC7878796 DOI: 10.1038/s41598-021-83176-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/13/2021] [Indexed: 11/08/2022] Open
Abstract
The morbidity and mortality of cryptococcal meningoencephalitis (CM) in previously healthy, HIV-negative individuals is increasingly recognized. We administered a healthcare associated quality of life (QOL) survey to the largest longitudinally followed cohort of these patients in the United States. We identified moderate or severe self-reported impairment in at least one QOL domain in 61% of subjects at least one year following diagnosis. Self-reported cognitive impairment was noted in 52% and sleep disturbance was noted in 55%. This is the first comprehensive study of cross-sectional long-term QOL in previously healthy patients following cryptococcal infection.
Collapse
|
2
|
Cheraghifard M, Taghizadeh G, Akbarfahimi M, Eakman AM, Hosseini SH, Azad A. Psychometric properties of Meaningful Activity Participation Assessment (MAPA) in chronic stroke survivors. Top Stroke Rehabil 2020; 28:422-431. [PMID: 33078689 DOI: 10.1080/10749357.2020.1834275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Meaningful Activity Participation Assessment (MAPA) is an appropriate tool for assessing both objective and subjective aspects of participation. OBJECTIVES This study aimed to investigate the psychometric properties of MAPA in chronic stroke survivors. METHODS Translation of MAPA was done according to the standard protocol of forward-backward translation. One hundred and seven chronic stroke survivors participated in this study. In addition to the MAPA, they were assessed by Satisfaction With Life Scale (SWLS), Center for Epidemiologic Studies of Depression Scale (CES-D), Life Satisfaction Index-Z (LSI-Z), Purpose in Life Test-Short Form (PIL-SF), and 36-Item Short-Form Survey (SF-36). To investigate the test-retest reliability, 37 participants were reassessed by MAPA after two weeks. Reliability, construct and known-groups validity were evaluated for MAPA. RESULTS The results showed an acceptable internal consistency (Cronbach's α = 0.79) and good test-retest reliability (ICC = 0.92) of MAPA. A significant moderate to high correlation was found between the MAPA and PIL-SF, CES-D, LSI-Z, SWLS, and different subscales of SF-36 (r = 0.32-0.65). MAPA showed good ability to differentiate between young adults (age≤ 65 years) and older adults (age> 65 years) with chronic stroke (P = .005) as well as between chronic stroke survivors with different levels of disability (P < .001). CONCLUSIONS The MAPA has appropriate reliability and validity in chronic stroke survivors and is suggested to be used in research and clinical settings.
Collapse
Affiliation(s)
- Moslem Cheraghifard
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Malahat Akbarfahimi
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Aaron M Eakman
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
| | - Seyed-Hossein Hosseini
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| |
Collapse
|
3
|
Askew RL, Capo-Lugo CE, Sangha R, Naidech A, Prabhakaran S. Trade-Offs in Quality-of-Life Assessment Between the Modified Rankin Scale and Neuro-QoL Measures. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1366-1372. [PMID: 33032781 PMCID: PMC7547147 DOI: 10.1016/j.jval.2020.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/23/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION We aimed to describe the physical and cognitive health of patients with differing levels of post-stroke disability, as defined by modified Rankin Scale (mRS) scores. We also compared cross-sectional correlations between the mRS and the Quality of Life in Neurological Disorders (Neuro-QoL) T-scores to longitudinal correlations of change estimates from each measure. METHODS Mean Neuro-QoL T-scores representing mobility, dexterity, executive function, and cognitive concerns were compared among mRS subgroups. Fixed-effects regression models with robust standard errors estimated correlations among mRS and Neuro-QoL domain scores and correlations among longitudinal change estimates. These change estimates were then compared to distribution-based estimates of minimal clinically important differences. RESULTS Seven hundred forty-five patients with ischemic stroke (79%) or transient ischemic attack (21%) were enrolled in this longitudinal observational study of post-stroke outcomes. Larger differences in cognitive function were observed in the severe mRS groups (ie, 4-5) while larger differences in physical function were observed in the mild-moderate mRS groups (ie, 0-2). Cross-sectional correlations among mRS and Neuro-QoL T-scores were high (r = 0.61-0.83), but correlations among longitudinal change estimates were weak (r = 0.14-0.44). CONCLUSIONS Findings from this study undermine the validity and utility of the mRS as an outcome measure in longitudinal studies in ischemic stroke patients. Nevertheless, strong correlations indicate that the mRS score, obtained with a single interview, is efficient at capturing important differences in patient-reported quality of life, and is useful for identifying meaningful cross-sectional differences among clinical subgroups.
Collapse
Affiliation(s)
- Robert L Askew
- Department of Psychology, Stetson University, DeLand, FL, USA.
| | - Carmen E Capo-Lugo
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajbeer Sangha
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew Naidech
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shyam Prabhakaran
- Department of Neurology, The University of Chicago, Chicago, IL, USA
| |
Collapse
|
4
|
Askew RL, Capo-Lugo CE, Naidech A, Prabhakaran S. Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke. Arch Phys Med Rehabil 2020; 101:1515-1522.e1. [PMID: 32450061 DOI: 10.1016/j.apmr.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 04/02/2020] [Accepted: 05/06/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke. DESIGN Prospective cohort study. SETTING Comprehensive stroke care center in a large metropolitan city. PARTICIPANTS Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively. RESULTS Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score<5, longer time to therapy consult was associated with worse BI scores (BI=100; odds ratio [OR], 0.818; P=.008), executive function T scores (b=-0.865; P=.001), and general cognitive concerns T scores (b=-0.609; P=.009) at 1-month in adjusted analyses. In those with NIHSS score≥5, longer time to therapy treatment led to increased disability (ie, mRS≥ 2; OR, 1.15; P=.039) and lower extremity mobility T scores (b=-0.591; P=.046) at 1 month in adjusted analyses. CONCLUSIONS Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA.
Collapse
Affiliation(s)
- Robert L Askew
- Department of Psychology, Stetson University, DeLand, Florida.
| | - Carmen E Capo-Lugo
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew Naidech
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | |
Collapse
|
5
|
Hegedűs B. The Potential Role of Thermography in Determining the Efficacy of Stroke Rehabilitation. J Stroke Cerebrovasc Dis 2017; 27:309-314. [PMID: 29030045 DOI: 10.1016/j.jstrokecerebrovasdis.2017.08.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/29/2017] [Accepted: 08/31/2017] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Maintaining good physiological circulation in the extremities requires an optimally functioning muscle pump. Stroke symptoms indicate a change in venous circulation. In this study, changes were measured in joint function and microcirculation, and the correlation between them was examined. SETTING Physiotherapy Center, Ss. Cosmas and Damian Rehabilitation Institute, Visegrád, Hungary. METHODOLOGY Sixteen randomly selected poststroke patients with hemiparesis affecting mainly the upper extremities began undergoing rehabilitation 13 ± 4 days following stroke. Thermograms were taken with a Fluke Ti 20 (Fluke Corporation, WA) pretreatment and post-treatment, and a physiotherapy documentation form was completed. Treatment comprised 15 physiotherapy, massage, and galvanic therapy sessions per patient, with the side exhibiting no neurological symptoms as a control. RESULTS Joint function showed significant improvement on the affected side (P < .05). Thermographic examinations revealed microcirculatory dysfunction in the affected extremities in 100% of the cases. Following treatment, temperature increased significantly (P ≥ .5°C) on the affected side. A strong correlation (r) was observed between joint function and temperature change (P < .05). CONCLUSION Thermography is shown to be a reliable method for monitoring the effects of stroke rehabilitation treatment. Thermographic testing may enable us to predict the course of the trauma and the efficacy of treatment even at the acute stage.
Collapse
Affiliation(s)
- Béla Hegedűs
- Ss. Cosmas and Damian Rehabilitation Institute, Visegrád, Hungary.
| |
Collapse
|
6
|
Cordier R, Milbourn B, Martin R, Buchanan A, Chung D, Speyer R. A systematic review evaluating the psychometric properties of measures of social inclusion. PLoS One 2017; 12:e0179109. [PMID: 28598984 PMCID: PMC5466312 DOI: 10.1371/journal.pone.0179109] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/10/2017] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. OBJECTIVE To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. METHODS A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. RESULTS Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. CONCLUSIONS The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working definition of social inclusion as an overarching construct for ongoing research in the area of the psychometric properties of social inclusion instruments.
Collapse
Affiliation(s)
- Reinie Cordier
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ben Milbourn
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Robyn Martin
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Angus Buchanan
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Donna Chung
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
7
|
Bergström A, Guidetti S, Tham K, Eriksson G. Association between satisfaction and participation in everyday occupations after stroke. Scand J Occup Ther 2016; 24:339-348. [PMID: 27774829 DOI: 10.1080/11038128.2016.1245782] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Within occupational therapy, it is assumed that individuals are satisfied when participating in everyday occupations that they want to do. However, there is little empirical evidence to show this. AIMS The aim of this study is to explore and describe the relation between satisfaction and participation in everyday occupations in a Swedish cohort, 5 years post stroke. METHODS Sixty-nine persons responded to the Occupational Gaps Questionnaire (OGQ). The questionnaire measures subjective restrictions in participation, i.e. the discrepancy between doing and wanting to do 30 different occupations in everyday life, and satisfaction per activity. Results were analysed with McNemar/chi-square. RESULTS Seventy percent of the persons perceived participation restrictions. Individuals that did not perceive restrictions in their participation had a significantly higher level of satisfaction (p = .002) compared to those that had restrictions. Participants that performed activities that they wanted to do report between 79 and 100% satisfaction per activity. CONCLUSION In this cohort, there was a significant association between satisfaction and participating in everyday occupations one wants to do, showing that satisfaction is an important aspect of participation and substantiates a basic assumption within occupational therapy. The complexity of measuring satisfaction and participation in everyday occupations is discussed.
Collapse
Affiliation(s)
- Aileen Bergström
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden
| | - Susanne Guidetti
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden
| | - Kerstin Tham
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden
| | - Gunilla Eriksson
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden.,b Department of Neuroscience, Rehabilitation Medicine , Uppsala University , Uppsala , Sweden
| |
Collapse
|
8
|
Carod-Artal FJ. Determining quality of life in stroke survivors. Expert Rev Pharmacoecon Outcomes Res 2012; 12:199-211. [PMID: 22458621 DOI: 10.1586/erp.11.104] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Post-stroke health-related quality of life (HRQoL) reflects a comprehensive view of subjective health and a measure of a person's perceived physical, mental and social health following stroke. Generic scales may enable comparisons between groups of patients with a diverse range of conditions, although they may underestimate the effect of stroke owing to its limited content validity. Stroke-specific HRQoL measures were designed to assess relevant domains that are important to stroke patients. The Stroke Impact Scale, the Stroke Specific Quality of Life scale and The Burden of Stroke Scale are specific HRQoL instruments developed in the last decade. Demographic factors, comorbidity, stroke severity, disability and psychosocial factors (e.g., post-stroke depression and social support) are significant predictors of HRQoL in stroke survivors. Stroke caregiver burden and HRQoL are inversely correlated. HRQoL measures are increasingly used to evaluate the effect of some therapeutic interventions in stroke survivors.
Collapse
|