Post-stroke health-related quality of life at 3 and 12 months and predictors of change in a Danish and Arctic Norwegian Region
Guri Heiberg, Oddgeir Friborg, Synne Garder Pedersen, Gyrd Thrane, Henriette Holm Stabel, Jørgen Feldbæk Nielsen, Audny Anke
Department of RehabilitationFaculty of Health Sciences, Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromsoe, Norway. E-mail: email@example.com
Objectives: To investigate changes in health-related quality of life between 3- and 12-months post-stroke in a north Norwegian and a Danish region that organize their rehabilitation services differently, and to identify clinically relevant predictors of change.
Design: Prospective multicentre cohort study.
Subjects: In total, 304 patients with first-ever stroke (male sex 59%, mean age 68.7 years) participated from Norway (n = 170) and Denmark (n = 134).
Methods: The Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS) was administered twice to measure change in satisfaction with function and wellbeing.
Results: QOLIBRI-OS scores showed a small statistically significant difference in favour of Norway at 12 months post-stroke (p = 0.02; Cohen’s d = 0.26). Using a calculated minimal clinically important difference score of 12, 20% reported worse, 54% unchanged and 26% better QOLIBRI-OS scores between 3 and 12 months. Age below 65 years predicted a negative change (odds ratio (OR) 0.4, p = 0.007).
Conclusion: In this population with mild and moderate stroke, QOLIBRI-OS scores were slightly higher in the Norwegian region. Approximately 50% of participants experienced clinically important changes in satisfaction with functioning and wellbeing between 3 and 12 months post-stroke. Younger age predicted negative change. This result could indicate increased rehabilitation needs over time in young patients and should be investigated further.
This article compares experiences in satisfaction with functioning and wellbeing at 3 and 12 months between patients with stroke in a region in Denmark and a region in North Norway. Acute treatment of stroke in stroke units at hospitals is comparable in the 2 regions, but subsequent rehabilitation services differ. The Danish region had more organized municipality-based rehabilitation, while the North Norwegian region used more in-patient rehabilitation at specialized rehabilitation wards. In total, 170 patients from Norway and 134 from Denmark answered questionnaires about satisfaction with functioning and wellbeing at 3 and 12 months after stroke. At 3 months, patients reported comparable satisfaction, but after one year, the Norwegians were slightly more satisfied, especially with cognitive and emotional status. Change in satisfaction with functioning between 3 and 12 months was comparable between the 2 regions.
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