Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria; World Federation for Neurorehabilitation, WFNR-Blossom Specialist Medical Center, First Center for NeuroRehabilitation in East, West and Central Africa, PO Box 30946, Se
Owolabi, M.O., Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria, World Federation for Neurorehabilitation, WFNR-Blossom Specialist Medical Center, First Center for NeuroRehabilitation in East, West and Central Africa, PO Box 30946, Secretariat Post Office, 200001 Ibadan, Nigeria
Background: Various studies have reported discordant profiles of health-related quality of life (HRQOL) after stroke. The aims of this study, the first of its kind, were to determine the real impact of stroke on HRQOL across diverse cultures; and to compare HRQOL between stroke patients and healthy adults, and across stroke severity strata.Methods: 100 stroke patients and 100 apparently healthy adults (AHAs) in Nigeria; as well as 103 stroke and 50 AHAs in Germany participated. Stroke severity was measured using the National Institute of Health Stroke Scale, Stroke Levity Scale and modified Rankin scale. HRQOL was evaluated using the HRQOL In Stroke Patients (HRQOLISP) measure, a holistic multiculturally-validated measure with seven therapeutically-relevant domains distributed into two spheres.Results: Domains within the spiritual sphere were considered more important by stroke patients. In both countries, stroke patients significantly (0.00001 < p < 0.004) had worse HRQOL than AHAs in all domains within the physical sphere. This was not so for the spiritual sphere. Consistently, stroke severity correlated significantly with all domains in the physical sphere unlike the spiritual sphere. In diverse cultures, the correlation coefficients between HRQOL and all indices of stroke severity revealed a decremental trend from the physical domain (rho = 0.77, p < 0.00001) to the spiritual domain (rho = 0.01, p = 0.893).Conclusions: Consistently, stroke elicited a decremental response across domains, with domains in the spiritual sphere being relatively stroke-resilient. The potential utility of the relatively preserved spiritual sphere in facilitating stroke rehabilitation requires evaluation in diverse cultures. © 2011 Owolabi; licensee BioMed Central Ltd.
adult; aged; article; controlled study; correlation coefficient; disease severity; female; Germany; human; major clinical study; male; multicenter study (topic); National Institutes of Health Stroke Scale; quality of life; stroke; chi square distribution; clinical trial; comparative study; cultural factor; hospitalization; middle aged; multicenter study; Nigeria; pathophysiology; psychological aspect; quality of life; questionnaire; stroke; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Cross-Cultural Comparison; Female; Germany; Humans; Male; Middle Aged; Nigeria; Quality of Life; Questionnaires; Severity of Illness Index; Stroke