S-3-09-03
AGE-AND-GENDER-DEPENDENT DIFFERENCES IN QOL IN STROKE PATIENTS AND THEIR SPOUSES: ITS IMPROVEMENT BY GOAL-ORIENTED APPROACH IN REHABILITATION
Yayoi Okawa, M.D. (National Institute of Longevity Sciences, Obu City, Aichi, Japan)
A series of fact-finding studies on the objective and subjective quality of life (QOL) in post-stroke hemiplegic patients on a regular rehabilitation program and their spouses was performed in total of 496 cases, consisting of; 1) 110 pairs (52 aged and 58 non-aged) of male patients and their wives, 2) 94 pairs (52 aged and 58 non-aged) of female patients who had been homemakers previously and their husbands, and 3) 44 pairs (12 aged and 32 non-aged) of female patients who had had a job previously and their husbands, using semi-structured interview with a newly standardized Comprehensive Evaluation System based on a theory of the structure of QOL, which makes assessments of ten aspects of QOL concerning to four time-spots (Before the onset, Worst after the onset, The present, and Future outlook).
The results were analyzed and showed a general tendency of a sharp drop in most aspects of QOL between Before the onset and Worst after the onset, followed by a relatively good recovery (not reaching the Before the onset level) at The present and a Future outlook a little lower than The present. This was true not only in the patients themselves but also in their spouses, although less prominent. There was also various age-and-gender-dependent differences: for example, the impact of the disease was less prominent in an aged sub-group than a corresponding non-aged subgroup in all three groups, again in both patients and spouses.
Another series of QOL studies was performed after an innovation of rehabilitation practices had been introduced by Positive Rehabilitation Program based on the Goal-Oriented Approach. A total of 500 (125 pairs) of stroke patients and their spouses in the corresponding three groups were given the same evaluation. The results in this study revealed a markedly higher QOL as compared with the previous study in its many aspects, especially in social QOL and subjective QOL not only in patients but also in their spouses. This fact testifies to the importance of innovated program for better QOL in patients and spouses.
S-3-09-04
THE RAYS - A QUALITY OF LIFE SCALE FOR MULTIPLE SCLEROSIS PATIENTS
A. Achiron, Y. Barak, G. Harari, S. Noy, Z. Rotstein
Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel
Purpose: Multiple sclerosis (MS) is a disabling demyelinating disease adversely affecting different dimensions of everyday living. We have developed a novel scale aimed at quantifying quality of life amongst MS patients.
Methods: The RAYS scale assesses three dimensions of life: physical, psychological, and social-familial. Each of the 3 subscales includes 15 items scored by the patients (self-report) from l (best) to 4 (worse). The scale rates the week preceding its endorsement.
Results: Items included in the final version were derived from a source of 600 questions composed by our Center's experts and commonly used instruments (e.g.,- fatigue, MSQ- sleep, etc.). Prior to validation by patients, the RAYS was administered to 15 health professionals actively involved in rehabilitation programs. Clarity, importance, relevance and specificity were graded for each item by every professional independently. The RAYS was graded for each item by every professional independently. The RAYS was graded as good to excellent in all these aspects.
Conclusions: Construction of the RAYS scale for measuring quality of life in MS patients resulted in a disease related specific tool.
