Quality of life among older stroke patients in Taiwan during the first year after discharge

Aim and objective. To explore the one-year poststroke trajectories in health-related quality of life and physical function in a sample of older stroke patients in Taiwan. Background. Health-related quality of life has repeatedly been reported as decreased in poststroke patients. The vast majority of information on the health-related quality of life of older patients after stroke is based on data collected in Western developed countries. In contrast, little is known about older stroke patients in Asian countries. Design. A descriptive, prospective and correlational design was used. Methods. Older stroke survivors (n = 98) were assessed at the end of one, three, six and 12 months after hospital discharge for health-related quality of life (measured by the Medical Outcomes Study Short Form 36) and physical functioning (measured by the Chinese Barthel Index and Instrumental Activities of Daily Living Scale). Results. The subjects, who were 65-88 years old, performed considerably worse at 12 months after hospital discharge in social and physical functioning (means = 61·1, 54·8, respectively) than the age-matched community-dwelling norm (means = 78·7, 69·7, respectively). During the first year after discharge, subjects improved significantly on the Medical Outcomes Study Short Form 36 physical component summary scale and role limitations due to physical problems; during the first three months after discharge, they improved significantly on performance of activities of daily living and instrumental activities of daily living; and from the third to sixth month after discharge, they improved significantly in physical functioning. Conclusions. The first year, especially the first three months after hospital discharge, is critical for improvements in health-related quality of life and physical functioning for older stroke survivors in Taiwan. Relevance to clinical practice. Older Taiwanese/Chinese people who suffer a stroke will likely benefit from interventions during the first 12 months after discharge and the most effective interventions may be earlier, during the first three months after discharge.