Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV) e os seus resultados em sobreviventes de acidente vascular cerebral (AVC). MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrovascular accident, stroke, QV e acidente cerebrovascular. RESULTADOS: Consideraram-se relevantes 96 estudos e 31 entram neste trabalho, de acordo com os critérios de inclusão. Foram encontrados cinco tipos diferentes de instrumentos genéricos/perfil, nove genérico/utility e dois específicos. O mais freqüente foi o SF-36, em 45,2% dos estudos. Observou-se que a baixa QV relacionou-se, principalmente, ao déficit da função física, à presença de depressão ou de seus sintomas, ser do sexo feminino e ser mais idoso. De modo geral, os sujeitos no pós-AVC possuíam pior QV do que aqueles que não sofreram o evento. CONCLUSÃO: Foram encontrados 16 instrumentos para avaliação da QV. A baixa QV foi prevalente nos sobreviventes pós-AVC e se correlacionou com a função física, a depressão, o sexo e a idade.<br>OBJECTIVE: The purpose of this study is to identify generical and specific instruments used for valueing quality of life (QOL) and their outcomes in stroke survivors. METHODS: Review of literature of last 10 years, with people above 18 years old, in MedLine and Lilacs database. The instruments used on the studies were validated for the their countries. 96 articles have been considered relevant and 31 were in accordance with inclusion criteria. Five kind of generic/profile, nine generic/utility and two specific instruments were found. The more frequent was SF-36, on the 45,2% of the studies. It has been observed that poverty in quality of life was related to defective the physical function, to the presence of depression or its symptoms, to the feminine gender and to being older. In general, survivors of cerebrovascular accident had worse QOL than the ones who did not suffer it. CONCLUSION: It has been found 16 instruments for QOL' assessment. The poverty of QOL was frequent on stroke survivors and was related to physical function, depression, sex and age

Cognition, Emotion and Fatigue Post-stroke

After stroke, the less visible cognitive and emotional problems including fatigue are common and have a negative impact on the lives of patients as well as their caregivers. Given their prevalence, severity and impact, every stroke patient should at least be screened regularly for consequences in these areas of functioning. Cognitive complaints may not be related to cognitive deficits, and caregivers may have other experiences and consequences than the stroke patients themselves. Subjective cognitive functioning as experienced by both patients and their family members is therefore essential to assess as well. At the start of rehabilitation, and also when support is needed for community reintegration, an extensive neuropsychological assessment should be conducted. All patients and their caregivers need information and education about stroke and its neuro-psychological consequences because this knowledge has a positive influence on mood and quality of life. Further rehabilitation and support should be offered if community reintegration is delayed or stagnates. Cognitive rehabilitation should be combined with more holistic approaches including emotional, psychological and family support. Assistive technology can be helpful in compensating for lasting cognitive impairments. Restorative approaches, such as computerized brain training and non-invasive brain stimulation, can be used for improvement at impairment level, but have not shown effects on the long term nor on daily life functioning, but promising developments are anticipated.keywordscognitionemotionneuropsychologycompensationholistic