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Consequences of stroke: aspects of impairments, disabilities and life satisfaction : with special emphasis on perception and on occupational therapy
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
1987 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Perceptual and motor functions and self-care ability after stroke were assessed within two weeks (n:109; mean age 69±10) and 4-6 years (n:75;70±9) after admission to a non-intensive care stroke unit. Sixty-two of the long-term stroke survivors reported on their life satisfaction (7 items) as experienced (in retrospect) before the stroke and at the time of the investigation. Perceptual functions and actual levels of life satisfaction were registered in 60 clinically healthy subjects aged about 60 or about 80 years.

Both early on and late after stroke the 16 items of perceptual function were clearly grouped into two factors, which neatly fitted an ecological perceptual concept. One factor characterized low-order and the other higher-order perception. Impairments of low-order perception occurred for about 10% of the patients, whether investigated early or late after stroke. No one among the reference populations had such impairments. Higher-order perceptual impairments prevailed in 60% early on and in 57% late after stroke and were often more pronounced than those occurring in the reference populations, among whom 35% of the 60 year olds and significantly more - 77% - of the 80 year olds had such impairments. Hence, perceptual impairments are common after stroke, but slight age-dependent reductions should be considered when higher-order perceptual function is assessed and treated after stroke.

Together with motor function, which was impaired in 52% of the early and 36% of the late stroke samples, higher-order perceptual function and to a limited extent low-order perception could predict the level of self-care ability in 70% and 62% of the early and late samples, respectively.

Whereas levels of global and of domain specific variables of life satisfaction were similar in the two reference populations, the stroke had lead to a reduction in life satisfaction for 61% of the long-term survivors. Reductions were particularly pronounced for global life satisfaction and for satisfaction with leisure and sexuality. Although significantly associated with motor impairment and self-care disability, these reductions could not be attributed only to impairments and disability.

The findings are discussed with particular reference to assessment and treatment in occupational therapy.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 1987. , 58 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 202
Keyword [en]
stroke, impairment, disability, life satisfaction, perception, hemiplegia, occupational therapy
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
URN: urn:nbn:se:umu:diva-99335ISBN: 91-7174-310-3 (print)OAI: oai:DiVA.org:umu-99335DiVA: diva2:791055
Public defence
1987-12-18, Hörsal G, Humanisthuset, Umeå universitet, Umeå, 13:00
Supervisors
Projects
digitalisering@umu
Note

S. 1-58: sammanfattning, s. 59-139: Härtill 5 uppsatser

Available from: 2015-02-26 Created: 2015-02-06 Last updated: 2015-04-08Bibliographically approved
List of papers
1. Motor and perceptual impairments in acute stroke patients: effects on self-care ability
Open this publication in new window or tab >>Motor and perceptual impairments in acute stroke patients: effects on self-care ability
1987 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 18, no 6, 1081-1086 p.Article in journal (Refereed) Published
Abstract [en]

The relative importance of motor, perceptual, and some cognitive functions for self-care ability was analyzed in a representative sample of 109 subjects within 2 weeks of acute stroke. Forty-nine patients (45%) were dependent or partly dependent in self-care. Profound motor dysfunction was present in 39%, low-order perceptual deficits in 10%, high-order perceptual deficits in 60%, and disorientation in time and space in 13% of the patients. There was a significant covariation between motor function and self-care ability and between low-order perception and orientation function. Low-order and high-order perception covaried only weakly. Discriminant analyses showed that the actual level of self-care proficiency could be correctly predicted in 70% of the cases by the 4 indexes of motor function, low-order perception, high-order perception, and orientation. The dominating predictor was motor function, and the next highest was high-order perception. When a program for early training is designed with the aim to alleviate long-term self-care disability after stroke, correct assessment of motor and perceptual functions in the individual stroke patient is essential.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 1987
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81608 (URN)3686581 (PubMedID)
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2017-12-06Bibliographically approved
2. Perceptual function in the elderly and after stroke
Open this publication in new window or tab >>Perceptual function in the elderly and after stroke
1988 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 2, no 2, 75-79 p.Article in journal (Refereed) Published
Abstract [en]

Perceptual function was assessed in 60 clinically healthy subjects aged about 60 (n=34) and 80 (n=26), and in stroke survivors who were assessed either early (n=109) or four to six years (n=75) after the stroke. Using two indices, one characterising low-order perception and the other higher-order perception, the clinically healthy subjects invariably had no impairment in the low-order index. Slight impairments occurred in 35% of 60-year-old and 77% of 80-year-old healthy subjects. Considerably more pronounced disturbances occurred in the stroke victims, among whom about 60% had impairment or higher-order perceptual function and about 10% had low-order perceptual deficits. Thus as higher-order perception is age dependent, it appears that in rehabilitation of stroke allowance should be made for predictable signs of advancing age.

Place, publisher, year, edition, pages
John Wiley & Sons, 1988
Keyword
stroke, perception in elderly, perception after stroke
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81611 (URN)10.1111/j.1471-6712.1988.tb00349.x (DOI)3212304 (PubMedID)
Projects
digitalisering@umu
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2017-12-06Bibliographically approved
3. Life satisfaction in long-term survivors after stroke
Open this publication in new window or tab >>Life satisfaction in long-term survivors after stroke
1988 (English)In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 20, no 1, 17-24 p.Article in journal (Refereed) Published
Abstract [en]

Different aspects of the quality of life before and after stroke were registered for 62 communicable, representative long-term (4-6 years) survivors, who reported the global and domain specific life satisfaction that they experienced (7 items, 6 graded-ordinal scales). Reference subjects were 60 healthy individuals in two age cohorts (60-61 years, n = 34; 79-81 years, n = 26) none of whom had been hospitalized during the last seven years prior to the investigation. The main finding is that, after the stroke, at least one aspect of the quality of life had decreased for 61% of them; this concerned global, sexual and leisure satisfaction mainly. Moreover, persisting motor impairment and ADL-disability had a negative effect on several aspects of life satisfaction. As nearly 30% of the non-impaired and the non-disabled interviewees reported decreased global life satisfaction, these changes indicate that they do not cope psychosocially with the stroke as such nor with its sequelae. In contrast, the levels of life satisfaction were similar for the 60-61 and 79-81 year-old interviewees, clinically healthy respondents, indicating stability in the quality of life that they experienced from late middle age into senectitude. For the patients, social integration estimated normatively did not covariate significantly with post-stroke satisfaction derived from social relationships.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81609 (URN)3413451 (PubMedID)
Projects
digitalisering@umu
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2017-12-06Bibliographically approved

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