Quality of life and illness perception in stroke patients : a 12 month study

  • John Dinsmore

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Stroke is a leading cause of disability in the island of Ireland. This research examines the quality of life and illness perceptions in stroke patients in a longitudinal, multi- centred study. 203 stroke patients from Belfast and Dublin hospitals were recruited and assessed on admission for stroke. Patients will be cognitively capable of participation. Measures included the Illness Perception Questionnaire-Revised (IPQ- R, Moss-Morris et al., 2002), The Schedule for the Evaluation of Individual Quality of Life - Direct Weighting (SEIQoL-DW, O’Boyle et al., 1992), the Stroke Specific Quality of Life Scale (SSQOL, Williams, et al, 1999), The Single Item Self-Esteem Scale (SISE, Robins, Hendin & Trzesniewski, 2001), Hospital Anxiety and Depression Scale (HADS, Zigmond & Snaith, 1983), The Recovery Locus of Control (RLOC, Partridge & Johnston, 1989) and Multiple Perceived Social Support Scale (MSPSS, Zimet et al, 1988). Patients were followed up at 12 months post stroke using the same measures as on admission. Significant differences in outcomes were seen between patients located in Northern Ireland National Health System (NHS) and The Republic of Ireland Health Care System. Gender reported only minor differences. Stroke was analysed longitudinally across two different health systems for the first time using the Illness Perception Questionnaire-Revised. Results supported a logical inter-related schematic model to illness representations and stroke establishing the benefit of combining quality of life (QoL) and health related quality of life (HRQoL) measures to provide an in depth analysis of post stroke quality of life. All five research hypotheses were accepted as true over 12 months of assessment in stroke; The SEIQoL-DW was firstly proved to have appropriate construct validity in stroke QoL assessment. It is recommended that the SEIQoL-DW be combined with a stroke specific measure such as the SSQoL to obtain a global assessment to both the psychological and physical facets of QoL. Increased quality of life post stroke is associated with a confident and positive illness perception model in which the patient understands their illness and perceives the illness not to have many consequences on their life. High scores on cognitive mediators such as selfesteem, internal control and perceived social support with low scores in anxiety and depression also increase patient post stroke quality of life. Patients who show confident psychological recovery post stroke appear to have improved functional ability 12 months post stroke.
Date of Award2009
LanguageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorVivienne Crawford (Supervisor)

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