M S Clark1, D S Smith. 1. Rehabilitation and Ageing Studies Unit, Repatriation General Hospital, Adelaide, Daw Park, SA, Australia.
Abstract
OBJECTIVE: To examine the effect of abnormal illness behaviour (AIB) on rehabilitation outcome following stroke. DESIGN: A longitudinal design, with assessments on admission to and discharge from rehabilitation, and six and 12 months after discharge. SETTING: The study was undertaken in the rehabilitation unit at Repatriation General Hospital, in Adelaide, South Australia. SUBJECTS: Ninety-four 12-month stroke survivors who had undergone an inpatient rehabilitation programme. MAIN OUTCOME MEASURES: AIB was assessed using the Illness Behaviour Questionnaire. Additional psychological measurements comprised the Zung Self-Rating Depression Scale, General Health Questionnaire, and a visual analogue mood scale. Functional ability was assessed with the Australian ADL Index, and lifestyle activities with the Frenchay Activities Index. RESULTS: Cluster analysis of discharge data was used to define a rule for identifying patients with AIB. AIB was apparent in nearly 30% of patients at discharge, and persisted for 12 months. Patients with AIB scored more poorly than non-AIB patients on functional, social and psychological indicators. CONCLUSIONS: AIB emerged as a key determinant of long-term disability. It is important to consider why AIB develops during rehabilitation, and how to identify patients at risk.
OBJECTIVE: To examine the effect of abnormal illness behaviour (AIB) on rehabilitation outcome following stroke. DESIGN: A longitudinal design, with assessments on admission to and discharge from rehabilitation, and six and 12 months after discharge. SETTING: The study was undertaken in the rehabilitation unit at Repatriation General Hospital, in Adelaide, South Australia. SUBJECTS: Ninety-four 12-month stroke survivors who had undergone an inpatient rehabilitation programme. MAIN OUTCOME MEASURES: AIB was assessed using the Illness Behaviour Questionnaire. Additional psychological measurements comprised the Zung Self-Rating Depression Scale, General Health Questionnaire, and a visual analogue mood scale. Functional ability was assessed with the Australian ADL Index, and lifestyle activities with the Frenchay Activities Index. RESULTS: Cluster analysis of discharge data was used to define a rule for identifying patients with AIB. AIB was apparent in nearly 30% of patients at discharge, and persisted for 12 months. Patients with AIB scored more poorly than non-AIBpatients on functional, social and psychological indicators. CONCLUSIONS:AIB emerged as a key determinant of long-term disability. It is important to consider why AIB develops during rehabilitation, and how to identify patients at risk.
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