Effect of Chronic Disease Self-management on Activities of Daily Living and Quality of Life of Stroke Patients in Community / 中国康复理论与实践

ABSTRACT

@#Objective To investigate the impact of chronic disease self-management on motor function, activities of daily living, quality of life, and depression of patients in poststroke rehabilitation in community. Methods 120 stroke patients living in Gangdu community, Wuhan city were selected and randomly divided into self-management group (n=60) and control group (n=60). The control group experienced home rehabilitation and functional training by themselves, meanwhile they were asked to have regular outpatient referral and do the followup clinic when feeling indisposed. Self-management mode was used in the self-management group instructed by the professor and under the rehabilitation assessment by community doctors, therapist and family members. Also group separated instruction, individualized rehabilitation plan, home visit processes and patients' group activity had been organized. They were evaluated with Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI), Hamilton Depression Rating Scale (HAMD) and the World Health Organization Quality of Life (WHOQOL-100) before and 6 months after intervention. Results There were no difference in FMA upper and lower limbs scores as well as the MBI score, HAMD score and WHOQOL-100 score before intervention (P>0.05). The FMA upper and lower limbs score, MBI score and WHOQOL- 100 score significantly improved in the self-management group and were better than in the control group 6 months after intervention (P<0.05). The control group also improved in the above items, however, the differences were not statistically significant (P>0.05). HAMD score significantly reduced in the self-management group and less than in the control group 6 months after intervention (P<0.05). The control group also reduced in the above scores, however, the differences were not statistically significant (P>0.05). Conclusion Chronic disease self-management for stroke patients in community can significantly improve their motor function, activities of daily living and quality of life, and reduce depression caused by stroke.