Recuperation of daily activities and quality of life after stroke : The EAVQ-QdV scale.
Dr Marine LUNVENa, Ms Stéphanie CORREIAb, Dr Raffaella MIGLIACCIOa, Dr Christophe DURETb, Dr Marianne BLANCHARDb, Dr Géraldine LAURENTb, Prof Paolo BARTOLOMEOa, Dr Clémence BOURLONb
a Hôpital Pitié Salpétrière, ICM, Inserm U1127, CNRS UMR 7225, Paris, France, b Clinique Les Trois Soleils, Boissise-Le-Roi, France
Aim. Stroke is a leading cause of long-term disability in adults. Few studies have investigated the impact of cognitive deficits on health-related quality of life (HRQOL) in patients or caregivers, notably in function of stroke laterality and of lesion volume. This research aims to a better evaluation of HRQOL with a new multi-dimensional scale based on description of the person’s present state compared to the pre-stroke state.
Methods. EAVQ-QdV is an auto-administered questionnaire composed of physical, cognitive, psychic and social domains. For each domain, difficulties and emotional report are evaluated. Patients’ and caregivers’ points of view are collected. Sixty-nine patients filled out the EAVQ-QdV in the chronic phase (46 right stroke, 23 left stroke). Patients also filled out SF36. MRI brain imaging was performed in all patients.
Results. Preliminary results show a significant negative correlation between EAVQ-QdV and SF36 (r=-0,54). Age, educational level, delay post stroke or lesion volume did not correlated with the EAVQ-QdV scores. There was no difference between EAVQ-QdV scores in left-sided vs. right-sided strokes (p>.45). However, right-brain damaged patients, but not left-brain damaged patients, underestimated their difficulties when their scores were compared to the caregivers’ (p<.03). Analysis of the distinct domains of the scale revealed differences in language, attention, executive functions, memory and social relation, with greater severity in patients with left hemisphere strokes, and in the domain of visual neglect for patients with right-sided stroke (p<.02).
Discussion. A single questionnaire exploring different cognitive domains, and comparing patients’ and caregivers’ assessments, with the evaluation of the emotional impact of patients’ and caregivers’ difficulties may permit to obtain a better estimation of residual handicap in stroke patients.
Keywords : stroke, quality of life, cognitive disorders