A PROSPECTIVE STUDY ON COPING STRATEGIES AND QUALITY OF LIFE IN PATIENTS AFTER STROKE, ASSESSING PROGNOSTIC RELATIONSHIPS AND ESTIMATES OF COST-EFFECTIVENESS

被引:30
|
作者
Darlington, Anne-Sophie E. [2 ]
Dippel, Diederik W. J. [1 ]
Ribbers, Gerard M. [3 ,4 ]
van Balen, Romke [5 ]
Passchier, Jan [2 ]
Busschbach, Jan J. V. [2 ,6 ]
机构
[1] Erasmus MC, Dept Neurol, Rotterdam, Netherlands
[2] Erasmus Univ, Med Ctr, Dept Med Psychol & Psychotherapy, Erasmus MC, NL-3015 GE Rotterdam, Netherlands
[3] Erasmus MC, Rijndam Rehabil Ctr, Rotterdam, Netherlands
[4] Erasmus MC, Dept Rehabil Med, Rotterdam, Netherlands
[5] Antonius Binnenweg Nursing Home & Geriatr Ctr, Rotterdam, Netherlands
[6] Viersprong Inst Studies Personal Disorders, Halsteren, Netherlands
关键词
cost-effectiveness; stroke; quality of life; coping; PROBLEM-SOLVING THERAPY; CARE; PREVENTION; HANDICAP; EUROQOL; NICE;
D O I
10.2340/16501977-0313
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To examine the prognostic value of coping strategies of patients after stroke at time of discharge on quality of life approximately one year later. In addition, we estimated the maximum cost of improving quality of life by enhancing coping strategies using strict assumptions. Methods: Eighty patients with a stroke completed several questionnaires, at discharge to home and 9-12 months later (follow-up). Questionnaires measured quality of life, coping strategies Tenacious Goal Pursuit and Flexible Goal Adjustment. First, a regression analysis was carried out predicting quality of life at follow-up from coping strategies at discharge. Secondly, a maximum in terms of acceptable cost was calculated for several possible effect sizes. Results: Both coping strategies at discharge were positively associated with quality of life at follow-up. With regards to cost-effectiveness, a medium effect size would result in an increase in quality of life of approximately 10%. The maximum acceptable cost of an intervention for a single patient is therefore set at (sic)2500, assuming a benefit of one year and a cost per quality adjusted life year of (sic)25,000. Conclusion: Coping strategies at discharge are predictive of quality of life one year later. The costs of improving quality of life are thought to be within the limits that determine a cost-effective intervention.
引用
收藏
页码:237 / 241
页数:5
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