Abstract
It has been suggested that external factors, such as perceived control of life and social support, influence the interactions of impairment, disability and handicap in the WHO model. Therefore, we assessed the effect of these two factors on the relationships between disability, handicap and quality of life in patients recovering from stroke. One hundred individuals, retrospectively and randomly selected from participants in an inpatient stroke rehabilitation program, were tested one year after discharge, using the Functional Independence Measure, the London Handicap Scale, the Life Satisfaction Assessment, the Tel-Aviv Social Support Instrument, and the Perceived Stress Scale. Impairment, disability, handicap and quality of life after stroke correlated positively and significantly with each other. Significant moderation of the influence that disability exerts on handicap was affected by perception of control, and by the influence of handicap over quality of life by social support. Thus, external factors can cause inconsistent interactions between components of the WHO model. Patient outcome may be improved if such factors are considered.
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References
WHO international classification of impairments and disabilities and handicaps: A manual of classification relating to the consequences of disease. WHO, Geneva, 1980.
Fletcher A.E., Dickinson E.J., Philp I.: Review: Audit measures: Quality of life instruments for everyday use with elderly patients. Age Ageing 21: 142–150, 1992.
Badley E.M.: The genesis of handicap: definition, model of disablement and role of external factors.Disabil. Rehabil.17: 53–62, 1995.
Cobb S.: Social support as a moderator of life stress. Psychosom. Med. 38: 300–314, 1976.
Jongbloed L.: Adaptation to a stroke: The experience of one couple. Am. J. Occup. Ther. 48: 1006–1013, 1994.
Roberts S.J.: Social support and help seeking: review of the literature. Adv. Nurs. Sci. 10: 1–11, 1988.
Partridge C., Johnston M.: Perceived control of recovery from physical disability: Measurement and prediction. Br. J. Clin. Psychol. 28: 53–59, 1989.
Gottlieb D., Kipnis M., Sister E., Brill S.: Stroke rehabilitation of elderly patients in Israel. 1st World Congress in Neurological Rehabilitation, Newcastle Upon Tyne, 1996. Eur. J. Neurol. 3 (Suppl. 2): 101, 1996.
Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders: Recommendations on stroke prevention, diagnosis and therapy. Stroke 20: 1407–1431, 1989.
Reding M.: A model stroke classification scheme and its use in outcome research. Stroke 21 (Suppl. II): 35–37, 1990.
Gottlieb D., Kipnis M., Sister E., Medvedev V., Brill S., Vardi Y.: Classification of stroke rehabilitation patients with a simple impairment scale. J. Neurorehabil. 11: 239–245, 1997.
Heinemann A.W., Linacre J.M., Wright B.D., Hamilton B.B., Granger C.G.: Relationships between impairment and physical disability as measured by the Functional Independence Measure. Arch. Phys. Med. Rehabil. 74: 566–573, 1993.
Hamilton B.B., Granger C.G.: Disability outcomes following inpatient rehabilitation for stroke. Phys. Ther. 74: 494–503, 1994.
Harwood R.H., Gompertz P., Ebrahim M.S.: Handicap one year after stroke. J. Neurol. Neurosurg. Psychiatry 57: 825–829, 1994.
Adams D.L.: Analysis of life satisfaction index. J. Gerontol. 24: 470–474, 1969.
Shmotkin D.: The structure of the life satisfaction index A in elderly Israeli adults. Int. J. Aging Hum. Dev. 33: 131–150, 1991.
Bar-Tal Y.: Uncertainty and the perception of sufficiency of social support, control and information. Psychol. Rec. 44: 13–24, 1994.
Cohen S., Kamarck T., Mermelstein D.: Global Measure of Perceived Stress. J. Health Soc. Behav. 24: 385–396, 1983.
Astrom M., Asplund K., Astrom T.: Psychosocial function and life satisfaction after stroke. Stroke 23: 527–531, 1992.
Lindmark B., Hamrin E.: A five-year follow up of stroke survivors: motor function and activities of daily life. Clin. Rehabil. 9: 1–9, 1995.
Garraway W.M., Akhtar A.J., Hockey L., Prescott R.J.: Management of acute stroke in the elderly: follow-up of a controlled trial. BMJ 281: 827–829, 1980.
Harwood R.H., Gompertz P., Pound P., Ebrahim S.: Determinants of handicap 1 and 3 years after a stroke. Disabil. Rehabil. 19: 205–211, 1997.
Harris L.: The myth and reality of aging in America. National Council on Aging, Washington, DC, 1975.
King R.B.: Quality of life after stroke. Stroke 27: 1467–1472, 1996.
Clarke P.J., Black S.E., Badley E.M., Lawrence J.M., Williams J.I.: Handicap in stroke survivors.Disabil. Rehabil.21: 116–123, 1999.
Tuomilehto J., Nuottimaki T., Salmi K., Aho K., Kotila M., Sarti C., Rastenyte D.: Psychosocial and health status in stroke survivors after 14 years. Stroke 26: 971–975, 1995.
Morris J.N., Morris S., Sherwood S.: Assessment of informal and formal support in high risk elderly population. In: Granger C.V., Gresham G.E. (Eds.), Functional assessment in rehabilitation medicine. William & Wilkins, Baltimore, 1984.
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Gottlieb, A., Golander, H., Bar-Tal, Y. et al. The influence of social support and perceived control on handicap and quality of life after stroke. Aging Clin Exp Res 13, 11–15 (2001). https://doi.org/10.1007/BF03351488
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DOI: https://doi.org/10.1007/BF03351488