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Quality of life and psychological problems in patients undergoing neurological rehabilitation
Anupam Gupta1, S Deepika, A B Taly
1Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India. anupam@nimhans.kar.nic.in
Aim:
To assess the quality of life (QoL) and prevalence of psychological problems (PP) in patients with neurological illness, and their correlation with functional abilities.
Materials And Methods:
Prospective cross-sectional study conducted in the neurological rehabilitation unit of tertiary research hospital in 30 consecutive hospitalized patients (21 men), age 16-55 years (34.63+/-11.87).
Outcome Measure:
WHOQoL-BREF was used to assess QoL. The prevalence of PP was recorded using Hospital Anxiety Depression Scale (HADS) and General Health Questionnaire (GHQ-12). QoL and HADS scores were correlated with functional abilities using mean Barthel Index (BI) Score.
Results:
The duration of illness was three to 30 months (10.63+/-7.83) and their primary diagnoses were stroke 12, traumatic spinal cord injury seven and non-traumatic spinal cord lesion 11. Twenty-two patients qualified for GHQ-12 caseness, with 15 patients having distress (score >/=15) and seven having severe problem and psychological distress (score>/=20). Twenty five patients had abnormal anxiety and 17 had abnormal depression on HADS (abnormal = 8-21), with moderate to severe anxiety and depression (scores>/=11) in nine and three patients respectively. The mean WHOQoL-BREF transformed scores (on WHOQoL 0-100 scale) were (38.83+/-8.02), (50.76+/-9.79), (48.53+/-18.46) and (49.13+/-10.63) in physical, psychological, social, and environmental domains respectively. The social domain of QoL had significant correlation (P<.05) with functional abilities.
Conclusion:
Patients with neurological disorders requiring inpatient rehabilitation have impaired QoL that affects all domains of life. There is high prevalence of psychological problems, including anxiety and depression. The social domain of QoL adversely affected functional abilities, but the correlation between PP and functional abilities was insignificant.