Study On Quality Of Life And Influencing Factors Of Stroke Patients In Rural Areas Of Shandong Province

As one of the three "killers" of people's health, stroke is one of the most common diseases, which has high disability rate and mortality. 50%～70% survivors have paralysis, aphasia and so on, which greatly destroy patients' daily life, social psychology behaviors and life quality with heavy burden to the society and patients' families.With the change of health values and medical model, it has obvious limitations to evaluate patients' health status and therapy effect only through incidence rate, disability rate and mortality rate of a disease. The decrease of death rate is no longer the only goal of stroke treatment. It is difficult to cure stroke, so it is not proper to evaluate the therapy effect according to cure. The function of survival rate is limited, too. So we need establish new evaluation criteria. Life quality is multidimensional centers on patients, including physical functions, psychological functions, social functions and symptoms related to disease or treatment. SF-36 is a common scale recognized as a life quality test scale in Europe and America, widely used in the inspection of health state and clinic results, evaluation of health needs of different diseases and therapy effects. SF-36 evaluates life quality in eight aspects: PF, RP, BP, GH, VT, SF, RE and MH. The life quality of stroke has gradually become the credible criterion to evaluate the therapy effect. It can help us to understand patients' body, psychology, social functions and life environment, to take better measures for therapy, to promote health level, and speed up the healing process of stroke and improve the life quality of stroke patients.This study is designed by research purpose to test quality of life of patients in rural areas of Shandong province, combine with visitation, discuss and analyze the influencing factors of quality of life, take effective measures to prevent and cure stroke and promote the life quality of patients in the rural areas.Concrete research purpose: 1) Find out and survey quality of life of patients in rural areas of Shandong province; 2) Analyze and ascertain influencing factors of stroke patients in rural areas of Shandong province; 3) Take effective measures to promote the life quality of patients in the rural areas and offer proposals.In this study we use both quantitative research and qualitative research methods. According to the economic status and geographical position of different areas in Shandong Province, we selected Laiyang, Qingzhou and Gaotang County at random, 3 towns from each county, 3～4 villages from each town and all strokers from each village. Then we investigated the general information about the sickness, therapy, prevention and health care by questionnaire designed according to research purpose. SF-36 table used to investigate life quality of stroke patients has passed correlative study estimation both in China and abroad. It has better reliability and validity.We collected qualitative information through interviewing patients, their family members and village doctors. The interview questions include: 1) patients: satisfaction degree with their life quality; evaluation to their family care; expectations about the disease and so on; 2) family members: attitude to patients; family care; difficulties; 3) village doctors: measures improving patients' life quality; how to develop healing therapy; ideas and advice.Results: Life Quality has differences among stroke patients at different ages : life quality of stroke patients at the age above 70 is the worst with lowest score and the scores of this group in the aspects of GH,PF,RP,SF,VT and total scores are lower than the scores of the other two groups with statistical significance (P<0.05); the group at the age below 50 get higher scores than the group at the age 50～69 in the aspect of VT and has statistical difference (P<0.01). The life quality of male is better than female (P<0.05), particularly in the aspects of SF, VT. Every latitude life quality of rural patients in Shandong province is lower than that of common rural residents in Sichuan Province, especially in the aspects of PF, RP, RE and SF. The influencing factors of life quality of stroke patients include: deformity degree, education degree, daily living ability, occupation, delay to see the doctor, stroke type, family function, and average annual income of per person in a family. The influencing factors with 8 latitudes are as follows:1) The influencing factors of GH include: Education degree, recurrence times, concomitant symptom, delay to see the doctor, prevention and health care.2) The influencing factors of PF: Stroke type, deformity degree, daily living ability and delay to see the doctor.3) The influencing factors of RP: Recurrence times, complication, daily living ability and drinking wine or not.4) The influencing factors of RE: Concomitant symptom, deformity degree, daily living ability, family function, prevention and health care.5) The influencing factors of SF: Sex, average annual income of per person in a family, recurrence times, daily living ability and delay to see the doctor. 6) The influencing factors of BP: Recurrence times, stroke type, complication and daily living ability.7) The influencing factors of VT: Sex, stroke type, daily living ability, delay to see the doctor and prevention and health care.8) The influencing factors of MH: Concomitant symptom, deformity degree, daily living ability, delay to see the doctor, family function, prevention and health care.Conclusion: the influences of stroke to patients are various, including obstructions of language, cognition and psychology besides obstacles of body, movement and feelings. It is a great challenge for doctors and patients'family to improve life quality of stroke patients in rural areas. Doctors not only have to intervene patients' body function, but also have to help patients to adjust their psychological state and social function which is good to the healing. Aiming to the influencing factors of life quality, this paper finds the keystone of prevention and cure, and accelerates the healing and improvement of life quality.Suggestions: 1) Strengthen health education; 2) Perfect three steps prevention of stroke; 3) Perfect family care and healing therapy;4) Develop rural health system and medical insurance system; 5) Discuss new mode of stroke therapy and carry out integrated unit therapy.