Health problems in elderly patients during the first post-stroke year

Figures & data

Figure 1. Flow chart of the study population.

Table I. Key words and their content in the Well-being, Integrity, Prevention, and Safety (VIPS) classification for nursing documentation.

Key word	Content
Communication	Speech impairment, aphasia, apraxia
Cognition, development	Memory deficits, concentration difficulty, understanding of health and illness, lack of initiative or motivation, attention impairment, difficulties with planning and organizing, post-stroke dementia
Breathing, circulation	Respiratory problems, aspiration, dyspnoea, coughing, heart problems, deep vein thrombosis, bleeding, body temperature, oedema, cyanosis
Nutrition	Swallowing difficulties, nausea, vomiting, appetite loss, weight loss
Elimination	Urinary tract problem, bladder or bowel incontinence, diarrhoea, constipation
Skin	Integument, lesions, ulcers, wound infection, sweating
Activity	Paralysis, falls, spasticity, contracture, deteriorated condition, activity limitations
Sleep	Fatigue, day-time sleepiness, tiredness, restlessness, sleeping problems
Perception with pain	Shoulder pain, pain syndrome, headache
Perception other than pain	Perception and co-ordination deficits, vision or hearing limitation, sensibility impairment, balance disturbance, dizziness
Psycho-social	Inability to control emotions, pathological crying, anxiety, uneasiness, stressfulness, social deprivation, personality change, uncertainty, irritability, depression
Well-being	Deterioration, stroke recurrence
Composite assessment	Other health problems

Table II. Functional ability according to Katz Activity of Daily Living, Mini Mental State Examination score, self-rated health, Hospital Anxiety and Depression scale, and Nottingham Health Profile scale as measured on three occasions during the first post-stroke year, after adjustment for the influence of age, sex, marital status, stroke number, loneliness, and education.

	Time of measurement
	1 week after discharge	3 months after index admission	12 months after index admission	P for trend
Functional ability (1–7)	2.4	2.2	2.3	0.73
Mini Mental State Examination (0–30)	22.3	24.0	22.6	0.50
Self-rated health (1–5)	2.4	2.3	2.2	0.12
Hospital Anxiety and Depression scale
Depression (0–21)	4.3	4.3	4.2	0.37
Anxiety (0–21)	3.7	3.3	3.3	0.09
Nottingham Health Profile
Energy (0–100)	38.2	36.4	36.4	0.97
Physical mobility (0–100)	32.5	30.3	33.4	0.45
Sleep (0–100)	23.1	22.1	22.8	0.75
Emotional reactions (0–100)	20.4	20.4	18.4	0.19
Social isolation (0–100)	18.0	16.6	18.1	0.63
Pain (0–100)	9.6	10.0	11.2	0.51

Table III. Period prevalence of health problems according to Well-being, Integrity, Prevention, and Safety (VIPS) classification key words as reported at interview and found in primary health care and municipal elderly health care records, measured on three occasions during the first post-stroke year, after adjustment for the influence of age, sex, marital status, stroke number, loneliness, education, and for non-exposure (hospital admissions and mortality).

		Health problems reported at interviews				Health problems in patient records
		1 week after discharge	3 months after index	12 months after index	P for trend	1 week after discharge	3 months after index	12 months after index	P for trend
Health problems, total, %		82.2	87.0	97.2	< 0.0001	43.3	55.2	91.5	< 0.0001
	Perception	47.3	51.5	69.6	< 0.0001	9.7	13.2	42.4	< 0.0001
	Activity	27.9	33.9	64.2	< 0.0001	9.6	12.5	35.3	< 0.0001
	Sleep	36.0	40.6	62.4	< 0.0001	10.9	14.4	41.3	< 0.0001
	Cognition	19.8	23.2	42.5	< 0.0001	2.2	2.9	11.0	< 0.0001
	Pain	19.9	21.8	32.2	< 0.0005	12.0	16.5	50.6	< 0.0001
	Elimination	13.6	16.1	32.1	< 0.0001	19.0	23.4	50.4	< 0.0001
	Nutrition	14.2	16.4	29.3	< 0.0001	6.0	7.9	25.4	< 0.0001
	Breathing or circulation	8.6	10.6	25.4	< 0.0001	7.9	11.3	44.3	< 0.0001
	Communication	12.8	14.5	24.9	< 0.0001	3.5	4.2	8.7	= 0.005
	Psycho-social	12.2	13.4	20.4	< 0.0001	8.2	10.5	28.6	< 0.0001
	Skin	1.6	2.1	6.9	< 0.0001	6.1	8.5	32.2	< 0.0001
	Miscellaneous	2.9	3.5	8.5	< 0.0005	1.3	1.9	10.3	< 0.0001

Figure 2. The prevalence of all health problems combined, based on primary health care and municipal elderly health care records during the first post-stroke year, adjusted for non-exposure (hospital admissions and mortality), week by week.

Figure 3. Health problem reporting across time with VIPS key word prevalence based on patient interviews in relation to those based on record scrutiny at 1 week after discharge (a), and 3 (b) and 12 months (c) after index admission. Misc = Miscellaneous.