Abstract
A growing number of elderly people are living with the consequences of a stroke (CVA). This thesis describes the quality of life for this group of elderly people and whether Dutch general practitioners are providing the correct prevention and aftercare.
First of all it was determined whether the survival of stroke patients has increased since the introduction of the guideline ’Dutch Transmural Protocol TIA/CVA’ and whether the aftercare provided changed after this. No increase in the one-year survival was found. However, it was discovered that more attention was paid to the aftercare.
Next it was determined exactly what type of aftercare elderly stroke patients receive. Dutch general practitioners were found to comply reasonably well with the guidelines but more attention could be paid to issues such as secondary prevention.
It is important to know what the quality of life of stroke patients is and how we can improve this. This thesis reveals that the quality of life for elderly stroke patients who live independently is comparable with that of the elderly population in the Netherlands. In this regard, thrombolysis (treatment in which a clot in a blood vessel is dissolved) is particularly valuable in achieving a better quality of life. Quality of life is detrimentally influenced by a lower ADL independence, decrease in activities/hobbies and by depressions and anxiety disorders. As depression and anxiety disorders are highly prevalent, due consideration should be given to these.
To further improve the well-being, an aftercare programme has been developed with extra attention for the mental functioning and for the keeping up of various hobbies and activities. Despite this more intensive form of aftercare, no large differences were found in the well-being of patients with and without this aftercare.
First of all it was determined whether the survival of stroke patients has increased since the introduction of the guideline ’Dutch Transmural Protocol TIA/CVA’ and whether the aftercare provided changed after this. No increase in the one-year survival was found. However, it was discovered that more attention was paid to the aftercare.
Next it was determined exactly what type of aftercare elderly stroke patients receive. Dutch general practitioners were found to comply reasonably well with the guidelines but more attention could be paid to issues such as secondary prevention.
It is important to know what the quality of life of stroke patients is and how we can improve this. This thesis reveals that the quality of life for elderly stroke patients who live independently is comparable with that of the elderly population in the Netherlands. In this regard, thrombolysis (treatment in which a clot in a blood vessel is dissolved) is particularly valuable in achieving a better quality of life. Quality of life is detrimentally influenced by a lower ADL independence, decrease in activities/hobbies and by depressions and anxiety disorders. As depression and anxiety disorders are highly prevalent, due consideration should be given to these.
To further improve the well-being, an aftercare programme has been developed with extra attention for the mental functioning and for the keeping up of various hobbies and activities. Despite this more intensive form of aftercare, no large differences were found in the well-being of patients with and without this aftercare.
| Translated title of the contribution | Één jaar na CVA: Een onderzoek naar de kwaliteit van leven van oudere CVA-patiënten en nazorg |
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| Original language | English |
| Qualification | Doctor of Philosophy |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 16-Jun-2014 |
| Place of Publication | [S.l.] |
| Publisher | |
| Print ISBNs | 978-90-367-7003-3 |
| Electronic ISBNs | 978-90-367-7004-0 |
| Publication status | Published - 2014 |