Quality of life is poorer for patients with stroke who require an interpreter an observational australian registry study

Monique F. Kilkenny, Natasha A. Lannin, Craig S. Anderson, Helen M. Dewey, Joosup Kim, Karen Barclay-Moss, Chris Levi, Steven Faux, Kelvin Hill, Brenda Grabsch, Sandy Middleton, Amanda G. Thrift, Rohan Grimley, Geoffrey Donnan, Dominique A. Cadilhac

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background and Purpose-In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. Methods-An observational study of patients with stroke or transient ischemic attack (2010-2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 level measured 90 to 180 days after stroke. Logistic regression was undertaken to assess the association between domains of EuroQoL-5 dimension and interpreter status. Results-Among 34562 registrants, 1461 (4.2%) required an interpreter. Compared with patients without interpreters, patients requiring an interpreter were more often women (53% versus 46%; P<0.001), aged =75 years (68% versus 51%; P<0.001), and had greater access to stroke unit care (85% versus 78%; P<0.001). After accounting for patient characteristics and stroke severity, patients requiring interpreters had comparable discharge outcomes (eg, mortality, discharged to rehabilitation) to patients not needing interpreters. However, these patients reported poorer Health-Related Quality of Life (visual analogue scale coeffcient,-9; 95% CI,-12.38,-5.62), including more problems with self-care (odds ratio: 2.22; 95% CI, 1.82, 2.72), pain (odds ratio: 1.84; 95% CI, 1.52, 2.34), anxiety or depression (odds ratio: 1.60; 95% CI, 1.33, 1.93), and usual activities (odds ratio: 1.62; 95% CI, 1.32, 2.00). Conclusions-Patients requiring interpreters reported poorer Health Related Quality of Life after stroke/transient ischemic attack despite greater access to stroke units. These fndings should be interpreted with caution because we are unable to account for prestroke Health Related Quality of Life. Further research is needed.

Original languageEnglish
Pages (from-to)761-764
Number of pages4
JournalStroke
Volume49
Issue number3
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Ischemic attack, transient
  • Quality of health care
  • Quality of life
  • Stroke
  • Visual analog scale

Cite this

Kilkenny, Monique F. ; Lannin, Natasha A. ; Anderson, Craig S. ; Dewey, Helen M. ; Kim, Joosup ; Barclay-Moss, Karen ; Levi, Chris ; Faux, Steven ; Hill, Kelvin ; Grabsch, Brenda ; Middleton, Sandy ; Thrift, Amanda G. ; Grimley, Rohan ; Donnan, Geoffrey ; Cadilhac, Dominique A. / Quality of life is poorer for patients with stroke who require an interpreter an observational australian registry study. In: Stroke. 2018 ; Vol. 49, No. 3. pp. 761-764.
@article{93c202a2bf644170a99a1e1bdbf341c4,
title = "Quality of life is poorer for patients with stroke who require an interpreter an observational australian registry study",
abstract = "Background and Purpose-In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. Methods-An observational study of patients with stroke or transient ischemic attack (2010-2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 level measured 90 to 180 days after stroke. Logistic regression was undertaken to assess the association between domains of EuroQoL-5 dimension and interpreter status. Results-Among 34562 registrants, 1461 (4.2{\%}) required an interpreter. Compared with patients without interpreters, patients requiring an interpreter were more often women (53{\%} versus 46{\%}; P<0.001), aged =75 years (68{\%} versus 51{\%}; P<0.001), and had greater access to stroke unit care (85{\%} versus 78{\%}; P<0.001). After accounting for patient characteristics and stroke severity, patients requiring interpreters had comparable discharge outcomes (eg, mortality, discharged to rehabilitation) to patients not needing interpreters. However, these patients reported poorer Health-Related Quality of Life (visual analogue scale coeffcient,-9; 95{\%} CI,-12.38,-5.62), including more problems with self-care (odds ratio: 2.22; 95{\%} CI, 1.82, 2.72), pain (odds ratio: 1.84; 95{\%} CI, 1.52, 2.34), anxiety or depression (odds ratio: 1.60; 95{\%} CI, 1.33, 1.93), and usual activities (odds ratio: 1.62; 95{\%} CI, 1.32, 2.00). Conclusions-Patients requiring interpreters reported poorer Health Related Quality of Life after stroke/transient ischemic attack despite greater access to stroke units. These fndings should be interpreted with caution because we are unable to account for prestroke Health Related Quality of Life. Further research is needed.",
keywords = "Ischemic attack, transient, Quality of health care, Quality of life, Stroke, Visual analog scale",
author = "Kilkenny, {Monique F.} and Lannin, {Natasha A.} and Anderson, {Craig S.} and Dewey, {Helen M.} and Joosup Kim and Karen Barclay-Moss and Chris Levi and Steven Faux and Kelvin Hill and Brenda Grabsch and Sandy Middleton and Thrift, {Amanda G.} and Rohan Grimley and Geoffrey Donnan and Cadilhac, {Dominique A.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1161/STROKEAHA.117.019771",
language = "English",
volume = "49",
pages = "761--764",
journal = "Stroke",
issn = "0039-2499",
publisher = "American Heart Association",
number = "3",

}

Quality of life is poorer for patients with stroke who require an interpreter an observational australian registry study. / Kilkenny, Monique F.; Lannin, Natasha A.; Anderson, Craig S.; Dewey, Helen M.; Kim, Joosup; Barclay-Moss, Karen; Levi, Chris; Faux, Steven; Hill, Kelvin; Grabsch, Brenda; Middleton, Sandy; Thrift, Amanda G.; Grimley, Rohan; Donnan, Geoffrey; Cadilhac, Dominique A.

In: Stroke, Vol. 49, No. 3, 01.01.2018, p. 761-764.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Quality of life is poorer for patients with stroke who require an interpreter an observational australian registry study

AU - Kilkenny, Monique F.

AU - Lannin, Natasha A.

AU - Anderson, Craig S.

AU - Dewey, Helen M.

AU - Kim, Joosup

AU - Barclay-Moss, Karen

AU - Levi, Chris

AU - Faux, Steven

AU - Hill, Kelvin

AU - Grabsch, Brenda

AU - Middleton, Sandy

AU - Thrift, Amanda G.

AU - Grimley, Rohan

AU - Donnan, Geoffrey

AU - Cadilhac, Dominique A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Purpose-In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. Methods-An observational study of patients with stroke or transient ischemic attack (2010-2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 level measured 90 to 180 days after stroke. Logistic regression was undertaken to assess the association between domains of EuroQoL-5 dimension and interpreter status. Results-Among 34562 registrants, 1461 (4.2%) required an interpreter. Compared with patients without interpreters, patients requiring an interpreter were more often women (53% versus 46%; P<0.001), aged =75 years (68% versus 51%; P<0.001), and had greater access to stroke unit care (85% versus 78%; P<0.001). After accounting for patient characteristics and stroke severity, patients requiring interpreters had comparable discharge outcomes (eg, mortality, discharged to rehabilitation) to patients not needing interpreters. However, these patients reported poorer Health-Related Quality of Life (visual analogue scale coeffcient,-9; 95% CI,-12.38,-5.62), including more problems with self-care (odds ratio: 2.22; 95% CI, 1.82, 2.72), pain (odds ratio: 1.84; 95% CI, 1.52, 2.34), anxiety or depression (odds ratio: 1.60; 95% CI, 1.33, 1.93), and usual activities (odds ratio: 1.62; 95% CI, 1.32, 2.00). Conclusions-Patients requiring interpreters reported poorer Health Related Quality of Life after stroke/transient ischemic attack despite greater access to stroke units. These fndings should be interpreted with caution because we are unable to account for prestroke Health Related Quality of Life. Further research is needed.

AB - Background and Purpose-In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. Methods-An observational study of patients with stroke or transient ischemic attack (2010-2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 level measured 90 to 180 days after stroke. Logistic regression was undertaken to assess the association between domains of EuroQoL-5 dimension and interpreter status. Results-Among 34562 registrants, 1461 (4.2%) required an interpreter. Compared with patients without interpreters, patients requiring an interpreter were more often women (53% versus 46%; P<0.001), aged =75 years (68% versus 51%; P<0.001), and had greater access to stroke unit care (85% versus 78%; P<0.001). After accounting for patient characteristics and stroke severity, patients requiring interpreters had comparable discharge outcomes (eg, mortality, discharged to rehabilitation) to patients not needing interpreters. However, these patients reported poorer Health-Related Quality of Life (visual analogue scale coeffcient,-9; 95% CI,-12.38,-5.62), including more problems with self-care (odds ratio: 2.22; 95% CI, 1.82, 2.72), pain (odds ratio: 1.84; 95% CI, 1.52, 2.34), anxiety or depression (odds ratio: 1.60; 95% CI, 1.33, 1.93), and usual activities (odds ratio: 1.62; 95% CI, 1.32, 2.00). Conclusions-Patients requiring interpreters reported poorer Health Related Quality of Life after stroke/transient ischemic attack despite greater access to stroke units. These fndings should be interpreted with caution because we are unable to account for prestroke Health Related Quality of Life. Further research is needed.

KW - Ischemic attack, transient

KW - Quality of health care

KW - Quality of life

KW - Stroke

KW - Visual analog scale

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U2 - 10.1161/STROKEAHA.117.019771

DO - 10.1161/STROKEAHA.117.019771

M3 - Article

VL - 49

SP - 761

EP - 764

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 3

ER -