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
UR - http://www.scopus.com/inward/record.url?scp=85043724171&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.117.019771
DO - 10.1161/STROKEAHA.117.019771
M3 - Article
C2 - 29439194
AN - SCOPUS:85043724171
SN - 0039-2499
VL - 49
SP - 761
EP - 764
JO - Stroke
JF - Stroke
IS - 3
ER -