Agreement between patient and proxy assessments of oral health-related quality of life after stroke: an observational longitudinal study

J Oral Rehabil. 2009 Apr;36(4):264-70. doi: 10.1111/j.1365-2842.2009.01941.x. Epub 2009 Feb 9.

Abstract

This study aimed to assess agreement between patient and proxy assessment of patients' oral health-related quality of life (OHRQoL) during the acute stroke phase and 6 months after hospital discharge. As part of an observational longitudinal study, 161 consecutive patients hospitalized after stroke and their caregivers (CGs) were monitored during acute stroke and 6 months after hospital discharge. Patient-CG agreement of health-related quality of life as assessed by the General Oral Health Assessment Index (GOHAI) and Medical Outcomes Study 12-item Short Form (SF-12) which comprises physical (PCS-12) and mental component summaries (MCS-12) was determined by comparison and correlation analyses. Complete data were available for 65 patients and CGs. Compared with acute stroke, there were improvements in GOHAI and SF-12 scores from patient's and CG's perspective at 6-month follow-up. Caregivers overestimated the impact of stroke on MCS-12 over a period of time (P < 0.01) and underestimated the impact on GOHAI during acute stroke (P < 0.001) and on PCS-12 6 months later (P < 0.05). Patient-CG agreement was substantial to excellent during acute stroke [intra-class correlation coefficient (ICC 0.69-0.86)] and fair-to-moderate 6 months later (ICC 0.28-0.60). Agreement was adequate between patients' and CGs' assessment of patient OHRQoL during acute stroke but it was less reliable 6 months after hospital discharge. These findings suggest that proxy assessment of OHRQoL after stroke is effective in assessing stroke-related oral impairments that affect life quality without placing additional burden on stroke patients themselves to assess OHRQoL.

MeSH terms

  • Aged
  • Caregivers
  • Female
  • Hong Kong
  • Humans
  • Longitudinal Studies
  • Male
  • Oral Health / standards*
  • Proxy*
  • Quality of Life* / psychology
  • Self Care / standards*
  • Stroke Rehabilitation
  • Stroke* / complications
  • Stroke* / psychology
  • Surveys and Questionnaires
  • Time Factors