Effects of long-term unmet needs and unmet rehabilitation needs on the quality of life in stroke survivors

Abstract

Background Unmet long-term needs and rehabilitation needs are prevalent among stroke survivors and affect their quality of life. We aimed to identify the long-term unmet needs and unmet rehabilitation needs among stroke survivors in South Korea and evaluate their intercorrelations with health-related quality of life. Methods Stroke survivors who were admitted to four Regional Cardiocerebrovascular Disease Centers between January 1, 2015 and December 31, 2019 were telephonically surveyed using a computer-assisted telephone interview method. With the aim of surveying approximately 1,000 patients, 9,204 people were recruited through random sampling. Unmet needs were evaluated on the basis of Longer-term Unmet Needs after Stroke questionnaire items. Quality of life was evaluated using the EuroQoL 5-dimension, 3-level (EQ-5D-3L) questionnaire and the EQ-5D index. Results Among the participants, 93.6% experienced at least one unmet need and 311 (32.6%) reported unmet rehabilitation needs. The number of unmet needs, age, modified Rankin Scale (mRS) score, and previous stroke showed significant negative correlations with the EQ-5D index (p-value < 0.05). The age-adjusted odds ratio (OR) for reporting unmet rehabilitation needs significantly increased with problems in mobility (OR, 4.96; 95% confidence interval [CI], 3.64-6.76), self-care (OR, 4.46; 95% CI, 3.32-5.98), usual activities (OR, 5.78; 95% CI, 4.21-7.93), pain/discomfort (OR, 3.76; 95% CI, 2.76-5.06), anxiety/depression (OR, 3.67; 95% CI, 2.74-4.91), higher mRS score (OR, 3.13; 95% CI, 2.29-4.28), prior hyperlipidemia (OR, 1.35; 95% CI, 1.00-1.81), and number of unmet needs (OR, 1.30; 95% CI, 1.25-1.36). Conclusions Unmet needs were prevalent among stroke survivors and were associated with a lower quality of life and increased odds of reporting unmet rehabilitation needs. Further research is needed to investigate strategies for addressing these subjective unmet needs with the aim of improving the long-term quality of life of stroke survivors.