Predictors of Poststroke Health-Related Quality of Life in Nigerian Stroke Survivors: A 1-Year Follow-Up Study

Abstract

This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.

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“…In-line with what obtains in other regions of the world, depression was the most important emotional symptom that influences HRQOL of stroke survivors in Africa [2,17,18,20,39,40,29].…”

“…In this review severity of stroke related symptoms and impairments were shown to adversely affect HRQOL of African stroke survivors [2,17,22,26,27,28,9]. Importantly the included studies were able to exclude stroke survivors suffering from other life chronic threatening conditions not directly related to stroke that may concurrently impact on their HRQOL of such as cancers [16], brain tumors [13], stroke-like symptom due to previous head injury [13], heart failure [2,29], peritoneal or hemodialysis [2,29] and active psychiatric disease [2].…”

“…The depression status ranges from mild mood disturbance [29] to severe depression [20]. It is important to note that majority of the included studies did not adequately report the emotional status of stroke survivors that is, for example most of them failed to explain the number of the survivors that were depressed and the severity of the emotional disorder the among the study participants.…”

“…It is worth mentioning that stroke rehabilitation in Africa lead to significant improvement of the survivors' functional status [16,21,29,39].…”

The Course of Activities in Daily Living: Who Is at Risk for Decline after First Ever Stroke?

“…A flow-chart is presented in figure 1. In total, 28 unique studies were included, based on 36 publications [13,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50] that fulfilled all selection criteria. Six studies recruited populations from a rehabilitation setting [18,19,29,34,40],FuPro study [13,38,45,46] and the other studies included hospital-based populations.…”