Self-rated health after stroke: a systematic review of the literature

Araújo, Érika de Freitas; Viana, Ramon Távora; Teixeira-Salmela, Luci Fuscaldi; Lima, Lidiane Andréa Oliveira; Faria, Christina Danielli Coelho de Morais

doi:10.1186/s12883-019-1448-6

Cited by 20 publications

(19 citation statements)

References 88 publications

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“…These variables fall into the other 2 dimensions of SRH (physical and social). However, no studies were found that investigated which of the 3 dimensions of SRH is most relevant for SRH of post-stroke individuals (9). Considering the results of the present study, the physical and social dimensions appear to be less significant for the SRH of post-stroke individuals in the chronic phase when variables representing the mental or psychological dimension are considered.…”

Section: Discussioncontrasting

confidence: 57%

“…Considering the results of the present study, these professionals should systematically assess the SRH and emotional function of post-stroke individuals in the chronic phase, which can provide valuable information for their clinical decision-making. In the present study, the first question of the SF-36 and the GDS were applied for these purposes, but other feasible instruments are available, such as the EuroQol-5D (EQ5D) (9,39) and the Patient Health Questionnaire (PHQ) (40). Finally, it is important to point out that the emotional function is considered a changeable variable, even in the chronic post-stroke phase, and therefore, intervention programmes with proven efficacy in this outcome could also be used to improve the SRH of post-stroke individuals.…”

Section: Discussionmentioning

confidence: 99%

“…This variable was dichotomized into 2 categories: "good SRH" and "poor SRH." "Good SRH" was composed of the answers: excellent, very good, and good, and "poor SRH" of the answers: fair and poor (9).…”

Section: Data Collection Proceduresmentioning

confidence: 99%

“…In addition, according to a previous multicentre longitudinal study developed in England, psychological and social factors are important determinants of SRH in older subjects with stroke (15). Despite the important information already provided by previous studies that have explored the SRH after stroke (9)(10)(11)(12)(13)(14)(15), no studies were found on post-stroke individuals that have investigated a group of variables characterizing functioning and disability as possible determinants of SRH (9).…”

mentioning

confidence: 99%

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Self-rated health determinants in post-stroke individuals

Araújo¹,

Viana²,

Cruz³

et al. 2020

J Rehabil Med

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The main question studied was: Could variables in func tion and disability, which have potential to be modified by rehabilitation, be determinants of selfrated health in chronic poststroke individuals? The variables investiga ted were: emotional function, motor recovery level, ma nual and locomotion skill, and participation. Only emo tional function determined the selfrated health of the subjects. Individuals with impaired emotional function were 6.6 times more likely to assess their own health as poor. Assessment of selfrated health and emotional function is recommended, since these factors can help to improve clinical decisionmaking in the rehabilitation process in chronic poststroke individuals.Objective: To investigate whether variables of func tion and disability, which have potential to be modi fied by rehabilitation, are determinants of self-rated health in poststroke individuals in the chronic pha se. Design: Crosssectional exploratory study. Methods: The dependent variable was selfrated health. The independent variables were organized according to the International Classification of Fun ctioning, Disability and Health components: Body structure and function (emotional function and mo tor recovery level), Activity (manual and locomo tion skill), and Participation (participation). Logistic regression analysis was performed to identify signi ficant associations between the independent variables and self-rated health (α = 5%). Results: Sixtythree individuals were included in the study: 44 (70%) rated their own health as good ("excellent"/"very good"/"good") and 19 (30%) as poor ("fair"/"poor"). Significant association with self-rated health was identified only for emotional function. Individuals with impaired emotional fun ction were 6.6 times more likely to assess their own health as poor (odds ratio (OR) 6.56; 95% confiden ce interval 1.53-28.21). Conclusion:Emotional function was found to be a determinant of selfrated health in poststroke indi viduals in the chronic phase and, therefore, must be assessed carefully in order to help provide integral healthcare and improve clinical decision-making. Fu ture studies should investigate whether enhancing emotional function is associated with improvements in selfrated health in poststroke individuals.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Data Collection Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

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Self-rated health determinants in post-stroke individuals

Araújo¹,

Viana²,

Cruz³

et al. 2020

J Rehabil Med

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“…HRQoL and SRH represent important patient-reported long-term outcomes since they focus on the patient’s own perceptions. A review of studies on SRH after stroke [ 12 ] states that the diversity in questions and ways to assess SRH makes comparisons of results from different studies difficult. A 6 year follow-up study found that stroke survivors were more dependent and had a lower mean score for general health measured with SF-36 compared to a general population [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Self-rated health over the first five years after stroke

Bjälkefur

Nasic

Bertholds³

et al. 2020

BMC Neurol

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Background Self-rated health (SRH) focuses on the patient’s own perception, and represents an important patient-reported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH. Methods Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007–2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionnaire. SRH was assessed by the question about general health from SF-36. Factors associated with SRH were investigated by multiple logistic regression analysis. Results Response-rate was > 90% at all time points. Overall, 40.2, 41.9, 40.7, 45.0 and 46.3% of the patients reported good SRH, 1 to 5 years after stroke. Performance in activities of daily living (ADL) was strongly associated with good SRH; 49.8 and 14.7% after 1 year in independent and dependent survivors respectively, p < 0.001. In independent survivors 1 year after stroke, good SRH was positively associated with female sex (OR = 2.0; p = < 0,001), physical activity (OR = 2.14; p = < 0,001), car driving (OR = 2.25; p = < 0,001), and negatively associated with age (OR = 0.99; p = < 0,001), pain (OR = 0.49; p = < 0,001), depression (OR = 0.30; p = < 0,001), and self-perceived unmet care needs (OR = 0.39; p = < 0,001). In dependent survivors, depression (OR = 0.23; p = < 0,001) and age (OR = 0.96; p = < 0,05), were negatively associated with good SRH 1 year after stroke. Similar patterns were observed throughout the follow-up. Conclusion The proportion stroke survivors reporting their health as good is slightly increasing over time. After stroke, SRH is associated with pain, depression, ability to perform activities and self-perceived unmet care needs, indicating that efforts to support stroke survivors in the chronic phase after stroke should concentrate on targeting these factors.

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