Stroke-Specific Quality of Life one-year post-stroke in two Scandinavian country-regions with different organisation of rehabilitation services: a prospective study

Abstract

Purpose: To compare stroke-specific health related quality of life in two country-regions with organisational differences in subacute rehabilitation services, and to reveal whether organisational factors or individual factors impact outcome. Materials and methods: A prospective multicentre study with one-year follow-up of 369 first-ever stroke survivors with ischaemic or haemorrhagic stroke, recruited from stroke units in North Norway (n ¼ 208) and Central Denmark (n ¼ 161). The 12-domain Stroke-Specific Quality of Life scale was the primary outcome-measure. Results: The Norwegian participants were older than the Danish (M age ¼ 69.8 vs. 66.7 years, respectively), had higher initial stroke severity, and longer stroke unit stays. Both cohorts reported more problems with cognitive, social, and emotional functioning compared to physical functioning. Two scale components were revealed. Between-country differences in the cognitive-social-mental component showed slightly better function in the Norwegian participants. Depression, anxiety, pre-stroke dependency, initial stroke severity, and older age were substantially associated to scale scores. Conclusions: Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as prestroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services. ä IMPLICATIONS FOR REHABILITATION The stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clinically important information for the rehabilitation services. The cognitive-social-mental component and the physical health component, indicate specific functional problems which may vary across and within countries and regions with different organisation of rehabilitation services. For persons with mild to moderate stroke, longer-term functional improvements may be better optimised if the rehabilitation services particularly address cognitive, emotional, and social functioning.

Determinants of Quality of Life after Stroke in Southern Portugal: A Cross Sectional Community-Based Study

“…The study demonstrated that in stroke survivors, several sociodemographic factors (being older, widow, less educated), economic factors (lower monthly family income) and clinical factors (hemorrhagic stroke type, comorbidities, high chronic mRankin score) are associated with reduced perception of QoL in different dimensions. These findings are similar to those reported in previous studies [5,6,[8][9][10][11]. A large proportion of stroke survivors have poor perception of their QoL and probably face unmet long-term needs [6].…”

“…These findings are similar to those reported in previous studies [5,6,[8][9][10][11]. A large proportion of stroke survivors have poor perception of their QoL and probably face unmet long-term needs [6]. Sociodemographic, economic and health factors have been shown to influence the QoL of stroke survivors [18][19][20].…”

“…Most studies addressing the health impact of stroke are based on short, long-term mortality and functional neurological outcome. However, even in patients without significant neurological disability, stroke can be associated with poor Quality of Life (QoL) [3][4][5][6]. QoL measurements are potentially more relevant and informative to patients than the evaluation of functional outcomes [7].…”

“…Worldwide, there are few studies addressing QoL among stroke survivors. These studies have identified factors such as functional status, depression, low socioeconomic status, or pain as the main determinants of QoL in stroke survivors [5,6,[8][9][10][11]. Despite the extreme importance for patients and community, there are no community based published studies describing the QoL of stroke survivors in Portugal.…”

Influence of Physical Therapy and Cholinergic Medication on the Life Quality Parameters in Post-Stroke with the arm Motor Dysfunction

“…Impact of general mobility, motor dysfunction and social interactions on the QOL have been reported in recent researches [18,24], though they have not focused precisely on different parameters of post-stroke motor dysfunction, i.e. upper extremity function.…”