Biopsychosocial Factors Affecting Quality of Life in Post-stroke Patients: A Path Analysis Evidence from Surakarta Hospital, Central Java

Abstract

Background : Basic health research shows that the prevalence of non-communicable diseases has in­creased, including cancer, stroke, chronic kidney disease, diabetes mellitus, and hypertension. The impact of these changes can cause one of them to decrease the quality of life of patients. Stroke in individuals can cause several changes including physical, social and psychological changes that will affect the quality of life. This study aimed to analyze the determinants of the quality of life of pa­tients post stroke. Subjects an d Met h od: This study was a cross sectional study conducted at Surakarta City Hos­pital, from September to October 2019. The sample used was 200 patients post stroke. The sam­pling technique used purposive sampling. The dependent variable was the quality of life of patients post stroke. The independent variables were age, gender, employment status, patient income, fa­mi­ly income, attack status, post-stroke comorbidity, duration of illness, marital status, family sup­port, level of functional disorders, and depression status. The data were collected by questionnaire. The data were analyzed by path analysis with the Stata 13 program. Result : The quality of life of post-stroke patients increased directly in patients with married status (b=1.79; 95% CI=0.24 to 3.35; p=0.024), have a job (b=1.93; 95% CI=0.13 to 3.72; p=0.035), good fa­mily support (b=2.17; 95% CI=0.46 to 3.88; p=0.013), and mild functional disorders (b=1.68; 95% CI=0.11 to 3.25; p=0.036). Quality of life decreased directly in patients aged ≥60 years old (b=-1.99; 95% CI=-3.80 to -0.17; p=0.032), female gender (b=-1.74; 95% CI=-3.28 to -0.19; p= 0.027), stro­­kes more than 1 time (b=-1.87; 95% CI=-3.59 to -0.15; p=0.033), sick ≥6 months (b=-2.12 ; 95% CI=-3.87 to -0.36; p=0.018), have comorbidities (b=-1.96; 95% CI=-3.67 to -0.24; p= 0.025), and de­pression (b=-1.40; 95% CI=-2.97 to 0.16; p=0.078). Quality of life was indirectly affected by age, ill­ness, marital status, family support, family income, and employment status. Conclusions: The quality of life of post-stroke patients increased directly affected by marital sta­tus, employment status, family support, and functional disorders. Quality of life was directly affec­ted by age, gender, attack status, duration of illness, comorbidity and depression. Keywords : stroke, quality of life, path analysis. Cor r espondence: Maki Zamzam. Master Program of Public Health Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: makizz477@gmail.com. Mobile: +6281251543935. Journal of Epidemiology and Public Health (2020), 5(1): 1-14 https://doi.org/10.26911/jepublichealth.2020.05.01.01.