Factors associated with health related quality of life of patients with stroke in Sri Lankan context

Pramudika Nirmani Kariyawasam,Don Chandana Hewage,Kithsiri Dedduwa Pathirana

doi:10.1186/s12955-020-01388-y

Abstract

BackgroundStroke is a major global health concern which affects the health related quality of life (HRQOL). As the prevalence of stroke is increasing especially in lower-middle income countries, it is vital to identify the factors associated with the HRQOL of affected individuals.Available literature for post stroke HRQOL and the associated factors are mainly from high income countries. Therefore, we conducted this study to identify the factors associated with HRQOL of stroke survivors using a stroke specific measure.MethodsA longitudinal study was conducted with the participation of 257 stroke survivors. Participants were followed up after 3 months at the neurology and medical clinics in the Teaching Hospital, Karapitiya, Sri Lanka.Health related quality of life was assessed using the validated version of Stroke Aphasia Quality of Life (SAQOL)-39 generic scale. Pearson correlation, independent sample t-test, one-way ANOVA and regression analysis were used to identify the factors associated with quality of life.ResultsMean age of the participants with stroke was 66.1 (SD 11.7) years. The mean overall HRQOL was 3.15 (SD 0.96) as measured by the SAQOL-39 g. The socio-demographic factors which had significant associations with HRQOL were; gender, level of education, marital status, occupation and monthly income (p < 0.05). The clinical factors which had significant associations with HRQOL were; level of dependence and disability, type of stroke, side of the lesion, type of aphasia, level of language impairment, receiving physiotherapy and speech therapy and follow up care (p < 0.05). The results of regression indicated six independent predictors [F (6,234) = 42.6, p < 0.05], with an R2 of 0.52. The HRQOL was significantly predicted by the level of dependence (β = .43, p < .01), level of language impairment (β = .20, p < .01), age (β = −.23, p < .01), type of stroke (β = −.19, p < .01), side of the lesion (β = .17, p < .01) and the level of education (β = .12, p < .05).ConclusionSevere degree of dependence, severe level of language impairment, older age, hemorrhagic stroke, and lesions in the left side were associated with lower HRQOL. Higher education level was associated with higher HRQOL scores.

Highlights

Stroke is a major global health concern which affects the health related quality of life (HRQOL)
Expert knowledge and experiences gained by treating stroke survivors, we aimed to assess the association of different variables that can affect the post-stroke HRQOL
We identified socio-demographic as well as clinical care factors that are associated with the HRQOL of study participants

Summary

Introduction

Stroke is a major global health concern which affects the health related quality of life (HRQOL). As the prevalence of stroke is increasing especially in lower-middle income countries, it is vital to identify the factors associated with the HRQOL of affected individuals. Stroke is the second leading cause of mortality and the third leading cause of disability worldwide [1] It is a major global health concern that affects the quality of life of affected individuals [2, 3]. In Sri Lanka, stroke was the 7th major cause of in-hospital deaths in 2017 [6] It is the leading cause of adult disability in the country and the risk of stroke is increasing with the rising aged population [7]. Stroke survivors encounter challenges to restore their health status within the limitations of the residual impairment [8]

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