Health-related quality of life, social support, and social networks in African-American stroke survivors with and without aphasia.

Abstract

Background Health-related quality of life (HRQL) provides insight into the impact of a health condition on an individual's ability to lead a fulfilling life. Previous research has identified determinants of HRQL in stroke survivors to include communication, mobility, mental/emotional health, role, and social functioning. However, health disparities among minority populations may influence HRQL in stroke survivors with and without aphasia. The aim of this study was to explore the HRQL and social functioning in a homogenous sample of African-Americans with chronic stroke. Methods A cross-sectional case control descriptive research design was adopted. A total of 39 African-American men (53.8%) and women (46.2%) participated in the study aged from 33 to 79 (M = 62.4 ±11.10). Three groups of 13 were developed based on behavioral performance and neurological report: stroke survivors with aphasia (SWA), stroke survivors without aphasia (SSA) and successfully aging/healthy adults with no history of neurological injury (SAH). The majority of stroke survivors (84.6%) reported a left hemisphere stroke. Patient-reported outcomes were administered face to face without the use of a proxy to measure HRQL and social functioning–the Stroke and Aphasia Quality of Life Scale-39g, the EuroQol-5D, the Medical Outcome Study Social Support Survey and the Lubben Social Network Scale. An ANOVA test and Scheffe post hoc analysis was used to compare means of the three groups. Results Chronic stroke survivors reported a lower HRQL than SAH adults. No differences were noted between the groups in specific areas of social functioning related to social support and social network. However, condition-specific HRQL differences in communication and social domains were identified between SWA to SSA and SAH adults. Physical domain differences were noted between SSA and SAH groups. Level of education was significantly different among the sample with individuals with higher education reporting a better HRQL. No significant differences were noted between the groups for presence of co-morbid conditions. Conclusion This study provides a preliminary examination of HRQL and social functioning in African American stroke survivors with and without aphasia compared to age and ethnicity-matched peers. Larger studies will be needed to examine determinants of HRQL in this understudied population.