Post-stroke Quality Of Life Research Articles

Predictors of social risk for post-ischemic stroke reintegration

After stroke rehabilitation, patients need to reintegrate back into their daily life, workplace and society. Reintegration involves complex processes depending on age, sex, stroke severity, cognitive, physical, as well as socioeconomic factors that impact long-term outcomes post-stroke. Moreover, post-stroke quality of life can be impacted by social risks of inadequate family, social, economic, housing and other supports needed by the patients. Social risks and barriers to successful reintegration are poorly understood yet critical for informing clinical or social interventions. Therefore, the aim of this work is to predict social risk at rehabilitation discharge using sociodemographic and clinical variables at rehabilitation admission and identify factors that contribute to this risk. A Gradient Boosting modelling methodology based on decision trees was applied to a Catalan 217-patient cohort of mostly young (mean age 52.7), male (66.4%), ischemic stroke survivors. The modelling task was to predict an individual’s social risk upon discharge from rehabilitation based on 16 different demographic, diagnostic and social risk variables (family support, social support, economic status, cohabitation and home accessibility at admission). To correct for imbalance in patient sample numbers with high and low-risk levels (prediction target), five different datasets were prepared by varying the data subsampling methodology. For each of the five datasets a prediction model was trained and the analysis involves a comparison across these models. The training and validation results indicated that the models corrected for prediction target imbalance have similarly good performance (AUC 0.831–0.843) and validation (AUC 0.881 - 0.909). Furthermore, predictor variable importance ranked social support and economic status as the most important variables with the greatest contribution to social risk prediction, however, sex and age had a lesser, but still important, contribution. Due to the complex and multifactorial nature of social risk, factors in combination, including social support and economic status, drive social risk for individuals.

Impact of rehabilitation adherence and depressive symptoms on post-stroke self-care ability and quality of life: a longitudinal study

ABSTRACT Background Good rehabilitation adherence leads to effective post-stroke recovery. However, some recovering patients experience post-stroke depressive symptoms, which can affect post-stroke health outcomes. Previous studies have not examined the effect of a combination of rehabilitation adherence and depressive symptoms on recovery after a stroke. Objectives This study explored the combined predictive influence of rehabilitation adherence and post-stroke depressive symptoms on self-care abilities and quality of life in patients with stroke. Methods This prospective longitudinal study analyzed data from 75 stroke patients. We examined rehabilitation adherence (self-reported, five-point scale), post-stroke depressive symptoms (Taiwanese Depression Scale), self-care ability (Chinese versions of the Barthel Index and Lawton – Brody Instrumental Activities of Daily Living Scale), and post-stroke quality of life (World Health Organization Quality of Life-BREF). Patients were followed up for six months after inclusion. The influence of rehabilitation adherence and post-stroke depressive symptoms on post-stroke self-care abilities and quality of life was examined using generalized estimating equations. Results The sample’s mean age was 60.85 (±12.9) years. Patients with perfect rehabilitation adherence had better self-care abilities and quality of life than those with imperfect rehabilitation adherence. Patients without post-stroke depressive symptoms had a better quality of life than their counterparts. Patients with perfect rehabilitation adherence and no post-stroke depressive symptoms had better self-care abilities and quality of life than those with imperfect rehabilitation adherence and post-stroke depressive symptoms. Conclusion Both depressive symptoms and rehabilitation adherence behavior impacted the rehabilitation effect among patients who are recovering from a stroke.

Results of the Healthy GOALS Efficacy Study of a Life Management Intervention on Engagement in Meaningful Activities & Quality of Life Poststroke

Abstract Date Presented 04/21/2023 The purpose of this poster is to present the results of the efficacy of a life management intervention for stroke survivors on meaningful activity, occupational performance, and quality of life outcomes. This study adds an efficacious intervention for OT. Primary Author and Speaker: Valerie Ann Hill Additional Authors and Speakers: Valerie Miller Contributing Authors: Rebecca Leugers, Erin Wagner

Impact of Botulinum Toxin Along with Task-Specific Training in Post-Stroke Quality of Life in Focal Hand Dystonia

Objective: To investigate the impact of BOTOX, along with task-specific training, on focal hand dystonia in post-stroke patients and to determine the correlation between quality of life and motor outcomes in upper extremity dystonic patients. Methodology: A quasi-experimental involving 20 patients, study was conducted at Holy Family Hospital (HFH), Chambeli Institute of Rehabilitation in Rawalpindi, and Neurocounsel Clinic in Islamabad. A convenient sampling technique was utilized to select participants for inclusion in the study. Assessments were conducted at four time points: baseline (0 weeks), 4 weeks, 8 weeks, and 12 weeks. The assessment tools used were the Abductor Digiti Minimi Abduction (ADDA) test, Modified Ashworth Scale (MAS), and Stroke-Specific Quality of Life (SS-QoL) questionnaire. Repeated measures ANOVA was employed to analyze mean differences in data across various weeks. The associations between scales were evaluated using Spearman's rho and Pearson correlation coefficients, based on different variables. Results: The mean age was 42.7 ± 10.45 years. The study included 14 males and 6 females. Repeated measures ANOVA indicated a significant difference between MAS scores for upper extremity and quality of life in post-stroke dystonic patients, with a p-value of 0.001**. A strong positive correlation coefficient was found between MAS and SS-QoL through Spearman's correlation analysis, with a p-value of less than 0.05. Conclusion: The administration of Type a Botulinum toxin, coupled with task-specific training, not only exhibited improvements in upper limb motor outcomes but also in the quality of life of focal hand dystonic patients after a stroke.

SENSORINEURAL HEARING LOSS IN ISCHEMIC STROKE - A LONGITUDINAL OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL.

Hearing impairment commonly involves dysfunction of the inner ear or auditory nerve, a condition known as sensorineural Hearing loss (SNHL). A longitudinal observational study of 38 stroke patients was conducted at a tertiary care hospital for a period of 6 months to know the proportion of sensorineural hearing loss in stroke patients and also the progression of hearing loss during the recovery period of stroke. Clinical & audiological evaluation was done for all patients and they underwent pure tone audiometry at serial intervals of 1st, 2nd and 3rd month from the date of diagnosis of stroke. The proportion of sensorineural hearing loss in stroke patients was found to be 60%. On comparison of serial pure tone audiometry readings, it was observed that hearing loss improved signicantly during the recovery period of stroke. This study concluded that high proportion of sensorineural hearing loss in stroke patients indicates the importance of screening for hearing loss to improve the rehabilitation as well as quality of life post stroke.

Associations between pre-stroke physical activity and physical quality of life three months after stroke in patients with mild disability.

Much is known about the association between physical activity and the occurrence of stroke. However, the evidence about the correlation between pre-stroke physical activity and post-stroke quality of life remains inconsistent. Thus, there is a high public health relevance to the topic. The aim of this study was to investigate the association between pre-stroke physical activity and physical quality of life after three months. Data arises from 858 patients with stroke included a prospective single-centre observational cohort study in Augsburg, Germany, between September 2018 and November 2019. The participants were recruited at the Department of Neurology and Clinical Neurophysiology, University Hospital of Augsburg after their stroke event. The level of physical activity was determined following the short form of the International Physical Activity Questionnaire at baseline. Physical quality of life was assessed three months after hospital discharge using the German version of the Stroke Impact Scale (SIS). A multiple linear regression model and a quantile regression were carried out. A total of 497 patients were included in the analysis (mean age 69.6, 58.8% male), 26.2% had a high, 18.9% a moderate and 54.9% a low level of pre-stroke physical activity. Patients with high pre-stroke physical activity had a significantly better physical quality of life three months after stroke in the SIS physical domain (beta = 4.1) and in the SIS subdomains hand function (beta = 5.6), mobility (beta = 4.1) and activities of daily living (beta = 3.7). In the physical domain and the subdomain mobility, the effect was especially strong for persons with low physical quality of life after three months. Pre-stroke physical activity seems to have an important and positive association with physical quality of life after three months in patients with mild disability. Further studies are needed to confirm these results.

The factors that influence the adaptation process 6 months after a stroke: A path analysis

ObjectiveThe purpose of this study was to identify the determinant factors that influence the adaptation process and quality of life after a stroke. MethodsThis study is an observational study using a cross-sectional design. Respondents were patients who were 6 months post-discharge after non-hemorrhagic strokae and their family caregivers. Information about respondents was taken from medical record data at two regional general hospitals in West Kalimantan Province, Indonesia. A total of 80 patients were selected using a consecutive sampling method. Theoretical models of patient and caregiver factors that influence adaptation responses and post-stroke quality of life were tested using path analysis. ResultCaregiver coping, self-efficacy, and illness acceptance had a direct effect on the post-stroke psychosocial adaptation response by 58.1%, with self-efficacy contributing the most (β = 0.668, P < .0001). Self-efficacy, illness acceptance, and healthy behavior had a direct effect on the physiological adaptation response by 24.3%, where self-efficacy also contributed the most (β = 0.272, P < .014). Psychosocial adaptation and physiological adaptation had a direct effect on the quality of life by 54.6%, where psychosocial adaptation showed the largest contribution (β = 0.63, P < .0001). ConclusionSelf-efficacy contributes the most to both psychosocial and physiological adaptations 6 months after stroke. Psychosocial adaptation and self-efficacy have been proven to be the determinant factors that contribute the most to the quality of life of patients 6 months after stroke.

Quality of Life in the First Year after Ischemic Stroke Treated with Acute Revascularization Therapy.

(1) Background: we aimed to describe the disease-specific quality of life (QoL) of ischemic stroke patients treated with acute revascularization therapy, its evolution from 6 months to 12 months, and associated factors. (2) Methods: QoL was assessed with the SS-QoL in consecutive patients treated with either intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT). Variables associated with QoL scores and its evolution were studied using multivariate mixed models, and interaction with time. Analyses were performed in four domains of SS-QoL: self-care, mobility, mood, and social roles. (3) Results: Among the 501 included patients (mean (sd) age 68.9 (14.5), 49% women), lower post-stroke QoL was independently related to lower level of school education, prestroke mRS > 2, and 24 h NIHSS score > 4. Independent predictors of unfavorable evolution of QoL over time were age <75 years (Mobility p = 0.0194 and Mood p = 0.0015), NIHSS score ≤ 4, (Self-care p = 0.0053 and Mood p = 0.0048), and modified Rankin Scale score ≤ 2 (Social roles, p = 0.0006). Revascularization therapy had no significant effect on the QoL scores, but patients treated with MT (alone or as bridging therapy) had significantly greater improvement in mobility score between 6 and 12 months than patients treated with IVT alone (p = 0.0072). (4) Conclusion: QoL evolution over one year had only slight variation and was associated with the modalities of acute treatment, age, and stroke severity.

Breathing Exercises for Improving Cognitive Function in Patients with Stroke.

Patients with stroke may experience a certain degree of cognitive decline during the period of recovery, and a considerable number of such patients have been reported to show permanent cognitive damage. Therefore, the period of recovery and rehabilitation following stroke is critical for rapid cognitive functional improvements. As dysfunctional breathing has been reported as one of the factors affecting the quality of life post stroke, a number of studies have focused on the need for improving the breathing function in these patients. Numerous breathing exercises have been reported to enhance the respiratory, pulmonary, cognitive, and psychological functions. However, scientific evidence on the underlying mechanisms by which these exercises improve cognitive function is scattered at best. Therefore, it has been difficult to establish a protocol of breathing exercises for patients with stroke. In this review, we summarize the psychological, vascular, sleep-related, and biochemical factors influencing cognition in patients and highlight the need for breathing exercises based on existing studies. Breathing exercises are expected to contribute to improvements in cognitive function in stroke based on a diverse array of supporting evidence. With relevant follow-up studies, a protocol of breathing exercises can be developed for improving the cognitive function in patients with stroke.

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

Introduction: the perception of Quality of Life (QoL) has been used to evaluate the treatment and evolution of several pathologies. QoL evaluation allows a better understanding of the patient and his adaptation to the disease. An observational, community-based and descriptive correlational study was carried out to analyze stroke survivors’ perception of QoL. Methods: consecutive case-series of stroke survivors (≥3 months) followed in a single public primary health center (“Tavira Primary Health Centre”) from Algarve, southern Portugal. The Portuguese version of the World Health Organization Quality of life instrument was administered in 102 stroke survivors. Results: Perception of QoL was associated (p < 0.05) with specific sociodemographic (age, sex, marital status, academic training), economic (monthly family income) and clinical factors (number of vascular risk factors, type of stroke, evolution, chronic mRankin score). On multivariate analysis, chronic mRankin score on physical (R2 = 0.406; F = 8.757; p < 0.001), psychological (R2 = 0.286; F = 5.536; p < 0.001) and general domain (R2 = 0.357; F = 7.287; p < 0.001); and family income (R2 = 0.160; F = 3.156; p < 0.005) on environmental domain, emerged as predictors of QoL. Conclusion: Different socio-demographic, economic and health factors are associated with post-stroke QoL. Description of QoL contributes to the overall evaluation of the impact of stroke on health and should be a priority for health professionals.

Abstract P232: Patient and Caregiver Agreement on Stroke Survivor Quality of Life in the Year After Stroke Onset

Background: The burden of post-stroke disability falls on both stroke survivors and their caregivers. To better understand patient and caregiver perspectives on post-stroke quality of life (QoL), we explored their agreement on a QoL testing instrument in the year after an ischemic stroke. Methods: This is a secondary analysis of the IMS-III trial. The primary outcome are scores of the 5 domains of the EQ-5D-3L during the year after stroke onset. We included pairs of EQ-5D-3L scores obtained from both the patient and their proxy to determine the level of agreement and Cohen’s Kappa for the individual domains. Results: There were 1,042 instances of a paired EQ-5D-3L during the first year of follow-up, derived from six study visits described in Table 1. The agreement between patient and proxy was highest for the Mobility and Self-Care domains of the EQ-5D-3L (Table 2), achieving a Kappa of 0.7407 and 0.7567, respectively. The agreement for the Anxiety/Depression domain of the EQ-5D-3L was lowest, with a Kappa of 0.6009 (Table 2). Conclusion: In the year after ischemic stroke, the agreement between patients and their caregivers was highest for the motor domains of QoL and lowest for the mental health domain. Depression and anxiety are known to be under-diagnosed and under-treated after stroke. Further research is warranted to explore the reasons for less agreement between patient and caregiver perception of the stroke survivor’s mental health QoL after ischemic stroke.

Measuring Quality of Life in Stroke Survivors

Introduction: The number of patients living with the consequences of stroke is increasing worldwide due to the improving stroke care and the modern differentiated treatment options for ischemic stroke – thrombolysis and thrombectomy. Hence, a significant interest has arisen in quality of life (QOL) measurement in post-stroke patients. Objectives. Measuring QOL in stroke survivors can be achieved by using various generic and stroke specific questionnaires. All tools should assess different domains of health such as physical acting, communication, daily activities and others. This article describes the most commonly used scales for measuring post-stroke QOL. Methods. We searched the PubMed electronic databases with the keywords — Quality of life, Stroke, Measuring for the period from January 2000 to May 2020. Results. Various generic and specific scales for quality of life measuring are available. The advantages of the specific scales include high accuracy and detailed information for the assessed domains. The limitations are due to numerous items, long evaluation time and high dependency on patient’s compliance. The generic scales give the ability to compare the QOL in patients with different diseases. The disadvantage is lack of detailed information for the health status in certain disease or condition. Conclusion. Measuring the different aspects of QOL in post-stroke patients is powerful tool in order to focus the further efforts to the most affected domains. A combination between generic and stroke-specific measure might be considered in order to overcome the limitations. The choice of measuring scales must be balanced in the terms of lengthy and repetitive surveys.

Quality of life of stroke survivors in Africa: a systematic review and meta-analysis.

Functional impairments and socioeconomic constraints associated with stroke affect quality of life (QoL). With limited care and social support resources, there is a greater anticipated decline in QoL among stroke survivors in Africa. This study aims to examine post-stroke QoL, properties of outcome measures adopted and predictors of the QoL among African stroke survivors. African Journals Online, CINAHL, PsychINFO, PubMed and Web of Science databases were searched from inception to February 2020. Methodological quality was assessed using the Agency for Healthcare Research and Quality (ARHQ) methodology checklist for observational studies. Twenty-eight studies recruiting 2572 (76.4%) stroke survivors and 795 (23.6%) healthy volunteers were included. Studies were conducted in eight African countries between 2007 and 2019. Methodological quality of studies was good. Overall, stroke survivors reported a low QoL. Six studies comparing QoL between stroke survivors and healthy controls were pooled for meta-analysis. Results showed a biased-adjusted standardised mean difference (Hedges's g) of 1.13 (95% CI 0.71 to 1.56; p < 0.001), indicating better QoL among healthy controls. Only 4 (14.3%) studies used translated or cross-culturally adapted QoL assessment tools. The most commonly reported predictor of QoL was post-stroke disability (35.8% of studies) which is followed by depression (28.6%) and stroke severity (28.6%). Overall, African stroke survivors reported comparatively lower QoL as compared to age-matched healthy controls. This highlights the need for cross-culturally validated assessment tools and more robust post-stroke QoL evaluation across the African continent. To improve QoL of stroke survivors in Africa, early interventions should focus on reducing disability and depression associated with stroke. PROSPERO registration number: CRD42019137653.

Post-stroke Quality of Life Index: A quality of life tool for stroke survivors from Sri Lanka

BackgroundBurden of stroke is rising due to the demographic and epidemiological transitions in Sri Lanka. Assessment of success of stroke-management requires tools to assess the quality of life (QOL) of stroke survivors. Most of currently used QOL tools are developed in high-income countries and may not reflect characteristics relevant to resource-constrained countries. The aim was to develop and validate a new QOL tool for stroke survivors in Sri Lanka.MethodsThe COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was referred. A conceptual framework was prepared. Item generation was done reviewing the existing QOL tools, inputs from experts and from stroke survivors. Non-statistical item reduction was done for the 36 generated items with modified-Delphi technique. Retained 21 items were included in the draft tool. A cross sectional study was done with 180 stroke survivors. Exploratory Factor Analysis was done and identified factors were subjected to varimax rotation. Further construct validity was tested with 6 a-priori hypothesis using already validated tools (SF-36, EQ-5D-3 L) and a formed construct. Internal consistency reliability was assessed with Cronbach alpha.ResultsFour factors identified with principal-component-analysis explained 72.02% of the total variance. All 21 items loaded with a level > 0.4. The developed tool was named as the Post-stroke QOL Index (PQOLI). Four domains were named as “physical and social function”, “environment”, “financial-independence” and “pain and emotional-wellbeing”. Four domain scores of PQOLI correlated as expected with the SF-36, EQ-5D Index and EQ-5D-VAS scores. Higher domain scores were obtained for ambulatory-group than the hospitalized-group. Higher scores for financial-independence domain were obtained for the group without financial-instability. Five a-priori hypothesis were completely proven to be true. Cronbach-alpha level ranged from 0.682 to 0.906 for the four domains.ConclusionsThere is first evidence for sufficient construct validity of the PQOLI as a valid QOL tool for measuring the QOL of stroke survivors with satisfactory internal consistency reliability.

Effect of Deep Lumbar Muscle Stabilization Exercise on the Spatiotemporal Walking Ability of Stroke Patients

Background: Walking is a complex activity. The main components of walking include balance, coordination, and symmetrical posture. The characteristics of walking patterns of stroke patients include slow walking, measured by gait cycle and walking speed. This is an important factor that reflects post-stroke quality of life and walking ability. Objective: This study aimed to examine the effect of deep lumbar muscle sta­bilization exercise on the spatiotemporal walking ability of stroke patients. Design: Quasi-experial study Methods: The experiment was conducted 5 times per week for 4 weeks, with 30 minutes per session, on 10 subjects in the experimental group who per­formed the deep lumbar muscle stabilization exercise and 10 subjects in the control group who performed a regular exercise. Variables that represent the spatiotemporal walking ability (step length, stride length, step rate, and walk­ing speed) were measured using GAITRrite before and after the experiment and were analyzed. Results: There was a significant difference in the pre- and post-exercise spa­tiotemporal walking ability between the two groups (p<.05). Furthermore, there was a significant difference in the step rate and walking speed between the two groups (p<.05). Conclusions: Deep lumbar muscle stabilization exercise is effective in improv­ing the walking ability of stroke patients. Therefore, its application will help improve the spatiotemporal walking ability of stroke patients.

Quality of Life Within Three Months After Stroke: A Study in the City of Arak, Iran

IntroductionThe impact of stroke on quality of life (QoL) may be different in diverse societies because of varying availability and accessibility of health and social care services provided in various settings. The purpose of the present study was to evaluate changes in patients’ QoL within three months after stroke and to address the research question; “What factors influence QoL after stroke in Iranian population?” MethodsA total number of 172 patients admitted to the Stroke Unit of Amiralmomenin Hospital in the city of Arak, Iran, were recruited in this study. The Stroke Impact Scale (SIS-16) was used at three different time-points to evaluate post-stroke QoL. Repeated measures analysis of variance (ANOVA) followed by Bonferroni method and marginal model with generalized estimating equation (GEE) were employed to analyze the data. ResultsThe findings revealed a significant decline in QoL within the first month after stroke compared with post-stroke state. The mean values of patients' QoL also improved within three months after stroke although they did not reach the pre-stroke level. A positive relationship was also observed between age, high National Institutes of Health Stroke Scale (NIHSS) scores, hypertension, right side lesion and previous stroke, as well as patients’ poor QoL. Moreover; gender, level of education, job status, and income had no influence on QoL in stroke survivors. ConclusionIt was concluded that being older, having higher NIHSS score, suffering from hypertension, right side lesion and previous stroke could be significantly correlated with poor patients’ QoL. Therefore, effective interventions focusing on older individuals especially those with more severe impairments were assumed to help in improving post-stroke QoL in patients; regardless of their gender, level of education, and social activities.

Abstract WP545: White Matter Hyperintensity Burden and Quality of Life Following Lacunar Stroke: A Secondary Analysis of SPS3 Study

Introduction: White matter hyperintensity (WMH) burden has been linked to cognitive impairment, but its effect on post-stroke quality of life has not been examined. Hypothesis: Larger WMH burden, measured by Fazekas score on MRI, will negatively impact quality of life post lacunar stroke in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. Methods: We evaluated patients from SPS3. The primary outcome was the stroke specific quality of life scale (ss-QoL) at baseline and study completion (mean follow-up 3.4 years). Results: There were 2804 patients with baseline ss-QoL and 2185 patients with ss-QoL at study completion. Mean age was 62.7 ± 10.7 years, 62% male, and 53.6% white. Higher Fazekas score had a negative impact on ss-QoL (Table 1), which persisted in a multivariate model (Table 2 &amp; 3). On subgroup ss-QoL, Fazekas had a greater impact on self-care, mobility, productivity, upper extremity, family and social roles (Graph 1). Conclusion: Larger WMH burden negatively impacts quality of life following lacunar strokes. The negative effect is seen in specific quality of life categories.

Impact of unilateral spatial neglect on chronic patient's post-stroke quality of life

Background: Unilateral spatial neglect (USN) is the prevalent feature in patients with right-sided stroke. It is diagnosed through the behavior inattention test (BIT) and has a negative impact on patients affecting both their functional capacity and quality of life.Objective: Here, we aimed to evaluate the impact of USN on the quality of life of patients in the chronic phase of stroke.Methods: This is a cross-sectional study with stroke patients with USN. After confirming the presence of stroke through neuroimaging examinations and of USN through the BIT, patients’ quality of life was evaluated by using the EUROQOL scale. Spearman’s correlation was used to validate the correlation between patients’ USN and quality of life, with a p < .05 representing significant results.Results: Eighteen individuals were included. When correlating the value of each domain of the EUROQOL scale with the results of the BIT, we observed a negative correlation between mobility (r = –0.97; p = .000), self-care (r = –0.82; p = .013), usual activities (r = –0.87; p = .005); pain or discomfort (r = –0.88; p = .004), anxiety or depression (r = –0.97; p = .000), and EUROQOL total score (r = –0.97, p = .000).Conclusion: After a correlation between the overall EUROQOL and BIT scores, we suggest that the higher the USN degree is in stroke patients, the worse their perceived quality of life tends to be.

STATUS FUNGSIONAL SEBAGAI FAKTOR DETERMINAN KUALITAS HIDUP LANSIA PASCA STROKE DI JAKARTA SELATAN

Perubahan fungsional pada lansia pasca stroke dapat mempengaruhi lansia dan keluarga secara fisik, psikologis, sosial, dan spiritual. Berfokus pada dampak stroke bagi lansia dan keluarga, maka tujuan penelitian ini adalah mengidentifikasi status fungsional sebagai faktor yang mempengaruhi kualitas hidup lansia pasca stroke. Penelitian cross-sectional ini menggunakan teknik purposive sampling dengan 70 responden lansia pasca stroke yang tinggal bersama keluarga di Jakarta Selatan. Penelitian mengkaji status fungsional dengan instrumen IADL dan kualitas hidup lansia pasca stroke dengan SS-QOL12. Peneliti mengkaji faktor lain yang memiliki hubungan signifikan dengan kualitas hidup yaitu dukungan sosial dan beban pelaku rawat. Model regresi linear digunakan dalam penelitian untuk mengetahui factor yang paling mempengaruhi kualitas hidup. Hasil penelitian menunjukkan bahwa status fungsional, dukungan sosial dan beban pelaku rawat keluarga mempengaruhi kualitas hidup lansia pasca stroke. Status fungsional merupakan faktor yang paling berpengaruh terhadap kualitas hidup lansia pasca stroke. Kesimpulan penelitian adalah tingginya status fungsional lansia pasca stroke berhubungan dengan meningkatnya kualitas hidup lansia pasca stroke. Perawat komunitas dan keluarga memiliki peran penting dalam proses rehabilitasi lansia pasca stroke.&#x0D; &#x0D; Kata kunci : lansia pasca stroke, pelaku rawat keluarga, kualitas hidup, beban rawat

Abstract WP168: Socioeconomic Status and Stroke Severity

Background: Stroke has been shown to disproportionately strike those of lower income, either inhabitants of low-income countries, or low-income groups within high-income countries. Norway is a social democratic welfare state where every citizen has the same access to health care services, including acute stroke treatment. The aim of this prospective study was to assess if stroke severity and short-term functional outcome is affected by socioeconomic status (SES). Methods: All ischemic stroke patients admitted to the stroke unit at Haukeland University Hospital, Norway, between February 2006 and December 2008 were sent a questionnaire 6 months after stroke ictus. The questionnaire included information regarding SES as well as subjective opinion of quality of life post stroke. SES data was self-reported and included gender, age, marital status, education, individual net income and occupation. Stroke severity was determined by use of National Institutes of Health Stroke Scale Score (NIHSS) on admission and short-term functional outcome was defined using the modified Rankin Scale (mRS) score on day 7 after ictus. NIHSS and mRS were dichotomized in high/low depending on their mean values; respectively NIHSS score ≤ 6 / &gt; 6 and mRS score ≤ 2 / &gt; 2. Logistic regression was chosen for multivariate analysis and SES factors (income, education and marital status) were forced into all regression models. Results: A total of 328 patients with ischemic stroke were included in the study; mean age was 67.7 years (SD 13.3) at the time of stroke ictus, and 63 % were male. Patients with a high net income were more often married ( P &lt; .01 ) than those of lower income, and as expected, had a higher level of education ( P &lt; .001 ). On logistic regression analysis lower net income level was the only SES factor associated with a more severe stroke ( OR = 0.64, 95 % CI 0.44 - 0.92, P = 0.02). SES did not affect short-term functional outcome. Conclusion: Preliminary results show that lower net income predicts a more severe stroke. This was found in a Norwegian stroke population despite equal access to health care services and free education for all citizens.