Quality Of Life In Stroke Survivors Research Articles

Effects of A Benefit-Finding Intervention in Stroke Caregivers in Communities

ABSTRACT Objectives: To verify the effectiveness and feasibility of a nine-week benefit-finding intervention on the burden, quality of life, and benefit finding of caregivers, as well as on the quality of life of stroke survivors. Methods: Benefit finding refers to the individual, social, psychological and spiritual benefits perceived by an individual experiencing stress or post-traumatic events. A randomized controlled trial was performed in which 68 stroke survivors and their caregivers were recruited from the Zhengzhou community, China, and randomly split into two groups. The intervention group included those having undergone a nine-week benefit-finding intervention, while the control group included those individuals having undergone a nine-week routine health education. At baseline and one-week post-intervention (after a 9-week intervention), the quality of life of stroke survivors and caregivers and the burden and benefit finding of caregivers were determined. Results: In comparison to the control group, caregiver benefit finding, quality of life, burden, and stroke survivor quality of life were significantly improved (P <.005). Conclusions: The intervention appears to be feasible for stroke patients and caregivers. The intervention is capable of improving the quality of life of caregivers and survivors, increasing the benefit finding of caregivers and reducing the burden of caregivers. Clinical Implications: The benefit-finding intervention is capable of improving the health condition of stroke patients and caregivers.

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.

Relationship between functional independence and psychosocial quality of life of stroke survivors undergoing outpatient rehabilitation in Maiduguri, Nigeria

BackgroundThere are divergent findings on the impact of functional independence on psychosocial quality of life (QoL) of stroke survivors.AimTo investigate the relationship between functional independence and psychosocial QoL among stroke survivors in Maiduguri, Nigeria.MethodsA cross-sectional design was utilized, and functional independence and psychosocial QoL of consecutive stroke survivors undergoing rehabilitation were assessed with the motor subscale of the Functional Independence Measure (motor- FIM) and the psychosocial subscale of the Stroke-Specific Quality of Life Scale-12 (SS-QoL- 12) respectively. Relationships between the two variables were explored with Pearson’s correlation coefficients and multivariable regression analysis.ResultsFifty-nine stroke survivors participated in the study with a male majority (54.2%). Correlation between motor-FIM and the psychosocial subscale scores was not statistically significant (r = 0.24; p = 0.07) while correlation between motor-FIM and each item of the psychosocial subscale showed that a statistically significant correlation (r = 0.29; p = 0.02) was present for the ‘mood’ item only. Functional independence however did not statistically contribute to the multivariable regression model (R2 = 0.22; P < 0.01) for the ‘mood’ item after controlling for the effect of the participants’ age and sex.ConclusionFunctional independence had no independent or statistically significant relationship with overall psychosocial QoL. Further studies are therefore needed to explore modifiable factors that influence psychosocial QoL of stroke survivors in our setting.

Cough Effectiveness, Functional Independence and Quality of Life of Stroke Survivors: A Cross-sectional Survey

Background: Stroke is associated with clinical spectrum of respiratory impairments, a significant one being aspiration pneumonia owing to failure to safeguard and clear the airway through coughing. Objectives: This research evaluated the correlation among cough effectiveness, functional independence, and quality of life of stroke survivors. Methods: This study involved 33 stroke survivors (13 males and 20 females) aged between 39-80 years. They were recruited from a teaching hospital in Nigeria. The participants were recruited between April and October, 2018. Cough effectiveness, functional independence (FI) and perception of quality of life (QoL) were assessed using Peak flow meter, Functional Independence Measure (FIM) and Stroke Specific Quality of Life Scale (SS-QoL) respectively. Spearman rank correlation coefficient was used to obtain the relationship between measured parameters. Level of significance was set at p&lt;0.05. Results: The mean peak cough flow (PCF) was 195.75±51.90 L/min for all the study participants. There was a positive significant correlation between cough effectiveness and motor subunit of FIM (rs=0.530, p=0.002) and overall FIM (rs=0.484, p=0.004). There was also a positive significant correlation between cough effectiveness and overall QoL score (rs=0.517, p=0.002). Five domains of QoL showed positive significant correlation to cough effectiveness; these include Mobility (rs=0.524, p=0.002), Self-care (rs=0.448, p=0.009), Social role (rs=0.487, p=0.004), Upper-limb function (rs=0.535, p=0.001), and Work and productivity (rs=0.556, p=0.001). Conclusion: Cough effectiveness is significantly positively correlated to functional independence and the QoL of stroke survivors.

Impact of stroke on quality of life and functional independence

Background: Cerebrovascular accident is the prime cause for the functional disability and deteriorated quality of life (QOL) which affects person’s social and physical capabilities. Present stroke outcomes are restricted to evaluate global influence of event on patient’s well-being. Hence, it is mandatory to know the effect of stroke on functional independence and domain (DOM)-specific QOL in stroke survivors. Aims and Objectives: The objectives of this study are to assess DOM-specific QOL and functional independence in stroke survivors. Materials and Methods: A cross-sectional survey was conducted on 30 stroke survivors after approval from the Institutional Ethics Committee and their written voluntary consent. QOL was measured with the use of the World Health Organization Quality of Life Instruments (WHOQOLBREF) questionnaire, and functional independence was measured with the use of Functional Independence Measurement (FIM) scale. Results: Thirty patients (63.33% were men and 36.66% were women) were participated with the mean age of 61.47 ± 10.17 years for men and 64 ± 12.14 years for women. The QOL in DOM 1 (physical) was 10.6 ± 3.42, and in DOM 2 (psychological), it was 12.8 ± 6.09. DOM 3 (social relationship) was 14.06 ± 1.52 and DOM 4 (environmental) was 20.23 ± 5.71, i.e., DOM 1 and 2 were more affected. Further, motor component in functional independence was 41.83 ± 20.11, and in cognitive component, it was 34.76 ± 0.43, i.e., motor component was more affected than cognitive component in our patients. Conclusion: The stroke survivors had lower QOL and functionally dependent in the activity of daily living. Physical and psychological dimensions of QOL and motor component of FIM were more affected.

Predictors of quality of life for chronic stroke survivors in relation to cultural differences: a literature review

Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self-perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences.

Quality of life after stroke in Pakistan.

BackgroundThere is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden.MethodologyWe used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36. In addition; we assessed complications, psychosocial and functional disability of stroke survivors. Following this quantitative survey, caregivers were qualitatively interviewed to uncover contextually relevant themes that would evade quantitative surveys. Multiple linear regression technique was applied to report adjusted β-coefficients with 95% C.I.ResultsThe QOL study was conducted from January 2014 till June 2014, in two large private and public centers. At each center, 175 dyads were interviewed to ensure representativeness. Median age of stroke survivors was 59(17) years, 68% were male, 60% reported depression and 70% suffered post-stroke complications. The mean SSQOLS score was 164.18 ± 32.30. In the final model severe functional disability [adjβ -33.77(-52.44, -15.22)], depression [adjβ-23.74(-30.61,-16.82)], hospital admissions [adjβ-5.51(-9.23,-1.92)] and severe neurologic pain [adjβ -12.41(-20.10,-4.77)] negatively impacted QOL of stroke survivors (P < 0.01).For caregivers, mean age was 39.18 ± 13.44 years, 51% were female and 34% reported high stress levels. Complementary qualitative study revealed that primary caregivers were depressed, frustrated, isolated and also disappointed by health services.ConclusionThe QOL of Stroke survivors as reported by SSQOLS score was better than compared to those reported from other LMIC settings. However, Qualitative triangulation revealed that younger caregivers felt isolated, depressed, overwhelmed and were providing care at great personal cost. There is a need to develop cost effective holistic home support interventions to improve lives of the survivor dyad as a unit.Trial registration NCT02351778 (Registered as Observational Study).Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0774-1) contains supplementary material, which is available to authorized users.

Effect of Monitored Home Exercise Program on Quality of Life in Stroke Survivors

Stroke or brain attack is the sudden loss of neurological function caused by an interruption of the blood flow to the brain and it is the second leading cause of death in the world and the first cause of functional incapacity for Activities of Daily Living (ADL).It can affect the survivor physically, emotionally and cognitively, ultimately resulting in behavioral changes and depression which leads to disability and functional dependence for ADL which reduces community participation and hence the Quality of Life (QoL). Studies showed that supervised exercises at hospital level have more significant improvement in the QoL in stroke survivors than the non supervised exercises at the community level. Hence the purpose of the study was to study the effect of community-based monitored home exercise programme in stroke survivors to improve the motor performance and the functional independence and hence the QoL. 58 subjects were included and randomly allocated in to monitored and non-monitored group. QoL was assessed by using Stroke Specific Quality of Life (SS-QoL) Questionnaire and functional independence was assessed by using Modified Barthel Index (MBI) on the first day and last day of treatment. Exercises were performed twice a day for 3 days/week for 10 weeks by both the groups. Result of the study showed significant difference in SSQoL (p<0.0001) and MBI (p<0.0001) of monitored group. Hence, the study concludes that the 10 weeks of monitored home exercise program was effective to improve the QoL in stroke survivors.

Quality of life and functional outcome in stroke survivors

Background: Modern treatment and rehabilitation strategies reduce the risk of death or dependency after stroke. However, better functional outcome may not always be translated to better quality of life (QoL). The aim of the study was to assess QoL in stroke survivors in relation to their functional outcome.

OA10.03. Improved activity, participation, and quality of life for individuals with chronic stroke following an 8-week yoga intervention

Methods For this pilot study, individuals were randomized 3:1 into the experimental group or wait list control. Forty-seven individuals were recruited into the study, with 37 individuals randomized to the yoga arm, and 10 randomized into the control group. Twenty-nine individuals completed the yoga intervention (22% attrition). The yoga intervention occurred twice per week for 1 hour each session, and was designed for individuals with chronic stroke (>6 months post event). All yoga classes were led by a registered yoga therapist. To measure activity and participation, the ICF Measure of Participation and Activity (IMPACT) subscales were utilized (lower scores indicate higher activity or participation). To measure quality of life, the Stroke Survivor Quality of Life (SSQOL) scale was utilized. Paired t-tests were utilized to compare the baseline and 8-week scores on each of the measures for both groups.

The quality of life of long-term stroke patients and related factors

Objective To investigate the quality of life(QOL)of patients with stroke and its related factors.Methods The QOL of eighty-two stroke survivors was assessed in terms of SF-36 scores,motor impairment (Fugl-Meyer),disability[Barthel index(BI)]and depression(HAMD)more than one year after their first episode.Their social demographic characteristics such as age,gender,education and income were recorded,as were the characteristics of their disease and any complications.Multiple regression analysis was used to analyse the related factors.Results The average age of the 82 subjects was 61.89 + 9.81 years(range,33-81).56 of them were male (68.2％).Scores on all items of the SF-36 for these subjects were lower than those of a normal population.Correlation analysis showed income,cost for medical care,regular exercise,movement function,ability in the activities of daily living,depression,hypertension and shoulder pain were significantly correlated with most of the SF-36 domain scores.Motor function,income and cost for medical care explained 34％ of the variance in SF-36 scores.Motor function was the single most important factor.Conclusion The major factors affecting the QOL of stroke patients are motor function,level of income and cost for medical care.Paying more attention to rehabilitation treatment,taking regular exercise and more income could help improve the QOL of stroke survivors. Key words: Stroke; Quality of life; Multiple regression analysis

Caregiver characteristics predict stroke survivor quality of life at 4 months and 1 year

Evaluating factors that reduce stroke survivors' (SS) health-related quality of life (HRQOL) is important for developing interventions to improve HRQOL after stroke. The influence of baseline caregiver and family characteristics (physical health, depressive symptoms, family communication) on five domains of SS HRQOL (physical function, memory/thinking, social activities, communication, and mood) was examined. Data were collected on 132 SS-caregiver dyads at baseline, 4 months, and 12 months. Baseline caregiver depressive symptoms predicted lower scores for SS physical function and communication at 4 months and social participation and mood at 12 months. Male caregiver gender was negatively associated with SS HRQOL (communication and mood) at 12 months. Early intervention targeting these family characteristics, especially caregiver depressive symptoms, may improve survivors' HRQOL.

Abstract 2849: Family Variables in Early Recovery Predict Stroke Survivor Quality of Life in 12 months

Purpose : Quality of life (QOL) after stroke may be influenced by the family context in addition to the stroke survivor’s physical ability. The purpose of this study was to determine whether baseline caregiver (CG) and family characteristics (age, physical function, depressive symptoms, and family communication) predict stroke survivor (SS) QOL: physical function, memory/thinking, social activities, communication, and mood at 1 year follow-up. Methods : Data were collected on 132 SS-CG dyads. SSs were 3–9 months post stroke, 30 to 83 years old ( M = 62.2 ± 12.6), male (64%), Caucasian (74 %), and had an ischemic stroke (88%). CGs were age 25 to 85 years ( M = 56.7 ± 13.7), female (74 %), well-educated (73 %), and spouses (80 %) enrolled in a multi-site caregiving study complementary to a clinical trial testing constraint-induced movement therapy in SSs. Measures included CG physical function (SF-36), CG depressive symptoms (CES-D), family communication (McMaster Family Assessment Device), and SS QOL (Stroke Impact Scale). Pearson’s correlations and hierarchal multiple regression analyses (n = 107) controlling for SS gender, the EXCITE intervention group, and SS functional level were used for analysis. Results : Baseline CG depressive symptoms were negatively related to both SS mood ( r = -.24, p &lt; .01) and social activities ( r = -.26, p = .01) at 1 year. Better family communication was related to higher SS memory/thinking ( r = -.24, p = .01). CG age and physical function were not associated with any SS QOL domains. In the regression models, CGs with more depressive symptoms (β = -.28, p = .007) at baseline predicted poorer SS mood ( F = 2.56, p = .02; R 2 = .13) and worse social participation (β = -.27, p = .01; F = 1.61, p = .15; R 2 = .09). Although the overall model was not significant ( F = 1.20, p = .31; R 2 = .07), worse family communication (β = -.22; p = .04) predicted poorer SS memory and thinking at 1 year. No CG or family characteristics were associated with SS physical or communication QOL domains. Conclusions : Early recognition and intervention of CG depressive symptoms may have profound effects on both CG and aspects of SS QOL in the early and chronic stroke recovery periods. Family interventions focusing on improving communication early may also improve long term stroke recovery.