Quality of Life and Loneliness in Stroke Survivors Living in Appalachia

Abstract

Background and Purpose Negative outcomes of stroke are associated with poorer quality of life (QoL) and impact stroke recovery. The purpose of this study was to characterize QoL and loneliness in a sample of rural Appalachian stroke survivors within 1 year of stroke. Methods Using mail survey methodology, survey data were collected from 121 ischemic and hemorrhagic stroke survivors living in West Virginia using 13 subscales from the Neuro-QOL survey and the three-item UCLA Loneliness Scale. Statistical Package for Social Sciences v. 20 was used to conduct descriptive, comparative, and predictive analyses. Multiple linear regression models were used to assess explanatory value of loneliness for QoL domains while controlling for comorbidities. Results: Participants who were discharged to a nursing home had poorer QoL when compared with those who were discharged to home. Stroke survivors who continued to smoke were less satisfied with social roles and reported higher mean loneliness and depression scores. History of psychological problems negatively correlated with all QoL domains and loneliness scores. Loneliness predicted poorer QoL even when controlling for age, gender, and significant comorbidities. Conclusion Nurses need to assess for loneliness, include loneliness in care planning, and implement smoking cessation and cognitive behavioral interventions. Interventions that target loneliness for stroke survivors could potentially diminish psychological sequelae after stroke and enhance QoL.

Rethinking Recovery

“…They are therefore subsequently unaddressed and lead to functional, psychological and emotional disturbances, especially in rural populations. 9 These deficits will continue unless a member of the interdisciplinary care team proactively addresses these issues and advocates for the holistic wellbeing of the patient and his or her caregiver.…”

The Development of LISTEN: A Novel Intervention for Loneliness

“…Plans include fully disseminating the results of the first trial and seeking funding for larger longitudinal trials of LISTEN in multiple populations. In addition, the study team has completed preliminary work on loneliness with stroke survivors [63], college students [4], children [64], and adults with multiple chronic conditions [65] [66]; building a foundation of knowledge for future studies of LISTEN. In order to understand the long-term benefit of diminishing loneliness and the potential impact this could have on the human health experience, future trials are needed.…”

“…Loneliness is linked to multiple chronic health conditions including: cardiovascular problems like hypertension [2] and stroke [3], metabolic problems such as obesity [4], metabolic syndrome [5], diabetes [6], and behavioral health problems like anxiety [7] and depression [8]. Recently, loneliness was identified to be an independent predictor of functional decline [9] and mortality [10] in older adults.…”

Loneliness in Treatment-Seeking Substance-Dependent Populations: Validation of the Social and Emotional Loneliness Scale for Adults–Short Version

“…Loneliness can be experienced as transient or chronic, and this experience can change over time (Perlman & Peplau, 1981). Loneliness has consistently been linked to poor physical health (Cacioppo et al, 2002;Christiansen, Larsen, & Lasgaard, 2016;Petitte et al, 2015;Stickley et al, 2013), poor mental health (Beutel et al, 2017), poor quality of life (Theeke et al, 2014), and increased morbidity and mortality (Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015). Loneliness has been likened to physical inactivity, obesity, and smoking as a leading health risk factor for mortality (Holt-Lunstad et al, 2015).…”

“…Stickley, Koyanagi, Koposov, Schwab-Stone, & Ruchkin, 2014), lower quality of life (e.g. Theeke et al, 2014), and poorer physical and mental health would be associated with higher levels of loneliness.…”