Self-rated health over the first five years after stroke

Abstract

Background Self-rated health (SRH) focuses on the patient’s own perception, and represents an important patient-reported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH. Methods Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007–2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionnaire. SRH was assessed by the question about general health from SF-36. Factors associated with SRH were investigated by multiple logistic regression analysis. Results Response-rate was > 90% at all time points. Overall, 40.2, 41.9, 40.7, 45.0 and 46.3% of the patients reported good SRH, 1 to 5 years after stroke. Performance in activities of daily living (ADL) was strongly associated with good SRH; 49.8 and 14.7% after 1 year in independent and dependent survivors respectively, p < 0.001. In independent survivors 1 year after stroke, good SRH was positively associated with female sex (OR = 2.0; p = < 0,001), physical activity (OR = 2.14; p = < 0,001), car driving (OR = 2.25; p = < 0,001), and negatively associated with age (OR = 0.99; p = < 0,001), pain (OR = 0.49; p = < 0,001), depression (OR = 0.30; p = < 0,001), and self-perceived unmet care needs (OR = 0.39; p = < 0,001). In dependent survivors, depression (OR = 0.23; p = < 0,001) and age (OR = 0.96; p = < 0,05), were negatively associated with good SRH 1 year after stroke. Similar patterns were observed throughout the follow-up. Conclusion The proportion stroke survivors reporting their health as good is slightly increasing over time. After stroke, SRH is associated with pain, depression, ability to perform activities and self-perceived unmet care needs, indicating that efforts to support stroke survivors in the chronic phase after stroke should concentrate on targeting these factors.

Life satisfaction and its influencing factors of middle-aged and elderly stroke patients in China: a national cross-sectional survey

“…While pain is one of the most common sequelae of stroke,22 45 about 71% of the patients in this study had pain symptoms. We also found that patients who had a stroke had poor self-reported health status, low health satisfaction and decreased ability to work, which was consistent with other related studies 21 23. Our study found that the proportion of patients who had a stroke who smoked and drank were 23.8% and 26.9%, respectively, lower than that of the middle-aged and elderly Chinese population (using 2015 CHARLS samples, 45.7%, 46.2%) 46.…”

Orthotic Research Initiative for Outcomes aNalysis (ORION I): predictors of PROMIS PF for stroke survivors seeking orthotic intervention

“…The large proportion of respondents utilizing some form of assistance in the present study may explain why the initially hypothesized predictors of PF were not supported by the results. Predictors of selfreported health in the post-stroke population are different among those who are ADL-dependent versus ADL-independent [32]; therefore, previously established predictors of PF (e.g., age and pain) may be less important for individuals with severe PF impairment, as seen in the current study sample. Interestingly, PF T-scores were higher for individuals who had been dealing with foot and ankle problems for a longer period of time.…”

“…One potential explanation for the significantly lower scores in the present study is the condition under which an individual needs lower limb orthotic intervention post-stroke. Unmet care needs related to rehabilitation have been shown to influence selfreported health in the post-stroke population [32] and those seeking AFO intervention may cross a threshold of PF impairment that requires above-average treatment and resources to improve. Despite most of the respondents currently using an assistive device and receiving physical therapy, the severity of PF impairment was such that additional support from an AFO was required.…”

Individualized home-based rehabilitation after stroke in France: a pragmatic study of a community stroke rehabilitation team

“…8 A study measuring the perceived state of health over the 5 years following stroke in a cohort of 2190 patients identified unmet care needs as one of the main determining factors, with an odds ratio of 0.39 at 1 year, 0.49 at 3 years, and 0.32 at 5 years. 9 In order to avoid this disruption and ensure continuity of care, the rehabilitation program must continue at home, taking into account the contextual factors. 7 It is in this context that community stroke rehabilitation teams (CSRT) were created to facilitate the implementation of home-based rehabilitation programs.…”