Stroke disease‐specific quality of life trajectories after rehabilitation discharge and their sociodemographic and clinical associations: A longitudinal, multicentre study

Abstract

Aim To investigate the longitudinal growth trajectories of disease‐specific quality of life (QoL) dimensions and their associations over 1 year. Design A longitudinal design. Data were collected between February 2015‐May 2017. Methods Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope. Results We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12‐month follow‐up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left‐hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion. Conclusions This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables. Impact Stroke has a great impact on stroke survivors' QoL. Disease‐specific QoL significantly increases from the baseline to 12‐month follow‐up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.

Minimal Clinically Important Differences and Changes in Stroke Disease-Specific Quality of Life in Stroke Survivors: A Prospective Cohort Study

“…The social participation domain appears to have lower baseline values compared with the cognitive and emotion domains. This finding is consistent with previous studies (Carod-Artal et al, 2009; Chiu et al, 2021; Pucciarelli et al, 2021), although the stroke survivors investigated in those studies were undergoing rehabilitation a year or more post-stroke. Pucciarelli et al (2021) noted a significant linear increase in the SIS domains of stroke survivors discharged from rehabilitation hospitals.…”

“…This finding is consistent with previous studies (Carod-Artal et al, 2009; Chiu et al, 2021; Pucciarelli et al, 2021), although the stroke survivors investigated in those studies were undergoing rehabilitation a year or more post-stroke. Pucciarelli et al (2021) noted a significant linear increase in the SIS domains of stroke survivors discharged from rehabilitation hospitals. Our findings also indicated that, among the eight domains of QOL, the three domain of strength, hand function, and social participation had the lowest baseline scores.…”

“…In addition, there are many instruments that assess QOL, including the Stroke Impact Scale (SIS), which is widely used to evaluation stroke patients’ QOL (Pucciarelli et al, 2021). The SIS includes eight dimensions of quality (strength, activities of daily living (ADLs)/instrumental ADLs (IADLs), mobility, hand function, communication, memory and thinking, emotion, and social participation), and the multidimensionality of the SIS may allow health professionals to track patient progress in terms of physical, psychological, and social aspects of life in the rehabilitation setting (Richardson et al, 2016).…”

The Effectiveness of Personalized Nursing on Quality of Life in Cardiovascular Disease Patients: A Systematic Review and Meta‐analysis

“…In the whole process, the nurses will discuss to the patients with their profiles and assess their activity level according to the actual situation in order to raise awareness of self-monitoring, self-monitor, and self-efficacy for improving the patient's level of physical activity [ 19 ]. Regarding the emotion dimension, patients in the nursing stage are more aware of the condition and what will happen once relapsing after a period of treatment [ 20 ]. For these reasons, they may follow nurses' suggestions by enhancing confidence and optimistic emotion to improve prognosis [ 20 ].…”

“…Regarding the emotion dimension, patients in the nursing stage are more aware of the condition and what will happen once relapsing after a period of treatment [ 20 ]. For these reasons, they may follow nurses' suggestions by enhancing confidence and optimistic emotion to improve prognosis [ 20 ]. As we know, emotional management was important for CVDs, with a vital role for the nurse specialist in terms of counseling and reassurance by focusing on patient activating patients to perform self-management, recovering from depression, may positively influence to change their actions more autonomously [ 15 ].…”