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[Purpose] The relationship between stroke patients' socio-economic conditions and quality of life (QOL) using the 2010 Korean Community Health Survey (KCHS) statistics was examined. [Subjects and Methods] A total of 4,604 stroke patients were analyzed. Socio-economic conditions were sex, age, educational level, monthly household income, occupation,...
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Objectives
This study aimed to determine regional differences and the factors that affect unmet medical needs.
Methods
Data from the 6th Korea National Health and Nutrition Examination Survey (2015) were used, and 4,946 health survey participants who provided responses on medical utilization and health behavior were included in the study.
Results...
Citations
... Whereas, lower QOL among stroke survivors who never consumed alcohol could potentially be linked to their lower socioeconomic status, which may limit their ability to afford regular alcohol consumption as part of their social habits. Notably, prior studies have established a significant correlation between stroke survivors with a lower socioeconomic status and a diminished QOL following a stroke (47,48). Additional research is also suggested in this context to gain better understanding of this association. ...
Background
Given the excessive length and inconsistent validity of the existing long stroke-specific quality of life (SS-QOL) scales, there is a need to validate a shorter measuring tool. The aim of this study was to validate the Arabic version of the short 12-item SS-QOL (SS-QOL-12-AR) and examine its validity measures and psychometric properties. Additionally, the study aimed to assess the QOL after stroke and identify the sociodemographic and clinical factors that influence it in Lebanon.
Methods
A cross-sectional study was conducted. The SS-QOL-12-AR structure was validated, and its reliability and internal consistency were assessed. The scale’s specificity and sensitivity were evaluated and then compared with those of other SS-QOL scales. The correlation between each item and the overall scale were examined, and its convergent validity was evaluated.
Results
A total of 172 stroke survivors were included. The SS-QOL-12-AR structure was validated with a solution of two factors, with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.850 and a significant Bartlett’s test of sphericity (p < 0.001). The Cronbach’s alpha of the scale was 0.917. According to ROC curve analysis, the optimal cut-off point for distinguishing between lower and better QOL was 32.50. At this cut-off, the sensitivity and specificity were 70.0% and 71.2%, respectively. The area under the curve was 0.779 (95% CI 0.704–0.855, p < 0.001). The SS-QOL-12-AR demonstrated a strong and highly significant correlation with existing versions of the SS-QOL, confirming its convergent validity. 61.6% of stroke survivors had a lower QOL, which was significantly associated with poor stroke prognosis, increased physical dependence, current smoking, and alcohol abstinence.
Conclusion
The SS-QOL-12-AR exhibits strong validity and reliability, demonstrating excellent psychometric properties. The scale holds potential for application in clinical practice and research settings, enabling the measurement of stroke-related consequences and evaluation of management outcomes.
... Marital status did not show a significant correlation with quality of life. Even though most participants were married or lived as married, our results are not consistent with previous studies, for example, Jun et al. (2015) and Haley et al. (2011) who found that the quality of life of married participants was higher than that of those who were single. The analyses used to test the sub-hypotheses H1.1, H1.2, H1.3 and H1.4, as well as the overall hypothesis H1 show that there is no significant correlation between the sociodemographic variables and the quality of life in elderly stroke patients, except in the sociodemographic characteristic of age, and in the domains of physical health (Domain 1) and psychological health (Domain 2) of the WHOQOL-BREF questionnaire. ...
Functionality in activities of daily living and social support are often used as indicators of quality of life, especially
in research involving gerontological and geriatric populations that assesses the functional independence of the patient and their
need to rely on help from others.
The effects of a stroke can significantly reduce the quality of life of the elderly. Therefore, the aim of this paper was to examine
the relationship between functionality and social support and the quality of life of elderly stroke patients.
This study included 50 stroke patients over the age of 65 years. All the participants lived at home in Zagreb. The participants’
quality of life was measured using The World Health Organization Quality of Life Brief Version (WHOQOL-BREF questionnaire),
which determines quality of life based on four domains (Physical, Psychological, Social relationships, and Environment).
Functionality was measured using the Functional Independence Measure, while social support was measured using the Social
Support Scale.
The correlation between functionality and quality of life was statistically significant with respect to physical health (r = 0.77,
p < 0.00), as well as psychological health (r = 0.53, p < 0.00). The correlation between social support and quality of life was
also significant with respect to social support from friends in the Social relationships domain (r = 0.40, p < 0.00) and in the
Environment domain (r = 0.45, p < 0.00), as well as in the overall social support in Social relationships (r = 0.29, p < 0.04) and
Environment domains (r = 0.35, p < 0.01).
A higher level of functionality indicates a higher quality of life in the Physical and Psychological domains, as well as in the
overall quality of life of elderly stroke patients. Strong social support from friends can encourage and help elderly stroke patients
to integrate into their social environment more successfully, thus potentially increasing their quality of life. The results of this
study imply that functionality and social support can be important factors in the quality of life in elderly stroke patients.
... Restoration of walking ability is one of the primary therapeutic goals of stroke rehabilitation [1,2]. Gait disturbance in patients with hemiparetic stroke reduces social participation and quality of life and increases socioeconomic burden and mortality [3]. Robot-assisted gait training (RAGT) has been highlighted as an efficient intervention after stroke that provides task-specific training similar to actual gait in the early stages of recovery [4,5]. ...
Objective:
To evaluate the feasibility and usability of cost-effective complex upper and lower limb robot-assisted gait training in patients with stroke using the GTR-A, a foot-plate based end-effector type robotic device.
Methods:
Patients with subacute stroke (n=9) were included in this study. The enrolled patients received 30-minute robot-assisted gait training thrice a week for 2 weeks (6 sessions). The hand grip strength, functional ambulation categories, modified Barthel index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go Test, and Short Physical Performance Battery were used as functional assessments. The heart rate was measured to evaluate cardiorespiratory fitness. A structured questionnaire was used to evaluate the usability of robot-assisted gait training. All the parameters were evaluated before and after the robot-assisted gait training program.
Results:
Eight patients completed robot-assisted gait training, and all parameters of functional assessment significantly improved between baseline and posttraining, except for hand grip strength and muscle strength test score. The mean scores for each domain of the questionnaire were as follows: safety, 4.40±0.35; effects, 4.23±0.31; efficiency, 4.22±0.77; and satisfaction, 4.41±0.25.
Conclusion:
Thus, the GTR-A is a feasible and safe robotic device for patients with gait impairment after stroke, resulting in improvement of ambulatory function and performance of activities of daily living with endurance training. Further research including various diseases and larger sample groups is necessary to verify the utility of this device.
... Survivors in this study who were 'not employed' (including 86% of whom were retired and 12% whose employment had changed following stroke) reported lower physical component quality of life scores than those who were 'employed' . A reduction in work activities [11] and reduced income [45] following stroke has been linked to poorer quality of life. As employment contributes to quality of life and satisfaction, these data reinforce the importance of identifying stroke patients of working age who may benefit from additional support to return to work [46]. ...
Background
Exploring sociodemographic and disease characteristics that contribute to patient-reported outcomes can inform targeting of strategies to support recovery and adaptation to stroke. This study aimed to examine among a sample of stroke survivors at three months post-hospital discharge: (1) self-reported physical and mental health quality of life scores; (2) self-reported depressive and anxiety symptoms; and (3) sociodemographic and clinical predictors of these outcomes.
Methods
This cross-sectional survey study recruited stroke survivors from eight hospitals in one Australian state. Adult survivors recently discharged from hospital stroke wards (within 3 months) were mailed a study information package and invited to complete a pen-and paper survey. Survey items assessed: quality of life (SF12v2), depression (PHQ-9), anxiety (GAD-7) and sociodemographic and clinical characteristics. Predictors were examined using multiple linear regression analysis.
Results
Of the 1161 eligible patients who were posted a recruitment pack, 401 (35%) returned a completed survey. Participants reported a mean SF-12v2 Physical Composite Score (PCS) quality of life score of 44.09 (SD = 9.57); and a mean SF-12v2 Mental Composite Score (MCS) quality of life score of 46.84 (SD = 10.0). Approximately one third of participants (34%; n = 132) were classified as depressed (PHQ-9 ≥ 10); and 27% (n = 104) were classified as anxious (GAD-7 ≥ 8). Lower PCS was associated with being female, not employed and having a comorbid diagnosis of diabetes and atrial fibrillation. Lower MCS was associated with a history of transient ischemic attack (TIA). Males and those with higher levels of education, had greater odds of having lower depression severity; those with a history of TIA or diabetes had lower odds of having lower depression severity. Males had greater odds of having lower anxiety severity; those with a history of TIA had lower odds of having lower anxiety severity.
Conclusion
Sub-groups of stroke survivors may be at-risk of poorer quality of life and psychological morbidity in the early post-discharge phase. These findings support the role of early identification and prioritisation of at-risk survivors at discharge, as they may require modifications to standard hospital discharge processes tailored to their level of risk.
... Literature findings highlighted that HRQoL after stroke is determined by age [9,10], time elapsed from stroke [11], depression [12], comorbidities [9], functional abilities [9,10], social support, caregiver characteristics [13][14][15], and socioeconomic status [16,17]. ...
... A proper evaluation of such complexity requires to account for the joint effect of several candidate predictors. However, studies addressing predictors of HRQoL after stroke often rely on models with few variables [9][10][11][12][13][14][15][16][17]. This is critical, also because potential predictors of patients' HRQoL might be interrelated (e.g. ...
Stroke causes a significant reduction in health-related quality of life (HRQoL), and studies addressing its predictors often rely on models with few variables. This study aimed to assess the degree to which health status, health habits, and features of the environment predict HRQoL in stroke survivors with stable clinical condition. WHO Quality of Life questionnaire for old-Age subjects (WHOQOL-AGE) was used to assess HRQoL. We ran a multivariable linear regression to predict WHOQOL-AGE variation, entering measures of health state, bad habits, healthy behaviors, physical environment features, and social support. Patients were stroke survivors with a stable clinical condition, distance from acute event of more than 6 months, and National Institutes of Health Stroke Scale (NIHSS) of 10 or less. A total of 122 participants (47 females, 97 with ischemic stroke) were enrolled, the mean age was 64.1, mean NIHSS 2.9, and mean distance from the acute event was 5.1 years. State anxiety (β = -0.202), trait anxiety (β = -0.232), depression (β = -0.255), social support (β = 0.247), and functional independence (β = -0.210) predicted WHOQOL-AGE variation (Adj. R2 = 0.549). Our results show that psychological symptoms, reduced social network, and functional dependence together have a negative impact on HRQoL. These elements, which are partly stroke-specific, should be taken into account in the recovery process to enhance patients' health outcomes.
... Aside from age, we found that sex has also been classified as a predominant factor of strokes, in which males are more likely to be diagnosed with a stroke compared with females, similar to a previous study. 19,20,22 This research found that a variety of support systems for stroke patients, including instrumental, emotional, information, and social interaction support, are inversely proportional to the level of depression. Instrumental support was the first significant support. ...
Background : Approximately one-third of stroke survivors experience depression at some point, which is linked to poor functional results and high mortality rate. Social support from family, friends, and the community is an intervening variable in stroke outcomes aside from the rehabilitation treatments that patients receive. This study assessed the importance of social support for stroke patients with depression and its relationship with patient rehabilitation.
Methods : This quantitative study used a cross-sectional approach on stroke patients and their families based on data from the Social Security Administrator for Health (BPJS Kesehatan). One hundred and four participants were recruited using purposive sampling by including stroke patients who have used National Health Insurance (JKN) for stroke medications.
Results: We found that instrumental, emotional, interactive, and information support contribute to lowering depressive symptoms. Instrumental support in the form of food availability, money, goods, and services had the highest coefficient value for reducing depression. Emotional support in the form of care and compassion had the second highest value in reducing depression. Further, interaction and informational support remain critical components of social support in reducing depression.
Conclusion : The support system plays a key role in decreasing the depression level in stroke survivors. The family and neighborhood have a significant impact on accelerating the rehabilitation process of stroke patients by providing support.
... We found a significant correlation between financial wellbeing and a better QOL. Although there is scarcity of data in the literature about the direct correlation between financial wellbeing and stroke outcomes, previous studies established a significant correlation between monthly income and QOL [38,39]. Those findings are supported by our results as we determined a significantly lower score of SS-QOL-17 among patients with lower monthly household income. ...
... The assessment of sociodemographic characteristics showed a significant correlation between QOL and age, level of education, and employment. Our results are consistent with other findings that determined a reduced QOL with older age, lower level of education, and unemployment [39][40][41]. Indeed, an older age is associated with higher stroke morbidity, disability, and polytherapy, all of which could impair the HRQOL [24]. ...
... Although this three-dimensional association was not established in stroke research, employed stroke survivors are generally determined to be in a better financial situation and therefore a better QOL [43]. Nonetheless, the correlation between employment and QOL might not be exclusively explained by the socioeconomic status, as it was suggested that returning to work after a stroke could accelerate recovery of the functional disability and improve QOL [39]. ...
(1) Background: The exiting stroke-specific quality of life (SS-QOL) measure scales are limited by their excessive length, inconsistent validity, and restricted breadths of assessment. The objectives of this study were to construct and validate a comprehensive short SS-QOL scale to assess stroke-related outcomes and QOL and determine the socioeconomic, sociodemographic, and pharmacotherapeutic predictors of QOL among stroke survivors. (2) Methods: The novel 17-item SS-QOL scale (SS-QOL-17) was constructed with the aim of providing a well-balanced measuring tool to depict QOL widely while ensuring the simplicity of administration. (3) Results: The SS-QOL-17 structure was validated over a solution of three factors with a Kaiser–Meyer–Olkin measure of sampling adequacy = 0.894 and a significant Bartlett’s test of sphericity (p < 0.001). The Cronbach’s alpha of the SS-QOL-17 was 0.903. Better QOL was correlated to financial wellbeing (beta 0.093, p < 0.001), and medication adherence (beta 0.305, p = 0.004), whereas reduced QOL was correlated to older age (beta −0.117, p = 0.014), illiteracy (beta −6.428, p < 0.001), unemployment (beta −6.170, p < 0.001), and higher amount of prescribed medication (beta −1.148, p < 0.001). (4) Conclusions: The SS-QOL-17 is a valid and reliable tool with promising psychometric properties. It is useful in clinical practice and research settings to evaluate the post-stroke therapeutic and rehabilitation outcomes.
... Economic status, considered an extrapersonal stressor, did not have a statistically significant effect on QoL. A study of 4604 people with stroke (Jun et al., 2015) reported that the QoL was significantly lower in the group with a monthly household income of 4 million won or less, compared to the group with 4.01 million won or more. The median monthly family income in this study was 1.9 million won, the IQR was between 1 and 3 million won, and more than 75% of the people with strokes had an income of less than 4 million won. ...
... Additionally, in this study, QoL reflecting the physical and somatic characteristics specific to stroke was measured, whereas Jun et al. (2015) measured the QoL of people with stroke using the EuroQoL-5D, which evaluates general health-related QoL. Therefore, further studies are necessary to determine the relationship between economic status and QoL in people with stroke. ...
This study explored the impact of intrapersonal (stroke severity, physical dysfunction, and fear of stroke recurrence), interpersonal (loneliness), and extra‐personal (economic status) stressors on the quality of life of people with stroke. A correlational cross‐sectional research design was employed. This study was based on Betty Neuman's systems theory. 139 people with stroke were recruited from ten hospitals in South Korea. Data were collected from January to February 2020 using a structured questionnaire. Data were analyzed using descriptive statistics, independent t‐test, one‐way analysis of variance, Scheffé test, Pearson's correlation coefficients, Spearman's correlation coefficients, and hierarchical multiple regression analysis. Stroke severity had the strongest association with quality of life among people with stroke, followed by loneliness and fear of stroke recurrence. These variables accounted for approximately 77% of the variance in the quality of life. Stroke severity, loneliness, and fear of stroke recurrence should be systematically monitored to enhance the quality of life in people with stroke. Additionally, a detailed intervention that considers all these stressors must be developed, and its effectiveness must be verified through further research. This article is protected by copyright. All rights reserved.
... The sub-items of the SS-QOL include mobility, language, vision, thinking, upper extremity function, self-care, energy, social role, personality, work/productivity, and mood. In patients with stroke, there are various factors affecting quality of life, such as physical, psychological, social, and environmental aspects, especially social and physical domains that affect the period of rehabilitation [77,78]. Therefore, the motivation of patients with stroke in this study was evaluated by determining their participation and achievement through the score differences in SS-QOL. ...
This study aimed to investigate the effects of lower limbs muscles’ strength, balance, walking, and quality of life through sit-to-stand training combined with real-time visual feedback (RVF-STS group) in patients with stroke and to compare the effects of classic sit-to-stand training (C-STS group). Thirty patients with stroke were randomly divided into two groups. The RVF-STS group received sit-to-stand training combined with real-time visual feedback using a Wii Balance Board (n = 15), and the C-STS group received classic sit-to-stand training (n = 15). All participants received training for 20 min once a day, 5 days a week for 6 weeks, and both groups underwent general physical therapy for 30 min before training. Before and after the training, the muscle strength of the hip flexor, abductor, and knee extensor were measured, and the Wii Balance Board was used to perform the center of pressure test and Berg Balance Scale to evaluate static and dynamic balance. Additionally, the 10 m walking test and the Timed Up and Go test were performed to evaluate gait function. The Stroke-Specific Quality of Life was used to measure the quality of life. The results showed that the lower extremity muscle strength, balance ability, walking ability, and quality of life of the RVF-STS group significantly improved in comparison of the pre- and post-differences (p < 0.05), and it also showed significant differences between groups (p < 0.05). This study showed that sit-to-stand training combined with real-time visual feedback was effective at improving the muscle strength of the lower extremities, balance, gait, and quality of life in patients with stroke. Therefore, repeating sit-to-stand training combined with real-time visual feedback could be used as an effective treatment method for patients with stroke.
... Similar to many strategies for chronic non-communicable diseases such as diabetes and obesity, a community-based program was reported to be an effective approach for hypertension screening and management [14] because, in South Korea, these programs increasingly involve home nursing and community-based surveys programs [15]. The Korean Community Health Survey (KCHS) also adopted a visit interview in 2008 [16], and BP measurement by a nurse or a visiting interviewer was planned to be adopted for the KCHS in 2021. ...
Purpose
A community program is an efficient model for improving the management of chronic diseases such as hypertension, diabetes, and dyslipidemia. A specific blood pressure (BP) measurement protocol was developed for community settings in which BP was measured by the interviewer at the interviewee’s home.
Materials and methods
In the 2018 Korean Community Health Survey, BP was measured twice at a five-minute interval after a five-minute resting period at the beginning of the survey. In 2019, BP was measured at the end of the survey after a two-minute rest and was obtained as three measurements at one-minute intervals. As factors related to BP level, stressful stimuli within 30 min before BP measurement such as smoking, caffeine, and/or exercise; duration of rest; and survey year were analysed.
Results
The mean age of participants was 55.2 years, and females accounted for 55.4% of the participants (n = 399,838). Stressful stimuli were observed in 21.9% of the participants in 2018 (n = 188,440) and 11.3% in 2019 (n = 211,398). Duration of rest was 0 min (2.1%), two minutes (55.0%), and five minutes (47.9%). When adjusted for age, sex, body mass index, antihypertensive medication, the arm of measurement, survey year (beta= −4.092), stressful stimuli (beta = 0.834), and resting time (beta = −1.296 per one minute of rest) were significant factors for mean systolic BP. A two-minute rest was not a significant factor in mean BP. The differences in adjusted mean systolic BPs were significant for rest times of five minutes vs. two minutes (3.1 mmHg, p < 0.0001), for stressful stimuli (0.8 mmHg, p < 0.0001), and for survey year (127.8 ± 0.2 mmHg vs. 122.2 ± 0.3 mmHg for 2018 vs. 2019, p < 0.0001).
Conclusion
For the community-based home visit survey, avoidance of stressful stimuli, five-minute rest, and allocation of BP measurement in the last part of the survey was useful for obtaining a stable BP level.
