Influence of educational status and migration background on the long-term health-related quality of life after stroke
- PMID: 35836373
- DOI: 10.1111/ene.15503
Influence of educational status and migration background on the long-term health-related quality of life after stroke
Abstract
Background and purpose: Acute stroke treatment and secondary prevention have tremendously improved functional outcomes after stroke. However, this does not always imply a likewise improvement in health-related quality of life (HRQoL). Knowledge on factors influencing HRQoL after stroke is still scarce, especially regarding social aspects like the level of education and the presence of migration background.
Methods: In the present stroke cohort study, participants were interviewed during their hospital stay and completed a postal questionnaire at 3 and 12 months post stroke. Functional outcomes were assessed by the modified Rankin Scale and HRQoL by evaluating the detailed Stroke Impact Scale (SIS). Logistic regression models were used to determine associations between education, migration background and quality of life end-points.
Results: A total of 945 (mean age 69 years; 56% male) stroke patients were enrolled. After adjusting for confounders, a lower educational level was associated with worse functional outcomes in the SIS domain 'strength' (odds ratio 2.67, 95% confidence interval 1.6-4.4, p < 0.001). Migration background was associated with worse outcomes in the SIS domain 'emotion' (p = 0.007, odds ratio 1.71, 95% confidence interval 1.2-2.5). Additionally, for female patients worse HRQoL outcomes were found in multiple other SIS domains.
Conclusions: Migration background and a lower educational level were significantly associated with lower long-term HRQoL after stroke. These aspects should be considered in targeted rehabilitation programmes and follow-up support of stroke patients.
Keywords: education; health-related quality of life; migration background; patient-reported outcome measures; stroke.
© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
References
REFERENCES
-
- Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982-3021.
-
- Ali M, Fulton R, Quinn T, Brady M. How well do standard stroke outcome measures reflect quality of life? A retrospective analysis of clinical trial data. Stroke. 2013;44(11):3161-3165.
-
- Kainz A, Meisinger C, Linseisen J, et al. Changes of health-related quality of life within the 1st year after stroke-results from a prospective stroke cohort study. Front Neurol. 2021;12:715313.
-
- de Bruijn MA, Synhaeve NE, van Rijsbergen MW, et al. Quality of life after young ischemic stroke of mild severity is mainly influenced by psychological factors. J Stroke Cerebrovasc Dis. 2015;24(10):2183-2188.
-
- Rachpukdee S, Howteerakul N, Suwannapong N, Tang-Aroonsin S. Quality of life of stroke survivors: a 3-month follow-up study. J Stroke Cerebrovasc Dis. 2013;22(7):e70-e78.