Factors Associated with Physical and Psychosocial Problems among Indian Stroke Survivors

BACKGROUND: Rehabilitative services in India are inadequate in dealing with the physical and psychosocial problems faced by stroke survivors. The present study assessed these problems and the associated sociodemographic factors. METHODS: Discharged stroke patients were interviewed at home. Logistic regression analysis assessed associations between patient variables and their problems. RESULTS: We interviewed 127 stroke patients. Patients with modified Rankin Scale score higher than 3 were more likely to have complaints of pain (odds ratio [OR] = 2.21, 95% confidence interval [CI] = 1.03–4.33), sleeping difficulties (OR = 2.78, 95% CI = 1.34–5.78), and feelings of hopelessness (OR = 2.92, 95% CI = 1.23–6.93). Patients aged 60 years or above were more likely to have feelings of helplessness (OR = 3.64, 95% CI = 1.23–10.75) and hopelessness (OR = 3.28, 95% CI = 1.02–10.54). Male patients were more likely to have feelings of hopelessness (OR = 2.88, 95% CI = 1.06–7.80). Patients residing in rural areas had higher odds of having thoughts of death (OR = 17.18, 95% CI = 1.98–153.93). Married patients were more likely to face difficulty in asking for help (OR = 4.39, 95% CI = 1.19–16.15) and preferred home-based care (OR = 3.95, 95% CI = 1.11–14.05). Patients educated above 2(nd) grade were more likely to have feelings of hopelessness (OR = 6.31, 95% CI = 2.17–17.29) and anger (OR = 3.35, 95% CI = 1.39–8.07). Employed patients were more likely to have feelings of helplessness (OR = 1.13, 95% CI = 1.03–8.54). CONCLUSIONS: Sociodemographic variables of stroke patients can predict their physical and psychosocial problems, which can help the health-care professionals optimize rehabilitation strategies. There is an urgent need of expert rehabilitative and palliative services in India.