Factors associated with health related quality of life of patients with stroke in Sri Lankan context

BACKGROUND: Stroke is a major global health concern which affects the health related quality of life (HRQOL). As the prevalence of stroke is increasing especially in lower-middle income countries, it is vital to identify the factors associated with the HRQOL of affected individuals. Available literature for post stroke HRQOL and the associated factors are mainly from high income countries. Therefore, we conducted this study to identify the factors associated with HRQOL of stroke survivors using a stroke specific measure. METHODS: A longitudinal study was conducted with the participation of 257 stroke survivors. Participants were followed up after 3 months at the neurology and medical clinics in the Teaching Hospital, Karapitiya, Sri Lanka. Health related quality of life was assessed using the validated version of Stroke Aphasia Quality of Life (SAQOL)-39 generic scale. Pearson correlation, independent sample t-test, one-way ANOVA and regression analysis were used to identify the factors associated with quality of life. RESULTS: Mean age of the participants with stroke was 66.1 (SD 11.7) years. The mean overall HRQOL was 3.15 (SD 0.96) as measured by the SAQOL-39 g. The socio-demographic factors which had significant associations with HRQOL were; gender, level of education, marital status, occupation and monthly income (p < 0.05). The clinical factors which had significant associations with HRQOL were; level of dependence and disability, type of stroke, side of the lesion, type of aphasia, level of language impairment, receiving physiotherapy and speech therapy and follow up care (p < 0.05). The results of regression indicated six independent predictors [F (6,234) = 42.6, p < 0.05], with an R(2) of 0.52. The HRQOL was significantly predicted by the level of dependence (β = .43, p < .01), level of language impairment (β = .20, p < .01), age (β = −.23, p < .01), type of stroke (β = −.19, p < .01), side of the lesion (β = .17, p < .01) and the level of education (β = .12, p < .05). CONCLUSION: Severe degree of dependence, severe level of language impairment, older age, hemorrhagic stroke, and lesions in the left side were associated with lower HRQOL. Higher education level was associated with higher HRQOL scores.