Title

Quality of life of stable stroke survivors evaluated at two tertiary care hospitals of Karachi, Pakistan

Date of Award

2014

Document Type

Thesis

Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)

Department

Community Health Sciences

Abstract

The social and physical consequences of stroke are highly devastating and have a profound influence on quality of life (QOL) of stroke survivor's. It is important to delineate the important associated factors which define the quality of life of stroke survivors which might be different from the West to inform local interventions. Aims: This study was aimed to find the impact of stroke on the quality of life of stroke survivors and to identify important associated factors that affect QOL of stroke survivors and their primary care giver. Methodology: A sequential mix methods approach was adopted. An analytical cross-section& study was conducted on 350 stroke survivors and their primary care givers visiting two tertiary carehospitals of Karachi. The participants underwent a detail assessment encompassing theirquality of life scores, socio-demographic, medical, post stroke complications, stroke severity, psychological and functional disability. Primary care givers were interviewedseparately via RAND-36. Focus group discussions and in-depth interviews were performed with primary care givers separately in order to uncover regionally relevant challenges not revealed viaquantitative study. Multiple linear regression teclmique was used for analysis. Means with standard deviation were calculated for continuous variables. For categorical variables, frequencies with percentages were reported. (3 coefficients with 95% C.I were reported for important associations. Results: Out of 350 participants 175 were recruited from each study site. The mean QOL score of the stroke participants was 164.18±32.30, which is better as compared to reported scores from other countries. Mean age was 57.14 ±13.34. Around 68 % participants were male and around 60% suffered from post-stroke depression. Around 34% of primary caregivers reported high levels of stress. QOL of primary care giver assessed by RAND-36 showed higher scores which indicate QOL on the better side. Further focus group discussions revealed that primary caregivers were deeply affected by their new role. Functional disability and depression were the most negative impacts on the quality of life of stroke survivors. Severity of stroke, hospital admissions, severe neurologic pain and dementia also decreased QOL as evident from multiple linear regression analysis. Conclusion: Stroke has severe effects not only on stroke survivors but also on their families. There is a need to develop home support systems for primary care givers to support them and toimprove lives as a whole.

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