Self-rated health over the first five years after stroke
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RESEARCH ARTICLE
Open Access
Self-rated health over the first five years after stroke Kerstin Bjälkefur1, Salmir Nasic2, Eric Bertholds3, Katarina Jood4,5 and Åsa Rejnö6,7*
Abstract Background: Self-rated health (SRH) focuses on the patient’s own perception, and represents an important patientreported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH. Methods: Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007–2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionnaire. SRH was assessed by the question about general health from SF-36. Factors associated with SRH were investigated by multiple logistic regression analysis. Results: Response-rate was > 90% at all time points. Overall, 40.2, 41.9, 40.7, 45.0 and 46.3% of the patients reported good SRH, 1 to 5 years after stroke. Performance in activities of daily living (ADL) was strongly associated with good SRH; 49.8 and 14.7% after 1 year in independent and dependent survivors respectively, p < 0.001. In independent survivors 1 year after stroke, good SRH was positively associated with female sex (OR = 2.0; p = < 0,001), physical activity (OR = 2.14; p = < 0,001), car driving (OR = 2.25; p = < 0,001), and negatively associated with age (OR = 0.99; p = < 0,001), pain (OR = 0.49; p = < 0,001), depression (OR = 0.30; p = < 0,001), and self-perceived unmet care needs (OR = 0.39; p = < 0,001). In dependent survivors, depression (OR = 0.23; p = < 0,001) and age (OR = 0.96; p = < 0,05), were negatively associated with good SRH 1 year after stroke. Similar patterns were observed throughout the follow-up. Conclusion: The proportion stroke survivors reporting their health as good is slightly increasing over time. After stroke, SRH is associated with pain, depression, ability to perform activities and self-perceived unmet care needs, indicating that efforts to support stroke survivors in the chronic phase after stroke should concentrate on targeting these factors. Keywords: Longitudinal study, Patient reported outcome measures, Person centered care, Questionnaire, Self-rated health, Sweden
Background Onset of stroke is an incident often leading to a major change in life, due to its consequences. Patients often survive with residual impairments and may need support from health services and relatives in the aftermath. Health care and research in stroke has a long tradition of measuring and observing outcome using objective instruments measuring body functions and disability such * Correspondence: [email protected] 6 Department of Health Sciences, University West, 461 86 Trollhättan, Sweden 7 Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden Full list of author information is available at the end of the article
as the National Institute of Health stroke Scale (NIHSS) and the modified Ranking Scale (mRS). During the last decade research also try to capture the experie
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