Factors Associated with Physical and Psychosocial Problems among Indian Stroke Survivors

Indian J Palliat Care. 2019 Jan-Mar;25(1):18-23. doi: 10.4103/IJPC.IJPC_106_18.

Abstract

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 2nd 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.

Keywords: Burden of disease; palliative care; rehabilitation; stroke.