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Living in Latvia after stroke: the association between functional, social and personal factors and the level of self-perceived disability - a cross-sectional study

Journal article
Authors G. Berzina
B. Smilskalne
A. Vetra
Katharina S Sunnerhagen
Published in Bmj Open
Volume 6
Issue 6
Pages e010327
ISSN 2044-6055
Publication year 2016
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages e010327
Language en
Links dx.doi.org/10.1136/bmjopen-2015-010...
Keywords Outcome, Functional factors, Social factors, Personal factors, Perceived disability, quality-of-life, inpatient rehabilitation, participation poststroke, independence measure, systematic analysis, regional burden, ischemic-stroke, position paper, global burden, disease, General & Internal Medicine
Subject categories Clinical Medicine

Abstract

Objective To investigate how functional, social and personal factors are associated with self-perceived level of disability in the chronic phase of stroke in a Latvian stroke population. The consequences of stroke can vary greatly and often leads to long-term disability that, according to the WHO definitions, depends on the interaction between the person and his/her context. Setting Community-dwelling persons who received specialised in-patient rehabilitation after stroke in Latvia. Participants Of 600 persons after stroke who were identified through hospital register and selected for the study, 255 were included in the analysis. Primary and secondary outcome measures The medical information and discharge data of the Functional Independence Measure (FIM) was extracted from medical records. Participants filled out a questionnaire on sociodemographic information and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), either in Latvian or Russian, depending on their wish when contacted for their oral agreement to participate. Stepwise multiple regression analysis was conducted to find a model that best explains the variance in WHODAS 2.0 scores. Results The models explained 23-43.5% of variance in outcomes. The best explained WHODAS 2.0 domains were mobility' and self-care'. The significant factors were level of independence in self-care', locomotion' and communication' according to FIM, as well as working status, time since rehabilitation, age, gender, living alone or in family and preferred language. Conclusions Functional, social and personal factors are of similar importance when explaining self-perceived disability in the chronic phase of stroke. Some, but not all, of the factors are modifiable by the healthcare system. Therefore, a complex approach and involvement of medical, social and political systems is needed.

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