Subjective well-being one year after stroke

Abstract

Objective: To compare the subjective well-being of stroke patients with that of a reference group, and to study its relationship to patient characteristics. Design: Cross-sectional study. Setting: Interviews performed in the respondents' homes, tests performed at the outpatient clinic. Subjects: Sixty patients one year after stroke (median age 74 years, interquartile range (IQR) 68-80), and 419 reference individuals (median age 75 years, IQR 71-80). Measures: Subjective well-being assessed with the General Health Questionnaire (GHQ-20). Explanatory variables were demographic and medical characteristics of the individuals and scores on validated tests: Barthel Index, Frenchay Activities Index (FAI), Sodring Motor Evaluation of Stroke Patients, Assessment of Cerebral Stroke and other Brain Damage, and Mini-Mental State Examination (MMSE). Results: A significantly higher proportion of the stroke patients than of the controls rated their subjective well-being as low, also after adjustment for age and gender (adjusted odds ratio 20.1, 95% confidence interval 9.6-42.0 by logistic regression). In bivariate analyses, leg and arm motor impairment, visuospatial impairment, apraxia, aphasia, low Barthel score, low FAI score, low MMSE score, and institutionalization were highly significant predictors of low subjective well-being (p-values <0.01). In multiple linear regression, a model with gender (p = 0.3) and upper extremity motor score (p <0.01 ) fitted the data well, and explained 48% of the variance in GHQ. Conclusion: Subjective well-being is decreased one year after stroke, and this is mainly attributed to arm motor impairments.