title: Consistent determinants of post-stroke health-related quality of life across diverse cultures: Berlin-Ibadan study.
abstract: OBJECTIVE
  Discovery of consistent determinants of post-stroke health-related quality of life (HRQOL) across different cultures is essential for the development of widely applicable therapeutic models for maximizing HRQOL in stroke patients. The objective of this study was to identify variables with consistent effect on post-stroke HRQOL across disparate cultures.
  
  
  METHODS
  Detailed socio-demographic and clinical data were obtained from successive stroke patients (≥1 month post-stroke) from Ibadan, Nigeria (n = 100) and Berlin, Germany (n = 103). Stroke severity was assessed using the National Institute of Health Stroke Scale and stroke levity score, while disability was graded with modified Rankin Scale. HRQOL was measured with the psychometrically robust holistic HRQOL in stroke patients (HRQOLISP) instrument. Variables with significant univariate or bivariate relationships to HRQOL were included in the multiple forward stepwise regression analysis at P = 0.05.
  
  
  RESULTS
  In disparate cultures, marital status (0.091 < P < 0.902) and stroke type (0.357 < P < 0.975) had no significant relationship to HRQOL. In regression models explaining up to 86% of the HRQOL variance in Ibadan and 70% of the HRQOL variance in Berlin; stroke severity, disability, emotional disorder, and sense of purpose in life were the key predictors of HRQOL after stroke (P < 0.0001 to P < 0.04).
  
  
  CONCLUSIONS
  Based on these consistent determinants, the stroke recovery cycle, a novel therapeutic model aimed at improving sense of purpose and meaning in life after stroke while promoting emotional and physical well-being, is proposed for further exploration.
authors.affiliation: Department of Medicine, University of Ibadan, Nigeria.
authors.forename: M O
authors.initials: MO
authors.lastname: Owolabi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003431:Cross-Cultural Comparison; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: determinants; health-related quality of life; predictors; purpose in life; quality of life; stroke rehabilitation