title: Determinants of Quality of Life in Stroke Survivors After 6 Months, from a Comprehensive Stroke Unit: A Longitudinal Study.
abstract: BACKGROUND
  In the social model of stroke, health-related quality of life (HRQoL) is the result of interplay among stroke severity, social support, and health-promoting behaviors. Our objective was to identify determinants of HRQoL in stroke survivors.
  
  
  METHODS
  Ischemic stroke patients were evaluated at 6 months with the Short Form 12 Health Survey, including physical component survey (PCS) and mental health component survey (MCS) summary scores. Multivariate stepwise regression analyses determined independent predictors of scores. Models included age, gender, socioeconomic class, education, residential environment, social support, previous comorbidity (Charlson Index), previous stroke, side of stroke, National Institutes of Health Stroke Scale (NIHSS) score at admission, Barthel Index (BI) and modified Rankin Scale (mRS) scores at discharge, and length of stay.
  
  
  RESULTS
  A total of 131 patients participated (mean age 70.1, SD = 12.5; 62.6% males). In all, 33.6% had a BI score <90 and an mRS score >2 (poor outcome). The mean (SD) PCS score was 39.46 (9.3) and mean (SD) MCS score was 34.86 (10.1). Lower PCS score was associated with female sex (β = 0.204, p = .009), poor social support (β = -0.225, p = .003), and poor Charlson Index (β = -0.162, p = .032) and BI scores (β = 0.384, p < .0001). Lower MCS score was associated with female sex (β = 0.162, p = .062) and poor NIHSS (β = -0.265, p = .019) and BI scores (β = 0.203, p < .071).
  
  
  CONCLUSIONS
  Stroke severity, disability, gender, social support, and previous stroke have significant impacts on the physical and mental domains of generic HRQoL.
authors.affiliation: Psychologist and Research Nurse, Stroke Unit, Hospital San Pedro de Alcantara, Caceres, Spain fidel.lopez.es@gmail.com.
authors.forename: Fidel
authors.initials: F
authors.lastname: Lopez-Espuela
authors.affiliation: Department of Nursing, University of Extremadura, Caceres, Spain.
authors.forename: Juan Diego Pedrera
authors.initials: JD
authors.lastname: Zamorano
authors.affiliation: Department of Neurology, Hospital Infanta Cristina, Badajoz, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Ramírez-Moreno
authors.affiliation: Department of Neurology, Stroke Unit, Department of Neurology, Hospital San Pedro de Alcántara, Caceres, Spain.
authors.forename: Pedro Enrique
authors.initials: PE
authors.lastname: Jiménez-Caballero
authors.affiliation: Department of Neurology, Stroke Unit, Department of Neurology, Hospital San Pedro de Alcántara, Caceres, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Portilla-Cuenca
authors.affiliation: Department of Nursing, University of Extremadura, Caceres, Spain.
authors.forename: Jesús María
authors.initials: JM
authors.lastname: Lavado-García
authors.affiliation: Department of Neurology, Stroke Unit, Department of Neurology, Hospital San Pedro de Alcántara, Caceres, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Casado-Naranjo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D014481:United States
keywords: SF-12 Health Survey; disability; health-related quality of life (HRQoL); stroke outcome; stroke unit