title: Living in Latvia after stroke: the association between functional, social and personal factors and the level of self-perceived disability-a cross-sectional study.
abstract: 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.
  
  
  
  Cross-sectional study with retrospective data gathering.
  
  
  
  Community-dwelling persons who received specialised in-patient rehabilitation after stroke in Latvia.
  
  
  
  Of 600 persons after stroke who were identified through hospital register and selected for the study, 255 were included in the analysis.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia.
authors.forename: Guna
authors.initials: G
authors.lastname: Bērziņa
authors.affiliation: Department of Secondary Outpatient Care, Psycho-neurological Hospital for Children "Ainaži", Ainaži, Latvia.
authors.forename: Baiba
authors.initials: B
authors.lastname: Smilškalne
authors.affiliation: Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia.
authors.forename: Anita
authors.initials: A
authors.lastname: Vētra
authors.affiliation: Section for Clinical Neuroscience and Rehabilitation, University of Gothenburg, the Sahlgrenska Academy, Gothenburg, Sweden Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Sunnerhagen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007844:Latvia; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012648:Self Care; D012649:Self Concept; D012959:Socioeconomic Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
keywords: Functional factors; Outcome; Perceived disability; Personal factors; Social factors