Self-rated health over the first five years after stroke.
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ABSTRACT:
SUBMITTER: Bjalkefur K
PROVIDER: S-EPMC7585295 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Self-rated health over the first five years after stroke.
Bjälkefur Kerstin K Nasic Salmir S Bertholds Eric E Jood Katarina K Rejnö Åsa Å
BMC neurology 20201024 1
<h4>Background</h4>Self-rated health (SRH) focuses on the patient's own perception, and represents an important patient-reported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH.<h4>Methods</h4>Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007-2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionn ...[more]
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Project description:BackgroundSelf-rated health and the factors that influence it have never been described in Singapore before. This paper presents a descriptive study of self-rated health in a nationally representative cross-sectional survey of 6236 persons.MethodsAs part of the National Health Surveillance Survey 2001, 6236 subjects aged 18 years and above were interviewed in the homes of participants by trained interviewers. The subjects were asked "In general, how would you rate your health today?", and given 5 possible responses. These were then categorized as "Good" (very good and good) and "Poor" (moderate, bad and very bad) self-rated health. The association of socio-economic and health behaviour risk factors with good self-rated health was studied using univariate and multivariate logistic regression analysis.ResultsUnivariate analyses suggest that gender, ethnicity, marital status, education, household income, age, self-reported doctor-diagnosed illnesses, alcohol intake, exercise and BMI are all associated with poor self-rated health. In multivariate regression analyses, gender, ethnicity, household income, age, self-reported illness and current smoking and BMI were associated with poor self-rated health. There are gender differences in the association of various factors such as household income, smoking and BMI to self-rated health.ConclusionSocioeconomic factors and health behaviours are significantly associated with self-rated health, and gender differences are striking. We discuss why these factors may impact self-rated health and why gender differences may have been observed, propose directions for further research and comment on the public policy implications of our findings.
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Project description:To determine a) proportions of behavior related health risk factors among job-seekers and b) to what extend these are related to self-rated health.Over 12 months, job-seekers were recruited at three job-agencies in northeastern Germany. Among all individuals eligible for study inclusion, 7,906 (79.8%) provided information on smoking, risky drinking, overweight/obesity (body mass index), fruit and vegetable intake, physical inactivity, illicit drug use, and self-rated health. Proportions and 95% confidence intervals stratified by gender, age and duration of unemployment were calculated. Multivariate logistic regression analyses predicting self-rated health were conducted.The proportions of each health-risk factor were high, and 52.4% of the sample (53.4% male, 33.5 years mean age) had 3 or more health risk factors. Mostly, the proportions were particularly high among men and long-term unemployed individuals; e.g. 84.8% of the 18-24 year old long-term unemployed men were current smokers. Proportions of substance use related health risk factors were highest among the 18-24 year olds (e.g. risky drinking 28.7%), and proportions of health risk factors related to nutrition and physical inactivity were highest among the 40-64 year olds (e.g. overweight/obesity 65.4%). Depending on gender, all health risk factors and having 3 or more health risk factors were associated with lower self-rated health; odd ratios ranged between 1.2 for smoking (95% CI: 1.0-1.3) and 1.7 for overweight and physical inactivity (95% CI: 1.5-1.9).Prevention efforts to reduce health risk factors and to increase health among job-seekers are needed, and job agencies appear a feasible setting for their implementation.
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Project description:IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1-5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.
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