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Ayasrah SM, Ahmad MM, Abuadas FH, Abu-Snieneh HM, Basheti IA. Health-Related Quality of Life Among Patients With Stroke: A Cross-Sectional Study. Arch Clin Neuropsychol 2024; 39:659-668. [PMID: 38364311 DOI: 10.1093/arclin/acae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE To assess levels and predictive factors of health-related quality of life (HRQOL) among stroke patients. METHODS The study employed a cross-sectional predictive correlational design. Levels of HRQOL were assessed using the Stroke-Specific Quality of Life (SS-QOL) scale, and the Hospital Anxiety and Depression Scale was employed to assess psychological aspects among 209 Saudi stroke patients. The analysis included demographic and medical variables to comprehensively explore influencing factors. RESULTS A two-step hierarchical multiple regression analysis was performed. The overall SS-QOL summary score (49 items) showed a mean score of 94.4 (SD = 8.1), indicating poor functioning. Nine predictor variables were found to significantly predict HRQOL levels, including age (β = -0.212, p ≤ .001), female (β = -5.33, p ≤ .001), unmarried (β = 2.48, p ≤ .001), low gross monthly income (GMI) (β = -9.02, p ≤ .001), medium GMI (β = -8.36, p ≤ .001), having a medical history of hypertension (β = 2.7, p ≤ .01), time since stroke (β = 3.26 p ≤ .001), and being a probable case of anxiety (β = -4.29, p ≤ .001) and/or depression (β = -2.75, p ≤ .001). These variables collectively explained ~76% of the variance in HRQOL scores (adjusted R2 = .762, F (16,192) = 42.6, p ≤ .001). CONCLUSIONS Stroke patients exhibited poor HRQOL levels influenced by various factors. Clinicians should consider these predictors and intervene early to enhance HRQOL among patients at risk, emphasizing the importance of optimizing patient outcomes.
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Affiliation(s)
- Shahnaz M Ayasrah
- Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt, Jordan
| | - Muayyad M Ahmad
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Fuad H Abuadas
- College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, Saudi Arabia
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Lu J, Yassin MM, Guo Y, Yang Y, Cao F, Fang J, Zaman A, Hassan H, Zeng X, Miao X, Yang H, Cao A, Huang G, Han T, Luo Y, Kang Y. Ischemic perfusion radiomics: assessing neurological impairment in acute ischemic stroke. Front Neurol 2024; 15:1441055. [PMID: 39081344 PMCID: PMC11286473 DOI: 10.3389/fneur.2024.1441055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/04/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Accurate neurological impairment assessment is crucial for the clinical treatment and prognosis of patients with acute ischemic stroke (AIS). However, the original perfusion parameters lack the deep information for characterizing neurological impairment, leading to difficulty in accurate assessment. Given the advantages of radiomics technology in feature representation, this technology should provide more information for characterizing neurological impairment. Therefore, with its rigorous methodology, this study offers practical implications for clinical diagnosis by exploring the role of ischemic perfusion radiomics features in assessing the degree of neurological impairment. Methods This study employs a meticulous methodology, starting with generating perfusion parameter maps through Dynamic Susceptibility Contrast-Perfusion Weighted Imaging (DSC-PWI) and determining ischemic regions based on these maps and a set threshold. Radiomics features are then extracted from the ischemic regions, and the t-test and least absolute shrinkage and selection operator (Lasso) algorithms are used to select the relevant features. Finally, the selected radiomics features and machine learning techniques are used to assess the degree of neurological impairment in AIS patients. Results The results show that the proposed method outperforms the original perfusion parameters, radiomics features of the infarct and hypoxic regions, and their combinations, achieving an accuracy of 0.926, sensitivity of 0.923, specificity of 0.929, PPV of 0.923, NPV of 0.929, and AUC of 0.923, respectively. Conclusion The proposed method effectively assesses the degree of neurological impairment in AIS patients, providing an objective auxiliary assessment tool for clinical diagnosis.
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Affiliation(s)
- Jiaxi Lu
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Mazen M. Yassin
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Yingwei Guo
- School of Electrical and Information Engineering, Northeast Petroleum University, Daqing, China
| | - Yingjian Yang
- Department of Radiological Research and Development, Shenzhen Lanmage Medical Technology Co., Ltd., Shenzhen, China
| | - Fengqiu Cao
- School of Information Science and Engineering, Shenyang Polytechnic University, Shenyang, China
| | - Jiajing Fang
- Shenzhen Academy of Metrology and Quality Inspection, Shenzhen, China
| | - Asim Zaman
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Haseeb Hassan
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Xueqiang Zeng
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Xiaoqiang Miao
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Huihui Yang
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Anbo Cao
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Guangtao Huang
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Taiyu Han
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Yu Luo
- Department of Radiology, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Yan Kang
- School of Applied Technology, Shenzhen University, Shenzhen, China
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Engineering Research Centre of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang, China
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Rahman MS, Adams J, Peng W, Sibbritt D. The impacts of a healthy lifestyle on the physical and mental health status of female stroke survivors in Australia. Top Stroke Rehabil 2024:1-12. [PMID: 39008430 DOI: 10.1080/10749357.2024.2377517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/29/2024] [Indexed: 07/17/2024]
Abstract
INTRODUCTION This longitudinal study aimed to explore the impacts of adopting a healthy lifestyle on self-reported physical and mental health outcomes among Australian females who are living with stroke. METHODS The study utilized data retrieved from the Australian Longitudinal Study on Women's Health's 1946-51 cohort (from survey 5 conducted in 2007 to survey 9 conducted in 2019), focusing on 531 female stroke survivors. The dependent variables for this study were self-reported physical and mental health status, whereas the independent variables were lifestyle behaviors, including physical activity, smoking, alcohol consumption, and supplement use. Generalized Estimating Equation models were employed to assess the longitudinal associations between a dependent variable and the independent and confounding variables. RESULTS The average age of the participants was 58.1 (SD = 1.4) years in survey 5 and 70.5 years in survey 9. The longitudinal analyses revealed that stroke survivors who engaged in moderate/high levels of physical activity had significantly better physical and mental health status than their inactive or sedentary counterparts. Besides, current smokers had significantly poorer physical and mental health status than nonsmokers. In addition, risky/high-risk alcohol consumers had significantly poorer mental health status compared to no/low-risk alcohol consumers. CONCLUSIONS Our findings suggest that post-stroke individuals can improve their physical and mental health by maintaining a healthy lifestyle. Specifically, targeted and appropriate programs and strategies are needed to promote physical activity and reduce smoking and alcohol consumption in female stroke survivors in order to optimize their overall health and quality of life.
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Affiliation(s)
- Md Sazedur Rahman
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Myers LC, Peltan ID, Thai KK, Kipnis P, Desai M, Devis Y, Clancy H, Lu YW, Brown SM, Go AS, Neugebauer RS, Liu VX, Walkey AJ. Predicting stroke risk after sepsis hospitalization with new-onset atrial fibrillation. J Hosp Med 2024; 19:565-571. [PMID: 38594918 DOI: 10.1002/jhm.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/20/2023] [Accepted: 03/17/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND New-onset atrial fibrillation (AF) during sepsis is common, but models designed to stratify stroke risk excluded patients with secondary AF. We assessed the predictive validity of CHA2DS2VASc scores among patients with new-onset AF during sepsis and developed a novel stroke prediction model incorporating presepsis and intrasepsis characteristics. METHODS We included patients ≥40 years old who survived hospitalizations with sepsis and new-onset AF across 21 Kaiser Permanente Northern California hospitals from January 1, 2011 to September 30, 2017. We calculated the area under the receiver operating curve (AUC) for CHA2DS2VASc scores to predict stroke or transient ischemic attack (TIA) within 1 year after a hospitalization with new-onset AF during sepsis using Fine-Gray models with death as competing risk. We similarly derived and validated a novel model using presepsis and intrasepsis characteristics associated with 1-year stroke/TIA risk. RESULTS Among 82,748 adults hospitalized with sepsis, 3992 with new-onset AF (median age: 80 years, median CHA2DS2VASc of 4) survived to discharge, among whom 70 (2.1%) experienced stroke or TIA outcome and 1393 (41.0%) died within 1 year of sepsis. The CHA2DS2VASc score was not predictive of stroke risk after sepsis (AUC: 0.50, 95% confidence interval [CI]: 0.48-0.52). A newly derived model among 2555 (64%) patients in the derivation set and 1437 (36%) in the validation set included 13 variables and produced an AUC of 0.61 (0.49-0.73) in derivation and 0.54 (0.43-0.65) in validation. CONCLUSION Current models do not accurately stratify risk of stroke following new-onset AF secondary to sepsis. New tools are required to guide anticoagulation decisions following new-onset AF in sepsis.
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Affiliation(s)
- Laura C Myers
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Ithan D Peltan
- Department of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USA
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Khanh K Thai
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Patricia Kipnis
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Manisha Desai
- Biomedical Informatics Department, Stanford University, Palo Alto, California, USA
| | - Ycar Devis
- Section of Pulmonary, Critical Care, Allergy, Sleep Medicine, Department of Medicine, The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Heather Clancy
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Yun W Lu
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Samuel M Brown
- Department of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USA
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Alan S Go
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
- Department of Epidemiology and Biostatistics and Department of Medicine, University of California, San Francisco, San Francisco, California, USA
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Romain S Neugebauer
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Vincent X Liu
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Allan J Walkey
- Section of Pulmonary, Critical Care, Allergy, Sleep Medicine, Department of Medicine, The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, USA
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Soleimani M, Ghazisaeedi M, Heydari S. The efficacy of virtual reality for upper limb rehabilitation in stroke patients: a systematic review and meta-analysis. BMC Med Inform Decis Mak 2024; 24:135. [PMID: 38790042 PMCID: PMC11127427 DOI: 10.1186/s12911-024-02534-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Stroke frequently gives rise to incapacitating motor impairments in the upper limb. Virtual reality (VR) rehabilitation has exhibited potential for augmenting upper extremity recovery; nonetheless, the optimal techniques for such interventions remain a topic of uncertainty. The present systematic review and meta-analysis were undertaken to comprehensively compare VR-based rehabilitation with conventional occupational therapy across a spectrum of immersion levels and outcome domains. METHODS A systematic search was conducted in PubMed, IEEE, Scopus, Web of Science, and PsycNET databases to identify randomized controlled trials about upper limb rehabilitation in stroke patients utilizing VR interventions. The search encompassed studies published in the English language up to March 2023. The identified studies were stratified into different categories based on the degree of immersion employed: non-immersive, semi-immersive, and fully-immersive settings. Subsequent meta-analyses were executed to assess the impact of VR interventions on various outcome measures. RESULTS Of the 11,834 studies screened, 55 studies with 2142 patients met the predefined inclusion criteria. VR conferred benefits over conventional therapy for upper limb motor function, functional independence, Quality of life, Spasticity, and dexterity. Fully immersive VR showed the greatest gains in gross motor function, while non-immersive approaches enhanced fine dexterity. Interventions exceeding six weeks elicited superior results, and initiating VR within six months post-stroke optimized outcomes. CONCLUSIONS This systematic review and meta-analysis demonstrates that adjunctive VR-based rehabilitation enhances upper limb motor recovery across multiple functional domains compared to conventional occupational therapy alone after stroke. Optimal paradigms likely integrate VR's immersive capacity with conventional techniques. TRIAL REGISTRATION This systematic review and meta-analysis retrospectively registered in the OSF registry under the identifier [ https://doi.org/10.17605/OSF.IO/YK2RJ ].
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Affiliation(s)
- Mohsen Soleimani
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroush Heydari
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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Bartsch BL, Hazen EM, Montgomery RN, Trieu C, Britton-Carpenter AJ, Billinger SA. Peripheral vascular function in stroke: systematic review and meta-analysis. J Appl Physiol (1985) 2024; 136:1182-1194. [PMID: 38482571 PMCID: PMC11368525 DOI: 10.1152/japplphysiol.00601.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 05/12/2024] Open
Abstract
Peripheral vascular dysfunction, measured as flow-mediated dilation (FMD), is present across all phases of stroke recovery and elevates the risk for recurrent cardiovascular events. The objective of this systematic review and meta-analysis was to characterize baseline FMD in individuals' poststroke, with consideration for each phase of stroke recovery. Three databases (PubMed, CINAHL, and Embase) were searched between January 1, 2000 and October 12, 2023 for studies that examined baseline FMD in stroke. Three reviewers conducted abstract and full-text screening, data extraction, and quality assessment. A random effects model was used to estimate FMD across studies. Meta-regression was used to examine the impact of age and time since stroke (acute, subacute, chronic) on FMD. Twenty-eight studies with ischemic and hemorrhagic stroke were included. Descriptive statistics for the demographics and FMD values of each study are presented. For the meta-analysis, average estimate FMD was 3.9% (95% CI: 2.5-5.3%). We report a large amount of heterogeneity (Cochrane's Q P value <0.001, and I2 = 99.6%). Differences in average age and the time poststroke between studies were not significantly associated with differences in FMD values. Despite the large heterogeneity for FMD values across studies, our primary finding suggests that FMD remains impaired across all phases of stroke.NEW & NOTEWORTHY This systematic review and meta-analysis offers invaluable insight into poststroke vascular function. Despite the inherent heterogeneity among the 28 studies analyzed, we report that peripheral vascular dysfunction, as quantified by flow-mediated dilation, exists across all stages of stroke recovery. This finding underscores the importance for interventions that focus on improving vascular health and secondary stroke prevention.
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Affiliation(s)
- Bria L Bartsch
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, United States
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Emily M Hazen
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Robert N Montgomery
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Calvin Trieu
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, United States
| | | | - Sandra A Billinger
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, United States
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Fairway, Kansas, United States
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas, United States
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, United States
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Cheon S, Li CY, Jeng JS, Wang JD, Ku LJE. Dynamic changes and lifetime effect of functional disability profiles for stroke patients: real-world evidence from South Korea. Qual Life Res 2024; 33:991-1001. [PMID: 38285281 DOI: 10.1007/s11136-023-03579-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE This work aimed to investigate the long-term dynamic changes of functional disabilities and estimate lifetime outcomes of different functional disabilities after a stroke, using real-world data from a nationally representative South Korean cohort. METHODS Patients aged 18 and above with ischemic and hemorrhagic strokes were identified from the Korea Health Panel (KHP) data (2008-2018). Functional disabilities were repeatedly measured for patients aged 55 and over for the prevalence of disabilities associated with activities of daily living (ADL), and kernel smoothing means were estimated for each item. The lifetime survival function of stroke patients in Korea was adopted from another study utilizing the National Health Insurance Service of Korea's national sample cohort. By multiplying the disability-free proportion with the survival function throughout life, disability-free life expectancy (DFLE) for each ADL item was estimated. The loss-of-DFLE was calculated by subtracting the DFLE from age-, sex-, and calendar year-matched referents simulated from Korean life tables. RESULTS The KHP dataset included 466 stroke patients. The overall functional disability needs increased over time after stroke diagnosis. DFLE was lowest for bathing (10.1 years for ischemic stroke and 12.8 years for hemorrhagic stroke), followed by those for dressing and washing. Loss-of-DFLE was highest for bathing for ischemic and hemorrhagic strokes (7.2 and 10.7 years, respectively), indicating that this task required the most assistance for stroke patients compared with the other tasks. DFLEs were slightly lower than the quality-adjusted life expectancy of stroke patients. CONCLUSION Our findings provide valuable insights for resource allocation and policy decisions in long-term stroke care, potentially enhancing the quality of life for stroke survivors and caregivers.
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Affiliation(s)
- Soyeon Cheon
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jiann-Shing Jeng
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 70101, Taiwan.
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Mensah Otabil E, Dai Q, Anzenberg P, Filippaios A, Ding E, Mehawej J, Mathew JE, Lessard D, Wang Z, Noorishirazi K, Hamel A, Paul T, DiMezza D, Han D, Mohagheghian F, Soni A, Lin H, Barton B, Saczynski J, Chon KH, Tran KV, McManus DD. Technology engagement is associated with higher perceived physical well-being in stroke patients prescribed smartwatches for atrial fibrillation detection. Front Digit Health 2023; 5:1243959. [PMID: 38125757 PMCID: PMC10731012 DOI: 10.3389/fdgth.2023.1243959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Background Increasing ownership of smartphones among Americans provides an opportunity to use these technologies to manage medical conditions. We examine the influence of baseline smartwatch ownership on changes in self-reported anxiety, patient engagement, and health-related quality of life when prescribed smartwatch for AF detection. Method We performed a post-hoc secondary analysis of the Pulsewatch study (NCT03761394), a clinical trial in which 120 participants were randomized to receive a smartwatch-smartphone app dyad and ECG patch monitor compared to an ECG patch monitor alone to establish the accuracy of the smartwatch-smartphone app dyad for detection of AF. At baseline, 14 days, and 44 days, participants completed the Generalized Anxiety Disorder-7 survey, the Health Survey SF-12, and the Consumer Health Activation Index. Mixed-effects linear regression models using repeated measures with anxiety, patient activation, physical and mental health status as outcomes were used to examine their association with smartwatch ownership at baseline. Results Ninety-six participants, primarily White with high income and tertiary education, were randomized to receive a study smartwatch-smartphone dyad. Twenty-four (25%) participants previously owned a smartwatch. Compared to those who did not previously own a smartwatch, smartwatch owners reported significant greater increase in their self-reported physical health (β = 5.07, P < 0.05), no differences in anxiety (β = 0.92, P = 0.33), mental health (β = -2.42, P = 0.16), or patient activation (β = 1.86, P = 0.54). Conclusions Participants who own a smartwatch at baseline reported a greater positive change in self-reported physical health, but not in anxiety, patient activation, or self-reported mental health over the study period.
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Affiliation(s)
- Edith Mensah Otabil
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Qiying Dai
- Division of Cardiovascular Medicine, Department of Medicine, Saint Vincent Hospital, Worcester, MA, United States
| | - Paula Anzenberg
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Andreas Filippaios
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Eric Ding
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jordy Mehawej
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Joanne E. Mathew
- Department of Internal Medicine, Central Michigan University, Mount Pleasant, MI, United States
| | - Darleen Lessard
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ziyue Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kamran Noorishirazi
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Alexander Hamel
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Tenes Paul
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Danielle DiMezza
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Dong Han
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, United States
| | - Fahimeh Mohagheghian
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, United States
| | - Apurv Soni
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Honghuang Lin
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jane Saczynski
- Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, United States
| | - Ki H. Chon
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, United States
| | - Khanh-Van Tran
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - David D. McManus
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Sakr F, Dabbous M, Akel M, Salameh P, Hosseini H. Cultural adaptation and validation of the Arabic version of the short 12-item stroke-specific quality of life scale. Front Neurol 2023; 14:1232602. [PMID: 37877033 PMCID: PMC10590920 DOI: 10.3389/fneur.2023.1232602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Background Given the excessive length and inconsistent validity of the existing long stroke-specific quality of life (SS-QOL) scales, there is a need to validate a shorter measuring tool. The aim of this study was to validate the Arabic version of the short 12-item SS-QOL (SS-QOL-12-AR) and examine its validity measures and psychometric properties. Additionally, the study aimed to assess the QOL after stroke and identify the sociodemographic and clinical factors that influence it in Lebanon. Methods A cross-sectional study was conducted. The SS-QOL-12-AR structure was validated, and its reliability and internal consistency were assessed. The scale's specificity and sensitivity were evaluated and then compared with those of other SS-QOL scales. The correlation between each item and the overall scale were examined, and its convergent validity was evaluated. Results A total of 172 stroke survivors were included. The SS-QOL-12-AR structure was validated with a solution of two factors, with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.850 and a significant Bartlett's test of sphericity (p < 0.001). The Cronbach's alpha of the scale was 0.917. According to ROC curve analysis, the optimal cut-off point for distinguishing between lower and better QOL was 32.50. At this cut-off, the sensitivity and specificity were 70.0% and 71.2%, respectively. The area under the curve was 0.779 (95% CI 0.704-0.855, p < 0.001). The SS-QOL-12-AR demonstrated a strong and highly significant correlation with existing versions of the SS-QOL, confirming its convergent validity. 61.6% of stroke survivors had a lower QOL, which was significantly associated with poor stroke prognosis, increased physical dependence, current smoking, and alcohol abstinence. Conclusion The SS-QOL-12-AR exhibits strong validity and reliability, demonstrating excellent psychometric properties. The scale holds potential for application in clinical practice and research settings, enabling the measurement of stroke-related consequences and evaluation of management outcomes.
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Affiliation(s)
- Fouad Sakr
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Créteil, France
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, Créteil, France
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- International Pharmaceutical Federation (FIP), The Hague, Netherlands
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Créteil, France
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, Créteil, France
- Stroke Unit, Service de Neurologie, CHU Henri Mondor, Créteil, France
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10
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Naknoi S, Li J, Ramasoota P, Liu X, Chen L, Phuanukoonnon S, Soonthornworasiri N, Kaewboonchoo O. Associations of effort-reward imbalance at work and quality of life among workers after stroke: a one-year longitudinal study in Thailand. BMC Public Health 2023; 23:1910. [PMID: 37789277 PMCID: PMC10548574 DOI: 10.1186/s12889-023-16784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
Stroke incidence is increasing among working-age population, but the role of psychosocial stress in the workplace in predicting quality of life (QoL) after stroke onset is understudied. This longitudinal study aimed to investigate the relationship between work stress, measured by the effort-reward imbalance (ERI) model, and QoL over one-year period among 103 Thai workers who had experienced a stroke. The study evaluated the effort (E)-reward (R) ratio and over-commitment, the extrinsic and intrinsic components of the ERI model, before discharge; QoL was repeatedly measured at baseline, six months, and 12 months after discharge, respectively, using the Short Form Version 2 (SF-12v2) indicators of physical and mental health composite scores. Generalized estimating equations were used to examine longitudinal relationships between work stress at baseline and QoL over one year by testing the hypotheses that E-R ratio and over-commitment would have direct effects on QoL, and potential moderating effects of over-commitment on E-R ratio and QoL. The results supported the ERI model partially, as over-commitment was significantly associated with poor mental health (coefficient - 8.50; 95% CI: -13.79, -3.20) after adjusting baseline sociodemographic, behavioral, and clinical characteristics, while the E-R ratio was not significantly associated with physical or mental health; the interaction between the E-R ratio and over-commitment was also not significant. These findings suggest that more attention should be paid to workers' personal coping skills and ability to handle work-related problems and prioritize interventions that address over-commitment to promote long-term mental health among workers with stroke.
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Affiliation(s)
- Siripan Naknoi
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
- Department of Public health Nursing, Faculty of Public health, Mahidol University, Bangkok, 10400, Thailand
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Pongrama Ramasoota
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Xinyue Liu
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Suparat Phuanukoonnon
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Ngamphol Soonthornworasiri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Orawan Kaewboonchoo
- Department of Public health Nursing, Faculty of Public health, Mahidol University, Bangkok, 10400, Thailand.
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11
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Milani G, Mantovani L, Baroni A, Lamberti N, Basaglia N, Lavezzi S, Manfredini F, Straudi S. Variations in Health-Related Quality of Life After Stroke: Insights From a Clinical Trial on Arm Rehabilitation With a Long-Term Follow-Up. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:27536351231214845. [PMID: 38034067 PMCID: PMC10687933 DOI: 10.1177/27536351231214845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 10/29/2023] [Indexed: 12/02/2023]
Abstract
Despite rehabilitation, stroke patients continue to have impaired function and reduced health-related quality of life (HRQoL) even in a chronic stage. However, no clear information is available on long-term variations in HRQoL. In this study, we aimed to report the short- and long-term changes in HRQoL in a subacute stroke sample that was enrolled in a clinical trial on arm rehabilitation. Thirty-nine stroke survivors (62% male, mean age 68 years) were assessed using the Stroke Impact Scale Version 2.0 (SIS 2.0) pre and post rehabilitation and at 6 months and 6 years follow-up. Long-term changes in physical function were explored through clinically meaningful changes in the Stroke Impact Scale-16 (SIS-16). After rehabilitation (P < .001), an overall improvement was found in all SIS domains except the memory and thinking, emotions, and communication domains. The baseline SIS-16 score (P < .001), the presence of a sensory deficit, and rehabilitation setting (P < .05) were factors related to the SIS-16 domain scores at the end of rehabilitation and at 6 months follow-up. Patients showed the most deterioration in the mobility (P < .001), strength (P < .003), and hand function (P < .05) domains 6 years after stroke. Stroke severity, male gender, and age ⩾65 years are related with a long-term HRQoL reduction after stroke.
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Affiliation(s)
- Giada Milani
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Iit@Unife Center for Translational Neurophysiology, Istituto Italiano Di Tecnologia, Ferrara, Italy
| | | | - Andrea Baroni
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Nino Basaglia
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Susanna Lavezzi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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