Abstract
OBJECTIVE: To examine if personal factors, stroke severity, social determinants of health, and functional status are associated with health-related quality of life (HRQOL) in individuals poststroke who have completed their inpatient rehabilitation facility (IRF) stay and have returned home. We hypothesized that functional status would explain a significant portion of variability in HRQOL after accounting for covariates, including personal factors, stroke severity, and metrics of social determinants of health. DESIGN: This study was a secondary analysis of data from a prospective, longitudinal cohort study. SETTING: The IRF to the community. PARTICIPANTS: Individuals (N=72) poststroke (mean age ± SD, 64.1±14.4y, 58.3% men) who returned home after completing rehabilitation in an IRF. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The HRQOL in Stroke Patients-26 (HRQOLISP-26) was captured after individuals were discharged to the home setting. RESULTS: Functional status explained an additional 40% of the variance in HRQOLISP-26 after controlling for personal factors, stroke severity, and metrics of social determinants of health (R(2) =0.63, ΔR(2) =0.40, F=6.21, p<.001). The specific functional measures that were significantly associated with HRQOLISP-26 were basic mobility (β=0.38, p=.01), applied cognition (β=0.56, p<.001), and depression (β=-4.58, p=.03). CONCLUSIONS: We found that functional status, including mobility, cognition, and depression, is implicated in affecting HRQOL in individuals with subacute stroke who have completed their IRF stay and have returned home. Thus, underlying the importance of rehabilitation is the consideration of not only the progression of physical and cognitive function but also mood.