Quality of life after first-ever stroke: An interviewbased study from Blantyre, Malawi|
Heikinheimo, T. & Chimbayo, D.
In post-stroke patients, impairment of quality of life (QOL) has been
associated with functional impairment, age, anxiety, depression, and
fatigue. Good social support, higher education, and better socioeconomic
status are associated with better QOL among stroke survivors. In Africa,
studies from Nigeria and Tanzania have reported on post-stroke QOL.
The aim of this study was to describe QOL more than six months after
first-ever stroke in Malawi.
This was an interview-based study about a stroke-surviving cohort. Adult
patients were interviewed six or twelve months after their first ever stroke.
HIV status, modified stroke severity scale (mNIHSS) score, and brain scan
results were recorded during the acute phase of stroke. At the time of the
interviews, the modified Rankin scale (mRS) was used to assess functional
outcome. The interviews applied the Newcastle Stroke-specific Quality of
Life Measure (NEWSQOL). All the data were analysed using Statview™:
the X2 test compared proportions, Student’s t-test compared means for
normally distributed data, and the Kruskal-Wallis test was used for nonparametric
Eighty-one patients were followed up at least six months after the acute
stroke. Twenty-five stroke patients (ten women) were interviewed with the
NEWSQOL questionnaire. Good functional outcome (lower mRS score)
was positively associated with better QOL in the domains of activities of
daily living (ADL)/self-care (p = 0.0024) and communication (p = 0.031).
Women scored worse in the fatigue (p = 0.0081) and cognition (p = 0.048)
domains. Older age was associated with worse QOL in the ADL (p =
0.0122) domain. Seven patients were HIV-seroreactive. HIV infection did
not affect post-stroke QOL.
In Malawi, within specific domains, QOL after stroke appeared to be
related to patients’ age, sex, and functional recovery in this small sample