Investigating predictors of community integration in individuals after stroke in a residential setting: A longitutinal study

• Published in: PloS one Vol. 15; no. 5; p. e0233015
• Main Authors: Matos, Isabela, Fernandes, Adriana, Maso, Iara, Oliveira-Filho, Jamary, de Jesus, Pedro Antônio, Fraga-Maia, Helena, Pinto, Elen Beatriz
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.05.2020; Public Library of Science (PLoS)
• Subjects: Aphasia; Biology and Life Sciences; Care and treatment; Data analysis; Demographic aspects; Diabetes; Diabetes mellitus; Diagnostic imaging; Family; Family income; Hospital admission and discharge; Hospitals; Integration; Ischemia; Lifestyles; Medical imaging; Medicine; Medicine and Health Sciences; Neuroimaging; People and places; Physical Sciences; Prognosis; Public health; Questionnaires; Regression analysis; Regression models; Rehabilitation; Research and Analysis Methods; Researchers; Robustness (mathematics); Schedules; Setting (Literature); Social aspects; Social Sciences; Sociodemographics; Stroke; Stroke patients; Studies; Time; Variables; Wages and salaries; Walkways; Workers; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0233015

To identify potential predictors of community integration in individuals after stroke using a residential setting-based strategy. A prospective cohort of post-stroke individuals was recruited from the Stroke Unit of the Roberto Santos General Hospital (UAVC-HGRS). All included individuals were aged over 18 years, received a diagnosis of ischemic stroke confirmed by neuroimaging and resided in the city of Salvador (Bahia, Brazil). Following discharge from the stroke unit, the individuals themselves, or their responsible parties, were contacted by telephone to schedule a home visit no less than three months after discharge. All subjects were examined in their homes, at which time the Community Integration Questionnaire (CIQ) was also applied. A robust linear regression model was used to assess community reintegration using CIQ score as the outcome variable. A total of 124 individuals effectively fulfilled the eligibility criteria: 51.6% were females, the median (IQR) age was 63(53-69) years, 82.3% were non-white, 53.2% were married, the median (IQR) of years of schooling was 6 (4-12) and family income averaged two minimum monthly wages. Investigated individuals presented a median (IQR) NIH Stroke Scale (NIHSS) score of 7 (4-12). Multivariate linear regression identified the following independent predictors of community integration: age (β = -0.095; 95% CI = -0.165 to -0.025; p = 0.008), diabetes mellitus (β = -2.348; 95% CI = -4.125 to -0.571; p = 0.010), smoking habit (β = -2.951; 95% CI = -5.081 to -0.821; p = 0.007), functional capacity upon hospital discharge (β = 0.168; 95% CI = 0.093 to 0.242; p = <0.001) and stroke severity (β = -0.163; CI = -0.318 to -0.009); p = 0.038). Regardless of length of time since stroke, individuals present restrictions that compromise their reintegration into their respective communities. The demographic, clinical and functional factors identified herein as potential predictors should be considered when conducting regular follow-up, as well as in the rehabilitation of individuals after stroke with the purpose to identify the interventions necessary to optimize their reintegration into the community.