Increasing levels of disability were associated with worse subjective well-being, with a greater decline in milder patients compared to those with higher disability.
What are the predictors of subjective well-being in stroke survivors with high versus low levels of disability?
The relationship between functional disability and subjective well-being varies across disability levels, with financial pressures, depression, and ethnicity (Mexican American) being significant predictors.
Absolute Event Rate: 0% vs 0%
Background: Stroke remains a leading cause for disability, though predictors of well-being at different levels of disability have not been well studied. We explored factors associated with subjective well-being among those with high versus low levels of disability. Methods: Participants had ischemic stroke or intracerebral hemorrhage and were able to self-report responses on a 90-day assessment as a part of the Brain Attack Surveillance in Corpus Christi study. The primary outcome was the Cantrill Ladder, a 0-10 self-report measure of subjective well-being. Functional disability was measured with the mean score from 22-items assessing activities of daily living/instrumental activities of daily living (ADL/IADL, range 1= no difficulty to 4= only with help). Factors associated with well-being were examined with linear regression models, adjusting for ADL/IADL and sequentially adding pre-specified covariates including demographics, clinical characteristics, socioeconomic factors, and depression. Models were stratified by lower (ADL/IADL =1.5) levels of disability based on visual inspection of the relationship between ADL/IADL and well-being. Inverse probability weighting was used to account for missing data. Results: The sample included 1121 patients (10/2019 to 12/2024), with characteristics shown in Table 1. Increasing levels of disability were associated with worse subjective well-being in all models, though there was a greater decline in well-being per unit change in disability scale among the milder patients (Table 2). Fully adjusted models are shown in Table 3. Among the lower disability group, other factors associated with well-being included income and depression symptoms. Among patients with higher disability, Mexican American participants reported almost a half-point greater subjective well-being score than non-Hispanic White patients after adjustment. Other factors associated with well-being in the higher disability group included delaying healthcare due to inability to pay, depression score, and social support. Conclusions: The relationship between functional disability and subjective well-being, as well as predictive factors, varies across disability levels. In addition to addressing financial pressures and depression, further studies of potential resilience factors among Mexican American stroke survivors are warranted to develop interventions to optimize well-being after stroke.
Mannion et al. (Thu,) reported a other. Increasing levels of disability were associated with worse subjective well-being, with a greater decline in milder patients compared to those with higher disability.