Burden of perceived stress among stroke survivors in Ghana: Insights from a multicentre, cross-sectional study

INTRODUCTION: Stroke incidence is rising rapidly in low- and middle-income countries, including Ghana. Stroke survivors face significant challenges in daily life, heightening their risk for stress. This study aims to examine the burden of perceived stress and its associated factors among stroke survivors in Ghana. METHODS: This cross-sectional study analysed baseline data from 486 recent stroke survivors enrolled within 1 month of stroke onset, across ten hospitals in Ghana. Perceived stress was measured using the 4-item Perceived Stress Scale (PSS-4). Associations between variables and perceived stress were analysed using Fisher's exact test, Wilcoxon rank sum, and Pearson's Chi-squared test. Binary logistic regression was performed to determine factors associated with perceived stress. RESULTS: 204 (42.0%) of study participants experienced high perceived stress. Stroke severity (measured by the NIH Stroke Scale) and depression were significantly associated with high perceived stress. For each unit increase in the NIH stroke score, the odds of high perceived stress increased by 14% (AOR = 1.14, 95% CI = 1.08, 1.20; p = 0.001). Survivors with moderate to severe depression were five times more likely to experience high perceived stress compared to those without depression (AOR = 4.75, 95% CI = 1.90, 13.1; p < 0.001). CONCLUSION: 4 out of 10 recent Ghanaian stroke survivors experience high psychological stress strongly associated with stroke severity and depression. These findings emphasise the need for integrating psychological support and stress management into comprehensive stroke care programs in Ghana and similar resource-limited settings.