Exploring Unmet Needs in Working-Age Stroke Survivors

護理系 郭玟佑 2024-07-16 10:16:42

Background: Unmet needs are a common issue in stroke survivors. The prior studies supported that unmet needs negatively correlated with post-stroke recovery. In addition, most existing studies explore post-stroke unmet needs in older adults and apply cross-section study design. Thus, the phenomenon of unmet needs in the young  population and how these unmet needs change over time remain unknown.

Aim: Exploring the trajectory of unmet needs and predictive factors in working-age stroke survivors.

Design: Prospective longitudinal study.

Method: Seventy-six patients with stroke were recruited, measured three times, and followed for three months. The stroke survivors self-reported their unmet needs on the  Unmet Needs Questionnaire before discharge and 1,3 months after inclusion in the study. The questionnaire contained five domains. The numerical scale utilized for assessing unmet needs within this study was structured as follows: 0=denoted absence of need, 1= represented complete fulfillment of need, 2= indicated predominantly fulfilled needs, 3= signified infrequent fulfillment, and 4= specified complete absence of met needs. Any item scored 3 or 4 means they had unmet needs, and then the percentage of unmet needs was calculated in five domains. The higher percentage indicated a higher amount of unmet needs. Depressive symptoms were assessed with the Taiwanese Depression Scale (Lee et al., 2000). Physical functions were measured using the Barthel Index (Zhang et al., 2022).

Result: Overall, unmet needs decreased over time (=-3.54, 95% confidence interval [CI]=-5.44– -1.64,p=<0.001). Stroke-related information had the highest unmet compared to the other four domains. Participants with post-stroke depressive symptoms (=4.31, 95% confidence interval [CI]=1.28– 7.33,p=<0.01) and poor physical activity function(=-0.13, 95% confidence interval [CI]=-0.17– -0.1,p=<0.001) predict high unmet needs.

Conclusion: Unmet needs in working-age stroke survivors decrease over time, with the highest needs in stroke-related information. Post-stroke depressive symptoms and poor physical activity predict higher unmet needs. Addressing these areas is crucial for improving recovery and quality of life. Future research should develop targeted interventions to meet these needs.

Reference

Lee, Y. U., Yang, M. J., Lai, T. J., Chiu, N. M., & Chau, T. T. (2000). Development of the Taiwanese depression questionnaire. Chang Gung Medical Journal, 23(11), 688–694.

Zhang, C., Zhang, X., Zhang, H., Zeng, P., Yin, P., Li, Z., . . . & Yao, Y. (2022). Psychometric Communications properties of the Barthel Index for evaluating physical function among Chinese oldest‐old. JCSM Clinical Reports, 7(2), 33-43.