Investigating the Quality of Life and Factors Affecting It in Stroke Patients in Iran: A Systematic Review and Meta-Analysis

Document Type : Review Article

Authors

1 Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Medical Library and Information Sciences, Health Information Technology Research Center, Student Research Committee, Faculty of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor of Health Services Management, Department of Health Services Management, School of Health Management and Information Science, Shiraz University of Medical Sciences, Shiraz, Iran

10.48305/jims.v43.i803.0184

Abstract

Background: Stroke is the second leading cause of death and a major cause of disability worldwide. Determining the quality of life of patients and its dimensions can help treatment staff, patients' caregivers, and patients themselves in choosing effective treatment methods to improve their health. The purpose of this study is to investigate the quality of life and its affecting factors in stroke patients in Iran using a systematic review and meta-analysis.
Methods: In this study, relevant articles on the quality of life in stroke patients in Iran were extracted from the domestic and international databases of Magiran, Medlib, SID ISI, PubMed, Scopus, without a time limit. After extraction and quality assessment using the STROBE checklist, article data were entered into comparative tables. Heterogeneity was assessed using the I² index and Cochrane’s Q-test. Analyses were performed using Comprehensive Meta-Analysis software.
Findings: After searching for articles based on inclusion and exclusion criteria, 19 articles were included in the final analysis. The findings of the present study showed that out of 19 studies, the highest mean total score for patients' quality of life was 191.26, and among the physical, social and mental health dimensions of stroke patients' quality of life, the highest mean score was related to the physical health dimension (87.5). Meta-analysis using a random-effects model showed the mean quality of life score for stroke patients in Iran was 90.4 (95% confidence interval).
Conclusion: Quality of life in stroke patients is positively correlated with rehabilitation interventions, increased income, social support, marriage, e-learning, Sertaline use, mental exercises and education. Negative correlations were observed with depression, fear of falling and hypertension. Therefore, while paying attention to the importance of these factors, education and continuous care for these patients are emphasized.

Highlights

Marziye Hadian: Google Scholar

Shima Bordbar: Google Scholar

Elaheh Mazaheri: Google Scholar

Abdosale Jafari: Google Scholar

Keywords

Main Subjects

References

  1. Katan M, Luft A. Global burden of stroke. Semin Neurol 2018; 38(2): 208-11.
  2. Gallehzan NA, Khosravi M, Jamebozorgi K, Mir N, Jalilian H, Soleimanpour S, et al. Cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing–remitting multiple sclerosis: a systematic review. Health Econ Rev 2024; 14(1): 12.
  3. Dianati M, Sirousinejad ZS, Sooki Z. Factors predicting quality of life in stroke patients: a cross-sectional study. Int Arch Health Sci 2021; 8: 290-5.
  4. Azadeh H, Fekri A, Amraie H, Roostaei M, Baharlouei H. The correlation between rates of falling, balance, quality of life and fear of falling in patients with chronic stroke. Archives of Rehabilitation 2018; 19(1): 36-43.
  5. Fattahi A, Azad A, Montazeri A. Quality of life among stroke patients in Kermanshah city [in Persian]. Journal of Modern Rehabilitation 2008; 2(1): 1-8.
  6. Timby BK, Smith NE. Introductory medical-surgical nursing. Phiadephia, PA: Lippincott Williams & Wilkins; 2013.
  7. Eisavi M, Mazaheri E, Rezapour A, Vahedi S, Hadian M, Jafari A. The cost-effectiveness and cost-utility of statin drug for the treatment of patients with cardiovascular disease: a systematic review. Int J Prev Med 2021; 12: 39.
  8. Ghandehari K. Epidemiology of stroke in Iran. Galen Med J 2016; 59(Suppl 1): 3-9.
  9. Hackett ML, Anderson CS, House AO. Management of depression after stroke: a systematic review of pharmacological therapies. Stroke 2005; 36(5): 1098-103.
  10. Stein F, Smith J. Short-term stress management programme with acutely depressed in-patients. Can J Occup Ther 1989; 56(4): 185-92.
  11. Larson J, Franzén‐Dahlin Å, Billing E, von Arbin M, Murray V, Wredling R. Predictors of quality of life among spouses of stroke patients during the first year after the stroke event. Scandinavian journal of caring sciences 2005, 19:439-445.
  12. Schlote A, Richter M, Frank B, Wallesch CW. A longitudinal study of health-related quality of life of first stroke survivors’ close relatives. Cerebrovasc Dis 2006; 22(2-3): 137-42.
  13. Tsai AC, Morton SC, Mangione CM, Keeler EB. A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care 2005; 11(8): 478-88.
  14. Juenger J, Schellberg D, Kraemer S, Haunstetter A, Zugck C, Herzog W, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002; 87(3): 235-241.
  15. Wu X, Min L, Cong L, Jia Y, Liu C, Zhao H, et al. Sex differences in health-related quality of life among adult stroke patients in Northeastern China. J Clin Neurosci 2014; 21(6): 957-61.
  16. Dijkers MP. Individualization in quality of life measurement: instruments and approaches. Arch Phys Med Rehabil 2003; 84(4 Suppl 2): S3-14.
  17. Jabbari A, Jafari A, Hadian M, Ghasemi M. Model-based cost-effectiveness analysis of atorvastatin drugs for prevention of cardiovascular diseases in Iran. Int J Prev Med 2020, 11: 57.
  18. Draper P. Nursing perspectives on quality of life. London, UK: Routledge; 2005.
  19. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. BMJ 2009; 339: b2700.
  20. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007; 18: 805-35.
  21. Haidich AB: Meta-analysis in medical research. Int J Surg 2014; 12(12): 1500-24.
  22. Babaeipour H, Sahebozamani M, Mohammadipour F, Vakilian AR. The effect of six weeks of aquatic training on the quality of life in patients with chronic ischemic stroke: a randomized clinical trial [in Persian]. J Rafsanjan Univ Med Sci 2018; 17: 699-714.
  23. Azimi R, Mohammadi F, Hosseini M, Farzi M. The effect of home-based rehabilitation on the quality of life of stroke patients and the caregiving pressure of their family caregivers [in Persian]. Evidence-Based Care 2012; 3(1): 77-85.
  24. Hadian M, Rezapour A, Mazaheri E, Asiabar AS. Barriers in the performance-based payment in Iran health system: Challenges and solutions. J Educ Health Promot 2021; 10: 106.
  25. Haghgoo HA, Pazuki ES, Hosseini AS, Rassafiani M. Depression, activities of daily living and quality of life in patients with stroke. J Neurol Sci 2013; 328(1-2): 87-91.
  26. Noorian K, Kazemian A, Yousef A. The effect of rehabilitation measures on the quality of life of stroke patients. Journal of Advances in Medical and Biomedical Research 2005; 13(50): 22-7.
  27. Ezzati J, Karimi Rahjardi H, Nik Rovan Mfard M, Alavi Majid H. Studying the quality of life of stroke patients referred to one of the intermediate hospitals to the Faculty of Medical Sciences of Qom province. Quality of life in stroke patients at a hospital affiliated to Qom University of Medical Sciences. Advances in Nursing & Midwifery 2008; 17(59): 33–7.
  28. Heydarzadeh, Garhamian, A, Hekhit, A, Yousefi E. Relationship between quality of life and social support in stroke patients [in Persian]. Iranian J Nurs 2009; 22(59): 23-32.
  29. Tarfi Amidpour K, Ghorbani AR, Zare K, Fayazi S. Evaluation of quality of life and mental health in stroke patients in Shariati Hospital, Tehran, in 2018-2018 [in Persian]. Jundishapur Journal of Chronic Disease Care 2020; 1(1): 9-16.
  30. Hoseinabadi MR, Taheri HR, Keavanloo F, Seyedahmadi M, Mohamadinia M, Pejhan A. The effects of physical therapy on exaggerated muscle tonicity, balance and quality of life on hemiparetic patients due to stroke. J Pak Med Assoc 2013; 63(6): 735-8.
  31. Amini N, Bagheri H, Abdolvahab M, Baghestani A R, Raji P, Jalili M, et al. Investigation of the effect of movement restriction on the quality of life, function and range of motion of the upper limbs of adult stroke patients [in Persian]. New Rehabilitation Quarterly 2012; 6(3): 1-4.
  32. Ghoreishi SMA, Shaafi Sh, Harizchi S, Perzeh R, Safi S, Rikhtegar Gheiasi R, et al. Investigation of the effect of sertraline on depression and quality of life in stroke patients [in Persian]. Studies in Medical Sciences 2014; 25(2): 97-104.
  33. Eghlidi Zh, Shafiei Z, Vatan Dost M, Rezaei M, Jamebozorgi AS, Tabatabai M. Investigating the effects of mental exercises on improving balance and quality of life of chronic stroke patients [in Persian]. Scientific-Research Quarterly Journal of Rehabilitation Medicine 2015; 4: 20-7.
  34. Atashi V, Sheikh Abumasoudi R, Moghimian M, Hashemi MS, Karimi T, Kashani F, et al. Studying the effect of e-learning on the quality of life of stroke patients [in Persian]. J Health Care 2017; 19(1): 30-8.
  35. Azadeh H, Fekri A, Amraie H, Roostaei M, Baharlouei H. Investigation of the relationship between the fear of falling and the number of times of falling, balance and quality of life in patients with chronic stroke [in Persian]. Rehabilitation Scientific Research Quarterly 2018; 19(1): 36-43.
  36. Salari Mehr S, Heydari M, Jalilian H, Imani A. Studying the quality of life of stroke patients in Razi Hospital, Tabriz [in Persian]. I Depiction of Health 2018; 9(1): 14-22.
  37. Babaeipour H, Sahebozamani M, Mohammadipour F, Vakilian A. The effect of six weeks of aquatic training on the quality of life in patients with chronic ischemic stroke: a randomized clinical trial [in Persian]. J Rafsanjan Univ Med Sci 2018; 17(8): 699-714.
  38. Salehi S, Tahan N, Bagheban AA, Monfared ME. Quality of Life Within Three Months After Stroke: A Study in the City of Arak, Iran. J Natl Med Assoc 2019; 111(5): 475-80.
  39. Masoudian N, Sarmadi M, Najafi R, Najafi F, Maleki S. Burden of Care and Quality of Life in Home Caregivers of Patients With Stroke in Iran. Home Health Care Management & Practice 2019; 31(5): 213-8.
  40. Jafari A, Mohammadpour M, Ghanbarzadegan A, Rossi-Fedele G, Bastani P. Oral health practitioners' knowledge, attitude, and awareness about coronavirus: A systematic review and meta-analysis. J Educ Health Promot 2021; 10: 39.
  41. Jahantabi-Nejad S, Khayatzadeh M, Rostami HR, Goharpey S. Comparison of the quality of life of people with stroke in Ahvaz city. Zahedan Med Sci Res 2013; 14(2): 86-90.
  42. Hadian M, Mozafari MR, Mazaheri E, Jabbari A. Challenges of the health system in preventing non-communicable diseases; systematized review. Int J Prev Med 2021; 12: 71.
  43. Jabbari A, Jafari A, Hadian M, Ghasemi M. Model-based Cost-effectiveness Analysis of Atorvastatin Drugs for Prevention of Cardiovascular Diseases in Iran. Int J Prev Med 2020; 11: 57.
  44. Jafari A, Mohammadpour M, Ghanbarzadegan A, Rossi-Fedele G, Bastani P. Oral health practitioners' knowledge, attitude, and awareness about coronavirus: A systematic review and meta-analysis. J Educ Health Promot 2021; 10: 39.
  45. Gorashizadeh M A, Shaafee S, Herizchi Ghadim S, Pirzeh R, Safikhanlou S, Rikhtegar Ghiasi R, et al. Investigation of the effect of sertraline on depression and quality of life in stroke patients [in Persian]. Urmia Med 2013; 25(2): 97-104.
Journal of Isfahan Medical School
Volume 43, Issue 806
2nd Week, May
May and June 2025
Pages 184-195

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History

  • Receive Date: 14 April 2024
  • Accept Date: 15 March 2025

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