Yobe State University Teaching Hospital, Damaturu, Yobe State, Nigeria.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Qual Life Res. 2021 Jan;30(1):1-19. doi: 10.1007/s11136-020-02591-6. Epub 2020 Jul 25.
Functional impairments and socioeconomic constraints associated with stroke affect quality of life (QoL). With limited care and social support resources, there is a greater anticipated decline in QoL among stroke survivors in Africa. This study aims to examine post-stroke QoL, properties of outcome measures adopted and predictors of the QoL among African stroke survivors.
African Journals Online, CINAHL, PsychINFO, PubMed and Web of Science databases were searched from inception to February 2020. Methodological quality was assessed using the Agency for Healthcare Research and Quality (ARHQ) methodology checklist for observational studies.
Twenty-eight studies recruiting 2572 (76.4%) stroke survivors and 795 (23.6%) healthy volunteers were included. Studies were conducted in eight African countries between 2007 and 2019. Methodological quality of studies was good. Overall, stroke survivors reported a low QoL. Six studies comparing QoL between stroke survivors and healthy controls were pooled for meta-analysis. Results showed a biased-adjusted standardised mean difference (Hedges's g) of 1.13 (95% CI 0.71 to 1.56; p < 0.001), indicating better QoL among healthy controls. Only 4 (14.3%) studies used translated or cross-culturally adapted QoL assessment tools. The most commonly reported predictor of QoL was post-stroke disability (35.8% of studies) which is followed by depression (28.6%) and stroke severity (28.6%).
Overall, African stroke survivors reported comparatively lower QoL as compared to age-matched healthy controls. This highlights the need for cross-culturally validated assessment tools and more robust post-stroke QoL evaluation across the African continent. To improve QoL of stroke survivors in Africa, early interventions should focus on reducing disability and depression associated with stroke. PROSPERO registration number: CRD42019137653.
与中风相关的功能障碍和社会经济限制会影响生活质量（QoL）。在资源有限的护理和社会支持下，非洲中风幸存者的 QoL 预计会有更大的下降。本研究旨在检查非洲中风幸存者的 post-stroke QoL、采用的结果测量的性质以及 QoL 的预测因素。
从开始到 2020 年 2 月，在 African Journals Online、CINAHL、PsychINFO、PubMed 和 Web of Science 数据库中进行了搜索。使用医疗保健研究与质量局（AHRQ）观察性研究方法检查表评估方法学质量。
纳入了 28 项研究，共纳入 2572 名（76.4%）中风幸存者和 795 名（23.6%）健康志愿者。这些研究于 2007 年至 2019 年在 8 个非洲国家进行。研究的方法学质量较好。总体而言，中风幸存者报告的生活质量较低。有 6 项比较中风幸存者和健康对照组之间生活质量的研究进行了荟萃分析。结果显示，调整偏倚后的标准化均数差（Hedges's g）为 1.13（95%CI 0.71 至 1.56；p<0.001），表明健康对照组的生活质量更好。只有 4 项（14.3%）研究使用了翻译或跨文化适应的生活质量评估工具。生活质量的最常见预测因素是 post-stroke 残疾（35.8%的研究），其次是抑郁（28.6%）和中风严重程度（28.6%）。
总体而言，与年龄匹配的健康对照组相比，非洲中风幸存者报告的生活质量相对较低。这突显了在整个非洲大陆需要使用跨文化验证的评估工具和更稳健的 post-stroke QoL 评估。为了提高非洲中风幸存者的生活质量，早期干预应侧重于减少与中风相关的残疾和抑郁。PROSPERO 注册号：CRD42019137653。
