Factors influencing self-care ability among stroke patients after discharge: a regression analysis of 1576 cases

There are few reported studies on self-care ability among stroke patients. However, the recovery of self-care ability is crucial to patients’ rehabilitation and quality of life. Therefore, this study aims to assess the current status of self-care ability among stroke patients at discharge and explore the factors influencing it, with the aim of providing a scientific basis for improving rehabilitation outcomes and quality of life for stroke patients in clinical practice. A total of 1576 stroke patients hospitalized at the affiliated hospital of Youjiang Medical University for Nationalities, China, from January 1 to June 30, 2023 were consecutively recruited via the convenience sampling method. Patients were divided into two groups according to their Barthel Index (discharge) score: the self-care group (≥ 60 points, 1227 cases) and the basically unable to take care of themselves (< 60 points, 349 cases). General information and disease data questionnaires, the Barthel Index, the Johns Hopkins Fall Risk Assessment (JH-FRAT), the Kubota Water Swallow Test, and the Nutritional Risk Screening 2002 (NRS2002) were used to investigate and study these variables. Univariate analyses and multivariate logistic regression analyses were employed to identify factors influencing self-care ability at discharge. The study revealed that 349 stroke patients (22.1%) were moderately or severely dependent at discharge, requiring substantial assistance to perform daily living activities or being unable to complete most activities independently. Independent factors influencing self-care ability at discharge included the presence of lacunar infarction (p = 0.001, OR = 0.465, 95% CI = 0.295 ~ 0.734), a clear injury site (p < 0.001, OR = 0.010, 95% CI = 0.004 ~ 0.026), limb paralysis (p < 0.001, OR = 0.148, 95% CI = 0.064 ~ 0.334), the NRS2002 score (p < 0.001, OR = 2.688, 95% CI = 1.787 ~ 4.043), and self-care ability at admission (p < 0.001, OR = 134.640, 95% CI = 76.643 ~ 236.526). These findings highlight the need for personalized rehabilitation plans in clinical practice, incorporating early initiation of rehabilitation treatment to enhance functional recovery and improve the quality of life for stroke patients. Future research should focus on longitudinal studies and interventions targeting these factors to further optimize patient outcomes.