背景:中风是美国第五大死亡和残疾原因。社会风险因素有助于中风的恢复,然而,社会风险因素与卒中幸存者的功能限制之间的关系仍然未知.
方法:分析了2016-2018年国家健康访谈调查中2,888名中风成年人的数据。主要自变量包括六个社会风险因素:经济不稳定,缺乏社区,教育赤字,粮食不安全,社会孤立,以及无法获得护理。结果测量是功能限制计数。运行负二项回归模型来测试对协变量进行调整的自变量和因变量之间的关系。
结果:总体而言,56%的研究参与者年龄在65岁以上,70%是非西班牙裔白人,95%有至少一种合并症。平均功能限制计数为1.8。在未调整的模型中,每个社会风险因素均与功能受限显著相关.在完全调整的模型中,在报告经济不稳定的个体中发现与功能受限显著相关(发生率比[IRR]1.65,95%CI1.33,2.06),粮食不安全(内部收益率1.28,95%CI1.15,1.42),和社会隔离(内部收益率1.64,95%CI1.48,1.82)。
结论:社会风险因素,如经济不稳定,食物不安全和社会隔离与卒中成年人的功能受限显著相关.旨在满足社会和医疗需求的干预措施有可能改善中风幸存者的身体功能和其他临床结果。
BACKGROUND: Stroke is the fifth leading cause of death and disability in the United States. Social risk factors contribute to recovery from stroke, however the relationship between social risk factors and functional limitation among stroke survivors remains unknown.
METHODS: Data on 2,888 adults with stroke from the National Health Interview Survey from 2016-2018 was analyzed. The primary independent variables included six social risk factors: economic instability, lack of community, educational deficit, food insecurity, social isolation, and inadequate access to care. The outcome measure was functional limitation count. Negative binomial regression models were run to test the relationship between the independent and dependent variables adjusting for covariates.
RESULTS: Overall, 56% of the study participants were aged 65+, 70% were Non-Hispanic White, and 95% had at least one comorbidity. The mean functional limitation count was 1.8. In the unadjusted model, each social risk factor was significantly associated with functional limitation. In the fully adjusted model, significant association with functional limitation was found in individuals reporting economic instability (Incidence rate ratio [IRR] 1.65, 95% CI 1.33, 2.06), food insecurity (IRR 1.28, 95% CI 1.15, 1.42), and social isolation (IRR 1.64, 95% CI 1.48, 1.82).
CONCLUSIONS: Social risk factors such as economic instability, food insecurity and social isolation are significantly associated with functional limitation in adults with stroke. Interventions designed to address both social and medical needs have the potential to improve physical functioning and other clinical outcomes in stroke survivors.