Psychosocial factors associated with risk of fall in stroke patients

Abstract

Background: Stroke is a leading cause of disability globally, and its aftermath often includes a myriad of physical, psychological and social challenges. Sub-acute stroke patients are particularly vulnerable to falls due to their compromised mobility and balance.Objectives: The study aimed to explore the psychosocial factors associated with falls in Sub-acute stroke patients. Method: A cross-sectional study was conducted at the Neurology Unit (Outdoor) located at the Centre for the Rehabilitation of the Paralysed (CRP) in Savar, Dhaka. A total of 120 individuals diagnosed with sub-acute stroke were selected as the sample for the investigation. Depression, Anxiety and Stress (DASS-21) scale, self-structured questionnaire, and Berg balance scale (BBS) were used to explore psychological status, social status, and risk of falls respectively. The chi-square test was used to find the association and relationship between the variables. Results: Among the 120 participants, 90 individuals (66.2%) were male and females 30 individuals (22.1%). In this study 78 cases of ischemic strokes were recorded, making up 65.0% of the total, while 42 cases of hemorrhagic strokes were reported, accounting for 35.0%. among the participants, 78% of the participants answered "Yes" to a tendency to fall and 22% of the participants responded “No”. The psychological factors, depression, anxiety, and stress were significantly associated (p<.05) with risk of falls. “Problems during community participation” which is a part of social participation had a significant association (P=.004) with fall risk with a chi-square test value of 25.558. Conclusion: Participants with stroke face challenges, difficulties in balance, and a decline in function significantly. Some factors impact balance which tends to fall. Our study found that psychological factors are the important factor that may lead to falls. There is a great need to initiate proper supportive steps to focus on the psychological status during stroke rehabilitation. Keywords: Stroke, Depression, Anxiety, Stress, Psychosocial factors, Fall risk