Stroke survival and the impact of geographic proximity to family members: A population-based cohort study

Choi, HJ (通讯作者),POB 1130, N-0318 Oslo, Norway.
2022-9
Introduction: Familial support may be important for post-stroke survival. Objective: To determine if geographical proximity between stroke survivors and their family members, i.e having a spouse/partner or distance to a nearest first-degree relative (parents, siblings, and offspring), as a proxy for familial support, is related to survivor mortality. Methods: This study included all stroke survivors (n=128,227) hospitalised in Norway from 1994 to 2009, who were 30 years or older at the time of the stroke (born before 1965). National registries and censuses were used to calculate the distance to the nearest first-degree relative in the hospitalisation year. Cox proportional hazards models estimated hazard ratios (HRs) of all-cause mortality from 1994 to 2014 (mean 6.4 years follow-up), adjusting for sociodemographic and clinical covariates. Results: Living up to 30 km from the nearest first-degree relative was associated with a higher mortality (HR 1.04, 95% CI: 1.03 to 1.06) than those living in the same household or neighbourhood as their nearest first-degree relatives. The association was more pronounced (1.13, 1.08 to 1.19 for <= 30 km; 1.25, 1.16 to 1.35 for > 30 km) in survivors hospitalised at age <= 65 years, compared to older survivors. Among familial care predictors, having a spouse/partner was the most prominent predictor of reduced mortality (0.80, 0.78 to 0.82) in stroke survivors. Conclusion: Living close to first-degree relatives was weakly associated with better survival in stroke patients while having a spouse/partner exhibited a stronger association. Both associations were larger for survivors hospitalised at age <= 65 years. Our findings thus suggest that the impact of familial support on survival after stroke may differ by familial support condition and patient's age at a stroke hospitalisation.
SOCIAL SCIENCE & MEDICINE
卷号:309
ISSN:0277-9536|收录类别:SCIE
语种
英语
来源机构
University of Oslo; University of Oslo; University of Oslo; Norwegian University of Life Sciences; Norwegian Institute of Public Health (NIPH); University of Oslo; University of Bergen; Norwegian Institute of Public Health (NIPH)
资助机构
Dam Foundation
资助信息
This research project (2019/FO247984) has been made possible by Dam Foundation (https://dam.no/) . Dam Foundation had no role in the study design, collection, analysis and interpretation of data; in the writing of the report: and in the decision to submit the article for publication. The authors thank Tomislav Dimoski at the Norwegian Institute of Public Health, Oslo, Norway for his contribution by developing the software necessary for obtaining data from Norwegian hospitals, including conducting the data collection and quality assurance.
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
2
2013以来使用计数
2
EISSN
1873-5347
出版年
2022-9
DOI
10.1016/j.socscimed.2022.115252
关键词
Stroke Post-stroke survival Familial support Social support Informal care Family Distance Norway
WOS学科分类
Public, Environmental & Occupational Health Social Sciences, Biomedical
学科领域
循证公共卫生 循证社会科学-综合