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Quality of Life and Loneliness in Stroke Survivors Living in Appalachia

Theeke, Laurie; Horstman, Patricia; Mallow, Jennifer; Lucke-Wold, Noelle; Culp, Stacey; Domico, Jennifer; Barr, Taura

Journal of Neuroscience Nursing: December 2014 - Volume 46 - Issue 6 - p E3–E15
doi: 10.1097/JNN.0000000000000097

ABSTRACT Background and Purpose: Negative outcomes of stroke are associated with poorer quality of life (QoL) and impact stroke recovery. The purpose of this study was to characterize QoL and loneliness in a sample of rural Appalachian stroke survivors within 1 year of stroke. Methods: Using mail survey methodology, survey data were collected from 121 ischemic and hemorrhagic stroke survivors living in West Virginia using 13 subscales from the Neuro-QOL survey and the three-item UCLA Loneliness Scale. Statistical Package for Social Sciences v. 20 was used to conduct descriptive, comparative, and predictive analyses. Multiple linear regression models were used to assess explanatory value of loneliness for QoL domains while controlling for comorbidities. Results: Participants who were discharged to a nursing home had poorer QoL when compared with those who were discharged to home. Stroke survivors who continued to smoke were less satisfied with social roles and reported higher mean loneliness and depression scores. History of psychological problems negatively correlated with all QoL domains and loneliness scores. Loneliness predicted poorer QoL even when controlling for age, gender, and significant comorbidities. Conclusion: Nurses need to assess for loneliness, include loneliness in care planning, and implement smoking cessation and cognitive behavioral interventions. Interventions that target loneliness for stroke survivors could potentially diminish psychological sequelae after stroke and enhance QoL.

Questions or comments about this article may be directed to Laurie Theeke, PhD FNP-BC GCNS-BC, at She is an Associate Professor, West Virginia University (WVU) School of Nursing, Morgantown, WV.

Patricia Horstman, RN MSN NEA-BC, is Director, Clinical Program Development, WVU Healthcare, Morgantown, WV.

Jennifer Mallow, PhD FNP-BC, is Assistant Professor, WVU School of Nursing, Morgantown, WV.

Noelle Lucke-Wold, BSN RN, is Student, WVU School of Nursing, Morgantown, WV.

Stacey Culp, PhD, is Research Assistant Professor, WVU Healthcare, Morgantown, WV.

Jennifer Domico, RN CCRP, is Nurse Clinician, WVU Healthcare, Morgantown, WV.

Taura Barr, PhD RN, is Assistant Professor, WVU School of Nursing and Emergency Medicine, Morgantown, WV.

The authors declare no conflicts of interest.

© 2014 American Association of Neuroscience Nurses