BACKGROUND: The relationship between social support and functional outcomes and health-related quality of life (HRQoL) after ischemic stroke (IS) remains unclear, especially in working-aged patients. AIM: To assess the relationship between perceived social support, functional outcomes, post-stroke psychosocial symptoms, and HRQoL in working-aged adults three months after IS. METHODS: A prospective and correlational design was used. Patients of working age (18-65 years) admitted for first-ever IS were enrolled in the prospective FRAILTY (Factors Affecting the Quality of Life After Ischemic Stroke in Young Adults) study (NCT04839887). HRQoL (using the Stroke Impact Scale, Quality of Life in Neurological Disorders), social support (using the Multidimensional Scale of Perceived Social Support), functional outcomes (using a modified Rankin Scale-mRS), and post-stroke psychosocial symptoms were assessed three months after IS. Descriptive statistics, Wilcoxon signed-rank test, Spearman's correlations and multiple linear regression were used for analysis. RESULTS: A total of 121 (54.5% males, mean age 51.7 ± 8.4 years) IS patients were analyzed. Of those, 87.7% had excellent clinical outcomes (mRS 0-1) after three months. Patients reported significant improvement in all domains of self-reported HRQoL except memory and communication after three months. The overall perceived social support was not associated with HRQoL domains. Post-stroke depression was negatively associated with all domains of HRQoL. Living arrangements (living alone) and post-stroke depression were negatively associated with perceived social support after IS. CONCLUSIONS: More insight into the relationship between variables of HRQoL in working-aged adults might increase their social participation, strengthen supportive relationships, and promote their recovery and rehabilitation process. Focusing on the management of emotional problems and supporting functional outcomes may be modifiable factors that may represent targets for strategies to improve the HRQoL. Further research is needed to clarify the relationship between pre-stroke perceived social support and its types and post-stroke psychosocial symptoms in the long term.

• Klíčová slova
• Functional outcomes, Health-related quality of life, Ischemic stroke, Social support, Working age,
• MeSH
• dospělí MeSH
• ischemická cévní mozková příhoda * psychologie   terapie   MeSH
• křehkost psychologie   MeSH
• kvalita života * psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prospektivní studie MeSH
• rehabilitace po cévní mozkové příhodě psychologie   MeSH
• senioři MeSH
• sociální opora * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Limited evidence of young adult patient-reported outcomes and experiences after ischaemic stroke has been conducted. AIM: To investigate the meaning of the lived experiences of stroke patients in working age 12-24 months after their first IS. MATERIAL AND METHODS: The exploratory qualitative study used an interpretative phenomenological analysis (IPA) design. Nine ischaemic stroke patients (with age ranges from 41 to 50 years) took part in semi-structured qualitative interviews. RESULTS: Even with mild residual neurological deficit, IS negatively impacted the quality of life daily and social life. Six subthemes and three interconnected group experiential themes were generated: (i) From confusion to understanding (ii) Triggers for rebuilding; and (iii) Challenges and benefits. CONCLUSION: The study highlights the current gaps and limitations in supporting the needs of stroke patients in working age in long-term post-stroke care. The findings are crucial for healthcare professionals to develop improved age- and mild- impairment-appropriate strategies or tailor self-management interventions for stroke patients of working age.ClinicalTrials.gov: NCT04839887.

• Klíčová slova
• Ischaemic stroke, interpretative phenomenological analysis, patient experience, working age, young adult,
• MeSH
• cévní mozková příhoda psychologie   komplikace   MeSH
• dospělí MeSH
• ischemická cévní mozková příhoda * psychologie   MeSH
• kvalita života * MeSH
• kvalitativní výzkum * MeSH
• lidé středního věku MeSH
• lidé MeSH
• rehabilitace po cévní mozkové příhodě * psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

OBJECTIVE: The article presents the results of a research study on a patient after an ischemic cerebral stroke, as presented in a case study. The aim of the research was to determine the impact of combined therapy, utilizing long-term and intensive special pedagogical care, occupational therapy and psychology, on the development of the patient's motor and communication abilities. The contribution deals with the possibilities of development and support for individuals in childhood after experiencing the illness, with the potential correction of identified deficits from a multidisciplinary perspective. CASE REPORT: The case study highlights a patient at the age of 7.2 years, following an ischemic cerebral stroke during the post-hospitalization period. Based on the analysis of medical documentation, we have developed a therapy proposal that reflects the individual needs of the patient from the perspective of special pedagogy, occupational therapy and psychology, taking into account the patients of school age. CONCLUSION: The results of the research study indicate that when working with a patient after an ischemic cerebral stroke, regular collaboration of a multidisciplinary team, along with effective integration of the various components of comprehensive rehabilitation, is necessary. Furthermore, this case study serves as a poignant example of the efficacy of such integrated therapy approaches in addressing the complex needs of pediatric stroke survivors. It not only highlights the potential for substantial functional recovery but also emphasizes the essential role of ongoing collaboration among diverse healthcare professionals.

• MeSH
• cévní mozková příhoda terapie   psychologie   MeSH
• dítě MeSH
• ergoterapie * metody   MeSH
• ischemická cévní mozková příhoda terapie   rehabilitace   psychologie   MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• rehabilitace po cévní mozkové příhodě * metody   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

After stroke rehabilitation, patients need to reintegrate back into their daily life, workplace and society. Reintegration involves complex processes depending on age, sex, stroke severity, cognitive, physical, as well as socioeconomic factors that impact long-term outcomes post-stroke. Moreover, post-stroke quality of life can be impacted by social risks of inadequate family, social, economic, housing and other supports needed by the patients. Social risks and barriers to successful reintegration are poorly understood yet critical for informing clinical or social interventions. Therefore, the aim of this work is to predict social risk at rehabilitation discharge using sociodemographic and clinical variables at rehabilitation admission and identify factors that contribute to this risk. A Gradient Boosting modelling methodology based on decision trees was applied to a Catalan 217-patient cohort of mostly young (mean age 52.7), male (66.4%), ischemic stroke survivors. The modelling task was to predict an individual's social risk upon discharge from rehabilitation based on 16 different demographic, diagnostic and social risk variables (family support, social support, economic status, cohabitation and home accessibility at admission). To correct for imbalance in patient sample numbers with high and low-risk levels (prediction target), five different datasets were prepared by varying the data subsampling methodology. For each of the five datasets a prediction model was trained and the analysis involves a comparison across these models. The training and validation results indicated that the models corrected for prediction target imbalance have similarly good performance (AUC 0.831-0.843) and validation (AUC 0.881 - 0.909). Furthermore, predictor variable importance ranked social support and economic status as the most important variables with the greatest contribution to social risk prediction, however, sex and age had a lesser, but still important, contribution. Due to the complex and multifactorial nature of social risk, factors in combination, including social support and economic status, drive social risk for individuals.

• Klíčová slova
• Machine learning, Prediction model, Rehabilitation, Reintegration, SHAP analysis, Social risk, Socioeconomic support, Stroke,
• MeSH
• dospělí MeSH
• ischemická cévní mozková příhoda * rehabilitace   psychologie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• rehabilitace po cévní mozkové příhodě * MeSH
• rizikové faktory MeSH
• senioři MeSH
• sociální opora MeSH
• socioekonomické faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH