Quality of life and associated factors among stroke survivors attending a Sri Lankan tertiary-care clinic: A cross-sectional study

Introduction: Stroke is a leading cause of disability worldwide, with a disproportionate burden in low- and middle-income countries. Health-related quality of life (HRQOL) has emerged as an important outcome for stroke survivors, reflecting both the clinical and social dimensions of recovery. However, data from Sri Lanka remain limited. This study aimed to assess quality of life and its associated factors among stroke survivors attending a tertiary care clinic. Methods: A descriptive cross-sectional study was conducted among 121 adults aged ≥40 years with confirmed stroke who attended outpatient clinics at the Colombo South Teaching Hospital in 2022. Data were collected using an interviewer-administered questionnaire and medical record review. Quality of life was assessed using the Stroke-Specific Quality of Life (SS-QOL) scale. Associations were evaluated using chi-square tests, and variables with p <0.20 were included in multivariable logistic and linear regression models.
Results: The mean age was 61.2±10 years, and 61.2% were male. The mean SS-QOL score was 168±28, with 64.5% demonstrating good quality of life. Post-stroke complications were common, with 79.3% reporting at least one complication. In multivariable analyses, employment, marital status, and adequate family and social support were independently associated with higher SS-QOL scores, while the presence of complications was associated with lower scores. Stroke subtype and time to hospital admission were not significantly associated with quality of life. The regression model explained approximately 32% of the variance in SS-QOL scores. The SS-QOL cut-off used to describe “good/poor” quality of life was study-defined and should be interpreted as exploratory.
Conclusion: Among stroke survivors in this cohort, quality of life was primarily associated with complication burden, employment, marital status, and perceived family and social support. The cross-sectional design, single-centre setting, and exclusion of patients with severe cognitive or communication impairment limit causal inference and generalisability.