• stroke rehabilitation;
  • quality of life;
  • purpose in life;
  • health-related quality of life;
  • predictors;
  • determinants


Discovery of consistent determinants of post-stroke health-related quality of life (HRQOL) across different cultures is essential for the development of widely applicable therapeutic models for maximizing HRQOL in stroke patients. The objective of this study was to identify variables with consistent effect on post-stroke HRQOL across disparate cultures.

Patients and methods

Detailed socio-demographic and clinical data were obtained from successive stroke patients (≥1 month post-stroke) from Ibadan, Nigeria (n = 100) and Berlin, Germany (n = 103). Stroke severity was assessed using the National Institute of Health Stroke Scale and stroke levity score, while disability was graded with modified Rankin Scale. HRQOL was measured with the psychometrically robust holistic HRQOL in stroke patients (HRQOLISP) instrument. Variables with significant univariate or bivariate relationships to HRQOL were included in the multiple forward stepwise regression analysis at P = 0.05.


In disparate cultures, marital status (0.091 < P < 0.902) and stroke type (0.357 < P < 0.975) had no significant relationship to HRQOL. In regression models explaining up to 86% of the HRQOL variance in Ibadan and 70% of the HRQOL variance in Berlin; stroke severity, disability, emotional disorder, and sense of purpose in life were the key predictors of HRQOL after stroke (P < 0.0001 to P < 0.04).


Based on these consistent determinants, the stroke recovery cycle, a novel therapeutic model aimed at improving sense of purpose and meaning in life after stroke while promoting emotional and physical well-being, is proposed for further exploration.