Rural–urban disparities in stroke outcomes: unveiling quality of life, self-efficacy, and healthcare utilization patterns of stroke patients in Türkiye

Early Abstract:

Introduction: Stroke is a leading cause of disability globally, impacting patients' quality of life and self-efficacy significantly. Research from various countries indicates that rural stroke patients face challenges such as reduced access to healthcare services and lower quality of life compared to their urban counterparts. The aim of the study was to examine how the residential location in Türkiye affects the quality of life and self-efficacy levels of stroke patients.
Methods: A cross-sectional research was carried out among stroke patients in Türkiye, examining the differences between individuals living in rural and urban areas. Information regarding population characteristics, use of healthcare services, and self-reported evaluations including the stroke specific quality of life scale (SSQoL) and stroke self-efficacy questionnaire (SSEQ) were collected.
Results: There were no difference in demographic and disease-related characteristics between the two groups. Patients from urban areas had notably fewer emergency department visits (p < 0.001) as well as fewer appointments at physical medicine and rehabilitation clinics (p < 0.001) and family practitioner clinics (p < 0.001) in the previous year. Additionally, rural patients demonstrated higher SSEQ scores (p = 0.036) and greater scores on the SSQoL (p < 0.001) compared to urban patients, while also having significantly more access to rehabilitation services (p=0.027).
Conclusion: The results of this study have shown that people living in rural areas experience reduced quality of life and confidence in managing their stroke compared to those residing in urban areas. Rural individuals with strokes often depend more on family physicians, urgent care facilities, and rehabilitation services for medical support. To improve the well-being and outcomes of stroke patients in rural regions, it is essential to address the limited access to rehabilitation services, healthcare infrastructure, resources, and medical professionals through policy changes and innovative strategies such as tele-rehabilitation.
Keywords: healthcare utilization, quality of life, self-efficacy, stroke, urban&ndash;rural disparities.