Influence Of Social Network on the Relationship Between Health-Related Quality of Life and Functional Impairment in Adult Stroke Survivors: A Cross-Sectional Study

Abstract

Stroke ranks first in frequency and importance among the neurological diseases of adult life and is a leading cause of long-term functional impairment. Its consequences extend beyond physical disability, disrupting the social networks that surround the survivor and shaping health-related quality of life (HRQoL). This study aimed to determine the relationship between functional impairment and HRQoL in adult stroke survivors and to examine whether social networks influence this relationship. A cross-sectional study was conducted on 57 medically stable stroke survivors aged 50 years and above, recruited from tertiary hospitals in Karnataka, India. HRQoL was measured with the World Health Organization Quality of Life–BREF (WHOQOL-BREF), functional impairment with the Functional Independence Measure (FIM) and social networks with Fillenbaum's questionnaire. Participants were divided by the median social-network score into a lower (Group A, n = 36) and a higher (Group B, n = 21) social-network group, and associations were assessed using the Pearson correlation test. Overall, functional impairment showed weak to moderate positive correlations with the psychological, social and environmental domains and a weak negative correlation with the physical domain (r = -0.19, p = 0.14). In survivors with a higher social network, lower functional impairment was associated with higher HRQoL across all domains, whereas in survivors with a lower social network this pattern was confined to the social-relationship and environmental domains. The findings indicate that a stronger social network broadens the beneficial link between preserved function and quality of life, underscoring the value of social support in stroke rehabilitation.