Posttraumatic stress disorder and associated factors among stroke survivors in Northwest Ethiopia

Abstract

Posttraumatic stress disorder (PTSD) can occur after life-threatening medical conditions; however, there is little consensus on its exact prevalence. Suffering from PTSD among stroke Survivors not only decreases Stroke Survivors’ quality of life but also relates to non-adherence to treatment. Evidence shows that there is limited research on PTSD in stroke survivors in low-income countries. This study aimed to investigate the prevalence and associated factors of PTSD among stroke survivors in Northwest Ethiopia in 2024. An institutional-based cross-sectional study was conducted from October 1 to December 30, 2024, among 326 adult stroke survivors (aged ≥ 18 years) with a confirmed clinical diagnosis of stroke (ischemic or hemorrhagic) who were at least one month post-stroke and able to communicate or respond to the questionnaire were included. Data were collected using validated and structured questionnaires, including the Posttraumatic Stress Disorder Checklist for DSM-5, the Hospital Anxiety and Depression Scale, the Modified Rankin Scale, the Medication Adherence Report Scale-5, the Brief COPE Inventory, and the Oslo 3-Item Social Support Scale. Data were analysed using SPSS version 27. Descriptive statistics such as frequencies, percentages, means, and standard deviations were computed to summarise sociodemographic, clinical, and psychosocial characteristics of the participants. Bivariate and multivariable logistic regressions were employed to identify associated factors, with significance set at p < 0.05. The prevalence of PTSD symptoms was 37.1% (95% CI 31.2–42.6%). Factors significantly associated with PTSD included being female [AOR = 3.92, 95% CI 2.05–7.47], having no formal education [AOR = 2.91, 95% CI 1.27–6.61], stroke duration of 1–5 years [AOR = 2.24, 95% CI 1.12–4.45] and > 5 years [AOR = 5.12, 95% CI 1.95–13.45], recurrent stroke [AOR = 2.01, 95% CI 1.04–3.89], poor functional status [AOR = 3.83, 95% CI 1.98–7.41], anxiety symptoms [AOR = 2.41, 95% CI 1.31–4.81], and maladaptive coping style [AOR = 3.41, 95% CI 1.76–6.59]. Over one-third of stroke survivors experienced PTSD symptoms. Female gender, low educational status, recurrent and long-standing stroke, poor functional status, anxiety symptoms, and maladaptive coping styles were key predictors. The findings underscore the need for routine PTSD screening and integrated psychosocial support within stroke rehabilitation programs to enhance recovery and mental well-being.