Management of Self-Care Activities among Stroke Patients with Diabetes : a quantitative study

Abstract

Background: Stroke is a leading cause of long-term disability and mortality worldwide, significantly impacting individuals' quality of life. Diabetes, a major risk factor for stroke, further complicates recovery by impairing neurological, physical, and cognitive rehabilitation. It is associated with poor functional outcomes, prolonged hospital stays, and an increased risk of recurrent strokes. Effective self-care, encompassing diet, physical activity, blood sugar monitoring, and foot care, is crucial for managing diabetes post stroke. Despite studies done in other countries on this dual health burden, limited evidence exists from Bangladesh, where diabetes prevalence is rising rapidly. Addressing this knowledge gap is essential to improve care for stroke survivors with diabetes in the country. Aim: This study examines the self-care challenges faced by stroke survivors with diabetes in Bangladesh, aiming to identify gaps and recommend strategies for improved rehabilitation and health outcomes. Methods: A quantitative, cross-sectional study was conducted among 114 stroke survivors with diabetes, selected through purposive sampling from CRP Savar. Data were collected using a Bengali-translated version of the validated Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Statistical analysis was performed using SPSS (v25) to explore associations between self-care domains and socio-demographic factors. Results: Dietary adherence was the most substantial self-care domain, with 86% of participants following a healthful eating plan. However, adherence to physical activity (21.1%), blood sugar monitoring (24.6%), and foot care (43%) was significantly lower. Men showed slightly higher medication adherence than women (p = .046). Older participants (67–86 years) were more consistent with dietary habits (p = .029), while those with longer injury durations showed better physical activity levels (p < .001). Education, income, and gender had minimal influence on other self-care behaviors. Conclusion: Stroke survivors with diabetes in Bangladesh face critical self-care challenges, particularly in physical activity, blood sugar monitoring, and foot care. Customized, community-driven interventions and technology-supported care are necessary to address these gaps. The findings provide insights for developing integrated rehabilitation strategies to enhance health outcomes and quality of life for this vulnerable population. Keywords: Stroke, Diabetes, Self-care