From Patient Reports to Recovery Pathways: Stroke Care Outcomes in Palestinian Hospitals رسالة ماجستير

Abstract

Background Although stroke is a major health burden globally and accounts for 11% of deaths in Palestine, making it the second leading cause of mortality, little is known about how stroke survivors in Palestine perceive their recovery using Patient-Reported Outcome Measures (PROMs). Objectives To assess the relationships between three key dimensions of patient reported outcome measures and patient demographic, stroke type, length of stay, ability to perform social roles, perception of overall health and rehospitalization among stroke patients in Palestinian hospitals. Methods A cross-sectional approach was adopted across 12 public hospitals in the West Bank. 100 stroke patients admitted 90 days prior to data collection period were recruited using convenient sampling. The data collection took place between June and September 2024.The questionnaire encompasses questions from three validated tools: ROMIS-10, the ICHOM Standard Set for Stroke and RIKSSTROKE. Data were gathered by medical record review and interviewer-administered questionnaire. Analysis was done in R using descriptive statistics, non-parametric tests (Mann–Whitney U, Kruskal– Wallis, Kendall’s rank correlation), and sample-specific T-score standardization. Result The study found a significant difference between mental and physical health outcomes and no significant difference in patient satisfaction between non-re-hospitalized patients (Mdn = 51.8, Q1–Q3 = 45.0–56.0) and re-hospitalized patients (Mdn = 51.8, Q1–Q3 = 45.0–52.6), W = 1200.5, p = .134. However, non-hospitalized patients reported better physical and mental outcomes. Significant associations were evident in other factors such as number of re-admissions, age, gender, level of education, level of income, and type of stroke, perception of overall health and social activity ability. Conclusion The findings support a holistic, patient-centred model of stroke care in Palestine. Mental and physical health outcomes are bidirectionally linked, and factors such as rehospitalization, female gender, older age, and low socioeconomic status predict poorer recovery. These results underscore the need for integrated, individualized stroke rehabilitation strategies tailored to patient-reported needs.