Symptom and Functional Clusters Regarding Patient-Reported Outcome Measures and Associated Factors Among Patients...

Background/Objectives: Stroke is the leading cause of death and disability among adults in China. Most survivors experience debilitating symptoms, including limb weakness, pain, fatigue, and depression, which impair quality of life and increase caregiver burden. This study aimed to identify clusters of symptoms and functional status in patients with stroke, their associated factors, and the influence of family burden. Methods: From February 2023 to February 2024, 779 patients with stroke from three Chinese tertiary hospitals completed an electronic questionnaire covering demographics and Patient-Reported Outcomes Measurement Information System measures, including depression, anxiety, pain interference, physical and cognitive function, social participation, and family burden. Using SPSS 26.0 and Mplus 8.0, chi-square tests, analysis of variance, latent class analysis, and multiple logistic regression were performed. Results: Latent class analysis identified three distinct symptom-functional clusters among stroke patients: "low-symptom high-function" (36.4%), "moderate-symptom moderate-function" (54.6%), and "high-symptom low-function" (9.0%). Multinomial logistic regression revealed that age ≥ 60 years (OR = 0.15, p = 0.001), freelancing (OR = 2.75, p = 0.019), unemployment (OR = 2.73, p = 0.018), monthly income ≥ 5000 yuan (OR = 2.56, p = 0.026), no medical insurance (OR = 4.26, p = 0.01), living alone (OR = 2.45, p = 0.031), and family burden (OR = 0.95, p < 0.001) were associated with the "high-symptom low-function class". Conclusions: Chinese stroke patients exhibit substantial heterogeneity in symptom and functional profiles. To optimize stroke rehabilitation, healthcare professionals should develop targeted management strategies, prioritizing high-risk populations, particularly socio-economically vulnerable and socially isolated patients.