Severity-graded supportive care need profiles in older adults during recovery after ischemic stroke: a latent profile analysis.

BACKGROUND

Supportive care needs may vary substantially among older adults during recovery after ischemic stroke and are relevant to the continuity of post-stroke rehabilitation and follow-up care. A person-centered approach may help characterize heterogeneity in need intensity and inform needs-based supportive care planning. However, evidence on supportive care need profiles and their associated factors in this population remains limited.

METHODS

A cross-sectional study was conducted among 388 older adults with ischemic stroke recruited from three tertiary hospitals in China. Supportive care needs were assessed using the Stroke Supportive Care Needs Scale. Latent profile analysis was performed using the mean scores of six supportive care need domains. Multinomial logistic regression was used to examine factors cross-sectionally associated with latent profile membership.

RESULTS

Three severity-graded profiles were identified: the low supportive care needs group (Class 1, n = 120, 30.9%), moderate supportive care needs group (Class 2, n = 142, 36.6%), and high supportive care needs group (Class 3, n = 126, 32.5%). Disease-related information needs were prominent across all profiles, whereas life care, symptom management, and rehabilitation care needs were particularly elevated in the high-need profile. Compared with Class 1, older age, anxiety symptoms, and depressive symptoms were associated with higher odds of membership in both Class 2 and Class 3, whereas better self-care ability was associated with lower odds of membership in these higher-need profiles. Higher educational attainment was generally associated with lower odds of higher-need profile membership, while higher income was associated with lower odds of Class 3 membership.

CONCLUSION

Older ischemic stroke survivors during recovery exhibited severity-graded heterogeneity in supportive care needs. Membership in the higher-need profiles was cross-sectionally associated with older age, poorer self-care ability, anxiety symptoms, depressive symptoms, and lower educational attainment, while higher income was associated with lower odds of membership in the high-need profile. These findings provide descriptive evidence for needs-based assessment and the future development of tiered rehabilitation and follow-up support during stroke recovery. Further longitudinal and external validation is needed to examine the stability and potential application of these profiles in post-stroke care.