The Relationship Between Mental Health and Quality of Life in Stroke Patients in the Context of the Local Wisdom of the Four Tribes of Kadatuan Tana Luwu

Abstract

Background: Stroke continues to rank among the primary causes of death and persistent disability globally, frequently resulting in physical, cognitive, and psychological impairments that significantly compromise quality of life (QoL). Post-stroke depression (PSD) and anxiety are among the most common psychological complications, exerting a significant negative impact on recovery and functional outcomes. Early detection and effective management of these conditions are essential to optimizing QoL among stroke survivors.

Methods: This study adopted a cross-sectional design and recruited 206 stroke patients from the Kadatuan Tana Luwu region of Indonesia through purposive sampling. Inclusion criteria were: stroke duration of more than one month, membership in one of four indigenous sub-ethnic groups (To Ugi, Toraja, To Rongkong, To Wotu), accompaniment by a primary caregiver, and no history of stem cell therapy. Depression, anxiety, and quality of life were measured using the BDI-II, GAD-7, and WHOQOL-BREF (Indonesian version), respectively, with associations tested by Chi-square (p < 0.05).

Results: The majority of respondents experienced severe depression (94.2%), very severe anxiety (74.8%), and poor quality of life (QoL) (56.8%). Statistical analysis identified significant associations between depression and QoL (p < 0.001), as well as between anxiety and QoL (p < 0.001). Participants with severe psychological distress consistently reported lower QoL across the physical, psychological, and social domains.

Conclusion: Depression and anxiety are strongly associated with poorer QoL among stroke patients. Integrating mental health care into stroke rehabilitation, together with culturally rooted community support systems, may improve recovery outcomes and promote overall well-being.