Rural-urban disparities in stroke outcomes: unveiling quality of life, self-efficacy and healthcare utilization patterns of stroke patients in Türkiye

Stroke is a leading cause of disability globally, significantly impacting patients' quality of life and self-efficacy. Research from various countries indicates that rural stroke patients face challenges such as reduced access to healthcare services and lower quality of life than their urban counterparts. The aim of the study was to examine how the residential location in Türkiye affects the quality of life and self-efficacy levels of stroke patients. A cross-sectional study was carried out among stroke patients in Türkiye, examining the differences between individuals living in rural and urban areas. Information regarding population characteristics, use of healthcare services, and self-reported evaluations, including the stroke-specific quality-of-life scale (SSQoL) and stroke self-efficacy questionnaire (SSEQ), was collected. There was no difference in demographic and disease-related characteristics between the two groups. Patients from urban areas had notably fewer emergency department visits (p<0.001) as well as fewer appointments at physical medicine and rehabilitation clinics (p<0.001) and family practitioner clinics (p<0.001) in the previous year. Additionally, rural patients demonstrated lower SSEQ scores (p=0.036) and poorer SSQoL scores (p<0.001) than urban patients, while also having significantly greater access to rehabilitation services (p=0.027). The results of this study show that people living in rural areas experience reduced quality of life and confidence in managing their stroke compared to those residing in urban areas. Rural individuals with strokes often depend more on family physicians, urgent care facilities, and rehabilitation services for medical support. To improve the wellbeing and outcomes of stroke patients in rural regions, it is essential to address the limited access to rehabilitation services, healthcare infrastructure, resources, and medical professionals through policy changes and innovative strategies such as telerehabilitation.