Abstract

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models with bootstrapping procedures. The structural model demonstrated moderate explanatory power (R² = 0.543), explaining 54.3% of the variance in multimorbidity among stroke patients. Anthropometric status, represented by body weight, height, and waist circumference (β = 0.414; p-value <0.05), family history of stroke (β = -0.384; p-value <0.01), healthy dietary lifestyle (β = 0.588; p-value <0.001), and healthcare access (β = -0.403; p-value <0.001) were significant determinants of multimorbidity. An unhealthy dietary lifestyle (high-fat intake and low fruit and vegetable consumption) was significantly associated with multimorbidity, suggesting possible reverse causality due to dietary changes after stroke diagnosis.

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