1
|
Lee J, Lee S. Impact of Illness Uncertainty on Health-Related Quality of Life in Patients With Unruptured Intracranial Aneurysms After Coil Embolization. J Neurosci Nurs 2024; 56:146-151. [PMID: 38936421 DOI: 10.1097/jnn.0000000000000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
ABSTRACT BACKGROUND: This study aimed to identify the impact of illness uncertainty on physical and mental health-related quality of life (HRQoL) in patients with unruptured intracranial aneurysms (UIAs) after coil embolization. METHODS: A cross-sectional study was conducted and HRQoL was evaluated using the Short Form-12 Health Survey Questionnaire, which assesses physical and mental HRQoL. RESULTS: The participants had a mean age of 56.4 years, and among them, 190 (71.2%) were women. Physical and mental HRQoL were negatively correlated with physical symptoms, anxiety, depression, and illness uncertainty. Mental HRQoL was positively correlated with social support. Physical HRQoL was significantly influenced by depression (β = -0.26, P = .004) and was not influenced by illness uncertainty (β = -0.10, P = .101). Mental HRQoL was significantly influenced by anxiety (β = -0.45, P < .001), depression (β = -0.19, P = .003), social support (β = 0.14, P = .004), and illness uncertainty (β = -0.14, P = .005). The finding that illness uncertainty influences HRQoL suggests a basis for interventions aimed at improving mental HRQoL by reducing illness uncertainty in patients with UIAs. CONCLUSION: The physical and mental HRQoL in patients with UIAs after coil embolization is negatively influenced by depression, whereas mental HRQoL is also affected by anxiety, illness uncertainty, and social support. These results may serve as reference data for the design and development of interventions to improve HRQoL in patients with UIAs after coil embolization.
Collapse
Affiliation(s)
- JiEun Lee
- JiEun Lee, PhD RN, is Assistant Professor, Department of Nursing, Jungwon University, Goesan, Republic of Korea
| | | |
Collapse
|
2
|
Fanaei H, Shoorijeh BT, Hafezinouri H, Mirzaei I, Parsi-Moud A. Impact of social isolation on corticosterone release and recovery after stroke in aged rats: A behavioral and biochemical analysis. Exp Gerontol 2024; 192:112453. [PMID: 38723916 DOI: 10.1016/j.exger.2024.112453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024]
Abstract
Social isolation (SI) after stroke reduces recovery. The aim of this study was to evaluate the effects of SI on corticosterone release and recovery after stroke in aged rats. A total of 64 male Wistar rats (aged 24 months) were used in the present study. All rats were housed in pairs for two weeks. After two weeks, rats were randomly assigned to one of four groups: (1) rats underwent sham surgery and kept socially isolated (control/social isolated (CO/SI) group); (2) rats underwent sham surgery and kept pair housed (control/pair housed (CO/PH) group); (3) rats underwent middle cerebral artery occlusion (MCAO) surgery and kept socially isolated (stroke/isolated (ST/SI) group); (4) rats underwent MCAO surgery and kept pair housed (stroke/pair housed (ST/PH)) group. Behaviors were assessed using the adhesive removal test, rotarod test and social interaction test at 1st, 7th, 14th and 21st days after stroke. Serum biochemical analysis was also performed on the behavioral testing days. Results showed THAT serum corticosterone and MDA levels in CO/PH group were significantly lower than CO/SI group. Serum BDNF levels in CO/PH group was significantly higher than CO/SI group. Serum corticosterone and MDA levels in ST/PH group were lower than ST/SI group. In ST/PH group, serum Total antioxidant capacity (TAC) and BDNF levels were significantly higher than ST/SI group. Biochemical analysis of certain regions of the brain (hippocampus, striatum and cerebral cortex) was performed on 21st day after stroke. In the hippocampus of CO/PH group, BDNF and TAC levels were significantly higher than CO/SI group. The hippocampal MDA level of CO/PH group were significantly lower than CO/SI group. BDNF and TAC levels in the hippocampus, striatum and cerebral cortex of ST/PH group were significantly higher and MDA level was significantly lower as compared with ST/SI group. Both ischemic groups showed sensorimotor recovery over a 21-day period, but recovery of ST/PH group was significantly greater than ST/SI group. Total social interaction time in ST/PH group was significantly longer than ST/SI group. Based on the results of this study, social interaction after stroke enhances histologic and sensorimotor recovery through reduction of HPA activity and corticosterone release, leading to increased TAC and BDNF levels.
Collapse
Affiliation(s)
- Hamed Fanaei
- Pregnancy Health Research Center, Department of Physiology, Zahedan University of Medical Sciences, Zahedan, Iran.
| | | | - Hamid Hafezinouri
- Laboratory Animal Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ilia Mirzaei
- Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abolfazl Parsi-Moud
- Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
3
|
Broomfield NM, Blake J, Gracey F, Steverson T. Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment. Int J Stroke 2024:17474930241242952. [PMID: 38503711 DOI: 10.1177/17474930241242952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Post-stroke emotionalism affects one in five stroke sufferers 6 months after their stroke, but despite its frequency remains a poorly understood stroke symptom. The literature is limited, especially compared to other frequently observed neurological conditions such as aphasia and visual neglect. AIM AND METHODS This narrative review presents a summary of the post-stroke emotionalism literature, to inform clinical practice and future research. We cover discussion of definitions, prevalence, neurobiology, predisposing and precipitating factors, and treatment. RESULTS Increasing evidence suggests that damage to specific areas functionally linked to emotion expression or regulation processes, disruption to structural pathways and those related to serotonin production and modulation individually or in concert give rise to emotionalism-type presentations. A range of emotionalism measurement tools have been used in research contexts making between study comparisons difficult. Testing for Emotionalism after Recent Stroke-Questionnaire (TEARS-Q) has recently been developed to allow standardized assessment. Treatment options are limited, and there have been few adequately powered treatment trials. Antidepressants may reduce severity, but more trial data are required. There have been no randomized-controlled trials of non-pharmacological interventions. CONCLUSIONS More research is needed to improve recognition and treatment of this common and disabling symptom. We conclude with research priorities and recommendations for the field.
Collapse
Affiliation(s)
- Niall M Broomfield
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Joshua Blake
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Steverson
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| |
Collapse
|
4
|
Calancie L, Leng XI, Whitsel EA, Cené C, Hassmiller Lich K, Dave G, Corbie G. Racial disparities in stroke incidence in the Women's Health Initiative: Exploring biological, behavioral, psychosocial, and social risk factors. SSM Popul Health 2024; 25:101570. [PMID: 38313870 PMCID: PMC10837642 DOI: 10.1016/j.ssmph.2023.101570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 02/06/2024] Open
Abstract
Background - Disparities in incident stroke risk among women by race and ethnicity persist. Few studies report the distribution and association of stroke risk factors by age group among a diverse sample of women. Methods - Data from the Women's Health Initiative (WHI) Observational Study collected between 1993 and 2010 were used to calculate cumulative stroke incidence and incidence rates among non-Hispanic African American (NHAA), non-Hispanic white (NHW), and Hispanic white or African American (HWAA) women by age group in participants aged ≥50 years at baseline (N = 77,247). Hazard ratios (HRs) and 95% CIs for biological, behavioral, psychosocial, and socioeconomic factors overall and by race or ethnicity were estimated using sequential Cox proportional hazard regression models. Results - Average follow-up time was 11.52 (SD, 3.48) years. The incident stroke rate was higher among NHAA (306 per 100,000 person-years) compared to NHW (279/100,000py) and HWAA women (147/100,000py) overall and in each age group. The disparity was largest at ages >75 years. The association between stroke risk factors (e.g., smoking, BMI, physical activity) and incident stroke varied across race and ethnicity groups. Higher social support was significantly associated with decreased stroke risk overall (HR:0.84, 95% CI, 0.76, 0.93); the degree of protection varied across race and ethnicity groups. Socioeconomic factors did not contribute additional stroke risk beyond risk conferred by traditional and psychosocial factors. Conclusions - The distribution and association of stroke risk factors differed between NHAA and NHW women. There is a clear need for stroke prevention strategies that address factors driving racial disparities in stroke risk.
Collapse
Affiliation(s)
| | - Xiaoyan Iris Leng
- Wake Forest University, 1834 Wake Forest Rd, Winston-Salem, NC, 27109, USA
| | - Eric A. Whitsel
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27599, USA
| | - Crystal Cené
- University of San Diego Health, 9300 Campus Point Drive, #7970, USA
| | | | - Gaurav Dave
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27599, USA
| | - Giselle Corbie
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27599, USA
| |
Collapse
|
5
|
Wang X, Zhang ZX, Lin BL, Jiang H, Wang W, Mei YX, Zhang C, Zhang Q, Chen SY. Mediation role of perceived social support between recurrence risk perception and health behaviour among patients with stroke in China: a cross-sectional study. BMJ Open 2024; 14:e079812. [PMID: 38355172 PMCID: PMC10868314 DOI: 10.1136/bmjopen-2023-079812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES To examine whether patients who had a stroke with high recurrence risk perception would have healthier behaviour and to explore whether perceived social support would function as a mediator. DESIGN A cross-sectional study. SETTING The study was conducted in a public tertiary hospital in China. PARTICIPANTS A total of 254 patients with stroke were invited to participate, and 250 patients with stroke completed questionnaires validly. PRIMARY AND SECONDARY OUTCOME MEASURES Questionnaires were administered offline to collect data, consisting of four parts: general demographics and scales related to recurrence risk perception, perceived social support, and health behaviour. A path analysis and correlation analysis were used to analyse the data. RESULTS Out of 250 patients with stroke, 78.4% had moderately low health behaviour. The majority (70.8%) of these patients were elderly. High recurrence risk perception and high perceived social support were significantly associated with better health behaviour (all p<0.001). Perceived social support mediated the relationship between recurrence risk perception and health behaviour after controlling for age, gender, education and monthly income in the regression model (95% CI 0.263 to 0.460) and the effect value was 0.360. It was also confirmed that perceived social support had the highest mediation effect with a proportion of mediation up to 59.31%. CONCLUSIONS Recurrence risk perception and perceived social support were influential factors in promoting health behaviour. Moreover, the impact of recurrence risk perception on health behaviour was partially mediated by perceived social support. Therefore, to enhance the sustainability of health behaviour, it is crucial to inform patients with stroke about the risk of recurrence. Patients with more perception of recurrence risk can improve their recovery confidence and thus perceive more social support.
Collapse
Affiliation(s)
- Xiaoxuan Wang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Zhen-Xiang Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Bei-Lei Lin
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Hu Jiang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Wenna Wang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Yong-Xia Mei
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Chunhui Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Qiushi Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Su-Yan Chen
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
6
|
Oei CW, Ng EYK, Ng MHS, Tan RS, Chan YM, Chan LG, Acharya UR. Explainable Risk Prediction of Post-Stroke Adverse Mental Outcomes Using Machine Learning Techniques in a Population of 1780 Patients. SENSORS (BASEL, SWITZERLAND) 2023; 23:7946. [PMID: 37766004 PMCID: PMC10538068 DOI: 10.3390/s23187946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Post-stroke depression and anxiety, collectively known as post-stroke adverse mental outcome (PSAMO) are common sequelae of stroke. About 30% of stroke survivors develop depression and about 20% develop anxiety. Stroke survivors with PSAMO have poorer health outcomes with higher mortality and greater functional disability. In this study, we aimed to develop a machine learning (ML) model to predict the risk of PSAMO. We retrospectively studied 1780 patients with stroke who were divided into PSAMO vs. no PSAMO groups based on results of validated depression and anxiety questionnaires. The features collected included demographic and sociological data, quality of life scores, stroke-related information, medical and medication history, and comorbidities. Recursive feature elimination was used to select features to input in parallel to eight ML algorithms to train and test the model. Bayesian optimization was used for hyperparameter tuning. Shapley additive explanations (SHAP), an explainable AI (XAI) method, was applied to interpret the model. The best performing ML algorithm was gradient-boosted tree, which attained 74.7% binary classification accuracy. Feature importance calculated by SHAP produced a list of ranked important features that contributed to the prediction, which were consistent with findings of prior clinical studies. Some of these factors were modifiable, and potentially amenable to intervention at early stages of stroke to reduce the incidence of PSAMO.
Collapse
Affiliation(s)
- Chien Wei Oei
- Management Information Department, Office of Clinical Epidemiology, Analytics and kNowledge (OCEAN), Tan Tock Seng Hospital, Singapore 308433, Singapore;
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Eddie Yin Kwee Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Matthew Hok Shan Ng
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore 308232, Singapore;
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore 169609, Singapore;
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yam Meng Chan
- Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore 308433, Singapore;
| | - Lai Gwen Chan
- Department of Psychiatry, Tan Tock Seng Hospital, Singapore 308433, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Udyavara Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Springfield, QLD 4305, Australia;
| |
Collapse
|
7
|
Marcassoli A, Guastafierro E, Toppo C, Leonardi M, Bersano A, Boncoraglio G, Canavero I, Raggi A. Psychosocial factors as main predictors of quality of life 5 years after stroke: a cross-sectional study from a third-level Italian center. Int J Rehabil Res 2023; 46:151-156. [PMID: 36691780 DOI: 10.1097/mrr.0000000000000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Stroke causes a significant reduction in health-related quality of life (HRQoL), and studies addressing its predictors often rely on models with few variables. This study aimed to assess the degree to which health status, health habits, and features of the environment predict HRQoL in stroke survivors with stable clinical condition. WHO Quality of Life questionnaire for old-Age subjects (WHOQOL-AGE) was used to assess HRQoL. We ran a multivariable linear regression to predict WHOQOL-AGE variation, entering measures of health state, bad habits, healthy behaviors, physical environment features, and social support. Patients were stroke survivors with a stable clinical condition, distance from acute event of more than 6 months, and National Institutes of Health Stroke Scale (NIHSS) of 10 or less. A total of 122 participants (47 females, 97 with ischemic stroke) were enrolled, the mean age was 64.1, mean NIHSS 2.9, and mean distance from the acute event was 5.1 years. State anxiety (β = -0.202), trait anxiety (β = -0.232), depression (β = -0.255), social support (β = 0.247), and functional independence (β = -0.210) predicted WHOQOL-AGE variation (Adj. R2 = 0.549). Our results show that psychological symptoms, reduced social network, and functional dependence together have a negative impact on HRQoL. These elements, which are partly stroke-specific, should be taken into account in the recovery process to enhance patients' health outcomes.
Collapse
Affiliation(s)
- Alessia Marcassoli
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
| | - Erika Guastafierro
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
| | - Claudia Toppo
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
| | - Anna Bersano
- Cerebrovascular Neurological Unit, Department of Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giorgio Boncoraglio
- Cerebrovascular Neurological Unit, Department of Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Isabella Canavero
- Cerebrovascular Neurological Unit, Department of Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta
| |
Collapse
|
8
|
Eizaguirre MB, Yastremiz C, Ciufia N, Sol Roman M, Alonso R, Silva BA, Garcea O, Cáceres F, Vanotti S. Relevance and Impact of Social Support on Quality of Life for Persons With Multiple Sclerosis. Int J MS Care 2023; 25:99-103. [PMID: 37250192 PMCID: PMC10211354 DOI: 10.7224/1537-2073.2022-012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND Social support is crucial for persons with multiple sclerosis (MS). We sought to analyze differences in perceived social support in persons with MS vs controls; to study associations between perceived social support, clinical measures, and health-related quality of life (HRQOL) variables in persons with MS; and to establish a predictive value of perceived social support for HRQOL. METHODS We studied 151 persons with MS (mean ± SD: age, 42.01 ± 9.97 years; educational level, 14.05 ± 3.26 years) and 89 controls (mean ± SD: age, 41.46 ± 12.25 years; educational level, 14.60 ± 2.44 years) using the Medical Outcomes Study Social Support Survey (MOS-SSS), Expanded Disability Status Scale, Fatigue Severity Scale, Beck Depression Inventory, and Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Parametric and nonparametric statistical methods were used accordingly; P < .05. RESULTS Persons with MS exhibited lower scores on the MOS-SSS's overall support index (t238 = -1.98, P = .04) and on each functional subscale (t238 = -2.56 to -2.19, P < .05). No significant differences were found on the social support structural component (P > .05). Significant associations were observed between social support and depression and fatigue (r = -0.20 to -0.29, P < .05) and with MusiQoL dimensions (r = -0.18 to 0.48, P < .05). Multiple regression analysis showed all 4 tested models contributed to HRQOL-explained variance (41%-47%). The emotional/informational support model explained the most HRQOL variability (47%). CONCLUSIONS Persons with MS perceived reduced social support, presenting lower functional scores than controls. Perceived social support proved to be a predictor of HRQOL. These findings should be considered during therapeutic treatment.
Collapse
Affiliation(s)
- María Bárbara Eizaguirre
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
- The Research Institute in Psychology, School of Psychology, Buenos Aires University, Buenos Aires, Argentina (MBE, NC, MSR, SV)
| | - Cecilia Yastremiz
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
| | - Natalia Ciufia
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
- The Research Institute in Psychology, School of Psychology, Buenos Aires University, Buenos Aires, Argentina (MBE, NC, MSR, SV)
| | - María Sol Roman
- The Research Institute in Psychology, School of Psychology, Buenos Aires University, Buenos Aires, Argentina (MBE, NC, MSR, SV)
- The Institute of Restorative Neurosciences, Buenos Aires, Argentina (MSR, FC, SV)
| | - Ricardo Alonso
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
| | - Berenice Anabel Silva
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
| | - Orlando Garcea
- From the Multiple Sclerosis University Center, Ramos Mejia Hospital, Buenos Aires, Argentina (MBE, CY, NC, RA, BS, OG)
| | - Fernando Cáceres
- The Institute of Restorative Neurosciences, Buenos Aires, Argentina (MSR, FC, SV)
| | - Sandra Vanotti
- The Research Institute in Psychology, School of Psychology, Buenos Aires University, Buenos Aires, Argentina (MBE, NC, MSR, SV)
- The Institute of Restorative Neurosciences, Buenos Aires, Argentina (MSR, FC, SV)
| |
Collapse
|
9
|
Gurková E, Štureková L, Mandysová P, Šaňák D. Factors affecting the quality of life after ischemic stroke in young adults: a scoping review. Health Qual Life Outcomes 2023; 21:4. [PMID: 36653785 PMCID: PMC9850784 DOI: 10.1186/s12955-023-02090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To synthesize the body of knowledge on the factors influencing the quality of life (QoL) after ischemic stroke (IS) in young adults. METHODS Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA-ScR checklist for a scoping review was used in this paper. A total of 1197 studies were identified through a bibliographic search in Web of Science, MEDLINE, PsycInfo, ScienceDirect, Scopus, and ProQuest Science Database. Articles published between the years 2000-2021 were included. RESULTS A total of nine papers were finally selected to respond to the research question. Three studies were prospective longitudinal studies compared QoL between young stroke and age-matched controls from the general population. Across all the analysed studies, 14 variables potentially associated with QoL were identified. QoL in young patients is mainly affected by clinical outcomes after IS (scored by the modified Rankin scale and the Barthel index-favourable initial functional status and higher independence in ADL leads to higher QoL) and psychological factors (post-stroke fatigue and depression-higher levels of fatigue and depression lead to lower QoL). The reviewed studies emphasized the importance of functional outcomes, post-stroke depression, fatigue and anxiety and early return to work. CONCLUSION Further longitudinal studies are needed to identify the trajectory of post-stroke psychosocial symptoms over time and other potential predictors of unfavourable long-term QoL, thus specific young stroke rehabilitation and stroke self-management support programmes should be developed (address physical, psychological factors which influence the psychosocial adaptation post-stroke and the perception of the QoL).
Collapse
Affiliation(s)
- Elena Gurková
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Lenka Štureková
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Petra Mandysová
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Daniel Šaňák
- grid.10979.360000 0001 1245 3953Comprehensive Stroke Center, Department of Neurology, Palacký University Medical School and Hospital, Olomouc, Czech Republic
| |
Collapse
|
10
|
Kuang J, Yang L, Lv R, Li J, Zhou K, Xu M. The mediating effect of post-stroke depression between social support and quality of life among stroke survivors: A meta-analytic structural equation modeling. Int J Geriatr Psychiatry 2022; 37. [PMID: 36317324 DOI: 10.1002/gps.5820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim was to confirm the relationship between social support (SS), post-stroke depression (PSD), and quality of life (QOL) and determine the mediating effect of PSD in stroke survivors. Additionally, we tested the impact of economic development level (in developed or developing countries) on the relationship between SS, PSD, and QOL. METHODS This study utilized meta-analytic structural equation modeling on systematically searched articles from PubMed, MEDLINE, Cochrane Library, Scopus, PsycINFO, Web of Science, China National Knowledge Infrastructure, and WanFang data published from inception to February 2022. Collect the sample size (n) of each study and the associations of observed variables, and conduct meta-analysis path analysis using AMOS 23.0 to assess the relationships. Concurrently, the effects of the national economic development level were extracted for moderator analysis. RESULTS A total of 28 studies (N = 3967) were included for analysis. SS and PSD were significant predictors of QOL (both p < 0.01). PSD mediated the relationship between SS and QOL (β = 0.31; 95% confidence interval 0.273-0.345; p < 0.01). Furthermore, in developed countries, SS was not statistically correlated with PSD (p = 0.811) compared to developing countries. CONCLUSIONS Improving SS may help improve the QOL of stroke patients. PSD should be addressed using a comprehensive approach that includes interventions to enhance the QOL. Additionally, people have different psychological reactions to SS at different stages of economic development; thus, further research is needed to develop different measurement standards for patients according to the country's level of economic development.
Collapse
Affiliation(s)
- Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Runtian Lv
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Jia Li
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| |
Collapse
|
11
|
Assessing the level of perceived social support among community-dwelling stroke survivors using the Multidimensional Scale of Perceived Social Support. Sci Rep 2022; 12:19318. [PMID: 36369351 PMCID: PMC9652448 DOI: 10.1038/s41598-022-23840-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022] Open
Abstract
Social support has an important role in stroke rehabilitation. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument examining the adequacy of perceived social support. However, the psychometric properties of the Chinese version of MSPSS (MSPSS-C) have not been examined in Chinese people with stroke. This study aimed at investigating the psychometric properties of the MSPSS-C, identifying the correlations between MSPSS-C scores and health-related measures of these people; and examining the differences in the levels of perceived social support between people with and without stroke in Hong Kong using a cohort of 57 community-dwelling people with stroke and 50 age-matched healthy controls. We found that the MSPSS-C subscales demonstrated excellent internal consistency, and a ceiling effect was observed for the family subscale of the MSPSS-C. The total MSPSS-C score had significant weak to moderate correlations with the scores of the concerned variables of interests. Exploratory factor analysis revealed a two-factor structure for the MSPSS-C. People with stroke had lower levels of perceived social support from friends and their significant other than those without stroke. The MSPSS-C is a valid tool for assessing perceived social support among chronic stroke survivors with moderate to very severe motor impairment.
Collapse
|
12
|
D'Souza S, Ciccone N, Hersh D, Janssen H, Armstrong E, Godecke E. Staff and volunteers' perceptions of a Communication Enhanced Environment model in an acute/slow stream rehabilitation and a rehabilitation hospital ward: a qualitative description study within a before-and-after pilot study. Disabil Rehabil 2022; 44:7009-7022. [PMID: 34739348 DOI: 10.1080/09638288.2021.1977397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE A lack of social interaction during early stroke recovery can negatively affect neurological recovery and health-related quality of life of patients with aphasia following stroke. A Communication Enhanced Environment (CEE) model was developed to increase patient engagement in language activities early after stroke. This study aimed to examine staff (n = 20) and volunteer (n = 2) perceptions of a CEE model and factors influencing the implementation and use of the model. This study formed part of a broader study that developed and embedded a CEE model on two hospital wards. MATERIALS AND METHODS Six focus groups and one interview with hospital staff were conducted and analysed using a qualitative description approach. Feedback emailed by volunteers was included in the data set. RESULTS Staff and volunteers perceived the CEE model benefitted themselves, the hospital system and patients. Staff identified a range of factors that influenced the implementation and use of the CEE model including individual staff, volunteer and patient factors, hospital features, the ease with which the CEE model could be used, and the implementation approach. CONCLUSIONS This study provides valuable insights into staff perceptions which may inform the implementation of interventions and future iterations of a CEE model.Implications for RehabilitationA CEE model may promote efficiency and increased patient engagement in stroke rehabilitation.The CEE model information session and aphasia communication partner training, and the provision of resources, may be useful strategies to increase staff confidence in using communication supporting strategies with patients with aphasia.Behaviour change and implementation science strategies may provide a framework to address barriers and promote facilitators to embed hospital-based interventions that require individual, ward, cultural and systems level change to reduce the evidence-based gap in clinical practice.
Collapse
Affiliation(s)
- Sarah D'Souza
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Heidi Janssen
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
13
|
Mao X, Mao X, Yu Y, Guo J. Chinese Translation and Psychometric Testing of the Simplified Version of Social Support Scale for Physical Activity. Psychol Res Behav Manag 2022; 15:2691-2700. [PMID: 36172544 PMCID: PMC9512534 DOI: 10.2147/prbm.s365639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/07/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Sallis et al’s social support scale for physical activity (SSSPH) is one of the most widely used scales to measure exercise-related social support yet has never been translated and validated in Chinese. The current study aims to simplify, translate, and validate a short form of SSSPH in a Chinese population. Patients and Methods A simplified Chinese version of the SSSPH (SSSPH-SC) retaining 6 items was achieved after the translation and back-translation process, which showed good content validity. The scale was then assessed among a convenience sample of 266 Chinese adults from various backgrounds. Internal consistency was tested by calculating Cronbach’s α. The a priori two-factor structure was tested with confirmatory factor analysis (CFA). Concurrent validity was examined by investigating the correlation of the SSSPH-SC with general social support, quality of life, and self-rated health. Results The SSSPH-SC full scale and subscales showed good internal consistency with Cronbach’s alpha ranging from 0.87 to 0.92. The CFA supported the a priori two-factor structure: family support and friend support, with χ2/df=2.93, CFI = 0.98, TLI = 0.98, RMSEA = 0.07, SRMR = 0.035. The concurrent validity of the SSSPH-CS was further supported by its significant positive correlations with social support (r=0.26, p<0.001), quality of life (r=0.25, p<0.001), and self-rated general health depression (r=0.23, p<0.001). Conclusion The SSSPH-SC had good reliability and validity and could be used as a simple and effective tool for assessing social support for physical activity in Chinese adults. The scale can be used as an effective tool to guide future health promotion programs as well as an evaluation tool to assess intervention effects.
Collapse
Affiliation(s)
- Xia Mao
- Department of Nursing, Yueyang Vocational Technical College, Yueyang, People's Republic of China
| | - Xianhua Mao
- Department of Nursing, Yueyang Vocational Technical College, Yueyang, People's Republic of China
| | - Yu Yu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jia Guo
- Department of Clinical Nursing, Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| |
Collapse
|
14
|
Rahman MS, Peng W, Adams J, Sibbritt D. The use of self-management strategies for stroke rehabilitation: a scoping review. Top Stroke Rehabil 2022:1-16. [PMID: 36165711 DOI: 10.1080/10749357.2022.2127651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Self-management is generally considered a dynamic and collaborative process by individuals and caregivers to manage a chronic condition. Self-management has recently emerged as a promising strategy for stroke rehabilitation. This scoping review aims to examine and summarize self-management strategies utilized by stroke survivors for stroke rehabilitation. METHODS PubMed, Scopus, CINAHL (EBSCO), Embase, and ProQuest were searched for articles published between January 2010 and December 2021. Studies were selected if they were published in English in a peer-reviewed journal, utilized a non-experimental research design, and focused on adult stroke survivors. All relevant information from the included articles was extracted in a systematic way using a pre-developed data extraction form. Two authors performed data extraction and quality evaluation independently. All issues were resolved through discussion among the authors. RESULTS We narratively summarized the findings of 15 quantitative, qualitative, and mixed-method studies, including a total of 1,494 stroke survivors. The stroke survivors used a range of self-management strategies for their stroke rehabilitation, including domains related to lifestyle, social support, communication, knowledge and information, and goal-setting. Gender, age, stroke-related disability, fatigue, self-management education, social support, and communication with others were found to be associated with self-management use in stroke rehabilitation. CONCLUSIONS This scoping review provides an important overview on stroke survivors' use of self-management strategies and their experience. Their use of self-management strategies is complicated and multifaceted, comprising several domains and involving a diverse range of approaches and personal experiences. However, we identified several gaps in the literature and more research is required.
Collapse
Affiliation(s)
- Md Sazedur Rahman
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Wenbo Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| |
Collapse
|
15
|
Translation and Initial Validation of the Chinese (Cantonese) Brief 2-Way Social Support Scale for Use in People with Chronic Stroke. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3511631. [PMID: 35813232 PMCID: PMC9259340 DOI: 10.1155/2022/3511631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022]
Abstract
Background. Social support is important for stroke rehabilitation. Conventionally, social support is evaluated from the level of support received. However, the bidirectional support hypothesis postulated that self-perceived social support is optimized if individuals provide and receive social support in a balanced manner. The Brief 2-Way Social Support Scale (Brief 2-Way SSS) is a social support instrument measuring the reciprocity of receiving and giving emotional and instrumental social support. Objective. (1) To translate and culturally adapt the English version of the Brief 2-Way SSS into Chinese (Cantonese) (Brief 2-Way SSS-C), (2) to report the results of validation of the Brief 2-Way SSS-C, and (3) to investigate the level of social support in people with stroke in Hong Kong. Methods. The Brief 2-Way SSS-C was produced following the standard forward-backward translation model. People with stroke (
) and age-matched controls (
) were recruited through a university-affiliated neurorehabilitation laboratory. Results. The Brief 2-Way SSS-C demonstrated excellent content validity, acceptable to good internal consistency (Cronbach’s alpha of 0.74–0.88), and good test-retest reliability (intraclass correlation coefficient of 0.76–0.81). There were no ceiling or floor effects, and the MDC95 across all subscales was 4. The Brief 2-Way SSS-C subscales had significant correlations with various health-related outcome measures. People with stroke had a lower level of social support than the age-matched healthy controls. Conclusions. The Brief 2-Way SSS-C is a culturally relevant, reliable, and valid outcome measure for the level of social support in community-dwelling people with stroke.
Collapse
|
16
|
Cavazzoni F, Pancake R, Veronese G. Impact of COVID-19 Pandemic on Mental Health and Quality of Life. An Exploratory Study During the First Outbreak in Italy. Psychol Rep 2022:332941211066259. [PMID: 35271789 PMCID: PMC8914301 DOI: 10.1177/00332941211066259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The coronavirus pandemic has been sweeping the world for more than a year. As physical health begins to stabilize in the western world, an increasing concern is related to the impact of the virus and its containment measures on people's mental health. This work aimed to explore the effect of demographic factors (age, gender, level of education, and socioeconomic status) and variables such as fear of COVID-19 and social support in predicting the quality of life and mental health of adults during the first wave of the pandemic in Italy. Through an online survey with 1087 Italian adults (M = 39.7, SD = 16.39; 74.4% women), gender and socioeconomic status emerged as crucial factors in determining differences regarding people's responses and reactions to the pandemic. In addition, the results highlighted the importance of perceived social support and a moderate fear of COVID-19 in predicting people's quality of life and mental health. The study suggests important guidelines for the development of interventions to support the population's well-being and mental health.
Collapse
Affiliation(s)
- Federica Cavazzoni
- Federica Cavazzoni, Department of Human Sciences “R. Massa,” University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, Milano 20126, Italy.
| | | | - Guido Veronese
- 9305University of Milano-Bicocca, Milan, Italy.,Stellenbosch University, South Africa
| |
Collapse
|
17
|
Bi H, Wang M. Role of social support in poststroke depression: A meta-analysis. Front Psychiatry 2022; 13:924277. [PMID: 36213910 PMCID: PMC9539912 DOI: 10.3389/fpsyt.2022.924277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Poststroke depression significantly affects health and quality of life of stroke patients. This study evaluates the role of social support in influencing poststroke depression. The literature search was conducted in electronic databases and study selection was based on precise eligibility criteria. The prevalence rates reported by individual studies were pooled. A meta-analysis of standardized mean differences (SMD) in social support between depressed and non-depressed stroke patients was performed. The odds ratios and correlation coefficients showing the relationship between social support and depression were pooled to achieve overall estimates. Twenty-five studies (9431 patients) were included. The prevalence of depression was 36% [95% confidence interval (CI): 28, 45]. Patients with poststroke depression had significantly lower social support in comparison with patients with no or lower levels of depression [SMD in social support scores -0.338 (95% CI: -0.589, -0.087); p = 0.008]. The odds of depression were lower in patients receiving higher levels of social support [OR 0.82 (95% CI: 0.69, 0.95)] but were higher in patients who were receiving weaker social support [OR 5.22 (95% CI: -0.87, 11.31)]. A meta-analysis of correlation coefficients found a significantly inverse correlation between social support and poststroke depression [r -0.336 (95% CI: -0.414, -0.254)]. Poststroke depression has a significant independent inverse association with social support.
Collapse
Affiliation(s)
- Haiyang Bi
- Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mengjia Wang
- Integrated Traditional Chinese and Western Medicine Rehabilitation Medical Center, Heilongjia Provincial Hospital, Harbin, China
| |
Collapse
|
18
|
Fong TCT, Lo TLT, Ho RTH. Indirect effects of social support and hope on quality of life via emotional distress among stroke survivors: A three-wave structural equation model. Front Psychiatry 2022; 13:919078. [PMID: 35966472 PMCID: PMC9365992 DOI: 10.3389/fpsyt.2022.919078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Stroke survivors are prone to functional impairments and reduced quality of life (QoL). This study examined the mediating role of social support and hope in the relationships between functional impairment, emotional distress, and QoL. METHODS A total of 188 stroke survivors in Hong Kong completed assessments on functional impairment, social support, and hope at baseline, with follow-up measurements of emotional distress at 2 months and QoL at 8 months. Structural equation modeling with bootstrapping was used to analyze the direct and indirect effects of functional impairment on emotional distress and QoL via the mediating factors of social support and hope. RESULTS The partial cascading model provided an adequate fit to the data. Functional impairment had significant negative direct effects on hope and physical QoL and social support had significant positive direct effects on hope and physical QoL. Social support had a significant positive indirect effect on physical QoL via hope and perceived stress and on psychosocial QoL via hope and depression. Functional impairment and hope had a significant negative interaction effect on perceived stress. CONCLUSION The findings support a mediating role for hope in the relationship between social support and QoL in stroke survivors. The protective effect of hope on perceived stress was stronger among patients with greater functional impairment.
Collapse
Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Temmy L T Lo
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rainbow T H Ho
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
19
|
Predictors of health-related quality of life in patients with non-communicable diseases: A national cross-section study. Appl Nurs Res 2022; 64:151566. [DOI: 10.1016/j.apnr.2022.151566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/09/2022] [Accepted: 01/18/2022] [Indexed: 11/19/2022]
|
20
|
D'Souza S, Hersh D, Godecke E, Ciccone N, Janssen H, Armstrong E. Patients' experiences of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward following stroke: a qualitative description approach. Disabil Rehabil 2021; 44:6304-6313. [PMID: 34780322 DOI: 10.1080/09638288.2021.1965226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities. PURPOSE Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model. METHODS A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews were conducted with seven patients, including four with aphasia, within 22 days post-stroke who had access to the CEE model. RESULTS Patients described variable experiences accessing different elements of the CEE model which were influenced by individual patient factors, staff factors, hospital features as well as staff time pressures. Those who were able to access elements of the CEE model described positive opportunities for engagement in language activities. CONCLUSIONS While findings are encouraging, further exploration of the feasibility of a CEE model in this complex setting is indicated to inform the development of this intervention.Implications for rehabilitationPatient access to a CEE model is challenging in a hospital setting.Patients who were able to access elements of the CEE model described positive opportunities for engagement in language activities.Patients' access to the CEE model was influenced by patient factors, staff factors, hospital features as well as staff time pressures.
Collapse
Affiliation(s)
- Sarah D'Souza
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Heidi Janssen
- School of Health Sciences, Hunter New England Local Health District, NSW Health, Australia
| | - Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| |
Collapse
|
21
|
D'Souza S, Godecke E, Ciccone N, Hersh D, Armstrong E, Tucak C, Janssen H. Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study. Clin Rehabil 2021; 36:15-39. [PMID: 34749509 DOI: 10.1177/02692155211032655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Develop and implement a Communication Enhanced Environment model and explore its effect on language activities for patients early after stroke. METHOD AND DESIGN Before-and-after pilot study. SETTING An acute/slow stream rehabilitation and a rehabilitation ward in a private hospital in Perth, Western Australia. PARTICIPANTS Fourteen patients recruited within 21 days of stroke. Seven recruited during the before-phase (control group: patients with aphasia = 3, patients without aphasia = 4) and seven recruited in the after-phase (intervention group: patients with aphasia = 4, patients without aphasia = 3). INTERVENTION The intervention group exposed to a Communication Enhanced Environment model had access to equipment, resources, planned social activities and trained communication partners. Both groups received usual stroke care. DATA COLLECTION Hospital site champions monitored the availability of the intervention. Behavioural mapping completed during the first minute of each 5-minute interval over 12 hours (between 7 am and 7 pm) determined patient engagement in language activities. RESULTS Seventy-one percent of the Communication Enhanced Environment model was available to the intervention group who engaged in higher, but not significant (95% CI), levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%). Unforeseen reorganisation of the acute ward occurred during the study. CONCLUSIONS Implementation of a Communication Enhanced Environment model was feasible in this specific setting and may potentially influence patients' engagement in language activities. The unforeseen contextual challenges that occurred during the study period demonstrate the challenging nature of the hospital environment and will be useful in future research planning.
Collapse
Affiliation(s)
- Sarah D'Souza
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, VIC, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, VIC, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Claire Tucak
- Hollywood Private Hospital, Nedlands, WA, Australia
| | - Heidi Janssen
- Hunter New England Local Health District, New Lambton Heights, NSW Health, NSW, Australia.,Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| |
Collapse
|
22
|
Vikan JK, Snekkevik H, Nilsson MI, Stanghelle JK, Geirdal AØ, Fugl-Meyer KS. Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation. Sex Med 2021; 9:100424. [PMID: 34474266 PMCID: PMC8498952 DOI: 10.1016/j.esxm.2021.100424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction The consequences of stroke on sexual life in stroke patients in need of specialized cognitive rehabilitation have been limited explored. A biopsychosocial perspective in post-stroke sexuality studies is warranted to capture the complex picture of stroke consequences and sexual life after stroke and sexual satisfaction is an important outcome measure when exploring such multifactorial associations. Aim To explore sexual satisfaction and associated biopsychosocial factors in stroke patients admitted to specialized cognitive rehabilitation. Methods A cross-sectional study was performed including 91 consecutive stroke patients admitted to specialized cognitive rehabilitation. Data were collected from medical records and by face-to-face interviews using a structured interview guide and questionnaires. Descriptive and inferential statistics were applied. Main outcome measures A wide range of biopsychosocial variables including medical and sociodemographic characteristics, social support, sexual complaints, aspects of sexual life, psychological distress and life satisfaction were analyzed in relation to the main outcome “Satisfaction with sexual life.” Results Only 33 % were satisfied with sexual life. Prevalence of sexual complaints was high, more frequent in women (84%) than in men (64%). Three-quarters were less sexually active than before stroke. Multivariable analyses showed that anxiety, sleep problems, manifested sexual complaint, decrease in sexual activity and fear of partner rejection were significantly associated with low odds of sexual satisfaction, while affectionate support and partnership satisfaction were significant for sexual satisfaction. When combined in a biopsychosocial multivariable model only fear of partner rejection (OR 0.07; 95 % CI: 0.01–0.42) and decrease in sexual activity (OR 0.11; 95 % CI: 0.02–0.58) showed significant contribution to sexual satisfaction. Conclusion The variety of predictors for sexual satisfaction indicates that therapeutic actions need to be individualized and points towards a broad assessment and interventional approach to meet the sexual rehabilitation needs of stroke patients with cognitive impairments in need of specialized rehabilitation. Vikan JK, Snekkevik H, Nilsson MI, et al. Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation. Sex Med 2021;9:100424.
Collapse
Affiliation(s)
- Jannike K Vikan
- Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Sunnaas Rehabilitation Hospital, Nesodden, Norway.
| | | | - Marie I Nilsson
- Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Function Area Social Work in Health, Karolinska University Hospital, Stockholm, Sweden
| | - Johan K Stanghelle
- Sunnaas Rehabilitation Hospital, Nesodden, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Amy Østertun Geirdal
- Faculty of Social Sciences, Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Kerstin S Fugl-Meyer
- Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Sunnaas Rehabilitation Hospital, Nesodden, Norway
| |
Collapse
|
23
|
Correlates of social support in individuals with a diagnosis of common mental disorders and non communicable medical diseases in rural South India. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1623-1631. [PMID: 33386410 PMCID: PMC8245575 DOI: 10.1007/s00127-020-01997-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of the study was to examine the association between socio-demographic and clinical characteristics and perceived social support among patients with a diagnosis of depression and/or anxiety and co-morbid medical conditions from rural south India. METHODS The study was conducted in 49 PHCs in Ramanagara district, Karnataka, and included 2481 participants, who were 30 years or older with co-morbid CMD (Common Mental Disorder) and hypertension, diabetes or ischemic heart disease. Socio-demographic characteristics of the participants were collected, and instrumental, emotional and total social support, quality of life, severity of disability, depression and anxiety were measured via face-to-face interviews using structured questionnaires. RESULTS The sample predominantly consisted of Hindu (98.5%) females (75%) in their middle to late adulthood. In multivariate models, age showed a significant curvilinear relation with all forms of social support (B = 0.001 and p < 0.05), and emotional social support (B = - 0.056, p = 0.004) was lower in employed than non-working participants. Household size was positively related to all forms of social support (B = 0.029 for instrumental, B = 0.022 for emotional, B = 0.025 for total social support, all p < 0.001). Quality of life was positively associated with all forms of social support (B = 0.019 for instrumental, B = 0.016 for emotional, B = 0.018 for total social support, all p < 0.001). CONCLUSIONS For this sample of outpatients diagnosed with both CMD and at least one comorbid medical condition in rural south India, greater household size was associated with better social support. The role of family in providing support can be utilized while designing interventions. TRIAL REGISTRATION NUMBER http://Clinicaltrials.gov : NCT02310932 registered December 8, 2014 URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932 ; Clinical Trials Registry India: CTRI/2018/04/013001 retrospectively registered on April 4, 2018.
Collapse
|
24
|
Abstract
BACKGROUND Because the recurrence rate of stroke increases 1 year after its initial occurrence, it is important to predict quality of life at this stage, although most functions are likely recovered. OBJECTIVES We aimed to construct and verify a model of quality of life in patients 1 year post stroke by considering their characteristics at the time of the stroke based on the Wilson and Cleary model and previous literature. METHODS Participants comprised 288 patients who had experienced their first ischemic stroke and were enrolled in 3 regional stroke centers in South Korea. Data were analyzed using path analysis to identify a model of patients' quality of life 1 year post stroke. RESULTS Age, National Institutes of Health Stroke Scale score, the modified Rankin Scale score, and anxiety had a direct effect on quality of life, whereas type D personality and social support had an indirect effect. Type D personality, age, National Institutes of Health Stroke Scale score, social support, the modified Rankin Scale score, and anxiety explained 32.9% of the total variance in quality of life. CONCLUSIONS When predicting quality of life in a patient 1 year after a stroke, it is important to consider variables such as type D personality, age, National Institutes of Health Stroke Scale score, social support, the modified Rankin Scale score, and anxiety at the time of the first stroke. Interventions to improve the quality of life of patients with stroke should consider these factors.
Collapse
|
25
|
The experience of close personal relationships after stroke: scoping review and thematic analysis of qualitative literature. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background and Purpose:
Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.
Method:
Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.
Results:
While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.
Conclusions:
Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.
Collapse
|
26
|
Gadson DS, Wallace G, Young HN, Vail C, Finn P. The relationship between health-related quality of life, perceived social support, and social network size in African Americans with aphasia: a cross-sectional study. Top Stroke Rehabil 2021; 29:230-239. [PMID: 33866954 DOI: 10.1080/10749357.2021.1911749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Stroke significantly impairs health-related quality of life (HRQL). Stroke survivors with aphasia (SWA) experience lower HRQL than stroke survivors without aphasia (SSA) as a result of poorer communication and social functioning. The extent to which aphasia influences HRQL in African-Americans and the components of social functioning that are most important to HRQL warrants further exploration.There were two main objectives of this paper. The first was to survey HRQL domains of communication, physical, mental/emotional, role, and social functioning in African American SWA and SSA. The second was to examine if social support and social network predicted HRQL in SWA.A total of 39 African American adults (62.4 ± 11.10) participated in this descriptive cross-sectional case control study. Patient-reported outcome measures were used to assess HRQL, perceived social support, and social network in SWA, SSA, and normal-aging healthy controls (NAH). Data analysis included an ANOVA and moderator regression to determine if social support or social network predicted HRQL in SWA.SWA reported a significantly lower overall HRQL (p = <.000) than NAH adults. Communication HRQL was the hallmark difference found between SWA and SSA (p = <.000). Social support and social network were relatively similar among all three groups. However, social support and social network did not predict HRQL in SWA.Findings from this study suggest that social HRQL continues to be significantly lower in SWA; however, social support and social network factors do not drive differences among African-Americans. Moreover, communication HRQL remains the hallmark difference between SWA and SSA.
Collapse
Affiliation(s)
- Davetrina Seles Gadson
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| | - Gloriajean Wallace
- Speech Language Pathology, Xavier University of Louisiana, New Orleans, United States
| | - Henry N Young
- Department of Clinical Administrative Pharmacy, University of Georgia, Athens, United States
| | - Cynthia Vail
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| | - Patrick Finn
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| |
Collapse
|
27
|
Yoon S, Kim HY, Kim SR. A prediction model of health-related quality of life in young adult patients with stroke. J Clin Nurs 2021; 30:2023-2035. [PMID: 33756032 DOI: 10.1111/jocn.15755] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/05/2020] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to establish and test a predictive model for explaining the health-related quality of life of young adult patients with stroke. BACKGROUND Individual characteristics, biological and physiological variables, social support, emotional and cognitive symptoms, physical function disability and general health perception may be interrelated and may directly or indirectly affect the health-related quality of life of young adult patients with stroke. DESIGN A cross-sectional study. METHODS 237 young outpatients with stroke were recruited and surveyed. Data collection used a structured questionnaire from July-November 2018. The collected data were analysed using SPSS version 25.0® and AMOS 23.0. This study is based on STROBE guidelines. RESULTS The hypothetical model's fit indices were adequate. Stroke severity, social support, fear of stroke recurrence, physical function disability and general health perceptions directly affected the health-related quality of life. Additionally, stroke severity, depression and fear of stroke recurrence also indirectly affected it. These variables explained 60.3% of the variance in this quality. CONCLUSIONS Variables such as severity of stroke, depression, fear of stroke recurrence, social support, physical function disability and general health perception were found to be related to the HRQoL of young adult patients with stroke. RELEVANCE TO CLINICAL PRACTICE A variety of physical, psychological, functional and social factors related to health-related quality of life should be systematically monitored. Furthermore, nurses need to develop and apply detailed nursing interventions that take into account all these variables.
Collapse
Affiliation(s)
- Susie Yoon
- School of Nursing, Cheju Halla University, Jeju, South Korea
| | - Hye Young Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
| | - Sung Reul Kim
- College of Nursing, Korea University, Seoul, South Korea
| |
Collapse
|
28
|
Zemed A, Nigussie Chala K, Azeze Eriku G, Yalew Aschalew A. Health-related quality of life and associated factors among patients with stroke at tertiary level hospitals in Ethiopia. PLoS One 2021; 16:e0248481. [PMID: 33735246 PMCID: PMC7971497 DOI: 10.1371/journal.pone.0248481] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 02/27/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Evidence on a patient-centered assessment of outcome among patients with stroke is limited in Ethiopia. Therefore, this study aimed to assess the level of health-related quality of life (HRQOL) and associated factors in Ethiopia's tertiary level hospitals. METHODS A cross-sectional study was conducted at three tertiary level hospitals (Felege Hiwot comprehensive specialized hospital, University of Gondar comprehensive specialized hospital, and Dessie referral hospital) from April 1 to May 31, 2019. A total of 180 patients with stroke were included, and a consecutive sampling method was employed to recruit the participants. RAND 36-Item Health Survey was used to measure the HRQOL. A generalized linear model with a gamma distribution and log-link function was used to investigate potential predictors, and variables with a P value of <0.05 were considered statistically significant. RESULTS Out of the participants, 50.56% were female. The average age and average duration of illness were 59.04 (12.71) and 1.5 (1.46) years, correspondingly. The physical health domain score was higher than the mental health domain score. Education (P = 0.041), social support (P = 0.050), disability (P <0.001), co-morbidity (P = 0.011), depression (P = 0.015) and income (<1000 ETB P = 0.002; 1000-4000 ETB P = 0.009) were associated with physical health domain. Whereas, ischemic stroke (P = 0.014), education (P = 0.020), disability (P <0.001), and depression (P <0.001) were associated with the mental health domain. CONCLUSION The HRQOL of the patients was low. Social support and lower disability status were associated with higher HRQOL, whereas disability and depression were associated with higher HRQOL. Therefore, attention should be given to strengthening social support; health professionals should focus on reducing disability/physical dependency and depression, as these are vital factors for improving HRQOL.
Collapse
Affiliation(s)
- Ashenafi Zemed
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kalkidan Nigussie Chala
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze Eriku
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Andualem Yalew Aschalew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| |
Collapse
|
29
|
Harris Walker G, Gonzalez-Guarda R, Yang Q, Shah S, Prvu Bettger J. Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study. J Adv Nurs 2021; 77:2860-2874. [PMID: 33650219 DOI: 10.1111/jan.14778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/13/2022]
Abstract
AIMS Stroke is affecting an increasing number of young and middle-aged adults. Given the substantial diversion from anticipated life trajectories that younger stroke survivors experience as a result of their stroke deficits, their health-related quality of life (HRQOL) is likely to be negatively impacted during the immediate post-acute recovery period. The aim of this study was to generate a comprehensive understanding of the influences on HRQOL and acute recovery during the first three months following stroke for younger adults using a socio-ecological perspective. DESIGN Longitudinal, convergent mixed methods design. METHODS HRQOL survey data, assessed using the Patient Generated Index (N = 31), and qualitative interview data about survivors' recovery experiences (N = 20) were collected. Simple linear regression and effect size results were integrated with themes and sub-themes identified from conventional content analysis using joint data displays. RESULTS Depression and fatigue negatively affected recovery at the individual level. At the family and societal level, family functioning, social support including being married, having insurance, working, adequate income and being unemployed post-stroke all positively impacted recovery. Qualitative findings revealed determination, coping, and accessing healthcare to positively affect recovery though a meta-inference could not be drawn as no quantitative data addressed these concepts. CONCLUSION A variety of factors intersecting across socio-ecological levels were perceived by young stroke survivors to influence acute recovery experiences and outcomes. IMPACT This study identified individual-, family- and societal-level factors in younger adults' environments that may affect the acute stroke recovery experience. Findings underscore the need for research and clinical approaches that consider environmental factors at multiple levels of influence when supporting stroke recovery for younger adults.
Collapse
Affiliation(s)
| | | | - Qing Yang
- Duke University School of Nursing, Durham, NC, USA
| | | | - Janet Prvu Bettger
- Duke University School of Nursing, Durham, NC, USA.,Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
30
|
Lardone A, Sorrentino P, Giancamilli F, Palombi T, Simper T, Mandolesi L, Lucidi F, Chirico A, Galli F. Psychosocial variables and quality of life during the COVID-19 lockdown: a correlational study on a convenience sample of young Italians. PeerJ 2020; 8:e10611. [PMID: 33384910 PMCID: PMC7751426 DOI: 10.7717/peerj.10611] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In 2020, to limit the spread of Coronavirus (COVID-19), many countries, including Italy, have issued a lengthy quarantine period for the entire population. For this reason lifestyle has changed, bringing inevitable repercussions to the Quality of Life (QoL). The present study aims to identify which psychosocial variables predict behaviors capable of affecting the QoL during the lockdown period, potentially highlighting factors that might promote well-being and health in the Italian population during the epidemic. METHODS Between 27 April 2020 and 11 May 2020, we administered a web-survey to a sample of young Italian people (age M = 21.2; SD = 3.5; female = 57.7% of the sample). Employing variance-based structural equation modeling, we attempted to identify whether social connectedness, social support, and loneliness were variables predictive of the QoL of young Italians. We also sought to identify specific psychological factors, such as symbolic threat, realistic threat, and the threat from potentially contaminated objects, was correlated to COVID-19 fear and whether engaging in particular behaviors was likely to improve the QoL. RESULTS Our results suggest that social connectedness and loneliness are significant predictors of QoL, while social support did not have a significant effect on QoL. Furthermore, we observed that symbolic and realistic threats and the threat from potentially contaminated objects are significant and positive predictors of COVID-19 fear. Moreover, COVID-19 fear had significant and positive relationships with the carrying out of specific behaviors, such as creative activities during the isolation period and that this related to affirming individuals' country-specific identity. Finally, COVID-19 fear is a significant predictor of behavioral factors related to the adherence to public health advice in line with national guidance regarding the containment of COVID-19; this factor, however, did not correlate with QoL. CONCLUSION Our results suggest the importance of social context and psychological factors to help devise intervention strategies to improve the QoL during lockdown from epidemic events and, in particular, support the importance of promoting social communication and accurate information about the transmission of the virus.
Collapse
Affiliation(s)
- Anna Lardone
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| | - Pierpaolo Sorrentino
- Institut de Neuroscience des Systemès, Aix-Marseille University, Marseille, France
| | - Francesco Giancamilli
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| | - Tommaso Palombi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| | - Trevor Simper
- School of Sports Science, Exercise & Health., University of Western Australia, Crawley, WA, Australia
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, Napoli, Italy
| | - Fabio Lucidi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| | - Andrea Chirico
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| | - Federica Galli
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, University of Roma “La Sapienza”, Rome, Italy
| |
Collapse
|
31
|
Becker I, Maleka MD, Stewart A, Jenkins M, Hale L. Community reintegration post-stroke in New Zealand: understanding the experiences of stroke survivors in the lower South Island. Disabil Rehabil 2020; 44:2815-2822. [PMID: 33135947 DOI: 10.1080/09638288.2020.1839792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Optimal community reintegration is a key rehabilitation outcome post-stroke. This concept has been investigated in many countries but not qualitatively in New Zealand. We explored perceptions about community reintegration of stroke survivors living in southern New Zealand. METHOD Qualitative interviews were used to collect data. Recruitment was via local stroke clubs, inviting adult stroke survivors (stroke duration > six months, any severity or type) living in the lower South Island. Data were analysed using the General Inductive Approach. RESULTS Eight stroke survivors (two female, six males; age range 50-80 years, mean 66 years (SD = 12); mean time since stroke 6.5 (SD = 4) years) participated. Participants' perceptions of what is integral to reintegration into their community were shaped by four themes, namely: (1) personal relationships, (2) re-establishing normality (old and new), (3) purpose in life, and (4) independence. CONCLUSIONS Stroke survivors in New Zealand hold many similar perceptions about optimal community reintegration with those living elsewhere. Key to successful community reintegration, irrespective of geography, culture and ethnicity, appears to be involvement in meaningful activities, and reduced reliance on others whilst maintaining or developing good social relationships. These fundamental components are then contextually nuanced by what is meaningful and important to the individual.IMPLICATIONS FOR REHABILITATIONOptimal community reintegration post-stroke is arguably the key goal of rehabilitation, and thus should be enabled and measured.To optimise community reintegration post-stroke, rehabilitation should focus on enabling stroke survivors' social relationships, independent community mobility, and engagement in meaningful activities.Optimal community reintegration post-stroke is however contextual. Rehabilitation professionals must understand what each patient considers successful community reintegration to be for them and tailor their rehabilitation accordingly.
Collapse
Affiliation(s)
- Ines Becker
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Morake Douglas Maleka
- Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Aimee Stewart
- Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Matthew Jenkins
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Leigh Hale
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
32
|
The evolution of social health research topics: A data-driven analysis. Soc Sci Med 2020; 265:113299. [PMID: 32905964 DOI: 10.1016/j.socscimed.2020.113299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 12/28/2022]
Abstract
The realm of social health has not yet been properly established in terms of fixed definitions, concepts, and research areas. This study attempts to define social health using macro and micro perspectives and explores trends in social health research by mapping their topics and fields. We used Latent Dirichlet allocation (LDA) topic modeling, which allows the extraction of key terms and topics derived from a large volume of literature. We traced the evolution of research topics from past (the literature that "present" articles cited), present (existing journal articles on social health), to future (the literature which cited the articles) studies based on connections between citations. The datasets were collected by the query terms "social health" in the Scopus database, including title, abstract, and keywords of journal articles. We collected a total of 443 articles from recent social health literature, 6588 articles from past literature that the recent articles on social health cited, and 2680 articles from future literature in which recent social health articles were cited. We defined social health as positive interaction that increases individual engagement in social life at the micro level, and the high degree of social integration that deals with collective problems in society at the macro level. The results of LDA showed that social health research has developed into seven fields: Health Care Delivery; Vulnerable Groups; Measurement; Health Inequality; Social Network and Empowerment; Clinical/Physical Health; and Mental/Behavioral Health. Based on citation relationships, topics grounded in an individual/micro perspective have grown increasingly specialized and productive, while topics grounded in a social/macro perspective have stagnated or was underexplored. Our findings imply that social health studies should follow a more interdisciplinary approach to integrate current health models of individual-centered treatments with social science concerns on building collective capacity for social well-being.
Collapse
|
33
|
Abstract
Given that stroke is an indispensable health burden in Saudi Arabia and around the world, great importance has been attached on studies of social support and other factors that could improve the quality of life of stroke survivors. Perceptions of quality of life and social support may vary depending on patients' cultural and societal background. This research assessed the quality of life and social support of community-dwelling Saudis who survived stroke. A quantitative study was performed among 123 Saudi stroke survivors. Questionnaire-guided interviews measuring social support and quality of life were performed, and the multivariate effects of predictor variables on the four domains of quality of life were determined through multivariate multiple regression analysis. Among the dimensions of social support, support from family members had the highest average, whereas support from friends had the lowest. The environmental domain of quality of life was perceived to be the best aspect, whereas physical health was perceived to be the poorest. Multivariate analysis revealed that age, gender, employment status, monthly family income, type of community, education, type of stroke, side of stroke and support from significant others had multivariate influences on the domains of quality of life. Several sociodemographic and disease-related variables and social support influence patients' quality of life. The study adds critical knowledge as to how Arab stroke survivors perceive their quality of life and social support. Ensuring that stroke survivors receive adequate social support is imperative because it can improve their quality of life.
Collapse
Affiliation(s)
- Abdulrahman M Alshahrani
- Department of Medicine (Neurology), College of Medicine, Shaqra University, Shaqra, Saudi Arabia
| |
Collapse
|
34
|
Minshall C, Castle DJ, Thompson DR, Pascoe M, Cameron J, McCabe M, Apputhurai P, Knowles SR, Jenkins Z, Ski CF. A psychosocial intervention for stroke survivors and carers: 12-month outcomes of a randomized controlled trial. Top Stroke Rehabil 2020; 27:563-576. [PMID: 32191569 DOI: 10.1080/10749357.2020.1738677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background and Purpose: Stroke can have a devastating impact on the mental and physical health of stroke survivors and their carers. We aimed to evaluate the effectiveness of a novel psychosocial intervention designed to improve health outcomes in both groups.Methods: We conducted a randomized controlled trial of a personalized psychosocial intervention (eight 1-hour weekly sessions plus one booster) compared to usual care for adult stroke survivors and carers. Participants recruited from hospital services and community referrals completed questionnaires at baseline, 3, 6, and 12 months. Primary outcomes were quality of life and self-efficacy; secondary outcomes were depressive and anxiety symptoms, coping, illness perception, work and social adjustment, carer strain, and carer satisfaction. Mixed-effect model repeated measures analysis between groups and across time was conducted.Results: Of the 173 participants recruited (89 stroke survivors; 84 carers), a total of 137 participants - 73 stroke survivors (intervention n = 42; usual care n = 31) and 64 carers (intervention n = 35; usual care n = 29) - underwent analysis up to 12 months. No statistically significant differences were found in the primary outcomes between groups over time, though a significant improvement in carer satisfaction was found at 6 months in the intervention group compared to the usual care group.Conclusion: A personalized psychosocial intervention resulted in a significant improvement in carer satisfaction at 6 months but in no other outcomes. A lack of available services and barriers to social engagement may have impeded the effectiveness of this intervention.
Collapse
Affiliation(s)
- Catherine Minshall
- Centre for Mental Health, University of Melbourne, Melbourne, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Michaela Pascoe
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - Jan Cameron
- School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Marita McCabe
- Faculty of Health Sciences, Swinburne University, Melbourne, Australia
| | | | - Simon R Knowles
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Faculty of Health Sciences, Swinburne University, Melbourne, Australia
| | - Zoe Jenkins
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
35
|
Mikula P, Timkova V, Linkova M, Vitkova M, Szilasiova J, Nagyova I. Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support. Front Psychol 2020; 11:504. [PMID: 32256439 PMCID: PMC7093596 DOI: 10.3389/fpsyg.2020.00504] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/02/2020] [Indexed: 01/03/2023] Open
Abstract
Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.
Collapse
Affiliation(s)
- Pavol Mikula
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Marcela Linkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Marianna Vitkova
- Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Jarmila Szilasiova
- Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia
| |
Collapse
|
36
|
Schindel D, Schneider A, Grittner U, Jöbges M, Schenk L. Quality of life after stroke rehabilitation discharge: a 12-month longitudinal study. Disabil Rehabil 2019; 43:2332-2341. [PMID: 31846594 DOI: 10.1080/09638288.2019.1699173] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To analyse trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge, and to investigate the impact of including proxy interviews in research and practice. METHODS A prospective cohort study with follow-up at 3, 6, and 12 months with 411 patients and proxy respondents was conducted. The EUROHIS-QOL 8-item index was used to assess QoL. By performing descriptive analyses, QoL development over time was compared among subgroups. Linear mixed models were calculated to estimate mean changes from baseline to 12-month follow-up. The effects of patient characteristics and time on QoL were investigated using comprehensive mixed models. RESULTS One year after rehabilitation discharge, the majority of patients had neither maintained nor regained their initial QoL. Proxy respondents reported significantly lower QoL (22.6-29.5 points, p < 0.001). Characteristics associated with lower QoL were stroke severity, depression, and pain. Having a small social network was negatively associated with QoL (-1.66 points, 95%CI: -2.84/-0.48, p = 0.006). CONCLUSIONS Quality of life scores reported at the time of rehabilitation discharge are often not lasting. Including severely impaired patients via proxies reduces the risk of overestimating QoL outcomes. Outpatient's characteristics should be taken into account when planning therapy strategies to maintain previously achieved health goals. Regular re-assessments are required.Implications for rehabilitationThere should be an awareness that improvements in quality of life (QoL) achieved during rehabilitation are not sustainable.Regularly re-assessing pain status, psychological burden, and social network size could help clinicians to determine treatment strategies for maintaining and improving rehabilitation achievements.Conducting proxy interviews is required to assess disease burden of patients with severe stroke (e.g., non-linguistic patients).
Collapse
Affiliation(s)
- Daniel Schindel
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alice Schneider
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Michael Jöbges
- Department of Neurology, Brandenburg Klinik, Bernau, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
37
|
Wang X, Shang S, Yang H, Ai H, Wang Y, Chang S, Sha X, Wang L, Jiang X. Associations of psychological distress with positive psychological variables and activities of daily living among stroke patients: a cross-sectional study. BMC Psychiatry 2019; 19:381. [PMID: 31795970 PMCID: PMC6888918 DOI: 10.1186/s12888-019-2368-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression and anxiety result in psychological distress, which can further affect mental status and quality of life in stroke patients. Exploring the associations between positive psychological variables and symptoms of psychological distress following stroke is of great significance for further psychological interventions. METHODS A total of 710 stroke patients from the five largest cities in Liaoning Province in China were enrolled into the present study in July 2014. All patients independently completed the questionnaires with respect to psychological distress and positive psychological variables. Depressive and anxiety symptoms were evaluated using Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale, respectively. Positive psychological variables were evaluated using Perceived Social Support Scale, Adult Hope Scale (AHS), General Perceived Self-Efficacy Scale and Resilience Scale-14 (RS-14). Activities of Daily Living (ADL) was measured using Barthel Index. Factors associated with psychological variables and depressive and anxiety symptoms were identified using t-test, ANOVA, correlation and hierarchical linear regression analysis. RESULTS Depressive and anxiety symptoms were present in 600 of 710 (84.51%) and 537 of 710 (75.63%) stroke patients enrolled, respectively. Social support (β = - 0.111, p < 0.001) and hope (β = - 0.120, p < 0.001) were negatively associated with both depressive and anxiety symptoms. Resilience (β = - 0.179, p < 0.001) was negatively associated with depressive symptoms. Self-efficacy (β = - 0.135, p < 0.001) was negatively associated with anxiety symptoms. Hierarchical regression analyses indicated that ADL accounted for 10.0 and 6.0% of the variance of depressive and anxiety symptoms, respectively. Social support, resilience, self-efficacy and hope as a whole accounted for 7.5 and 5.3% of the variance of depressive and anxiety symptoms. CONCLUSIONS The high frequency of depressive and anxiety symptoms among Chinese stroke survivors should receive attentions from all stakeholders. Findings suggested that intervention strategies on ADL, social support, hope, resilience and self-efficacy could be developed to improve psychosocial outcomes for stroke survivors.
Collapse
Affiliation(s)
- Xiaoxi Wang
- Department of Sports Medicine, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Shengjie Shang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Huazhe Yang
- Department of Biophysics, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Hua Ai
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Yin Wang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Shijie Chang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Xianzheng Sha
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China
| | - Xiran Jiang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang, 110122, People's Republic of China.
| |
Collapse
|
38
|
Meyer AC, Torssander J, Talbäck M, Modig K. Parents survive longer after stroke than childless individuals: a prospective cohort study of Swedes over the age of 65. Eur J Public Health 2019; 29:1090-1095. [PMID: 31220242 PMCID: PMC6896977 DOI: 10.1093/eurpub/ckz053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Parents have lower mortality than childless individuals, and one possible explanation is support provided by adult children. Since stroke often results in functional limitations, support from children may be of particular importance. Here, we examine whether the presence of children matters for survival after stroke among older Swedish men and women. METHODS This prospective cohort study linked data from several Swedish population registers. Individuals aged 65 years and older hospitalized for their first ischemic stroke between 1998 and 2002 (33 960 men and 36 189 women) were followed 12 years for survival. Hazard ratios for all-cause mortality were calculated by number of children using Cox proportional hazard regression stratified by sex and marital status and adjusted for education, income and comorbidities. RESULTS Childlessness and having only one child was associated with higher mortality after stroke compared with having two children among men and women. The relative survival disadvantage of childless individuals was largest among married women [HR 1.28 (1.18-1.39)] and smallest among married men [1.09 (1.03-1.15)]. The differences in predicted median survival between childless individuals and those with two children were 4 and 7 months among married and unmarried men, and 15 and 9 months among married and unmarried women, respectively. CONCLUSIONS Having children is associated with a longer survival after stroke among men and women regardless of marital status. Our findings further suggest that the presence of children is especially connected to married women's survival. These results may have implications for the improvement of informal care for childless older individuals.
Collapse
Affiliation(s)
- Anna C Meyer
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Torssander
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Mats Talbäck
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Modig
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
39
|
Kim SH, Shin YI, Kim SC, Ko SH, Kim DY, Lee J, Sohn MK, Lee SG, Oh GJ, Lee YS, Joo MC, Han EY, Han J, Chang WH, Min JH, Kim YH. Factors Associated to Returning Home in the First Year after Stroke. BRAIN & NEUROREHABILITATION 2019; 13:e1. [PMID: 36744270 PMCID: PMC9879522 DOI: 10.12786/bn.2020.13.e1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/02/2019] [Accepted: 09/12/2019] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the 'Return home' group and 99 subjects in the 'Rehabilitation hospitalization' group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be considered as basic data for establishing rehabilitation goals and treatment plans.
Collapse
Affiliation(s)
- Seung Han Kim
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Chan Kim
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sung Hwa Ko
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Deog Young Kim
- Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Sam-Gyu Lee
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University, School of Medicine, Jeju, Korea
| | - Junhee Han
- Department of Statistics, Hallym University, Chuncheon, Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hong Min
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
40
|
Minshall C, Pascoe MC, Thompson DR, Castle DJ, McCabe M, Chau JPC, Jenkins Z, Cameron J, Ski CF. Psychosocial interventions for stroke survivors, carers and survivor-carer dyads: a systematic review and meta-analysis. Top Stroke Rehabil 2019; 26:554-564. [PMID: 31258017 DOI: 10.1080/10749357.2019.1625173] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objective: To evaluate the effectiveness of psychosocial interventions on depressive symptoms, anxiety symptoms, quality of life, self-efficacy, coping, carer strain and carer satisfaction among stroke survivors, carers and survivor-carer dyads. Data sources: MEDLINE, CINAHL, PsycINFO, SocINDEX, Cochrane Library, Web of Science and Scopus databases and the grey literature were searched up to September 2018. Methods: A systematic review and meta-analysis of randomized controlled trials of psychosocial interventions for stroke survivors, carers and survivor-carer dyads, compared to usual care. Outcomes measured were depressive symptoms, anxiety symptoms, quality of life, coping, self-efficacy, carer strain, and carer satisfaction. Results: Thirty-one randomized controlled trials (n = 5715) were included in the systematic review which found improvements in depressive symptoms, anxiety symptoms, quality of life and coping, though the number of trials assessing each outcome varied. A meta-analysis (11 trials; n = 1280) on depressive symptoms found that in seven trials psychosocial interventions reduced depressive symptoms in stroke survivors (SMD: -0.36, 95% CI -0.73 to 0.00; p = .05) and in six trials reduced depressive symptoms in carers (SMD: -0.20, 95% CI -.40 to 0.00; p = .05). Conclusion: Psychosocial interventions reduced depressive symptoms in stroke survivors and their carers. There was limited evidence that such interventions reduced anxiety symptoms, or improved quality of life and coping for stroke survivors and carers and no evidence that they improved self-efficacy, carer strain or carer satisfaction.
Collapse
Affiliation(s)
- Catherine Minshall
- Faculty of Health Sciences, Australian Catholic University , Melbourne , Australia.,Mental Health Service, St. Vincent's Hospital , Melbourne , Australia
| | - Michaela C Pascoe
- Institute of Sport, Exercise and Active Living, Victoria University , Melbourne , Australia.,Department of Cancer Experiences, Peter MacCallum Cancer Centre , Melbourne , Australia
| | - David R Thompson
- Department of Psychiatry, University of Melbourne , Melbourne , Australia.,School of Nursing and Midwifery, Queen's University , Belfast , UK
| | - David J Castle
- Mental Health Service, St. Vincent's Hospital , Melbourne , Australia.,Department of Psychiatry, University of Melbourne , Melbourne , Australia
| | - Marita McCabe
- Faculty of Health Sciences, Swinburne University of Technology , Melbourne , Australia
| | - Janita P C Chau
- Nethersole School of Nursing, Chinese University of Hong Kong , Shatin , Hong Kong
| | - Zoe Jenkins
- Mental Health Service, St. Vincent's Hospital , Melbourne , Australia
| | - Jan Cameron
- School of Nursing and Midwifery, Monash University , Melbourne , Australia
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne , Melbourne , Australia.,School of Nursing and Midwifery, Queen's University , Belfast , UK
| |
Collapse
|
41
|
Measuring Community Mobility in Survivors of Stroke Using Global Positioning System Technology: A Prospective Observational Study. J Neurol Phys Ther 2019; 43:175-185. [PMID: 31205231 DOI: 10.1097/npt.0000000000000279] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Returning to community mobility is important for people recovering from a stroke, yet few studies have directly measured this construct following inpatient rehabilitation. Using global positioning system (GPS) technology, we examined community mobility of survivors of stroke (SS) over the first year after discharge and compared them to an age-matched comparison group without neurological impairment. METHODS We conducted a prospective observational study that included SS (n = 14) and age- and location-matched comparison subjects (CS; n = 6). All participants identified target locations important to their community mobility goals and wore a GPS unit during the first, fifth and ninth weeks after discharge, or from baseline for CS, and at 26 and 52 weeks' follow up. The 6-minute walk test (SMWT), Berg balance test (BBT), Reintegration to Normal Living (RNLI), and Short Form-36 Quality of Life Survey Physical Functioning domain (SF-36-PF) were collected. Number of trips and percentage of targets visited were extracted from GPS data. RESULTS Twelve of 14 SS completed 9 weeks, 7 completed the full year, and no CS withdrew. The SS took fewer trips and attained fewer targets compared with CS at weeks 1 and 9, but not at weeks 5, 26, and 52. All 4 clinical outcome measures were significantly correlated to trips (Spearman r for SMWT = 0.5067, BBT = 0.3841, RNLI = 0.4119, and SF-36-PF = 0.4192). DISCUSSION AND CONCLUSIONS Directly measured community mobility in SS was decreased through 9 weeks following discharge from inpatient rehabilitation. The limited strength of bivariate correlations between clinical measures and number of trips supported the uniqueness of the community mobility construct.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A277).
Collapse
|
42
|
Jaber AF, Sabata D, Radel JD. Self-perceived occupational performance of community-dwelling adults living with stroke. The Canadian Journal of Occupational Therapy 2019; 85:378-385. [DOI: 10.1177/0008417418821704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Stroke has long-term consequences for functional performance of daily activities. Evaluating client-perceived occupational performance provides insight for designing stroke-specific programs supporting home and community participation. Purpose. This study describes the personal characteristics and self-perceived occupational performance in community-dwelling adults with stroke. Method. A retrospective chart review was undertaken of 25 stroke survivors who sought services at a community-based centre. The outcome measures were the Canadian Occupational Performance Measure (COPM) to evaluate self-perceived occupational performance and the Montreal Cognitive Assessment (MoCA) to screen for cognitive impairment. The analysis used descriptive statistics. Findings. Mean participant age was 64 years, and most participants were Caucasian males (72%). The mean cognitive function score was 22.1 on MoCA, and the mean COPM performance and satisfaction subscores were 4.1 and 3.9, respectively. The top three challenging daily activities were driving, seeking employment, and functional mobility. Implications. Stroke-specific community programs should emphasize the diverse performance concerns important to stroke survivors.
Collapse
|
43
|
Social support, functional outcome and quality of life among stroke survivors in an urban area. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2019. [DOI: 10.1017/prp.2019.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Sophisticated medical technologies can prolong a stroke patient’s life but not always their quality of life (QoL) due to poor functional outcomes. Social support can theoretically assist a patient’s adaptation to life after stroke and improve their QoL, but existing findings are inconclusive. This inconclusiveness is especially found in large cities where family and social bonding can be scarce. We conducted a hospital-based, cross-sectional study among 358 stroke patients to identify the effects of social support and functional outcome on QoL and its domains. The study took place in Bangkok, Thailand between July and December 2016. Data were collected by personal interview using a structured questionnaire that included the Short-Form WHO Quality of Life Instrument (WHOQOL-BREF) and by review of medical records. A hierarchical linear regression method was used to analyze data. The mean age of stroke respondents was 66.0 years ( SD 13.5 years), and half were male. The mean total QoL score for patients was 68.6 ( SD 15.2). Hierarchical multiple regression analysis found emotional support significantly impacted QoL in every domain ( ps < .05) when all included variables were controlled for. To improve the quality of life among stroke survivors, health personnel and family members should provide not only physical assistance but also psychological support.
Collapse
|
44
|
Eadie T, Kapsner-Smith M, Bolt S, Sauder C, Yorkston K, Baylor C. Relationship between perceived social support and patient-reported communication outcomes across communication disorders: a systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:1059-1077. [PMID: 30039920 PMCID: PMC7335018 DOI: 10.1111/1460-6984.12417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 07/03/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND Beyond the severity of voice, speech and language impairments, one potential predictor of communication success across adult populations with communication disorders may be perceived social support: the expectation that others will provide support if needed. Despite the preponderance of intervention approaches that assume a positive relationship between perceived social support and patient-reported communication success, the evidence base for these relationships is limited. AIMS The aim of this systematic review is to explore relationships between measures of perceived social support and patient-reported communication outcomes in adult populations with communication disorders. METHODS & PROCEDURES The PRISMA guidelines were followed in the conduct and reporting of this review. Electronic databases including PubMed, PsychINFO and CINAHL were systematically searched up to 19 May 2017. Additional data were obtained for two studies. All the included studies were appraised using the Critical Appraisal Skills Program (CASP) tools. Given the heterogeneous nature of the studies, data synthesis was narrative for the quantitative studies. A meta-ethnographic approach was used to synthesize qualitative data. OUTCOMES & RESULTS Eight quantitative and four qualitative studies met eligibility criteria. All quantitative studies met eight of eight quality criteria. For the qualitative studies, one study met nine of nine quality criteria; the remaining three studies met three, seven and eight quality criteria. Of the eight included quantitative studies, six independent data sets were used. Results revealed no significant relationships between perceived social support and communication outcomes in three studies (two aphasia with one data set, one Parkinson's disease), while perceived social support was a weak, but significant predictor in two studies (one multiple sclerosis, one head and neck cancer). Three additional studies (two aphasia with one data set; one Parkinson's disease) found that relationships were initially weak, but strengthened over time to become moderate. Results from qualitative studies (one head and neck cancer, two aphasia, one multiple sclerosis) revealed that perceived social support acted as a facilitator, and absent or misguided support acted as a barrier to communication outcomes. Skilful, responsive family members were able to facilitate better quality of communicative interactions, whereas lack of social support, or negative attitudes and behaviours of other people, were barriers. CONCLUSIONS & IMPLICATIONS While perceived social support may affect communication outcomes in adults with communication disorders, current measures may not adequately capture these constructs. Results have implications for future research and interventions for speech and language therapists.
Collapse
Affiliation(s)
- Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Susan Bolt
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Cara Sauder
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
45
|
da Silva JK, dos Anjos KF, Santos VC, Boery RNSDO, Rosa DDOS, Boery EN. [Interventions for stroke survivor caregivers: a systematic reviewIntervenciones para los cuidadores de los sobrevivientes de un accidente cerebrovascular: revisión sistemática]. Rev Panam Salud Publica 2018; 42:e114. [PMID: 31093142 PMCID: PMC6385811 DOI: 10.26633/rpsp.2018.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/27/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To synthesize and critically review the literature on interventions aimed at decreasing the burden of stroke survivor caregivers and other associated factors. METHOD The literature search for the present systematic review was performed in PubMed, SciELO, Coordination for the Improvement of Higher Education Personnel (CAPES) website, and the Virtual Health Library using the following search terms: Stroke AND Caregivers AND Intervention; and Stroke AND Caregivers AND clinical trial. Eight randomized controlled clinical trials (RCT) published between 2008 and 2017 were selected. RESULTS The selected studies were performed in Sweden, Taiwan, Germany, China, India, and the United States. Psychoeducational, support, and skill acquisition interventions produced positive results for caregivers - in the psychological, physical, and social domains, in the quality of the care provided, and in the acquisition of knowledge by caregivers - and for stroke survivors - for example, decreased use of health care services and improved capacity for self-care. The critical evaluation of the studies showed that none met all the methodological requirements for RCTs. The main limitations were missing data and the heterogeneity of interventions. CONCLUSION The interventions had positive results for caregivers and survivors. However, future studies should consider long term assessments of the outcomes, with detailed description of the baseline needs that guided the study and the sharing of the support materials used to allow the intervention to be reproduced.
Collapse
Affiliation(s)
- Jaine Kareny da Silva
- Universidade Estadual do Sudoeste da Bahia, Programa de Pós-Graduação em Enfermagem e Saúde, Jequié (BA), Brasil
| | - Karla Ferraz dos Anjos
- Universidade Federal da Bahia (UFBA), Programa de Pós-Graduação em Enfermagem, Salvador (BA), Brasil
| | - Vanessa Cruz Santos
- Universidade Federal da Bahia (UFBA), Instituto de Saúde Coletiva, Salvador (BA), Brasil
| | | | | | - Eduardo Nagib Boery
- Universidade Estadual do Sudoeste da Bahia, Programa de Pós-Graduação em Enfermagem e Saúde, Jequié (BA), Brasil
| |
Collapse
|
46
|
Abstract
A stroke can have implications for all areas of a person's life. In research on adaptation to stroke, finding meaning is associated with better adaptation. This study focuses on one of the driving principles behind meaning-making processes: global meaning. The aim of this study was to explore whether global meaning (i.e., fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) is associated with processes and outcomes of rehabilitation, as experienced by people with stroke. In-depth, semi-structured interviews were conducted, and analysed using qualitative research methods. Aspects of global meaning were associated with the following elements of process and outcome of rehabilitation: motivation, handling stress and emotions, physical functioning and acceptance. The influence was mostly positive. If rehabilitation professionals took global meaning into account, respondents tended to associate this with better or faster recovery.
Collapse
|
47
|
Burns SP, Pickens ND, Dawson DR, Perea JD, Vas AK, Marquez de la Plata C, Neville M. In-home contextual reality: a qualitative analysis using the Multiple Errands Test Home Version (MET-Home). Neuropsychol Rehabil 2018; 30:787-801. [DOI: 10.1080/09602011.2018.1431134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Suzanne Perea Burns
- WISSDOM Center, Medical University of South Carolina, Charleston, SC, USA
- School of Occupational Therapy, Texas Woman’s University, Dallas, TX, USA
| | | | - Deirdre R. Dawson
- Rotman Research Institute, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Rehabilitation Science Institute, University of Toronto, Toronto, Canada
| | | | - Asha K. Vas
- School of Occupational Therapy, Texas Woman’s University, Dallas, TX, USA
| | | | - Marsha Neville
- School of Occupational Therapy, Texas Woman’s University, Dallas, TX, USA
| |
Collapse
|
48
|
Yang YO, Kim M, Park KY. Meta-Analysis of Social Psychological Factors related to Quality of Life in Stroke Patients. ACTA ACUST UNITED AC 2018. [DOI: 10.12799/jkachn.2018.29.4.510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Young-Ok Yang
- Associate Professor, Department of Nursing, Kaya University, Gimhae, Korea
| | - Minju Kim
- Associate Professor, Department of Nursing, Dong-A University, Busan, Korea
| | - Kyung-Yeon Park
- Professor, Department of Nursing, Silla University, Busan, Korea
| |
Collapse
|
49
|
Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Qual Life Res 2017; 27:783-792. [PMID: 29124499 DOI: 10.1007/s11136-017-1730-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS Social support was positively related to HRQOL (β = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.
Collapse
|
50
|
White BM, Magwood GS, Burns SP, Ellis C. Sex Differences in Patient-Reported Poststroke Disability. J Womens Health (Larchmt) 2017; 27:518-524. [PMID: 29064306 DOI: 10.1089/jwh.2017.6525] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Recent studies have shown that stroke has a differential impact in women compared to men. Women are more likely to survive strokes than men, yet they experience more severe strokes resulting in greater poststroke disability. However, few studies have characterized sex differences in functional ability after stroke. This study examined sex differences in long-term disability among stroke survivors. METHODS This was a retrospective analysis of the 2015 National Health Interview Survey. Respondents were asked to rate their ability to perform 11 functional tasks. Univariate comparisons were completed to evaluate sex differences in performance, and multinomial logistic regression was used to determine the odds of reporting functional limitations. RESULTS Five hundred fourteen men and 641 women stroke survivors completed the survey (mean age: 66.9 years). Approximately 75% of the sample reported having hypertension, 61% high cholesterol, 33% diabetes, 24% heart disease, 21% heart attack, and 16% chronic obstructive pulmonary disease. In the predictive models, men were less likely to report "very difficult/can't do at all" in walking ¼ mile (odds ratios [OR] = 0.68, 95% CI 0.51-0.90), climbing 10 steps (OR = 0.65, 95% CI 0.49-0.85), standing 2 hours (OR = 0.66, 95% CI 0.50-0.87), stooping (OR = 0.51, 95% CI 0.39-0.68), reaching overhead (OR = 0.69, 95% CI 0.49-0.97), carrying 10 pounds (OR = 0.45, 95% CI 0.34-0.59), and pushing large objects (OR = 0.37, 95% CI 0.28-0.5) compared to women. CONCLUSIONS The functional outcomes of men stroke survivors were significantly greater than women. The specific factors that contribute to sex differences in stroke-related outcomes are not entirely clear. Future research is needed to better understand these differences to ensure that equity of care is received.
Collapse
Affiliation(s)
- Brandi M White
- 1 College of Health Sciences, University of Kentucky , Lexington, Kentucky
| | - Gayenell S Magwood
- 2 College of Nursing, Medical University of South Carolina , Charleston, South Carolina
| | - Suzanne Perea Burns
- 3 American Heart Association Strategically Focused Research Network, WISSDOM Center, Medical University of South Carolina , Charleston, South Carolina
| | - Charles Ellis
- 4 Communication Equity and Outcomes Laboratory, Department of Communication Sciences and Disorders, East Carolina University , Greenville, North Carolina
| |
Collapse
|