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Wang Y, Xie H, Sun H, Ren L, Jiang H, Chen M, Dong C. Influencing Factors of Psychological Resilience in Stroke Patients: A Systematic Review and Meta-Analysis. Arch Clin Neuropsychol 2024; 39:644-654. [PMID: 38324660 DOI: 10.1093/arclin/acad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To systematically review the current status and influencing factors of psychological resilience in stroke patients and to provide a theoretical basis for future personalized rehabilitation support and psychological interventions. METHOD This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A comprehensive search of databases including PubMed, Web of Science, Medline, PsycINFO, CINAHL, Cochrane Library, CNKI, VIP, CMB, and WANGFANG was conducted from inception until November 22, 2023, resulting in the retrieval of 2099 studies. Literature screening and data extraction were performed by two independent evaluators based on pre-defined inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software. RESULTS The final review included 23 studies. The results showed that self-efficacy, hope, confrontation coping, avoidance coping, functional independence, quality of life, and social support were positively associated with psychological resilience. Conversely, anxiety, depression, and resignation coping were negatively associated with psychological resilience. CONCLUSIONS Patients with stroke have a low level of psychological resilience, which was influenced by a variety of factors. However, longitudinal and large sample studies are needed to further confirm these findings. These results should be integrated into clinical practice for early assessment and targeted intervention in psychological resilience to assist patients in coping with the rehabilitation process and life changes after a stroke.
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Affiliation(s)
- Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou 325035, China
| | - Hongxia Xie
- School of Computing, Hangzhou City University, Hangzhou 310015, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing 100191, China
| | - Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou 325035, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou 325035, China
| | - Meijia Chen
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325035, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou 325035, China
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Tsai SJ, Li CC, Pai HC. Effects of a nurse-led therapeutic conversations intervention in stroke patient-family caregiver dyads: A randomized control trial. Int J Nurs Pract 2024:e13257. [PMID: 38570203 DOI: 10.1111/ijn.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 01/24/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Few studies have evaluated the effectiveness of family functional care interventions among stroke caregiver dyads. This study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and quality of life (QoL) in stroke family caregiver dyads. AIMS This study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and QoL in stroke-family caregiver dyads. DESIGN This study was a single-blind (evaluator) randomized controlled trial. The planned execution time was from August 2021 to December 2022, in the rehabilitation ward of a medical university hospital. METHODS A total of 82 dyads were included in this analysis. Dyads randomized to the intervention group received nurse-led therapeutic conversations intervention one at four weeks after the patient's hospitalization for a stroke. The family caregiver dyads of stroke survivors in the control group received routine care. An effectiveness analysis that included patients' resilience, self-efficacy, and patient-family caregiver dyads' family function and QoL was conducted at one month. We used the CONSORT Checklist for reporting parallel group randomized trials in this study. RESULTS The patients in the intervention group showed improvement in resilience and self-efficacy after one month. Furthermore, the effects on resilience (Cohen's d = 0.49) and self-efficacy (Cohen's d = 0.46) were significantly higher than in the control group. Family functioning was significantly higher in patient-family caregiver dyads in the intervention group than in the control group (Cohen's d = 0.55; Cohen's d = 0.50). However, no significant difference in QoL was found between patients and caregivers in either group. CONCLUSIONS The intervention was effective in promoting family functioning and can also promote patient resilience and self-efficacy in disease management. However, the intervention did not have a significant effect on the QoL of patient-family caregiver dyads.
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Affiliation(s)
- Su-Ju Tsai
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University School of Medicine, Taichung City, Taiwan
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Chia-Chi Li
- Department of Nursing, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Hsiang-Chu Pai
- Department of Nursing, Chung Shan Medical University Hospital, Taichung City, Taiwan
- Department of Nursing, Chung Shan Medical University, Taichung City, Taiwan
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Zhang M, Wan M, Wang W, Lin S, Zhang X. Effect of interferon therapy on quality of life in patients with chronic hepatitis B. Sci Rep 2024; 14:2461. [PMID: 38291045 PMCID: PMC10827780 DOI: 10.1038/s41598-024-51292-4] [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: 07/25/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
Interferon therapy is the most effective treatment for achieving clinical cure in chronic hepatitis B (CHB) patients. However, the treatment outcomes of interferon therapy are uncertain, multiple side effects can occur during treatment, and the treatment is expensive. Although these characteristics may affect patients' quality of life, research examining this topic is limited. We used a cross-sectional design to examine 100 CHB patients receiving interferon, 100 receiving nucleoside/nucleotide analogues, and 87 receiving non-antiviral treatment. Characteristic information, the Hepatitis B Quality of Life Instrument, Connor Davidson Resilience Scale, and Work Productivity and Activity Impairment Questionnaire were used to collect information. We found that quality of life in the interferon treatment group was higher than that in the non-antiviral treatment and nucleoside/nucleotide analogue treatment groups (p < 0.05). The factors influencing quality of life were resilience, presenteeism, hair loss, and antiviral treatment (p < 0.05). Although interferon therapy has some potential side effects, the results suggested that it did not negatively affect quality of life. Overall, interferon therapy did not have a major impact on CHB patients' daily lives and work.
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Affiliation(s)
- Mengdi Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi Province, China
| | - Meijuan Wan
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi Province, China
| | - Wen Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi Province, China
| | - Shumei Lin
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi Province, China.
| | - Xi Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi Province, China.
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Champigny CM, Feldman SJ, Westmacott R, Wojtowicz M, Aurin C, Dlamini N, Dirks P, Desrocher M. Adjusting to life after pediatric stroke: A qualitative study. Dev Med Child Neurol 2023; 65:1357-1365. [PMID: 36866398 DOI: 10.1111/dmcn.15556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/28/2022] [Accepted: 01/23/2023] [Indexed: 03/04/2023]
Abstract
AIM To examine adjustment after stroke in adolescence from the perspective of affected young people. METHOD Fourteen participants (10 female) aged 13 to 25 years with a history of ischemic or hemorrhagic stroke in adolescence participated in one-on-one semi-structured interviews at the Hospital for Sick Children, Toronto, Canada. Interviews were audio-recorded and transcribed verbatim. Two independent coders conducted a reflexive thematic analysis. RESULTS Five themes were identified as representative of adjustment after stroke: (1) 'Processing the story'; (2) 'Loss and challenges'; (3) 'I've changed'; (4) 'Keys to recovery'; and (5) 'Adjustment and acceptance'. INTERPRETATION This qualitative study provides medical professionals with a personal, patient-driven lens through which to better understand the challenges of adjusting to life after pediatric stroke. Findings highlight the need to provide mental health support to patients to assist them in processing their stroke and adapting to long-lasting sequelae. WHAT THIS PAPER ADDS Processing the onset event is a key component of adjustment to stroke. Feelings of anxiety, sadness, frustration, and self-consciousness impede adjustment to stroke. Young people may feel overwhelmed academically owing to neurocognitive deficits. Sequelae may rid young people of hobbies and passions, and alter plans for the future. To adjust to stroke, survivors draw on resilience, patience, determination, and social support.
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Affiliation(s)
- Claire M Champigny
- Department of Psychology, the Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Samantha J Feldman
- Department of Psychology, the Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Robyn Westmacott
- Department of Psychology, the Hospital for Sick Children, Toronto, Canada
- Division of Neurology, the Hospital for Sick Children, Toronto, Canada
| | | | - Casey Aurin
- Department of Psychology, York University, Toronto, Canada
| | - Nomazulu Dlamini
- Division of Neurology, the Hospital for Sick Children, Toronto, Canada
| | - Peter Dirks
- Division of Neurosurgery, the Hospital for Sick Children, Toronto, Canada
| | - Mary Desrocher
- Department of Psychology, the Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
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Tsai SJ, Li CC, Tsai SM, Kao SC, Pai HC. The effect of action modules on resilience and psychological health of stroke patients: A pilot non-randomised control trial. J Clin Nurs 2023; 32:311-319. [PMID: 35118746 DOI: 10.1111/jocn.16238] [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] [Received: 08/17/2021] [Revised: 12/03/2021] [Accepted: 01/17/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To determine whether interventions that use the Specific Thematic Nursing Care Action Modules (STNC-AM) platform improve patients' psychological health over a two-month period. BACKGROUND Stroke survivors often are left with a disability after a stroke, which can have an impact on their physical and mental health. Therefore, it is necessary for stroke patients to have tailored programmes in the face of post-stroke mental health concerns and the need for care information. DESIGN A non-randomised controlled pilot study was conducted. METHODS Participants included 44 post-stroke patients at a medical university hospital, between 1 August 2019-28 February 2021, of whom 24 were assigned to the control group and 20 were assigned to the intervention (STNC-AM). Data were analysed on an intention-to-treat basis. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist (case-control studies) for this study. RESULTS There were no statistical differences between the two groups at baseline. At the end of two months, however, the scores for resilience, depression and positive factors illness representation were statistically different between the two groups (p < .05). The results of the generalised estimating equation model analysis indicated that resilience and anxiety remained more significant in decreasing depression in the intervention group than in the control group. CONCLUSION This preliminary trial suggests that, although action modules may be associated with a decrease in depression post-stroke, part of this effect was likely associated with an increase in resilience and a decrease in anxiety of the patients. RELEVANCE TO CLINICAL PRACTICE The STNC-AM platform provides a coaching platform that helps patients and caregivers to be effective and accessible.
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Affiliation(s)
- Su-Ju Tsai
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University and Hospital, Taichung, Taiwan
| | - Chia-Chi Li
- Department of Nursing, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Shu-Mei Tsai
- Department of Nursing, Chung Shan Medical University Hospital, Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Chuan Kao
- Department of Nursing, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiang-Chu Pai
- Department of Nursing, Chung-Shan Medical University, Research Consultant, Chung-Shan Medical University Hospital, Taichung, Taiwan
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Silva TAD, Miranda VBD, Mituuti CT, Berretin G. Oropharyngeal dysphagia and nutritional status in elderly patients in the chronic post-stroke phases. NUTR CLIN METAB 2023. [DOI: 10.1016/j.nupar.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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The Associated Factors of Quality of Life among Stroke Survivors: A Study in Indonesia. NURSE MEDIA JOURNAL OF NURSING 2022. [DOI: 10.14710/nmjn.v12i3.45763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: The prevalence and burden of stroke are still high, especially in low and middle-income countries. Stroke affects the economy and physics related to the Quality of Life (QoL). Various QoL-associated factors, including sociodemographic, functional outcome, emotional, and cognitive function, were studied. However, there was very limited information about the QoL-associated factors among stroke survivors in Semarang, Indonesia.Purpose: This study aimed to identify the QoL-associated factors among stroke survivors in Semarang, Indonesia.Methods: This cross-sectional study was conducted in outpatient services and involved 57 ischemic stroke survivors using convenience sampling. Demographic and clinical information were obtained using medical records and questionnaires. The questionnaires were the Short Version of Specific Stroke Quality of Life (SS-QoL) to measure QoL, GRID-HAMD 17 to measure Post Stroke Depression (PSD), Mini-Mental Status Examination (MMSE) to measure cognitive impairment, Barthel–Index (BI) to measure functional outcome, Hamilton Anxiety Rating Scale (HAM-A) to measure anxiety, and Multidimensional Scale of Perceived Social Support (MSPSS) to measure social support. Linear regression was conducted in the model performance of QoL-associated factors.Results: The stroke duration was 155(18) days, and 50.9% of participants were males. The linear regression showed that age (-.164 95% CI -.412 - .084), marital status (3.937 95% CI 1.010 - 6.864), functional outcome (.127 95% CI .013 - .241), PSD (-1.090 95% CI -2.144 - -.036), cognitive function (.308 95% CI -.482 - 1.098) and anxiety (-.408 95% CI -1.125 - .268) were QoL-predictors (p<.001, adjusted R2=52.1). It is assumed that age, marital status, functional outcome, PSD, cognition, and anxiety significantly predict the QoL among ischemic stroke survivors.Conclusion: The QoL-associated factors were age, marital status, functional outcome, PSD, cognition, and anxiety. These associated factors of QoL should be considered as elements in formulating nursing interventions that aim to improve the good QoL among stroke survivors.
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Matérne M, Simpson G, Jarl G, Appelros P, Arvidsson-Lindvall M. Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2119676. [PMID: 36062839 PMCID: PMC9467624 DOI: 10.1080/17482631.2022.2119676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. MATERIAL AND METHOD Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. RESULTS The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. CONCLUSION Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Grahame Simpson
- John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Yan HY, Lin HR. Resilience in Stroke Patients: A Concept Analysis. Healthcare (Basel) 2022; 10:2281. [PMID: 36421605 PMCID: PMC9691242 DOI: 10.3390/healthcare10112281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 05/01/2024] Open
Abstract
(1) Background: Resilience enables individuals to develop positive coping strategies when faced with adversity. However, knowledge on resilience in stroke patients remains limited, and resilience assessment methods continue to be debated. (2) Aim: To perform a concept analysis of resilience in stroke patients. (3) Methods: The Walker and Avant approach to concept analysis was adopted. Searches were performed in the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Chinese Electronic Periodical Services (CEPS) databases and grey literature using the keywords "stroke patient", "resilience", and "concept analysis". (4) Results: The defining attributes of resilience in stroke patients were classified into internal personality traits and external environmental support. Antecedents included physical, mental, and familial and social impairments caused by the disease, and the consequences were good adaptation, which included active cooperation with rehabilitation activities, positive thinking, goal setting, and harboring hope for the future. (5) Conclusion: Resilience is of a diverse and complex nature. Optimism and positivity, problem-solving ability, and familial and social support may assist in re-adjusting or restoring the balance between physical and mental health when a stroke patient faces adversity. Key factors affecting resilience in stroke patients should be further investigated in future research to assist in the development of effective interventional treatment measures.
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Affiliation(s)
- Huey-Yeu Yan
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 112303, Taiwan
- Department of Nursing, University of Kang Ning, Taipei City 114311, Taiwan
| | - Hung-Ru Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 112303, Taiwan
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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.
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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
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Love MF, Brooks AN, Cox SD, Okpala M, Cooksey G, Cohen AS, Sharrief AZ. The effects of racism and resilience on Black stroke- survivor quality of life: Study protocol and rationale for a mixed-methods approach. Front Neurol 2022; 13:885374. [PMID: 36034272 PMCID: PMC9399920 DOI: 10.3389/fneur.2022.885374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Stroke, a life-threatening stressor, often negatively impacts stroke-survivor (SS) quality of life (QoL). Annual age-adjusted incidence and death rates for stroke are significantly higher among Black Americans than among White Americans. Racism, a significant stressor, occurs at structural, cultural, and interpersonal levels and contributes to health disparities for Black SS. Resilience, a dynamic process of positive adaptation to significant stress, is impacted by factors or resources both internal and external to the individual. This study aims to examine the effects of experiences of racism and resilience on Black SS QoL during early stroke recovery. This article presents the study protocol. Methods and analyses This will be a prospective observational mixed-methods study. Black community-dwelling adults who are within 4 weeks of a stroke will be eligible for inclusion. Baseline measures will include the exposure variables of experiences of racism and resilience. Covariates measured at baseline include sociodemographic variables (age, sex, marital status, education, income, health insurance, employment status, number of people in household, residential address), clinical variables (date and type of stroke, inferred Modified Rankin Scale, anxiety and depression screening), and psychosocial variables (COVID-19 stress, perceived stress, mindfulness). The outcome variable (QoL) will be assessed 6-months post-stroke. Multiple-level linear regression models will be used to test the direct effects of experiences of racism, and the direct and indirect effects of resilience, on QoL. Qualitative data will be collected via focus groups and analyzed for themes of racism, resilience, and QoL. Discussion Racism can compound the stress exerted by stroke on Black SS. This study will occur during the COVID-19 pandemic and in the aftermath of calls for social justice for Black Americans. Experiences of racism will be measured with instruments for both “everyday” discrimination and vigilance. Sociodemographic variables will be operationalized to assess specific social determinants of health that intersect with structural racism. Because of the long-standing history of racism in the United States of America (USA), cultural influences and access to resources are central to the consideration of individual-level resilience in Black SS. Study results may inform the development of interventions to support Black SS QoL through enhanced resilience.
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Affiliation(s)
- Mary F. Love
- College of Nursing, University of Houston, Houston, TX, United States
- *Correspondence: Mary F. Love
| | | | - Sonya D. Cox
- College of Nursing, University of Houston, Houston, TX, United States
| | - Munachi Okpala
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Gail Cooksey
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Audrey Sarah Cohen
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
| | - Anjail Z. Sharrief
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX, United States
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Norvang OP, Dahl AE, Thingstad P, Askim T. Resilience and Its Association With Activities of Daily Living 3 Months After Stroke. Front Neurol 2022; 13:881621. [PMID: 35775055 PMCID: PMC9237386 DOI: 10.3389/fneur.2022.881621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Independence in basic activities of daily living (ADL) is an important outcome after stroke. Identifying factors associated with independence can contribute to improve post-stroke rehabilitation. Resilience, which is the ability of coping with a serious event, might be such a factor. Still, the impact of resilience and its role in rehabilitation after stroke is poorly investigated. Hence, the purpose of this study was to assess whether resilience assessed early after stroke can be associated with independence in basic ADL 3 months later. Hospitalized patients with a diagnosed acute stroke and a modified Rankin Scale score ≤ 4 were included. Bivariate and multivariate linear regression were applied to assess whether resilience as measured by the Brief Resilience Scale within the first 2 weeks after stroke was associated with basic ADL measured by Barthel Index at 3-month follow-up. Age, sex, fatigue, stroke severity at admission and pre-stroke disability were added as covariates. Sixty-four participants (35 (54.7%) male), aged 75.9 (SD 8.6) years were included 4.3 (SD 2.8) days after stroke. There was no significant change in resilience from baseline 3.1 (SD 0.3) to 3 months later 3.2 (SD 0.5). Resilience was not associated with basic ADL in neither the bivariate (b = 2.01, 95% CI −5.21, 9.23, p = 0.580) nor in the multivariate regression models (b = 0.50, 95% CI −4.87, 6.88, p = 0.853). Our results showed that resilience remained stable during follow-up. Early measurement of resilience was not associated with independence in basic activities of daily living 3 months after stroke. These results, indicate that resilience is a personal trait not associated with the outcome of physical adversity. However, future research should investigate whether resilience is related to the outcomes of psychosocial adversity after a stroke.
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Affiliation(s)
- Ole Petter Norvang
- Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Services, Department of Physiotherapy, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- *Correspondence: Ole Petter Norvang
| | - Anne Eitrem Dahl
- Clinical Services, Department of Physiotherapy, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Stroke Unit, Department of Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Hinwood M, Ilicic M, Gyawali P, Coupland K, Kluge MG, Smith A, Bowden S, Nilsson M, Walker FR. Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review. Ann Behav Med 2022; 57:111-130. [PMID: 35689664 PMCID: PMC9899067 DOI: 10.1093/abm/kaac002] [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] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Stroke can be a life-changing event, with survivors frequently experiencing some level of disability, reduced independence, and an abrupt lifestyle change. Not surprisingly, many stroke survivors report elevated levels of stress during the recovery process, which has been associated with worse outcomes. PURPOSE Given the multiple roles of stress in the etiology of stroke recovery outcomes, we aimed to scope the existing literature on stress management interventions that have been trialed in stroke survivors. METHODS We performed a database search for intervention studies conducted in stroke survivors which reported the effects on stress, resilience, or coping outcome. Medline (OVID), Embase (OVID), CINAHL (EBSCO), Cochrane Library, and PsycInfo (OVID) were searched from database inception until March 11, 2019, and updated on September 1, 2020. RESULTS Twenty-four studies met the inclusion criteria. There was significant variation in the range of trialed interventions, as well as the outcome measures used to assess stress. Overall, just over half (13/24) of the included studies reported a benefit in terms of stress reduction. Acceptability and feasibility were considered in 71% (17/24) and costs were considered in 17% (4/24) of studies. The management of stress was rarely linked to the prevention of symptoms of stress-related disorders. The overall evidence base of included studies is weak. However, an increase in the number of studies over time suggests a growing interest in this subject. CONCLUSIONS Further research is required to identify optimum stress management interventions in stroke survivors, including whether the management of stress can ameliorate the negative impacts of stress on health.
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Affiliation(s)
| | - Marina Ilicic
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
| | - Prajwal Gyawali
- School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Darling Heights, QLD, Australia
| | - Kirsten Coupland
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
| | - Murielle G Kluge
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia,Centre for Advanced Training Systems, The University of Newcastle, Callaghan, NSW, Australia
| | - Angela Smith
- HNE Health Libraries, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Sue Bowden
- Consumer Investigator, Moon River Turkey, Bathurst, NSW, Australia
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14
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Prather JG, Baughman B, Alexandrov AW, Grimes Stanfill A. A Conceptual Model of the Influence of Mindfulness-Based Interventions on Stress and Quality of Life in Patients With Chronic Conditions. Holist Nurs Pract 2022; 36:67-75. [PMID: 35166247 DOI: 10.1097/hnp.0000000000000500] [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: 11/26/2022]
Abstract
Individuals with chronic conditions are susceptible to stress-related health complications. Left unattended, chronic stress exacerbates inflammation, diminishes quality of life (QOL), and increases all-cause mortality. Here, we suggest a theoretical framework promoting the use of mindfulness-based interventions (MBIs) in patients with chronic conditions and a conceptual model of how MBIs may influence stress and QOL.
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Affiliation(s)
- Jenifer G Prather
- Department of Acute and Tertiary Care, College of Nursing, University of Tennessee Health Science Center, Memphis (Ms Prather and Drs Alexandrov and Grimes Stanfill); Semmes Murphy Clinic, Memphis, Tennessee (Dr Baughman); and Departments of Neurosurgery (Dr Baughman) and Neurology (Dr Alexandrov), College of Medicine, University of Tennessee Health Science Center, Memphis
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15
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Poststroke Anxiety at 1 Year After Rehabilitation. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Han ZT, Zhang HM, Wang YM, Zhu SS, Wang DY. Uncertainty in illness and coping styles: Moderating and mediating effects of resilience in stroke patients. World J Clin Cases 2021; 9:8999-9010. [PMID: 34786383 PMCID: PMC8567502 DOI: 10.12998/wjcc.v9.i30.8999] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/19/2021] [Accepted: 09/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Stroke has a great influence on the patient’s mental health, and reasonable psychological adjustment and disease perception can promote the recovery of mental health.
AIM To explore the relationships among resilience, coping style, and uncertainty in illness of stroke patients.
METHODS A retrospective study was used to investigate 154 stroke patients who were diagnosed and treated at eight medical institutes in Henan province, China from October to December 2019. We used the Mishel Uncertainty in Illness Scale, the Connor-Davidson Resilience Scale, and the Medical Coping Modes Questionnaire to test the uncertainty in illness, resilience, and coping style, respectively.
RESULTS Resilience had a significant moderating role in the correlation between coping style and unpredictability and information deficiency for uncertainty in illness (P < 0.05). Further, the tenacity and strength dimensions of resilience mediated the correlation between the confrontation coping style and complexity, respectively (P < 0.05). The strength dimension of resilience mediated the correlation between an avoidance coping style and the unpredictability of uncertainty in illness (P < 0.05), as well as correlated with resignation, complexity, and unpredictability (P < 0.05).
CONCLUSION Resilience has moderating and mediating roles in the associations between coping style and uncertainty in illness, indicating that it is vital to improve resilience and consider positive coping styles for stroke patients in the prevention and control of uncertainty in illness.
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Affiliation(s)
- Zi-Ting Han
- School of Nursing, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Hui-Min Zhang
- School of Nursing, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Yi-Ming Wang
- School of International Education, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Shan-Shan Zhu
- School of Nursing, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Dong-Yang Wang
- Department of Nursing, School of Pharmacy, Changzhou University, Changzhou 213000, Jiangsu Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
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17
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Resilience, Psychological Well-Being and Daily Functioning Following Hospitalization for Respiratory Distress Due to SARS-CoV-2 Infection. Healthcare (Basel) 2021; 9:healthcare9091161. [PMID: 34574935 PMCID: PMC8471260 DOI: 10.3390/healthcare9091161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
The ongoing COVID-19 pandemic has affected people's psychological well-being, and hospitalized patients could face an even greater risk of psychological distress. We aimed to study resilience in recovered COVID-19 patients after hospital discharge. We recruited 50 patients (38 males, aged 28-77) who were hospitalized for COVID-19 between March and April 2020. Participants underwent a psychological assessment 5 months after hospital discharge. We administered the Connor-Davidson Resilience Scale (CD-RISC-25), Beck's Depression inventory-II (BDI-II), and the State-Trait Anxiety Inventory Y-form (STAI). We also evaluated the impact of persisting physical, behavioral, and cognitive symptoms on resilience. Patients reported low resilience in the months following hospital discharge (CD-RISC-25 score [mean ± SD] = 55.82 ± 20.76), compared to data from studies on the general population. Lower resilience was associated with mood disturbances in the months following clinical recovery (p = 0.005), persisting fatigue (p = 0.015), sleep changes (p = 0.046), and subjective cognitive complaints (p < 0.05). Recovered COVID-19 patients exhibit low resilience following hospital discharge, which affects psychological well-being. The presence of persisting symptoms following hospital discharge affects psychological resilience. Interventions tailored to increase resilience should be considered to improve quality of life for recovered COVID-19 patients.
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18
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Love MF, Wood GL, Wardell DW, Beauchamp JES. Resilience and associated psychological, social/cultural, behavioural, and biological factors in patients with cardiovascular disease: a systematic review. Eur J Cardiovasc Nurs 2021; 20:604-617. [PMID: 34223625 DOI: 10.1093/eurjcn/zvaa008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/27/2020] [Indexed: 01/25/2023]
Abstract
AIMS The aim of this systematic review of the literature is to synthesize the evidence regarding the associations between individual-level psychological, social/cultural, behavioral, and biological variables with resilience in patients with CVD. METHODS AND RESULTS A systematic search of PubMed, PsycINFO and CINAHL was conducted from database inception through March 2020. Studies with a quantitative research design were eligible for inclusion if published in English and focused on resilience among adults with CVD. Of the 788 articles retrieved, 34 studies (35 articles) were included in the review. Twenty-three studies focused on psychological factors, with findings of inverse relationships between resilience and depression, anxiety, and stress. Evidence regarding associations between resilience and social/cultural or behavioral variables was scarce. Four of the 6 studies regarding biological factors found low stress resilience in young adulthood was associated with early diagnoses of stroke, heart failure, and coronary heart disease. CONCLUSION Enhancing resilience may improve quality of life for CVD patients, but research is needed to further explore the complex relationships between resilience and associated variables. This research should prioritize under-represented groups (i.e. women and minority racial/ethnic groups), with the eventual goal of developing interventions to support resilience in CVD patients.
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Affiliation(s)
- Mary F Love
- University of Houston, College of Nursing, 14004 University Boulevard, Sugar Land, TX 77479, USA
| | - Geri LoBiondo Wood
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Cizik School of Nursing,, 6901 Bertner Avenue Houston, TX 77030, USA
| | - Diane Wind Wardell
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Cizik School of Nursing,, 6901 Bertner Avenue Houston, TX 77030, USA
| | - Jennifer E S Beauchamp
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Cizik School of Nursing,, 6901 Bertner Avenue Houston, TX 77030, USA
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19
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Unveiling the importance of hidden personal resources in cerebrovascular diseases. Int Psychogeriatr 2021; 33:535-538. [PMID: 34173355 DOI: 10.1017/s104161022000099x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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20
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Green TL, McNair ND, Hinkle JL, Middleton S, Miller ET, Perrin S, Power M, Southerland AM, Summers DV. Care of the Patient With Acute Ischemic Stroke (Posthyperacute and Prehospital Discharge): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association. Stroke 2021; 52:e179-e197. [PMID: 33691469 DOI: 10.1161/str.0000000000000357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In 2009, the American Heart Association/American Stroke Association published a comprehensive scientific statement detailing the nursing care of the patient with an acute ischemic stroke through all phases of hospitalization. The purpose of this statement is to provide an update to the 2009 document by summarizing and incorporating current best practice evidence relevant to the provision of nursing and interprofessional care to patients with ischemic stroke and their families during the acute (posthyperacute phase) inpatient admission phase of recovery. Many of the nursing care elements are informed by nurse-led research to embed best practices in the provision and standard of care for patients with stroke. The writing group comprised members of the Stroke Nursing Committee of the Council on Cardiovascular and Stroke Nursing and the Stroke Council. A literature review was undertaken to examine the best practices in the care of the patient with acute ischemic stroke. The drafts were circulated and reviewed by all committee members. This statement provides a summary of best practices based on available evidence to guide nurses caring for adult patients with acute ischemic stroke in the hospital posthyperacute/intensive care unit. In many instances, however, knowledge gaps exist, demonstrating the need for continued nurse-led research on care of the patient with acute ischemic stroke.
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21
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Luo YH, Li WHC, Cheung AT, Ho LLK, Xia W, He XL, Zhang JP, Chung JOK. Relationships between resilience and quality of life in parents of children with cancer. J Health Psychol 2021; 27:1048-1056. [PMID: 33522296 DOI: 10.1177/1359105321990806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CLINICALTRIALS.GOV ID NCT03631485.
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Affiliation(s)
- Y H Luo
- University of Hong Kong, Hong Kong
| | - W H C Li
- University of Hong Kong, Hong Kong
| | | | - L L K Ho
- University of Hong Kong, Hong Kong
| | - W Xia
- University of Hong Kong, Hong Kong
| | - X L He
- People's Hospital of Hunan Province, China
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22
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Aza A, Verdugo MÁ, Orgaz MB, Amor AM, Fernández M. Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030927. [PMID: 33494473 PMCID: PMC7908370 DOI: 10.3390/ijerph18030927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/16/2022]
Abstract
Background: The sequelae and disabilities that follow an acquired brain injury (ABI) may negatively affect quality of life (QoL). The main objective of the study is to describe the QoL after an ABI and identify the predictors of a better QoL. Methods: Prospective cohort study with follow-up measurement after one-year. The sample comprised 203 adults with ABIs (64% male) aged 18–86 years (M = 53.01, SD = 14.44). Stroke was the main etiology of the injury (55.7%), followed by a TBI (32.8%), and the average time since injury was 8 years (M = 8.25, SD = 7.83, range = 0.5–47.5). Patients assessed their QoL through the scale Calidad de Vida en Daño Cerebral (CAVIDACE self-reported version; “quality of life in brain injury” in English), an ABI-specific tool based on the eight-domain QoL model. Other variables measured were: depression, self-awareness, community integration, resilience, and social support at baseline and one-year follow-up. Results: The studied factors showed few significant changes over time. The analyses showed statistically significant differences in QoL scores in several sociodemographic (age, civil status, education, legal capacity, and dependency), injury-related (time, location, and comorbidity), rehabilitation, and personal-social variables (self-awareness, depression, social support, resilience, and community integration). The levels of dependency, depression, and satisfaction with social support were independent predictors of the total QoL score one-year follow-up. Conclusions: QoL after ABI depends on multiple elements that must be considered. There are factors such as satisfaction with social support, depression, community integration, and resilience that must be monitored throughout the rehabilitation process.
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Affiliation(s)
- Alba Aza
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
- Correspondence: ; Tel.: +34-670576341
| | - Miguel Á. Verdugo
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
| | - María Begoña Orgaz
- Institute for Community Inclusion, Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain;
| | - Antonio M. Amor
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
| | - María Fernández
- Institute for Community Inclusion, Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (A.M.A.); (M.F.)
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23
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Zhao L, Yang F, Sznajder KK, Zou C, Jia Y, Yang X. Resilience as the Mediating Factor in the Relationship Between Sleep Disturbance and Post-stroke Depression of Stroke Patients in China: A Structural Equation Modeling Analysis. Front Psychiatry 2021; 12:625002. [PMID: 34040550 PMCID: PMC8141619 DOI: 10.3389/fpsyt.2021.625002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Stroke patients may suffer from a variety of symptoms which can result in sleep disturbance and post-stroke depression (PSD). Whereas, resilience can alleviate sleep disturbance and help maintain well-being after stroke. Objective: The aim of this study is to explore whether resilience plays a mediating role in the relationship between sleep disturbance and PSD of stroke patients in China. Methods: A cross-sectional study with a multi-stage sampling was carried out in Liaoning Rehabilitation Center and the Third People's Hospital of Chongqing in China from May to September 2019. A total of 353 stroke patients were enrolled in this study. Structural equation model (SEM) was used to test the mediating effect of resilience on the relationship between sleep disturbance and PSD. Results: The prevalence of PSD of stroke patients was 34.56%. Sleep disturbance contributed most to the variance of PSD and had a significantly positive association with PSD among stroke patients (P < 0.01). Resilience was negatively associated with PSD, and acted as a mediator between sleep disturbance and PSD (a * b = 0.201, BCa 95% CI: 0.156~0.254). Conclusions: The prevalence of PSD was high among the Chinese stroke patients. Sleep disturbance was highly associated with PSD, resulting in the increased risk of PSD. Furthermore, resilience has a mediating effect on the relationship between sleep disturbance and PSD, and could reduce the negative effect of sleep disturbance on the development of PSD.
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Affiliation(s)
- Lina Zhao
- Department of English, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, China
| | - Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
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24
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Luo D, Zhou M, Sun L, Lin Z, Bian Q, Liu M, Ren S. Resilience as a Mediator of the Association Between Perceived Stigma and Quality of Life Among People With Inflammatory Bowel Disease. Front Psychiatry 2021; 12:709295. [PMID: 34421685 PMCID: PMC8377363 DOI: 10.3389/fpsyt.2021.709295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Improving Quality of Life (QOL) is an essential objective in the management of inflammatory bowel disease. An accumulating body of research has been conducted to explore the association between perceived stigma and QOL among patients with chronic illness. Still, underlying mechanisms behind this pathway have not been thoroughly examined. Objective: To investigate (a) the effect of perceived stigma on QOL among patients with inflammatory bowel disease; and (b) the mediating role of resilience in the association between perceived stigma and QOL. Methods: This cross-sectional study included a convenient sample of patients diagnosed with inflammatory bowel disease from four tertiary hospitals in Jiangsu Province, China. Patients completed the Perceived Stigma Scale in Inflammatory Bowel Disease (PSS-IBD), the Resilience Scale for Patients with Inflammatory Bowel Disease (RS-IBD), and the Inflammatory Bowel Disease Questionnaire (IBDQ). A bootstrapping analysis was implemented using the SPSS macro PROCESS. Results: A total of 311 patients with Cohn's disease and ulcerative colitis participated in this study, and 57.6% were men. The mean disease duration was 3.51 ± 1.04 years. Approximately 40% of the sample exceeded the criterion score for moderate stigma. Patients who perceived moderate or severe stigma reported lower QOL compared with those with mild stigma. After controlling for sociodemographic and clinical variables, we observed that perceived stigma was negatively associated with resilience. Moreover, resilience was found to mediate the relationship between perceived stigma and all aspects of QOL. Conclusions: These findings suggested that QOL of patients with inflammatory bowel disease was associated with perceived stigma and resilience and identified the mediating effects of resilience in the relationship between perceived stigma and QOL. Furthermore, this suggests that integrating intervention techniques to target resilience into the QOL improvement program of individuals with perceived stigma is possible.
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Affiliation(s)
- Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Meijing Zhou
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lifu Sun
- School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Zheng Lin
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qiugui Bian
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Meihong Liu
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shurong Ren
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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25
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Azizi A, Khatiban M, Mollai Z, Mohammadi Y. Effect of Informational Support on Anxiety in Family Caregivers of Patients with Hemiplegic Stroke. J Stroke Cerebrovasc Dis 2020; 29:105020. [PMID: 32807435 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Brain stroke causes physical and mental disabilities, as well as dependence on one's family. In such cases, the families suffer from severe crisis and anxiety due to the unexpected incidence of the disease and unawareness of the associated consequences. OBJECTIVES The aim of the present study was to evaluate the effectiveness of informational support on the level of anxiety in family caregivers of hemiplegic stroke patients. METHODS This quasi-experimental study was performed on 78 family caregivers of hemiplegic stroke patients admitted to the Neurology Department of Farshchian Hospital in Hamadan, Iran, over 8 months. The subjects were selected through convenience sampling method and divided into two groups of intervention (n = 40) and control (n = 38). Intervention started from the third day of hospitalization and continued until the eleventh day. During this period, information about the ward, equipment, patient status, and care procedure at home, was provided for the intervention group individually and in groups. On the other hand, the control group only received the routine care. Anxiety level of caregivers was measured through the Spielberger scale both before and after the intervention. Data analysis was performed in SPSS software (version 16). RESULTS Based on the results, both groups were similar in terms of demographic variables (P > 0.05). Moreover, there was no significant difference between the two groups regarding the mean level of state and trait anxiety before the intervention (P > 0.05). However, after intervention, the mean level of state and trait anxiety of the intervention group showed a significant reduction in comparison to that of the control group (P < 0.05). CONCLUSIONS According to the findings, it can be concluded that informational support is effective in reducing the state and trait anxiety in family caregivers of stroke patients. Therefore, it is suggested that nurses consider informational support as an important nursing intervention during hospitalization.
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Affiliation(s)
- Azim Azizi
- PhD, Assistant Professor, Chronic Diseases (Home Care) Research Centre, Malayer Nursing School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahnaz Khatiban
- PhD, Professor, Mother & Child Care Research Center. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zhale Mollai
- M.Sc in Critical Care Nursing, Student Research Committee, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Younes Mohammadi
- PhD, Associate Professor, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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