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Zingelman S, Wallace SJ, Kim J, Mosalski S, Faux SG, Cadilhac DA, Alexander T, Lannin NA, Olaiya MT, Clifton R, Shiner CT, Starr S, Kilkenny MF. Is communication key in stroke rehabilitation and recovery? National linked stroke data study. Top Stroke Rehabil 2024; 31:325-335. [PMID: 37965905 DOI: 10.1080/10749357.2023.2279804] [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: 08/07/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Information on the characteristics or long-term outcomes of people with communication support needs post-stroke is limited. We investigated associations between communication gains in rehabilitation and long-term outcomes (quality-of-life [EuroQOL-ED-3 L], mortality) by post-stroke communication support need status. METHODS Retrospective cohort study using person-level linked data from the Australian Stroke Clinical Registry and the Australasian Rehabilitation Outcomes Centre (2014-2017). Communication support needs were assessed using the Functional Independence Measure™ comprehension and expression items recorded on admission indicated by scores one (total assistance) to five (standby prompting). Multivariable multilevel and Cox regression models were used to determine associations with long-term outcomes. RESULTS Of 8,394 patients who received in-patient rehabilitation after stroke (42% female, median age 75.6 years), two-thirds had post-stroke communication support needs. Having aphasia (odds ratio [OR] 4.34, 95% CI 3.67-5.14), being aged ≥65 years (OR 1.21, 95% CI 1.08-1.36), greater stroke severity (unable to walk on admission; OR 1.48, 95% CI 1.32-1.68) and previous stroke (OR 1.25, 95% CI 1.11-1.41) were associated with increased likelihoods of having communication support needs. One-point improvement in FIM™ expression was associated with reduced likelihood of self-reporting problems related to mobility (OR 0.85, 95% CI: 0.80-0.90), self-care (OR 0.79, 95% CI: 0.74-0.86) or usual activities (OR 0.84, 95% CI: 0.75-0.94) at 90-180 days. Patients with communication support needs had greater mortality rates within one-year post-stroke (adjusted hazard ratio 1.99, 95% CI: 1.65-2.39). CONCLUSIONS Two-thirds of patients with stroke require communication support to participate in healthcare activities. Establishing communication-accessible stroke care environments is a priority.
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Affiliation(s)
- Sally Zingelman
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, St Lucia, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, St Lucia, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Simon Mosalski
- Department of Rehabilitation, St Vincent's Hospital, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Medicine, Sydney Campus, The University of Notre Dame, Notre Dame, New South Wales, Australia
| | - Steven G Faux
- Department of Rehabilitation, St Vincent's Hospital, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Medicine, Sydney Campus, The University of Notre Dame, Notre Dame, New South Wales, Australia
| | - Dominique A Cadilhac
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Tara Alexander
- Australasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia
| | - Natasha A Lannin
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Occupational Therapy Department, Alfred Health, Melbourne, Australia
| | - Muideen T Olaiya
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Ross Clifton
- Australasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, Australia
| | - Christine T Shiner
- Department of Rehabilitation, St Vincent's Hospital, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Susan Starr
- Department of Speech Pathology, Braeside Hospital, Sydney, Australia
| | - Monique F Kilkenny
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
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2
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Wang S, Shen C, Yang S. Analysis of Health-Related Quality of Life in Elderly Patients with Stroke Complicated by Hypertension in China Using the EQ-5D-3L Scale. J Multidiscip Healthc 2024; 17:1981-1997. [PMID: 38706498 PMCID: PMC11069374 DOI: 10.2147/jmdh.s459629] [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: 02/21/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose To evaluate the health-related quality of life(HRQoL)status of elderly patients with hypertensive stroke, to understand the factors influencing it, and to provide a basis for the development of health intervention policies. Patients and Methods This study used the EQ-5D-3L scale to assess the HRQoL among elderly patients who experienced a stroke related to high blood pressure. Various analytical methods were employed to examine the factors that influenced the patient's quality of life. Univariate analysis, Tobit regression, random forest, and XGBoost models were applied to analyze the HRQoL of the patients. Furthermore, to interpret the machine learning results, the SHAP method was utilized. This method involved assessing the importance of each feature, examining the effect of each feature on the prediction result of a single sample, and determining the impact of individual features on the overall prediction. Results The study found that the median health utility value for elderly patients with hypertensive stroke was 0.427, with an interquartile range of 0.186 to 0.745. The results of the Tobit regression model, Random Forest, and XGBoost model were compared. The results of the model evaluation show that the performance of the machine learning model and the Tobit regression model are not very different. The XGBoost model performs slightly better relative to the random forest model. The factors that strongly influenced the health utility value of patients included BMI, social activities, smoking, education level, alcohol consumption, urban/rural residence, annual income, physical activity level, and hours of sleep at night. Conclusion Health-related quality of life in hypertensive stroke patients is influenced by a variety of factors. Health-related quality of life can be positively influenced by modifying these factors and making lifestyle adjustments. Maintaining a healthy weight, being socially active, quitting smoking, improving living conditions, increasing physical activity levels and getting enough sleep are recommended. Lifestyle changes need to be developed for each individual on a case-by-case basis and by medical advice.
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Affiliation(s)
- Shuai Wang
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, 233000, People’s Republic of China
| | - Caiyu Shen
- School of Health Management, Bengbu Medical University, Bengbu, Anhui, 233000, People’s Republic of China
| | - Shu Yang
- School of Health Management, Bengbu Medical University, Bengbu, Anhui, 233000, People’s Republic of China
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Chenbing X, Huiling X, Qianqian X, Dan W, Guilan X, Ling Y, Lingling X, Weiwei Q. Effect of ginger and P6 acupressure on chemotherapy-induced nausea and vomiting: a randomized controlled study. Rev Esc Enferm USP 2024; 57:e20230104. [PMID: 38461442 PMCID: PMC10911752 DOI: 10.1590/1980-220x-reeusp-2023-0104en] [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: 04/10/2023] [Accepted: 10/05/2023] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE To evaluate the effect of ginger with P6 acupressure in preventing and treating chemotherapy-induced nausea and vomiting (CINV) in cancer patients. METHOD A total of 172 participants were randomly divided into the control, ginger, acupressure, and joint groups, who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from February and September 2022. The baseline characteristics, nausea, vomiting, and retching, benefit finding, functional living index-emesis, treatment satisfaction, and adverse reaction, were used in data collection. RESULTS No significant difference was found in benefit finding and adverse reactions among the four groups (P > 0.05). Ginger significantly improved delayed CINV and function living index-nausea (P < 0.05) but had no significant effect on acute CINV, retching, and delayed vomiting, functional living index-emesis, and treatment satisfaction (P>0.05). Acute nausea and retching, delayed nausea, vomiting, and retching, functional living index-emesis, and treatment satisfaction were effectively improved in the acupressure and joint groups (P < 0.05). CONCLUSION Ginger with P6 acupressure may contribute to improving CINV in patients undergoing chemotherapy.
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Affiliation(s)
- Xiao Chenbing
- Xuzhou Medical University, School of Nursing Care, Xuzhou,
China
| | - Xia Huiling
- Xuzhou Medical University, School of Nursing Care, Xuzhou,
China
| | - Xing Qianqian
- Affiliated Hospital of Xuzhou Medical University, Department of
Oncology, Xuzhou, China
| | - Wang Dan
- Affiliated Hospital of Xuzhou Medical University, Department of
Oncology, Xuzhou, China
| | - Xie Guilan
- Affiliated Hospital of Xuzhou Medical University, Department of
Oncology, Xuzhou, China
| | - Yang Ling
- Affiliated Hospital of Xuzhou Medical University, Department of
Oncology, Xuzhou, China
| | - Xie Lingling
- Affiliated Hospital of Xuzhou Medical University, Department of
Oncology, Xuzhou, China
| | - Qian Weiwei
- Affiliated Hospital of Xuzhou Medical University, Department of
Nursing Care, Xuzhou, China
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Clavo B, Cánovas-Molina A, Díaz-Garrido JA, Cañas S, Ramallo-Fariña Y, Laffite H, Federico M, Rodríguez-Abreu D, Galván S, García-Lourve C, González-Beltrán D, Caramés MA, Hernández-Fleta JL, Serrano-Aguilar P, Rodríguez-Esparragón F. Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study. Front Psychol 2023; 14:1176204. [PMID: 37599784 PMCID: PMC10437070 DOI: 10.3389/fpsyg.2023.1176204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Patients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. Methods Before and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. Results Before ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. Conclusion The addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Universitary Institute for Research in Biomedicine and Health (iUIBS), Molecular and Translational Pharmacology Group, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Spanish Group of Clinical Research in Radiation Oncology (GICOR), Madrid, Spain
| | - Angeles Cánovas-Molina
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Juan A. Díaz-Garrido
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Silvia Cañas
- Psychiatry Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Santa Cruz de Tenerife, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), Santa Cruz de Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Horus Laffite
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Delvys Rodríguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Saray Galván
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Carla García-Lourve
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Damián González-Beltrán
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Miguel A. Caramés
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose L. Hernández-Fleta
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Pedro Serrano-Aguilar
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Francisco Rodríguez-Esparragón
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Tjokrowijoto P, Stolwyk RJ, Ung D, Kilkenny MF, Kim J, Dalli LL, Cadilhac DA, Andrew NE. Factors associated with mental health service access among Australian community-dwelling survivors of stroke. Disabil Rehabil 2023; 45:504-511. [PMID: 35139002 DOI: 10.1080/09638288.2022.2032413] [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] [Indexed: 01/19/2023]
Abstract
PURPOSE To describe types of mental health treatment accessed by community-based stroke survivors and factors associated with access. METHODS A sub-group of registrants from the Australian Stroke Clinical Registry completed a supplementary survey 2.5 years post-stroke. Self-reported information about depression/anxiety and treatment access were collected. Demographic and clinical data were obtained through linkages with registry and government data. Staged multivariable logistic regression was conducted to examine factors associated with treatment access. RESULTS Among 623 registrants surveyed (37% female, median age 69 years), 26% self-reported a medical diagnosis of depression/anxiety at 2.5 years post-stroke. Of these, only 30% reported having accessed mental health services, mostly through government-funded Medicare schemes. Younger age (odds ratio (OR) 0.95, 95% CI 0.93, 0.98), history of mental health treatment (OR 3.38, 95% CI 1.35, 8.48), feeling socially isolated (OR 2.32, 95% CI 1.16, 4.66), self-reported medical diagnosis of depression/anxiety (OR 4.85, 95% CI 2.32, 10.14), and government-subsidised team care plan arrangement (OR 4.05, 95% CI 1.96, 8.37) were associated with receiving treatment. CONCLUSIONS Many stroke survivors have untreated depression/anxiety. Primary care practitioners should be supported in undertaking effective detection and management. Older and newly diagnosed individuals should be educated about depression/anxiety and available supports.Implications for rehabilitationPrimary care providers play a pivotal role in the pathway to mental health care, and therefore should always screen for depression/anxiety and provide comprehensive assessment and referral to specialist services where necessary.Targeted psychoeducation should be provided to survivors of stroke who are older and newly diagnosed with depression/anxiety, to increase awareness about mood problems following stroke.Primary care providers should collaborate with other health professionals (e.g., through coordinating a team care arrangement plan), to address patients' multiple and complex rehabilitation needs.Rehabilitation professionals should remain informed about current evidence-based treatments for post-stroke depression/anxiety and pathways that enable their patients to access these services.
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Affiliation(s)
- Priscilla Tjokrowijoto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Stroke and Telehealth Research, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Stroke and Telehealth Research, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - David Ung
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
| | - Monique F Kilkenny
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Lachlan L Dalli
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Nadine E Andrew
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
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Zhang Y, Li X, Guo Y, Zhang Z, Xu F, Xiang N, Qiu M, Xiao Q, Wang P, Shi H. Dorsolateral Prefrontal Activation in Emotional Autobiographical Task in Depressed and Anxious College Students: An fNIRS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14335. [PMID: 36361214 PMCID: PMC9657988 DOI: 10.3390/ijerph192114335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The dorsolateral prefrontal cortex (dlPFC) is strongly associated with mood symptoms. This study used functional near-infrared spectroscopy (fNIRS) technology to explore the features of brain neural activity in the dlPFC of anxious and depressed college students, during an emotional autobiographical memory task, and to understand the differences in brain cognitive mechanisms caused by anxiety and depression. METHODS A simple random sampling method was used to test 440 college students at a university with a healthy control group (HC, 220 participants), a pure depression group (PD, 92 participants), and a pure anxiety group (PA, 128 participants). The average oxyhemoglobin in the dlPFC of the subjects during the emotional autobiographical memory task was collected by a 53-channel functional near-infrared spectroscopy imaging device. RESULTS The activation of the left dlPFC (ch13) in the pure depression group was significantly higher than in the pure anxiety group. The activation of the right dlPFC (ch48) was significantly higher under positive emotions than under negative emotions. The interaction between emotion valence and group was marginally significant, and the activation of the right dlPFC (ch41) in the pure depression group was significantly higher under positive emotion than in negative emotion. The activation of the pure depression group under positive emotions was significantly higher than that of the pure anxiety group. In comparison, the activation of the pure depression group under negative emotions was significantly lower than that of the healthy control group. The results of correlation analysis showed that the activation of the left dlPFC (ch13) was significantly negatively correlated with anxiety in positive emotions, but the activation of the right dlPFC (ch34, ch42) was significantly positively correlated with anxiety in positive and negative emotions. CONCLUSIONS The right dlPFC was insensitive to positive emotions in college students with high-anxiety symptoms, whereas this region was insensitive to negative emotions in college students with high depressive symptoms, which might be one of the critical differences in the cognitive mechanisms of anxiety and depression. Furthermore, left and right dlPFC activation correlated differently with anxiety. The higher the anxiety level, the lower the activation on the left side, and the higher the activation on the right side. The results suggested that anxiety might reduce the function of the left dlPFC.
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Affiliation(s)
- Yan Zhang
- School of Educational Science, Huazhong University of Science and Technology, Luoyu Road No. 1037, Hongshan, Wuhan 430074, China
| | - Xiaoqin Li
- School of Educational Science, Huazhong University of Science and Technology, Luoyu Road No. 1037, Hongshan, Wuhan 430074, China
| | - Ying Guo
- School of Psychology, Sichuan Normal University, Chengdu 610021, China
| | - Zhe Zhang
- Humanities Department, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Fang Xu
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Nian Xiang
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Min Qiu
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Qiang Xiao
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518000, China
| | - Hui Shi
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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7
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Mei YX, Zhang ZX, Wu H, Hou J, Liu XT, Sang SX, Mao ZX, Zhang WH, Yang DB, Wang CJ. Health-Related Quality of Life and Its Related Factors in Survivors of Stroke in Rural China: A Large-Scale Cross-Sectional Study. Front Public Health 2022; 10:810185. [PMID: 35450122 PMCID: PMC9016152 DOI: 10.3389/fpubh.2022.810185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Stroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China. Methods A total of 1,709 stroke patients aged 36–79 years from the baseline data of Henan Rural Cohort study (n = 39,259) were included in the cross-sectional study. The Chinese version of the European Quality of Life Five Dimension (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) Five Level Scale (EQ-5D-5L) and visual analog scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regression models were constructed to determine potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domain and VAS score. Results The mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that illiterate; a low monthly income; low physical activity intensity; and diabetes, anxiety, depression, or poor sleep quality were significantly associated with lower utility index and VAS scores among stroke patients. In addition, patients with stroke who were older, female, drinking, smoking, and consuming a high-fat diet, had a higher BMI, and lived with a stroke for a longer time, were also significantly associated with different dimensions of the EQ-5D. Conclusion Patients with stroke in rural areas in China had a low HRQoL. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need to be considered by health providers in rural areas. Patients with stroke in rural areas need to be included in national basic public medical services and managed systematically by medical institutions.
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Affiliation(s)
- Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,The People's Hospital of Hebi, Hebi, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, China.,School of Public Health, Tianjin Medical University, Tianjin, China.,Henan Province General Medical Educations and Research Center, Xinxiang, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiao-Tian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Sheng-Xiang Sang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhen-Xing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei-Hong Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | | | - Chong-Jian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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