Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients

Four modeling approaches to study restrictions on everyday life and social activities due to chronic diseases with consequences of suicidal behavior

The purpose of this study was to discover the association between disability in everyday life and social activities due to chronic diseases and suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) from the Korea National Health and Nutrition Examination Survey (KNHANES), considering the cross-sectional design of this study, 2016-2018 dataset. Variables for finding the associated factors of SI, SP, and SA were confirmed through random forest (RF), decision tree, generalized linear model (GLM), and support vector machine (SVM), and the performance of each model is listed. A total of 17,323 (males: 7,530, females: 9793) responders from the KNHANES from 2016 to 2018 were employed for the study. The relationship between restrictions on daily life, social activities, and three stages of suicidal behaviors due to diseases were analyzed using the R function (R version 4.2.0), randomForest, ctree, glm, and ksvm. The F1-score is a measure used to evaluate the accuracy of the performance of a model, in the binary classification. The score of 1 indicates good performance, whereas a score of 0 signifies poor performance. Due to chronic diseases, disability in everyday life and social activities lead to suicide behaviors. In our study, we examined the impact of limitations in daily living and social activities on suicidal behaviors among participants. Our findings revealed that for those experiencing such limitations, the odds ratios (ORs) for SIs were 6.10 (95% CI: 3.99-9.34) for males and 2.61 (1.79-3.81) for females. SPs were 3.69 (2.36-5.78) for males and 3.94 (2.70-5.75) for females. Similarly, the odds ratios for SAs were 5.04 (2.51-10.13) for males and 2.71 (1.48-4.98) for females, indicating a significant association between these limitations and increased suicidal behaviors, with variances observed between genders. These results underscore the necessity of addressing daily living and social activity restrictions when considering mental health interventions and suicide prevention strategies. In RF, GLM, and SVM, F1-score were 0.8192, 0.6887, and 0.9687 in SA, respectively. Among the patients with chronic disease, those with sequelae, low incomes, and low levels of education had limitations in daily activities and social activities, which increased the likelihood of suicidal thoughts, planning, and attempts.

Effect of social support and health education on depression scale scores of chronic stroke patients

Post-stroke depression (PSD) constitutes an important complication of stroke, leading to great disability. After stroke, the prevalence rate of depression is about 30%. Depression also affects rehabilitation motivation, delays function recovery, and increases family and social burden. The objective of this study was to explore the effect of social support on depression in chronic stroke patients and the relationship between demographic and disease characteristics. Total samples were randomly divided into an intervention group (n = 31) and a control group (n = 31). Sixteen social support interventions were performed over 8 weeks. Social support programs were implemented 2 times a week. Depressive symptoms were assessed at the second week, 4th week, 8th week, and 4 weeks after the end of the study using the 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D10). There was a significant correlation between depression and the economic status of the patients with chronic stroke, satisfaction in leisure, the presence or absence of caregivers, the duration of stroke, and with or without pain. A significant difference was found between two groups after social support for 8 weeks. Our findings suggest that remission of PSD needs at least 8 weeks of social support.