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Wang K, Lin X, Sheng S, Chen D, Liu X, Yao K. Association between glaucoma and stroke: A bidirectional mendelian randomization study. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:147-155. [PMID: 39022764 PMCID: PMC11253272 DOI: 10.1016/j.aopr.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/25/2024] [Accepted: 04/15/2024] [Indexed: 07/20/2024]
Abstract
Purpose Observational studies have reported positive associations between glaucoma and stroke; however, controversial results exist. Importantly, the nature of the relationship remains unknown since previous studies were not designed to test causality. Therefore, we aimed to investigate the possible causal relationships between glaucoma and stroke. Methods Our two-sample Mendelian randomization (MR) encompassed multi-ethnic large-scale genome-wide association studies with more than 20000 cases and 260000 controls for glaucoma, and more than 80000 cases and 630000 controls for stroke. Individual effect estimates for each SNP were combined using the inverse-variance weighted (IVW) method. To avoid potential pleiotropic effects, we adjusted the main results by excluding genetic variants associated with metabolic factors. The weighted median and MR-Egger methods were also used for the sensitivity analysis. Results Our MR analysis revealed that glaucoma and its subtypes, including primary open-angle glaucoma and primary angle-closure glaucoma, exhibited no causal role in relation to any stroke (AS), any ischemic stroke (AIS), large-artery atherosclerotic stroke (LAS), small-vessel stroke (SVS), or cardioembolic stroke (CES) across MR analyses (all P > 0.05). The null associations remained robust even after adjusting for metabolic-related traits and were consistent in both the European and Asian populations. Furthermore, reverse MR analyses also did not indicate any significant causal effects of AS, AIS, LAS, or CES on glaucoma risk. Conclusions Evidence from our series of causal inference approaches using large-scale population-based MR analyses did not support causal effects between glaucoma and stroke. These findings suggest that the relationship of glaucoma management and stroke risk prevention should be carefully evaluated in future studies. In turn, stroke diagnosis should not be simply applied to glaucoma risk prediction.
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Affiliation(s)
- Kai Wang
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueqi Lin
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Siting Sheng
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Chen
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Liu
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Pan R, Ye C, Zhang Z, Kwapong WR, Wang R, Lu K, Liao L, Yan Y, Yang T, Cao L, Jiang S, Zhang X, Liu J, Tao W, Wu B. Distinct alterations of retinal structure between thalamic and extra-thalamic subcortical infarction patients: A cross-sectional and longitudinal study. CNS Neurosci Ther 2024; 30:e14543. [PMID: 38018655 PMCID: PMC11017429 DOI: 10.1111/cns.14543] [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: 07/27/2023] [Revised: 10/25/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
AIMS Cerebrovascular lesions in the primary visual cortex, the lateral geniculate nucleus, and the optic tract have been associated with retinal neurodegeneration via the retrograde degeneration (RD) mechanism. We aimed to use optical coherence tomography (OCT) to assess the effects of the strategic single subcortical infarction (SSI) location on retinal neurodegeneration and its longitudinal impacts. METHODS Patients with SSI were enrolled and stratified by lesion location on cerebral MRI into the thalamic infarction group and extra-thalamic infarction group. Healthy controls from the native communities were also recruited. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) were quantified using OCT. Generalized estimating equation (GEE) models were used for cross-sectional analyses and linear mixed models for longitudinal analyses. P < 0.05 was considered statistically significant. RESULTS We included a total of 283 eyes from 149 SSI patients. Of these, 115 eyes of 60 patients with follow-up were included in the longitudinal analyses. Cross-sectionally, thalamic-infarction patients had reduced retinal thickness compared with extra-thalamic infarction patients after adjustment for age, gender, disease duration, and vascular risk factors (p = 0.026 for RNFL, and p = 0.026 for GCIPL). Longitudinally, SSI patients showed greater retinal thinning compared with healthy controls over time (p = 0.040 for RNFL, and p < 0.001 for GCIPL), and thalamic infarction patients exhibited faster rates of GCIPL thinning in comparison with extra-thalamic infarction patients (p < 0.001). CONCLUSION Our study demonstrates a distinct effect of subcortical infarction lesion site on the retina both at the early stage of disease and at the 1-year follow-up time. These results present evidence of significant associations between strategic infarction locations and retinal neurodegeneration. It may provide novel insights for further research on RD in stroke patients and ultimately facilitate individualized recovery therapeutic strategy.
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Affiliation(s)
- Ruosu Pan
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
- Center of Cerebrovascular DiseasesWest China Hospital, Sichuan UniversityChengduChina
| | - Chen Ye
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
- Center of Cerebrovascular DiseasesWest China Hospital, Sichuan UniversityChengduChina
| | - Zhimeng Zhang
- West China School of MedicineSichuan UniversityChengduChina
| | | | - Ruilin Wang
- Department of OphthalmologyWest China Hospital, Sichuan UniversityChengduChina
| | - Kun Lu
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Lanhua Liao
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Yuying Yan
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Tang Yang
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Le Cao
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Shuai Jiang
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Xuening Zhang
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
| | - Junfeng Liu
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
- Center of Cerebrovascular DiseasesWest China Hospital, Sichuan UniversityChengduChina
| | - Wendan Tao
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
- Center of Cerebrovascular DiseasesWest China Hospital, Sichuan UniversityChengduChina
| | - Bo Wu
- Department of NeurologyWest China Hospital, Sichuan UniversityChengduChina
- Center of Cerebrovascular DiseasesWest China Hospital, Sichuan UniversityChengduChina
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Lu K, Kwapong WR, Jiang S, Zhang X, Xie J, Ye C, Yan Y, Cao L, Zhao Y, Wu B. Differences in retinal microvasculature between large artery atherosclerosis and small artery disease: an optical coherence tomography angiography study. Front Aging Neurosci 2022; 14:1053638. [PMID: 36620764 PMCID: PMC9816383 DOI: 10.3389/fnagi.2022.1053638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose: Recent reports suggest retinal microvasculature mirror cerebral microcirculation. Using optical coherence tomography angiography (OCTA), we investigated the retinal microvasculature differences between ischemic stroke patients with large artery atherosclerosis (LAA) and small artery disease (SAD). Methods: All patients underwent MR imaging and were classified as SAD and LAA; LAA was subdivided into anterior LAS and posterior LAS depending on the location. Swept-source OCTA (SS-OCTA) was used to image and segment the retina into the superficial vascular complex (SVC) and deep vascular complex (DVC) in a 6 × 6 mm area around the fovea. A deep learning algorithm was used to assess the vessel area density (VAD, %) in the retinal microvasculature. Results: Fifty-eight (mean age = 60.26 ± 10.88 years; 81.03% males) were LAA while 64 (mean age = 55.58 ± 10.34 years; 85.94% males) were SAD. LAS patients had significantly reduced VAD in the DVC (P = 0.022) compared to SAD patients; the VAD in the SVC did not show any significant difference between the two groups (P = 0.580). Anterior LAA ischemic stroke showed significantly lower VAD (P = 0.002) in the SVC compared with posterior LAS patients. There was no significant difference in the DVC between the two groups (P = 0.376). Conclusions: We found LAA patients had significantly reduced DVC density compared with SAD; we also showed anterior LAA patients had significantly reduced SVC density compared with posterior LAA. These findings suggest retinal imaging has the potential to be used to detect microvasculature changes in subtypes of ischemic stroke.
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Affiliation(s)
- Kun Lu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Shuai Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuening Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jianyang Xie
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Le Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yitian Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China,The Affiliated People’s Hospital of Ningbo University, Ningbo, China,*Correspondence: Bo Wu Yitian Zhao
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Bo Wu Yitian Zhao
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Liang Y, Liu B, Xiao Y, Zeng X, Wu G, Du Z, Fang Y, Hu Y, Yang X, Yu H. Retinal Neurovascular Changes in Patients With Ischemic Stroke Investigated by Optical Coherence Tomography Angiography. Front Aging Neurosci 2022; 14:834560. [PMID: 35860669 PMCID: PMC9289443 DOI: 10.3389/fnagi.2022.834560] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo investigate retinal neurovascular structural changes in patients with ischemic stroke (IS) using optical coherence tomography angiography (OCTA).Materials and MethodsThe cross-sectional study was conducted in Guangdong Provincial People’s Hospital, China, consisting of 159 eyes from IS patients and 109 eyes from age-matched control subjects. Retinal microvascular parameters including the vessel density (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary (RPC), and neural parameters such as ganglion cell complex thickness (GCCt) and retinal nerve fibre layer thickness (RNFLt) were measured by OCTA.ResultsThe VD of SCP and DCP in the macular area were significantly reduced in IS patients compared to the control group (all p < 0.001). The VD of RPC at the optic disc was also significantly reduced in IS patients (all p < 0.05). IS patients showed reduced GCCt and RNFLt and increased GCC focal loss volume and global loss volume compared with the controls (all p < 0.05). Among patients with IS, the parafovea SCP VD was positively correlated with GCCt (r = 0.346–0.408, all p < 0.001) but not with DCP VD (all p > 0.1). In the optic disc region, the whole image RPC VD was positively correlated with mean RNFLt (r = 0.467–0.548, all p < 0.001).ConclusionReduction of retinal VD, GCCt and RNFLt was observed in patients with IS. The parafovea SCP VD and RPC VD were positively correlated with GCCt and RNFLt, respectively.
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Affiliation(s)
- Yingying Liang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Baoyi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yu Xiao
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiaomin Zeng
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guanrong Wu
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Zijing Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ying Fang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- *Correspondence: Yijun Hu,
| | - Xiaohong Yang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Xiaohong Yang,
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Honghua Yu,
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Jeena RS, Shiny G, Sukesh Kumar A, Mahadevan K. A Comparative analysis of stroke diagnosis from retinal images using hand-crafted features and CNN. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-189855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Stroke is a major reason for disability and mortality in most of the developing nations. Early detection of stroke is highly significant in bio-medical research. Research illustrates that signs of stroke are reflected in the eye and may be analyzed from fundus images. A custom dataset of fundus images has been compiled for formulating an automated stroke detection algorithm. In this paper, a comparative study of hand-crafted texture features and convolutional neural network (CNN) has been recommended for stroke diagnosis. The custom CNN model has also been compared with five pre-trained models from ImageNet. Experimental results reveal that the recommended custom CNN model gives the best performance by achieving an accuracy of 95.8 %.
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Affiliation(s)
- R. S Jeena
- Department of Electronics and Communication, College of Engineering Trivandrum, Kerala
| | - G. Shiny
- Department of Electronics and Communication, College of Engineering Trivandrum, Kerala
| | | | - K. Mahadevan
- Department of Ophthalmology, Sree Gokulam Medical College and Research Foundation, Kerala
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Yang JJ, Huang CH, Yang CH, Yang CM, Lin CW, Ho TC, Lin CP, Hsieh YT, Yeh PT, Lai TT, Chen PL, Chen TC. The Clinical Contribution of Full-Field Electroretinography and 8-Year Experiences of Application in a Tertiary Medical Center. J Pers Med 2021; 11:jpm11101022. [PMID: 34683163 PMCID: PMC8539721 DOI: 10.3390/jpm11101022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 12/15/2022] Open
Abstract
Electroretinography (ERG) is an important and well-established examination for retinal and visual pathway diseases. This study reviewed the medical records of patients who received full-field ERG (ffERG) at a single medical center between 2012 and 2019, which was an 8-year experience in the clinical contribution of ERG. Based on the indication for scheduling ffERG and the final diagnosis, patients could be classified into six groups: ‘retinal dystrophies’, ‘other retinal or macular diseases’, ‘optic neuropathies’, ‘visual complaints’, ‘systemic diseases’, and ‘others’. A total of 1921 full-field electroretinograms (ffERGs) (1655 patients) were included. The average number of ffERGs performed per year was 262 and the number of annual ffERGs was constant. The ‘retinal dystrophies’ group accounted for 36.5% of the studied population, followed by the ‘other retinal or macular diseases’ group (20.2%). The most common systemic disease was central nervous system disease. The rates of abnormal ffERGs in the ‘systemic diseases’, ‘optic neuropathies’, and ‘visual complaints’ groups were 27.3%, 22.6%, and 10.1%, respectively (p < 0.001). Higher rates were found in patients <20 years old in the ‘systemic diseases’ and ‘optic neuropathies’ groups; epilepsy and optic nerve atrophy were the most common diagnoses, respectively. In brief, by quantifying the functional response in the retina, ffERG is indispensable for diagnosis and prognosis in ophthalmologic and multidisciplinary practice.
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Affiliation(s)
- Jung-Je Yang
- Department of Medical Education, National Taiwan University Hospital, Taipei 10002, Taiwan;
| | - Chu-Hsuan Huang
- Department of Ophthalmology, Cathay General Hospital, Taipei 10002, Taiwan;
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
| | - Tzyy-Chang Ho
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Chang-Ping Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Po-Ting Yeh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
| | - Tso-Ting Lai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan;
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10002, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 10002, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (T.-C.H.); (C.-P.L.); (Y.-T.H.); (P.-T.Y.); (T.-T.L.)
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan;
- Correspondence: ; Tel.: +886-2-23123456 (ext. 63783)
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Mohammadi E, Hassandoost F, Mozhdehipanah H. Evaluation of the "partnership care model" on quality of life and activity of daily living in stroke patients: A randomized clinical trial. Jpn J Nurs Sci 2021; 19:e12448. [PMID: 34448546 DOI: 10.1111/jjns.12448] [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: 02/04/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stroke is a widespread chronic disease which remains a serious problem for public health and is the cause of major disability and death in adults. Despite valuable efforts, these patients still need new care programs for recovery and rehabilitation. AIM The aim of this study is to determine the effect of the partnership care model (PCM) on quality of life (QOL) and activities of daily living (ADL) in stroke participants. METHOD The study is a randomized clinical trial carried out in an educational and therapeutic center in 2019. Sixty-seven participants (allocated randomly in intervention and control groups) with cerebrovascular accident who had hospitalization histories were selected. Data collection instruments were the Stroke-Specific QOL scale and Lawton questionnaires. The care plan was developed and implemented for the intervention group after evaluating and recording basic information including demographic variables, care needs, and problems identified in the first PCM-based stage. Ethics approval was obtained from the University / Regional Research Ethics Committee (IR.NIMAD.REC.1397.236). RESULTS The results show that the mean scores of the QOL significantly increased after the intervention in the intervention group (before = 130.80; 3 months = 172.19; 6 months = 205.29) compared to the control group (before = 150; 3 months = 144.86; 6 months = 160.66). Also, the mean scores of the ADL significantly increased after the intervention in the intervention group (before = 1.96; 3 months = 3.64; 6 months = 4.87) compared to the control group (p < .05). The effect size is equal to 0.501 and 0.245 for QOL and ADL, respectively. CONCLUSION The findings show that the care program based on a PCM recovered the QOL and ADL of stroke participants more than other interventions.
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Affiliation(s)
- Eesa Mohammadi
- Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran
| | - Fateme Hassandoost
- Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran
| | - Hossein Mozhdehipanah
- Clinical Research Development Unit, Bouali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
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