Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T01:08:09.310Z Has data issue: false hasContentIssue false
  • English
  • Français

Resilience is an independent correlate of the course of quality of life in patients with first-ever ischemic stroke

Published online by Cambridge University Press:  18 May 2020

Zhihui Liu ,
Xuan Zhou Open the ORCID record for Xuan Zhou [Opens in a new window] ,
Wei Zhang  and
Lanshu Zhou
Zhihui Liu
Affiliation:
Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China Assisted Reproductive Department, Shanghai First Maternity and Infant Hospital, Shanghai, China
Xuan Zhou
Affiliation:
Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China Nursing Department, No. 923 Hospital of Chinese People Liberation Army, Nanning, Guangxi, China
Wei Zhang
Affiliation:
Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
Lanshu Zhou*
Affiliation:
Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
*
*Correspondence should be addressed to: Lanshu Zhou, Clinical Nursing Department, School of Nursing, Second Military Medical University, 800 Xiang Yin Road, Yangpu District, Shanghai200433, China. Phone: 021-81871511. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life.

Design:

A prospective longitudinal cohort study.

Setting:

This study was conducted in Shanghai, China.

Participants:

Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018.

Intervention:

None.

Measurements:

Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor–Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life.

Results:

Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = −.051, p = .0006), neurological function (B = −.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = −.100, p =< .0001), depression (B = −.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = −.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = −.014, p = .0273), and time (B = −.031, p < .0001).

Conclusions:

Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.

Keywords

life qualitypsychological elasticitycerebrovascular accidentlongitudinal study
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 6: Issue Theme: Diverse Strategies for Improving Seniors’ Well-Being , June 2021 , pp. 567 - 575
Copyright
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

These authors contributed equally to this work and should be considered co-first authors.

References

American Psychology Association Help Center. (2017). The road to resilience: what is resilience? [EB/OL]. [2017-01-06]. http://www.apa.org/helpcenter/road-resilience.aspx.Google Scholar
Bhaskar, S. et al. (2017). The influence of initial stroke severity on mortality, overall functional outcome and in-hospital placement at 90 days following acute ischemic stroke: a tertiary hospital stroke register study. Neurol India, 65, 1252–1259. doi: 10.4103/0028-3886.217947 CrossRefGoogle Scholar
Carvalho, I. G., Bertolli, E. D., Paiva, L., Rossi, L. A., Dantas, R. A. and Pompeo, D. A. (2016). Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases. Revista Latino-Americana de Enfermagem, 24, e2836. doi: 10.1590/1518-8345.1405.2836 CrossRefGoogle ScholarPubMed
Chinese Medical Association Neurology Branch. (2015). Guidelines for the diagnosis and treatment of acute ischemic stroke in China 2014. Chinese Journal of Neurology, 48, 246–257. doi: 10.3760/cma.j.issn.1006-7876.2015.04.002 Google Scholar
Connor, K. M. and Davidson, J. R. (2003). Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety, 18, 76–82. doi: 10.1002/da.10113 CrossRefGoogle Scholar
Davidson, J. R. T. and Connor, K. M. (2017). Connor-Davidson Resilience Scale (CD-RISC) manual. Unpublished. 01-01-2017 and partly accessible at www.cd-risc.com. doi: 10.1002/da.10113 CrossRefGoogle Scholar
Doumit, R., Afifi, R. A. and Devon, H. A. (2015). Serenity in political uncertainty. Holistic Nursing Practice, 29, 78–86. doi: 10.1097/HNP.0000000000000077 CrossRefGoogle Scholar
Dwyer Hollender, K. (2014). Screening, diagnosis, and treatment of post-stroke depression. Journal of Neuroscience Nursing, 46, 135–141. doi: 10.1097/JNN.0000000000000047 CrossRefGoogle Scholar
Erim, Y., Kahraman, Y., Vitinius, F., Beckmann, M., Kröncke, S. and Witzke, O. (2015). Resilience and quality of life in 161 living kidney donors before nephrectomy and in the aftermath of donation: a naturalistic single center study. BMC Nephrology, 16, 164. doi: 10.1186/s12882-015-0160-z CrossRefGoogle Scholar
Hamza, A. M., Al-Sadat, N., Loh, S. Y. and Jahan, N. K. (2014). Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study. BioMed Research International, 2014, 350281. doi: 10.1155/2014/350281 CrossRefGoogle ScholarPubMed
Henry, B. J. (2017). Quality of life and resilience: exploring a fly fishing intervention for breast cancer survivors. Clinical Journal of Oncology Nursing, 21, E9–E14. doi: 10.1188/17.CJON.E9-E14 CrossRefGoogle ScholarPubMed
Hsueh, I. P., Jeng, J. S., Lee, Y., Sheu, C. F. and Hsieh, C. L. (2011). Construct validity of the stroke-specific quality of life questionnaire in ischemic stroke patients. Archives of Physical Medicine and Rehabilitation, 92, 1113–1138. doi: 10.1016/j.apmr.2011.02.008 CrossRefGoogle ScholarPubMed
Janssen, P. M., Visser, N. A., Dorhout Mees, S. M., Klijn, C. J., Algra, A. and Rinkel, G. J. (2010). Comparison of telephone and face-to-face assessment of the modified Rankin Scale. Cerebrovascular Diseases, 29, 137–139. doi: 10.1159/000262309 CrossRefGoogle ScholarPubMed
Kirby, J. S., Butt, M., Esmann, S. and Jemec, G. B. E. (2017). Association of resilience with depression and health-related quality of life for patients with Hidradenitis Suppurativa. JAMA Dermatol, 153, 1263–1269. doi: 10.1001/jamadermatol.2017.3596 CrossRefGoogle Scholar
Lee, C. Y., Lee, Y., Wang, L. J., Chien, C. Y., Fang, F. M. and Lin, P. Y. (2017). Depression, anxiety, quality of life, and predictors of depressive disorders in caregivers of patients with head and neck cancer: a six-month follow-up study. Journal of Psychosomatic Research, 100, 29–34. doi: 10.1016/j.jpsychores.2017.07.002 CrossRefGoogle ScholarPubMed
Lies, J., Lau, S. T., Jones, L. E., Jensen, M. P. and Tan, G. (2017). Predictors and moderators of post-traumatic stress disorder: an investigation of anxiety sensitivity and resilience in individuals with chronic pain. Annals of the Academy of Medicine of Singapore, 46, 102–110.Google Scholar
Lopez-Espuela, F. et al. (2015). Determinants of quality of life in stroke survivors after 6 months, from a comprehensive stroke unit: a longitudinal study. Biological Research for Nursing, 17, 461–468. doi: 10.1177/1099800414553658 CrossRefGoogle ScholarPubMed
Mutai, H., Furukawa, T., Nakanishi, K. and Hanihara, T. (2016). Longitudinal functional changes, depression, and health-related quality of life among stroke survivors living at home after inpatient rehabilitation. Psychogeriatrics, 16, 185–190. doi: 10.1111/psyg.12137 CrossRefGoogle ScholarPubMed
Park, J., Gong, J. and Yim, J. (2017). Effects of a sitting boxing program on upper limb function, balance, gait, and quality of life in stroke patients. NeuroRehabilitation, 2017, 40, 77–86. doi: 10.3233/NRE-161392 CrossRefGoogle Scholar
Popa-Velea, O., Diaconescu, L., Jidveian Popescu, M. and Truţescu, C. (2017). Resilience and active coping style: effects on the self-reported quality of life in cancer patients. The International Journal of Psychiatry in Medicine, 52, 124–136. doi: 10.1177/0091217417720895 CrossRefGoogle ScholarPubMed
Pucciarelli, G. et al. (2017). Roles of changing physical function and caregiver burden on quality of life in stroke: a longitudinal dyadic analysis. Stroke, 48, 733–739. doi: 10.1161/STROKEAHA.116.014989 CrossRefGoogle ScholarPubMed
Rosenberg, A. R. et al. (2015). Resilience, health, and quality of life among long-term survivors of hematopoietic cell transplantation. Cancer, 121, 4250–4257. doi: 10.1002/cncr.29651 CrossRefGoogle ScholarPubMed
Sadler, E., Sarre, S., Tinker, A., Bhalla, A. and McKevitt, C. (2017). Developing a novel peer support intervention to promote resilience after stroke. Health & Social Care in the Community, 25, 1590–1600. doi: 10.1111/hsc.12336 CrossRefGoogle ScholarPubMed
Santos, G. L., Alcântara, C. C., Silva-Couto, M. A., García-Salazar, L. F. and Russo, T. L. (2016). Decreased brain-derived neurotrophic factor serum concentrations in chronic post-stroke subjects. Journal of Stroke and Cerebrovascular Diseases, 25, 2968–2974. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.014 CrossRefGoogle ScholarPubMed
Schlegel, D. et al. (2003). Utility of the NIH stroke scale as a predictor of hospital disposition. Stroke, 34, 134–137. doi: 10.1161/01.str.0000048217.44714.02 CrossRefGoogle ScholarPubMed
Tempski, P. et al. (2015). Relationship among medical student resilience, educational environment and quality of life. PLoS One, 10, e0131535. doi: 10.1371/journal.pone.0131535 CrossRefGoogle ScholarPubMed
Trompetter, H. R., de Kleine, E. and Bohlmeijer, E. T. (2017). Why does positive mental health buffer against psychopathology? An exploratory study on self-compassion as a resilience mechanism and adaptive emotion regulation strategy. Cognitive Therapy and Research, 41, 459–468. doi: 10.1007/s10608-016-9774-0 CrossRefGoogle Scholar
Tse, T. et al. (2017). Increased work and social engagement is associated with increased stroke specific quality of life in stroke survivors at 3 months and 12 months post-stroke: a longitudinal study of an Australian stroke cohort. Topics in Stroke Rehabilitation, 24, 405–414. doi: 10.1080/10749357.2017.1318339 CrossRefGoogle ScholarPubMed
van Mierlo, M. L., van Heugten, C. M., Post, M. W., Hajós, T. R., Kappelle, L. J. and Visser-Meily, J. M. (2016). Quality of life during the first two years post stroke: the restore stroke cohort study. Cerebrovascular Diseases, 41, 19–26. doi: 10.1159/000441197 CrossRefGoogle Scholar
Wang, Z. and Xu, J. (2017). Association between resilience and quality of life in Wenchuan Earthquake Shidu parents: the mediating role of social support. Community Mental Health Journal, 53, 859–863. doi: 10.1007/s10597-017-0099-6 CrossRefGoogle ScholarPubMed
White, J., Magin, P., Attia, J., Sturm, J., McElduff, P. and Carter, G. (2016) Predictors of health-related quality of life in community-dwelling stroke survivors: a cohort study. Family Practice, 33, 382–387. doi: 10.1093/fampra/cmw011 CrossRefGoogle ScholarPubMed
Williams, L. S., Weinberger, M., Harris, L. E., Clark, D. O. and Biller, J. (1999). Development of a stroke-specific quality of life scale. Stroke, 30, 1362–1369. doi: 10.1161/01.str.30.7.1362 CrossRefGoogle Scholar
Xie, Y., Peng, L., Zuo, X. and Li, M. (2016). The psychometric evaluation of the connor-davidson resilience scale using a Chinese military sample. PLoS One, 11, e0148843. doi: 10.1371/journal.pone.0148843 CrossRefGoogle Scholar
Xu, J. and Ou, L. (2014). Resilience and quality of life among Wenchuan earthquake survivors: the mediating role of social support. Public Health, 128, 430–437. doi: 10.1016/j.puhe.2014.03.002 CrossRefGoogle Scholar
Yang, M. and Li, X. S. (2007). Multi-Level Statistical Model Commonly Used in Medical and Public Health Research. Beijing: Peking University Medical Press.Google Scholar
Yee-Melichar, D., Boyle, A. R., Wanek, L. J. and Pawlowsky, S. B. (2014). Geriatric rehabilitation and resilience from a cultural perspective. Geriatric Nursing, 35, 451–454, e459. doi: 10.1016/j.gerinurse.2014.08.010 CrossRefGoogle ScholarPubMed
Wang, Y. L., Ma, J. G., Li, J. T. and Wang, Y. J. (2003). The study on reliability, validity and responsiveness of the Chinese version of Stroke-specific quality of life. Chinese Journal of Geriatric Cardiovascular and Cerebrovascular Diseases, 5, 391–394.Google Scholar
Yu, X. N., Lau, J. T., Mak, W. W., Zhang, J., Lui, W. W. and Zhang, J. (2011). Factor structure and psychometric properties of the Connor-Davidson Resilience Scale among Chinese adolescents. Comprehensive Psychiatry, 52, 218–224. doi: 10.1016/j.comppsych.2010.05.010 CrossRefGoogle ScholarPubMed
Zhou, X., Du, M. and Zhou, L. (2018). Use of mobile applications in post-stroke rehabilitation: a systematic review. Topics in Stroke Rehabilitation, 13, 1–11. doi: 10.1080/10749357.2018.1482446 Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale: manual. London. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle Scholar
Zhang, Z. J. (2015). Behavioral Medicine Scale Manual. China Medical Electronic Audio and Video Publishing House.Google Scholar