Minhee Suh; Smi Choi-Kwon

doi:10.4040/jkan.2010.40.4.533

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Original Article
Structural Equation Modeling on Quality of Life in Stroke Survivors: Minhee Suh, Smi Choi-Kwon; Journal of Korean Academy of Nursing 2010;40(4):533-541.
DOI: https://doi.org/10.4040/jkan.2010.40.4.533
Published online: August 31, 2010

¹Researcher, Research Institute of Nursing Science, Seoul National University, Seoul, Korea.

²Professor, College of Nursing, Seoul National University, Seoul, Korea.

Address reprint requests to: Choi-Kwon, Smi. College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-460, Korea. Tel: 82-2-740-8830, Fax: 82-2-766-1852, smi@snu.ac.kr

• Received: May 24, 2010 • Accepted: August 13, 2010

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Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was designed to test structural equation modeling of the quality of life of stroke survivors in order to provide guidelines for development of interventions and strategies to improve their quality of life.
Methods
The participants in the study were patients who visited the neurology outpatient department of a tertiary hospital in Seoul between June 25 and October 15, 2009. Data collection was carried out through one-on-one interviews. Demographic factors, functional independence, social support, nutritional status, post-stroke biobehavioral changes and quality of life were investigated.
Results
The final analysis included 215 patients. Fitness of the hypothetical model was appropriate (χ²=111.5, p=.000, GFI=.926, AGFI=.880, RMSA=.068, NFI=.911, CFI=.953). Functional dependency, social support and post-stroke biobehavioral changes were found to be significant explaining variance in quality of life. Post-stroke biobehavioral changes had the strongest direct influence on quality of life. Nutritional status had an indirect effect on the quality of life.
Conclusion
To improve the quality of life of stroke survivors, comprehensive interventions are necessary to manage post-stroke biobehavioral changes, and strengthening social support networks that can contribute to enhancing the quality of life of stroke survivors.
Keywords: Stroke; Quality of life; Depression; Nutritional status; Social support

This article is a condensed form of the first author's doctoral thesis from Seoul National University.

REFERENCES

1. Alves de Rezende CH, Coelho LM, Oliveira LM, Penha SN. Dependence of the geriatric depression scores on age, nutritional status, and haematologic variables in elderly institutionalized patients. The Journal of Nutrition, Health & Aging. 2009;13:617–621.Article PDF
2. Carod-Artal FJ, Egido JA. Quality of life after stroke: The importance of a good recovery. Cerebrovascular Disease. 2009;27:204–214.Article PDF
3. Carod-Artal FJ, Ferreira Coral L, Trizotto DS, Menezes Moreira C. Poststroke depression: Prevalence and determinants in Brazilian stroke patients. Cerebrovascular Disease. 2009;28:157–165.Article PDF
4. Carod-Artal J, Egido A, González L, Varela de Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke. Stroke. 2000;31:2995–3000.Article PubMed
5. Chang S, Park Y, Youn J. Study on relations of variables-attributions of somatic symptoms, fatigue, chronic pain and depression in the elderly. Journal of Korean Academy of Nursing. 2003;33:26–33.Article PubMed PDF
6. Choi-Kwon S, Choi J, Kwon S, Kang D, Kim J. Factors that affect the quality of life at 3 year post-stroke. Journal of Clinical Neurology. 2006;2:34–41.PubMed PMC
7. Choi-Kwon S, Han S, Kwon S, Kim J. Poststroke fatigue: Characteristics and related factors. Cerebrovascular Disease. 2005;19:84–90.Article PDF
8. Choi-Kwon S, Kim H, Kwon S, Kim J. Factors affecting the burden on caregivers of stroke survivors in South Korea. Archives of Physical Medicine and Rehabilitation. 2005;86:1043–1048.Article PubMed
9. Gonzales R. Central pain: Diagnosis and treatment strategies. Neurology. 1995;45:12 Suppl 9. S11–S16.
10. Guigoz Y, Vellas B, Garry P. Assessing the nutritional status of the elderly: The mini nutritional assessment as part of the geriatric evaluation. Nutrition reviews. 1996;54:S59–S65.Article
11. Kim E, Lee J. Factors influencing health-related quality of life in elderly who visited a senior center: With activity of daily living, quality of sleep and depression. Journal of the Korean Gerontological Society. 2009;29:425–440.
12. Kim H, Park Y. A study on life style, functional condition, depression and perceived health status of stroke patient at home. Journal of the Korean Public Health Association. 2003;29:127–139.
13. Kim I, Seo M, Kim K, Cho N. The Relationship between the characteristics of social support and post-stroke depression. Korean Journal of Rehabilitation Nursing. 1999;2:206–214.
14. Kim J. Post-stroke depression, anxiety, emotional incontinence, anger proness and fatigue. Journal of the Korean Neurological Association. 2005;23:1–8.
15. Kim J, Choi-Kwon S. Poststroke depression and emotional incontinence: Correlation with lesion location. Neurology. 2000;54:1805–1810.Article PubMed
16. Kim J, Kang H, Kim W, Wang M, Chang C. Factors affecting the quality of life in stroke patient at home. Korean Journal of Rehabilitation Nursing. 2006;9:49–55.
17. Klit H, Finnerup N, Jensen T. Central post-stroke pain: Clinical characteristics, pathophysiology, and management. Lancet Neurology. 2009;8:857–868.Article PubMed
18. Kohatsu W. Nutrition and depression. Explore. 2005;1:474–476.Article PubMed
19. Lee H. Adjustment of middle-aged people with hemiplegia after stroke. 2006;Seoul, Seoul National University. Unpublished doctoral dissertation.
20. Lee H, Lim J. Structural equation modeling and AMOS 16.0. 2009;Seoul, Bupmoonsa.
21. Lee M, Choh A, Demerath E, Knutson K, Duren D, Sherwood R, et al. Sleep disturbance in relation to health-related quality of life in adults: The Fels Longitudinal Study. The Journal of Nutrition, Health & Aging. 2009;13:576–583.Article PDF
22. Lee S, Chung H. Brain neurologic disorder and depression in elderly. Journal of Korean Geriatric Psychiatry. 2003;7:131–142.
23. Leppavuori A, Pohjasvaara T, Kaste M, Erkinjuntti T. Insomnia in ischemic stroke patients. Cerebrovascular Disease. 2002;14:90–97.Article PDF
24. Lim S. Structural model for quality of life in stroke patients. 2002;Seoul, Kyung Hee University. Unpublished doctoral dissertation.
25. Mitchell P, Powell L, Blumenthal J, Norten J, Ironson G, Pitula C, et al. A short social support measure for patients recovering from myocardial infarction: The ENRICHD Social Support Inventory. Journal of Cardiopulmonary Rehabilitation. 2003;23:398–403.Article PubMed
26. Park J, Kwon Y. Standardization of Korean version of Mini-Mental State Examination. Journal of Neuropsychiatry Association. 1989;28:508–513.
27. Skilbeck C, Wade D, Hewer R, Wood V. Recovery after stroke. Journal of Neurology, Neurosurgery, and Psychiatry. 1983;46:5–8.Article PubMed PMC
28. Snyder-Halpern R, Verran J. Instrumentation to describe subjective sleep characteristics in healthy subjects. Research in Nursing & Health. 1987;10:155–163.Article
29. So W, Marsh G, Ling W, Leung F, Lo J, Yeung M, et al. The symptom cluster of fatigue, pain, anxiety and depression and the effect on the quality of life of women receiving treatment for breast cancer: A multicenter study. Oncology Nursing Forum. 2009;36:E205–E214.Article PubMed
30. Staub F, Bogousslavsky S. Post-stroke depression or fatigue? European Neurology. 2001;45:3–5.Article PubMed PDF
31. Sterr A, Herron K, Dijk D, Ellis J. Time to wake-up: Sleep problems and daytime sleepiness in long-term stroke survivors. Brain Injury. 2008;22:575–579.Article PubMed
32. Suh M, Choi-Kwon S. Sleep-wake disturbance in post-stroke patients. Journal of Korean Biological Nursing Science. 2009;11:23–31.
33. UNC Biobehavioral laboratory. 2008;School of Nursing. University of North Carolina. from http://nursing.unc.edu/departments/research/bbl/index.html.
34. Van de Port I, Kwakkel G, Schepers V, Heinemans C, Lindeman E. Is fatigue an independent factor associated with activities of daily living, instrumental activities of daily living and health-related quality of life in chronic stroke? Cerebrovascular Disease. 2007;23:40–45.Article PDF
35. Whyte E, Mulsant B. Post stroke depression: Epidemiology, pathophysiology and biological treatment. Biological psychiatry. 2002;52:253–264.Article PubMed
36. Williams L, Weinberger M, Harris L, Clark D, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30:1362–1369.Article PubMed
37. Winward C, Sackley C, Metha Z, Rothwell P. A population-based study of the prevalence of fatigue after transient ischemic attack and minor stroke. Stroke. 2009;40:757–761.Article PubMed

Figure 1

Research framework.

Figure 2

Path diagram for the hypothetical model.

^*p<.05; ^**p<.01.

X1=Age; X2=Level of education; X3=Economical status; X4=Functional dependency; X5=Instrumental support; X6=Emotional support; X7=Structural support; Y1=Nutritional status; Y2=Depression; Y3=Fatigue; Y4=Quality of sleep; Y5=Post-stroke pain; Y6=Quality of life.

Table 1

Descriptive Statistics of Observed Variables, (N=215)

Table 2

Correlations among Observed Variables

^*p<.05; ^**p<.01.

Table 3

Standardized Direct, Indirect and Total Effects for the Hypothetical Model

^*p<.05; ^**p<.01. SMC=Squared multiple correlations.

Figure & Data

REFERENCES

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Structural Equation Modeling on Quality of Life in Stroke Survivors

J Korean Acad Nurs. 2010;40(4):533-541. Published online August 31, 2010

DOI: https://doi.org/10.4040/jkan.2010.40.4.533

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A Structural Equation Model on Social Re-Adjustment of Stroke Patients: Based on Roy’s Adaptation Model

Structural Equation Modeling on Quality of Life in Stroke Survivors

Figure 1 Research framework.

Figure 2 Path diagram for the hypothetical model. *p<.05; **p<.01. X1=Age; X2=Level of education; X3=Economical status; X4=Functional dependency; X5=Instrumental support; X6=Emotional support; X7=Structural support; Y1=Nutritional status; Y2=Depression; Y3=Fatigue; Y4=Quality of sleep; Y5=Post-stroke pain; Y6=Quality of life.

Figure 1

Figure 2

Structural Equation Modeling on Quality of Life in Stroke Survivors

Table 1

Descriptive Statistics of Observed Variables, (N=215)

Table 2

Correlations among Observed Variables

^*p<.05; ^**p<.01.

Table 3

Standardized Direct, Indirect and Total Effects for the Hypothetical Model

^*p<.05; ^**p<.01. SMC=Squared multiple correlations.

Table 1 Descriptive Statistics of Observed Variables, (N=215)

Table 2 Correlations among Observed Variables

^*p<.05; ^**p<.01.

Table 3 Standardized Direct, Indirect and Total Effects for the Hypothetical Model

^*p<.05; ^**p<.01. SMC=Squared multiple correlations.