Mediating roles of social support on poststroke depression and quality of life in patients with ischemic stroke

作者：Huang Chiung Yu; Hsu Mei Chi^*; Hsu Shin Pin; Cheng Pei Ching; Lin Shu Fen; Chuang Chia Hui

来源：Journal of Clinical Nursing, 2010, 19(19-20): 2752-2762.

DOI：10.1111/j.1365-2702.2010.03327.x

• depression
• nursing
• quality of life
• social support
• stroke

Aims.
The purposes of this study were to examine the associations among social support, poststroke depression and quality of life among patients with first-time ischemic stroke and to further test the impact of the dimensions of social support on poststroke depression and quality of life. The proposed models included mediation hypotheses to examine the mediating roles of social support.
Background.
Although considerable attention has recently been devoted to explaining why poststroke depression and poor quality of life are frequent concomitants of stroke, little empirical work has been conducted to test predictions based on these models, especially in Taiwan.
Design.
A cross-sectional, descriptive correlation design was used.
Methods.
The 102 patients with first-time ischemic stroke aged 32-90 (mean = 64 center dot 5, SD 11 center dot 8) were recruited from a large general hospital in Taiwan and through face-to-face survey interviews. The participants were assessed using the Social Support Inventory, Centre for Epidemiologic Studies Depression Scale, Barthel Index, the Instrumental Activities of Daily Living and Quality of Life Index-Stroke Version. The models were tested and confirmed through the application of structural equations with proposed variables.
Results.
Nearly half of the Taiwanese patients with stroke felt depressed. Social support fully mediated the prediction of quality of life by age and partially mediated the prediction of quality of life by functional ability. Social support partially mediated the prediction of poststroke depression by functional ability.
Conclusion.
This study provides researchers and nurses with increased understanding of the mediating role of social support between functional ability and poststroke depression/quality of life. Social support may be a promising intervening variable in stroke outcome.
Relevance to clinical practice.
The results suggest several clinical implications. The inclusion of social support in poststroke depression and quality of life after stroke may help nurses in planning stroke programme development, patient education, effective and efficient use of health care resources and effective rehabilitation, especially in those individuals who lack support or who are involved in stressful situations.

• 出版日期2010-10