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The Relationship of Continuity and Discontinuity, Functional Ability, Depression, and Quality of Life over Time in Stroke Survivors


  • Janet A. Secrest PhD RN,

    Associate Professor, Corresponding author
      615 McCallie Avenue, Chattanooga, TN 37403, or at
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    • Janet A. Secrest, PhD RN, is an associate professor at the University of Tennessee at Chattanooga.

  • Richard Zeller PhD

    Visiting ProfessorSearch for more papers by this author
    • Richard Zeller, PhD, is a visiting professor at Kent State College of Nursing, Kent State University, Kent, OH.

615 McCallie Avenue, Chattanooga, TN 37403, or at


The purpose of this study was to examine the concepts of continuity and discontinuity over time and to explore their relationships with depression, functional ability, and global quality of life (QOL). In a repeated-measures design, 51 participants in an inpatient rehabilitation hospital were entered within 1 month of stroke and followed at 3 and 6 months; 33 completed the study. Depression, functional ability, and QOL all changed significantly between time 1 and time 2 and remained so through time 3 (6 months after stroke). There were no changes in continuity or discontinuity over time. Continuity/self, continuity/other, and discontinuity correlated moderately with depression and QOL at time 1; discontinuity and functional ability at time 1 correlated moderately with QOL at time 3. Functional ability related to discontinuity at time 3 and with QOL, otherwise, functional ability did not relate to the other variables, such as depression, in any time period. Although other variables changed over time, the sense of continuity/discontinuity did not. One of nursing's contributions to stroke survivors' rehabilitation may be in helping patients feel more continuous and less discontinuous with their prestroke sense of self.

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