The mediating effect of psychological distress on functional dependence in stroke patients

Authors

  • Hui-Chuan Huang MSN, RN,

    Doctoral Candidate
    1. Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
    2. Department of Nursing, Cardinal Tien Junior College of Healthcare & Management, New Taipei City, Taiwan
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  • Li-Kai Huang MD,

    Attending Physician
    1. Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
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  • Chaur-Jong Hu MD,

    Director and Professor
    1. Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
    2. Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Chien-Hung Chang MD,

    Attending Physician
    1. Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center College of Medicine, Chang Gung University, Kueishan, Taoyuan, Taiwan
    2. Department of Electrical Engineering, College of Engineering, Chang Gung University, Kueishan, Taoyuan, Taiwan
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  • Hsin-Chien Lee MD,

    Associate Professor
    1. Department of Psychiatry and Medical Humanity, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
    2. Department of Psychiatry, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
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  • Nai-Fang Chi MD,

    Attending Physician and Lecturer
    1. Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
    2. Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Meei-Ling Shyu PhD, RN,

    Assistant Professor
    1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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  • Hsiu-Ju Chang RN, PhD

    Professor, Corresponding author
    1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
    • Correspondence: Hsiu-Ju Chang, Professor, 250 Wu-Hsing Street, Taipei City, Taiwan. Telephone: +886-2-27361661*6309.

      E-mail: hsiuju@tmu.edu.tw

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Abstract

Aims and objectives

To explore varied forms of psychological distress and to determine the mediating influence of psychological distress on functional outcomes in stroke patients.

Background

Previous studies attest to the influence of depression on poststroke functional recovery. While there is evidence for neuropathological deficits that occur after stroke to be associated with psychological distress, few studies have explored the effect of various types of psychological distress on functional recovery.

Design

A cross-sectional study was used.

Methods

Data were collected from 178 first-time stroke patients. Study variables included demographic and disease characteristics (stroke location and stroke syndrome classification), psychological distress (the Chinese language version of the Emotional and Social Dysfunction Questionnaire) and functional outcome (Barthel index). Regression and mediation models were used to evaluate the effect of psychological distress on functional outcome.

Results

Results revealed that stroke patients experience various forms of mild psychological distress, including anger, helplessness, emotional dyscontrol, indifference, inertia and euphoria, after stroke. Regression and mediation analyses further confirmed that various forms of psychological distress significantly mediated the effect of severe stroke syndromes on functional dependence.

Conclusion

The various forms of psychological distress after stroke might play a mediating role in functional recovery and explain how stroke severity affects functional dependence.

Relevance to clinical practice

By understanding the nature of various forms of psychological distress, healthcare professionals should adopt appropriate assessment instruments and design effective interventions to help improve mental and physical function of stroke patients.

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