Theeke Laurie, Horstman Patricia, Mallow Jennifer, Lucke-Wold Noelle, Culp Stacey, Domico Jennifer, Barr Taura
Questions or comments about this article may be directed to Laurie Theeke, PhD FNP-BC GCNS-BC, at
J Neurosci Nurs. 2014 Dec;46(6):E3-15. doi: 10.1097/JNN.0000000000000097.
Negative outcomes of stroke are associated with poorer quality of life (QoL) and impact stroke recovery. The purpose of this study was to characterize QoL and loneliness in a sample of rural Appalachian stroke survivors within 1 year of stroke.
Using mail survey methodology, survey data were collected from 121 ischemic and hemorrhagic stroke survivors living in West Virginia using 13 subscales from the Neuro-QOL survey and the three-item UCLA Loneliness Scale. Statistical Package for Social Sciences v. 20 was used to conduct descriptive, comparative, and predictive analyses. Multiple linear regression models were used to assess explanatory value of loneliness for QoL domains while controlling for comorbidities.
Participants who were discharged to a nursing home had poorer QoL when compared with those who were discharged to home. Stroke survivors who continued to smoke were less satisfied with social roles and reported higher mean loneliness and depression scores. History of psychological problems negatively correlated with all QoL domains and loneliness scores. Loneliness predicted poorer QoL even when controlling for age, gender, and significant comorbidities.
Nurses need to assess for loneliness, include loneliness in care planning, and implement smoking cessation and cognitive behavioral interventions. Interventions that target loneliness for stroke survivors could potentially diminish psychological sequelae after stroke and enhance QoL.
中风的负面后果与较差的生活质量(QoL)相关,并影响中风恢复。本研究的目的是描述阿巴拉契亚农村地区中风幸存者样本在中风后1年内的生活质量和孤独感。
采用邮寄调查方法,使用神经生活质量调查的13个分量表和三项版加州大学洛杉矶分校孤独感量表,从西弗吉尼亚州的121名缺血性和出血性中风幸存者中收集调查数据。使用社会科学统计软件包第20版进行描述性、比较性和预测性分析。在控制合并症的同时,使用多元线性回归模型评估孤独感对生活质量领域的解释价值。
与出院回家的患者相比,出院后入住疗养院的患者生活质量较差。继续吸烟的中风幸存者对社会角色的满意度较低,报告的平均孤独感和抑郁得分较高。心理问题史与所有生活质量领域和孤独感得分呈负相关。即使控制了年龄、性别和重大合并症,孤独感仍预示着较差的生活质量。
护士需要评估孤独感,将孤独感纳入护理计划,并实施戒烟和认知行为干预。针对中风幸存者孤独感的干预措施可能会减少中风后的心理后遗症并提高生活质量。