中风后的活动受限与主观幸福感
Activity limitations and subjective well-being after stroke.
作者信息
Zahuranec Darin B, Skolarus Lesli E, Feng Chunyang, Freedman Vicki A, Burke James F
机构信息
From the Stroke Program, Department of Neurology (D.B.Z., L.E.S., C.F., J.F.B.), and Institute for Social Research (V.A.F.), University of Michigan, Ann Arbor.
出版信息
Neurology. 2017 Aug 29;89(9):944-950. doi: 10.1212/WNL.0000000000004286. Epub 2017 Jul 21.
OBJECTIVE
As limitations in activities of daily living are major components of many stroke outcome scales, we examined how well activity limitations predicted subjective well-being among stroke survivors in a nationally representative survey.
METHODS
Individuals with a self-reported history of stroke were identified from the National Health and Aging Trends Study. Subjective well-being (primary outcome) was assessed with a validated 7-item measure (higher = greater well-being) assessing emotions (cheerful, bored, full of life, and upset) and self-realization (purpose in life, self-acceptance, and environmental mastery). Activity limitations were defined by the receipt of help in any of 11 activities of daily living/instrumental activities of daily living. Multivariable linear regression assessed predictors of well-being including medical, physical, cognitive, psychological, and environmental factors.
RESULTS
A total of 738 stroke survivors age 65 or older were included (57% female, 9% African American, 6% Hispanic). Activity limitations were modestly associated with well-being after adjusting for demographic characteristics and availability of assistance (estimate -0.49, 95% confidence interval -0.61 to -0.37). However, in the fully adjusted model ( = 0.28), neither activity limitations nor physical capacity was associated with subjective well-being. Predictors of lower well-being in the final model included depressive symptoms, chewing/swallowing problems, pain that limited activity, and restricted participation in valued life activities. Income and executive function were modestly associated with improved well-being, while comorbidities and communication technology access were not associated.
CONCLUSIONS
Activity limitations were not associated with stroke survivors' subjective well-being after adjustment for other factors. While some predictors of well-being after stroke were identified, the determinants of well-being remained largely unexplained.
目的
由于日常生活活动受限是许多中风预后量表的主要组成部分，我们在一项全国代表性调查中研究了活动受限对中风幸存者主观幸福感的预测效果。
方法
从国家健康与老龄化趋势研究中识别出有中风自我报告史的个体。主观幸福感（主要结果）通过一项经过验证的7项量表进行评估（得分越高 = 幸福感越强），该量表评估情绪（愉快、无聊、充满活力和心烦）和自我实现（生活目标、自我接受和环境掌控）。活动受限通过在11项日常生活活动/工具性日常生活活动中的任何一项接受帮助来定义。多变量线性回归评估了包括医学、身体、认知、心理和环境因素在内的幸福感预测因素。
结果
共纳入738名65岁及以上的中风幸存者（57%为女性，9%为非裔美国人，6%为西班牙裔）。在调整人口统计学特征和获得帮助的情况后，活动受限与幸福感呈适度相关（估计值 -0.49，95%置信区间 -0.61至 -0.37）。然而，在完全调整模型中（ = 0.28），活动受限和身体能力均与主观幸福感无关。最终模型中幸福感较低的预测因素包括抑郁症状、咀嚼/吞咽问题、限制活动的疼痛以及参与有价值生活活动受限。收入和执行功能与幸福感改善呈适度相关，而合并症和通信技术获取情况则无关。
结论
在调整其他因素后，活动受限与中风幸存者的主观幸福感无关。虽然确定了一些中风后幸福感的预测因素，但幸福感的决定因素在很大程度上仍未得到解释。
Zotero 插件