Chung Misook L, Miller Jennifer L, Lee Suk Jeong, Son Youn-Jung, Cha Geunyeong, King Rosemarie B
J Cardiovasc Nurs. 2022 Apr 23. doi: 10.1097/JCN.0000000000000920.
Depressive symptoms are substantial among stroke survivors and their caregivers in poststroke management. Optimism and social support are known to protect against depressive symptoms. However, little is known about how optimism and social support contribute to depressive symptoms among stroke survivor-caregiver dyads. The study's purpose was to examine actor and partner effects of optimism on depressive symptoms through perceived social support among stroke survivors and caregiver dyads in the chronic stage of rehabilitation.
Stroke survivors and caregivers (N = 105 dyads) completed the survey at 2 years of follow-up after the first stroke. Depressive symptoms, optimism, and perceived social support were assessed using the Center for Epidemiologic Studies-Depression, the Life Orientation Test, and the Interpersonal Support Evaluation List. The Actor-Partner Interdependence Model Extended to Mediation analysis was used to test the indirect effect of optimism on depressive symptoms through perceived social support.
Higher optimism was significantly associated with lower depressive symptoms for caregivers (direct actor effect, -0.6844; 95% confidence interval [CI], -0.9844 to -0.3844) and stroke survivors (direct partner effect, -0.4189; 95% CI, -0.0789 to -0.0889). Perceived social support availability significantly mediated the association between optimism and depressive symptoms for stroke survivors (indirect effect, -0.1957; 95% CI, -0.3923 to -0.0670). Caregiver perceived social support availability was also a significant mediator between caregivers' optimism and stroke survivors' depressive symptoms (indirect effect, 0.1658; 95% CI, 0.0559-0.3128).
Intervention improving dyad members' optimism and social support would be beneficial to improve depressive symptoms of the stroke survivors and caregivers in chronic stroke management.
在中风后管理中，中风幸存者及其照顾者的抑郁症状较为严重。已知乐观和社会支持可预防抑郁症状。然而，对于中风幸存者 - 照顾者二元组中乐观和社会支持如何导致抑郁症状，人们了解甚少。本研究的目的是通过康复慢性期中风幸存者和照顾者二元组中的感知社会支持，来检验乐观对抑郁症状的主效应和伴侣效应。
中风幸存者及其照顾者（N = 105个二元组）在首次中风后2年的随访时完成调查。使用流行病学研究中心抑郁量表、生活取向测试和人际支持评估量表对抑郁症状、乐观和感知社会支持进行评估。扩展到中介分析的主效应 - 伴侣效应相互依赖模型用于检验乐观通过感知社会支持对抑郁症状的间接效应。
较高的乐观情绪与照顾者较低的抑郁症状显著相关（主效应，-0.6844；95%置信区间[CI]，-0.9844至 -0.3844），也与中风幸存者较低的抑郁症状显著相关（伴侣效应，-0.4189；95%CI，-0.0789至 -0.0889）。感知到的社会支持可用性显著中介了中风幸存者乐观与抑郁症状之间的关联（间接效应，-0.1957；95%CI，-0.3923至 -0.0670）。照顾者感知到的社会支持可用性也是照顾者乐观与中风幸存者抑郁症状之间的显著中介因素（间接效应，0.1658；95%CI，0.0559 - 0.3128）。
改善二元组成员的乐观情绪和社会支持的干预措施，将有助于改善慢性中风管理中中风幸存者和照顾者的抑郁症状。
