Zhu Wei, Yang Qiaoyu, Zhang Baoyue, Wang Cong, Fan Chaofeng
Department of Neurosurgery, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.
Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.
BMC Public Health. 2025 May 9;25(1):1716. doi: 10.1186/s12889-025-22655-x.
The impact of recovery self-efficacy on health-related quality of life in haemorrhagic stroke survivors remains unclear. This longitudinal study examined this association through a one-year follow-up after discharge.
A prospective, longitudinal design was conducted. A total of 184 haemorrhagic stroke survivors in a tertiary hospital in western China from January 2020 to December 2021 were recruited by the convenience sampling method. The three-level EuroQol five-dimension questionnaire (EQ-5D-3 L) and Stoke Self-efficacy Questionnaire (SSEQ) were assessed at four post-discharge time points: 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4). The generalized estimating equation analysis was used to evaluate the associations between recovery self-efficacy and health-related quality of life.
The mean age of included participants were 54.0, with 65.2% of female. Generalized estimating equation analysis revealed significant interactions between time and SSEQ on EQ-5D-3 L (p < 0.001). The simple effects of time showed significant increases in EQ-5D-3 L scores from T3 to T4 in the low SSEQ group (β = 0.113-0.203, p < 0.001) and from T2 to T4 in the high SSEQ group (β = 0.038-0.054, p < 0.05). The simple effects of SSEQ showed that patients with higher SSEQ scores had significantly higher EQ-5D-3 L scores at T1 (β = 0.187, 95%CI: 0.132-0.242, p < 0.001), T2 (β = 0.154, 95%CI: 0.111-0.196, p < 0.001), and T3 (β = 0.084, 95%CI: 0.054-0.113, p < 0.001), but not at T4 (p = 0.803).
Recovery self-efficacy significantly interacted with time in shaping haemorrhagic stroke survivors' health-related quality of life recovery. Higher self-efficacy was associated with earlier improvements, while lower self-efficacy was associated with delayed but larger improvements of health-related quality of life levels, with effects diminishing by one year after stroke.
恢复自我效能感对出血性中风幸存者健康相关生活质量的影响尚不清楚。本纵向研究通过出院后一年的随访来探究这种关联。
采用前瞻性纵向设计。通过便利抽样法，招募了2020年1月至2021年12月在中国西部一家三级医院的184名出血性中风幸存者。在出院后的四个时间点：1个月（T1）、3个月（T2）、6个月（T3）和12个月（T4），使用三级欧洲五维健康量表（EQ-5D-3L）和中风自我效能量表（SSEQ）进行评估。采用广义估计方程分析来评估恢复自我效能感与健康相关生活质量之间的关联。
纳入参与者的平均年龄为54.0岁，女性占65.2%。广义估计方程分析显示，时间和SSEQ在EQ-5D-3L上存在显著交互作用（p < 0.001）。时间的简单效应表明，低SSEQ组从T3到T4时EQ-5D-3L得分显著增加（β = 0.113 - 0.203，p < 0.001），高SSEQ组从T2到T4时EQ-5D-3L得分显著增加（β = 0.038 - 0.054，p < 0.05）。SSEQ的简单效应表明，SSEQ得分较高的患者在T1（β = 0.187，95%CI：0.132 - 0.242，p < 0.001）、T2（β = 0.154，95%CI：0.111 - 0.196，p < 0.001）和T3（β = 0.084，95%CI：0.054 - 0.113，p < 0.001）时EQ-5D-3L得分显著更高，但在T4时无显著差异（p = 0.803）。
恢复自我效能感在塑造出血性中风幸存者健康相关生活质量恢复过程中与时间存在显著交互作用。自我效能感较高与早期改善相关联，而自我效能感较低与健康相关生活质量水平的延迟但更大改善相关联，中风后一年效果逐渐减弱。
