Resilience is an independent correlate of the course of quality of life in patients with first-ever ischemic stroke
Zhihui Liu, Xuan Zhou, Wei Zhang, Lanshu Zhou
Abstract
OBJECTIVES: To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life. DESIGN: A prospective longitudinal cohort study. SETTING: This study was conducted in Shanghai, China. PARTICIPANTS: Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018. INTERVENTION: None. MEASUREMENTS: Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor-Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life. RESULTS: Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = -.051, p = .0006), neurological function (B = -.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = -.100, p =< .0001), depression (B = -.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = -.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = -.014, p = .0273), and time (B = -.031, p < .0001). CONCLUSIONS: Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.