Impact of rehabilitation adherence and depressive symptoms on post-stroke self-care ability and quality of life: a longitudinal study

Top Stroke Rehabil. 2024 May;31(4):361-371. doi: 10.1080/10749357.2023.2259652. Epub 2023 Sep 18.

Abstract

Background: Good rehabilitation adherence leads to effective post-stroke recovery. However, some recovering patients experience post-stroke depressive symptoms, which can affect post-stroke health outcomes. Previous studies have not examined the effect of a combination of rehabilitation adherence and depressive symptoms on recovery after a stroke.

Objectives: This study explored the combined predictive influence of rehabilitation adherence and post-stroke depressive symptoms on self-care abilities and quality of life in patients with stroke.

Methods: This prospective longitudinal study analyzed data from 75 stroke patients. We examined rehabilitation adherence (self-reported, five-point scale), post-stroke depressive symptoms (Taiwanese Depression Scale), self-care ability (Chinese versions of the Barthel Index and Lawton - Brody Instrumental Activities of Daily Living Scale), and post-stroke quality of life (World Health Organization Quality of Life-BREF). Patients were followed up for six months after inclusion. The influence of rehabilitation adherence and post-stroke depressive symptoms on post-stroke self-care abilities and quality of life was examined using generalized estimating equations.

Results: The sample's mean age was 60.85 (±12.9) years. Patients with perfect rehabilitation adherence had better self-care abilities and quality of life than those with imperfect rehabilitation adherence. Patients without post-stroke depressive symptoms had a better quality of life than their counterparts. Patients with perfect rehabilitation adherence and no post-stroke depressive symptoms had better self-care abilities and quality of life than those with imperfect rehabilitation adherence and post-stroke depressive symptoms.

Conclusion: Both depressive symptoms and rehabilitation adherence behavior impacted the rehabilitation effect among patients who are recovering from a stroke.

Keywords: Stroke; adherence; depressive symptoms; nursing; rehabilitation.

MeSH terms

  • Activities of Daily Living
  • Depression / etiology
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Self Care
  • Stroke Rehabilitation*
  • Stroke* / complications