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

ABSTRACTBackground 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: Strokerehabilitationadherencenursingdepressive symptoms AcknowledgmentsWe express our gratitude to all the patients who actively participated in the study.Disclosure statementThe authors report there are no competing interests to declare.Ethical considerationsThe institutional review board of Chang Gung Memorial Hospital approved this study before data collection (No: 202000744B0). All participants provided written informed consent.Data availability statementThe data are not publicly available due to privacy/protection of personal information restrictions. Data are available from the corresponding author upon reasonable request.Authorship statementJeng Wang: Conceptualization, methodology, software, resources, supervision, visualization, writing – original draft, and writing – review and editing. Wen-Yu Kuo: Conceptualization, methodology, investigation, data curation, formal analysis, resources, supervision, visualization, funding acquisition, writing – original draft, and writing – review and editing. Min-Chi Chen: Conceptualization, formal analysis, and writing – original draft. Chen-Yin Chen: Conceptualization, investigation, project administration, and writing – original draft. All authors are in agreement with the content of this manuscript and approve of its publication.Additional informationFundingThis study was supported by grants from the Ministry of Science and Technology, Taiwan (MOST109-2314-B-255-006).