title: The mediating effect of psychological distress on functional dependence in stroke patients.
abstract: OBJECTIVE
  To explore varied forms of psychological distress and to determine the mediating influence of psychological distress on functional outcomes in stroke patients.
  
  
  BACKGROUND
  Previous studies attest to the influence of depression on poststroke functional recovery. While there is evidence for neuropathological deficits that occur after stroke to be associated with psychological distress, few studies have explored the effect of various types of psychological distress on functional recovery.
  
  
  METHODS
  A cross-sectional study was used.
  
  
  METHODS
  Data were collected from 178 first-time stroke patients. Study variables included demographic and disease characteristics (stroke location and stroke syndrome classification), psychological distress (the Chinese language version of the Emotional and Social Dysfunction Questionnaire) and functional outcome (Barthel index). Regression and mediation models were used to evaluate the effect of psychological distress on functional outcome.
  
  
  RESULTS
  Results revealed that stroke patients experience various forms of mild psychological distress, including anger, helplessness, emotional dyscontrol, indifference, inertia and euphoria, after stroke. Regression and mediation analyses further confirmed that various forms of psychological distress significantly mediated the effect of severe stroke syndromes on functional dependence.
  
  
  CONCLUSIONS
  The various forms of psychological distress after stroke might play a mediating role in functional recovery and explain how stroke severity affects functional dependence.
  
  
  CONCLUSIONS
  By understanding the nature of various forms of psychological distress, healthcare professionals should adopt appropriate assessment instruments and design effective interventions to help improve mental and physical function of stroke patients.
authors.affiliation: Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Cardinal Tien Junior College of Healthcare & Management, New Taipei City, Taiwan.
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Huang
authors.forename: Li-Kai
authors.initials: LK
authors.lastname: Huang
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chang
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.forename: Nai-Fang
authors.initials: NF
authors.lastname: Chi
authors.forename: Meei-Ling
authors.initials: ML
authors.lastname: Shyu
authors.forename: Hsiu-Ju
authors.initials: HJ
authors.lastname: Chang
mesh_terms: D000203:Activities of Daily Living; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*; D020521:Stroke / Q000451:nursing / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires
keywords: function; psychological distress; stroke