The effect of cognitive appraisal in middle-aged women stroke survivors and the psychological health of their caregivers: a follow-up study.
OBJECTIVE
This study identified the factors that affect health-related quality of life at one and six months post-stroke in women who have undergone a mild stroke and that affect their informal caregivers' psychological health status.


BACKGROUND
Middle-aged women perform the main care roles in a family. When they suffer a stroke, it upsets the equilibrium of their family life.


METHODS
This is a longitudinal design.


METHODS
This prospective follow-up study recruited 41 middle-aged women stroke survivors (mean age = 54.95, SD = 9.63) and their informal caregivers (mean age = 41.56, SD = 15.93). The Short-Form Health Survey (SF-36) was used to assess stroke survivor's health-related quality of life, and the Chinese Health Questionnaire was used to measure the level of depression of the stroke survivor's informal caregiver. Data were analysed through descriptive statistics, Wilcoxon signed-rank tests and the generalised estimating equation approach for modelling repeatedly measures.


RESULTS
All stroke survivors showed significant improvement in the physical component summary of the health-related quality of life at one and six months after stroke, but there was no significant difference in the mental component summary. In addition, there was no significant difference in the health of the informal caregivers of the women over time. Generalised estimating equation analysis showed that the most important determinant of mental component summary of health-related quality of life among women stroke survivors was cognitive appraisal. The informal caregivers' most important determinants of health status, as measured by level of depression, were their sense of coherence, burden and patients' mental component summary of the health-related quality of life.


CONCLUSIONS
This study highlights the impact of cognitive appraisal in determining health-related quality of life of women stroke survivors and how it affects their caregivers' mental health.


CONCLUSIONS
The findings of this study may contribute to home care nurses' understanding the importance of the psychosocial impact of the stroke for the survivor and their ability to help the surviving women to promote the confidence needed for self-care, which will contribute to their quality of life and affect their caregivers' health.
Division of Neurology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan City, Taiwan.
Ming-Hsiu
MH
Wu
School of Nursing, Chung-Shan Medical University, Taichung City, Taiwan.|National Defense Medical Center, Taipei City, Taiwan.
Sheuan
S
Lee
Department of Nursing, Tainan Sin-Lau Hospital, Tainan City, Taiwan.
Hui-Yi
HY
Su
School of Nursing, Chung-Shan Medical University, Taichung City, Taiwan.
Hsiang-Chu
HC
Pai
D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000150:complications / Q000451:nursing / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009730:Nursing Assessment; D011446:Prospective Studies; D011788:Quality of Life; D020521:Stroke / Q000150:complications / Q000451:nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D016387:Women's Health
burden; cognitive appraisal; mild-stroke women; quality of life; sense of coherence; social support; stroke