title: Time-Varying Effects of Psychological Distress on the Functional Recovery of Stroke Patients.
abstract: To explore the temporal effects of psychological distress on the functional recovery of stroke survivors.
  
  
  
  A longitudinal follow-up study. All participants were interviewed at 5 days after stroke onset, and at 1, 2, 3, and 6 months after discharge from acute care hospitals.
  
  
  
  Neurology inpatient and outpatient departments and rehabilitation clinics.
  
  
  
  First-time stroke participants (N=62) without cognitive impairment, psychiatric disorders, or cancer were recruited.
  
  
  
  Not applicable.
  
  
  
  Measurements consisted of demographic characteristics, disease severity, social support, the Chinese version of the Emotional and Social Dysfunction Questionnaire (ESDQ_C), and the Barthel Index.
  
  
  
  Our findings showed that psychological distress had a dynamic effect on functional recovery over time, and as the total ESDQ_C score increased by 1 point, the concurrent functional recovery decreased by .23 points (P<.001). Additionally, 5 subscales of the ESDQ_C including anger, emotional dyscontrol, helplessness, indifference, and euphoria also had dynamic effects on functional recovery over time (P<.05). Regardless of when a single form or various forms of psychological distress occurred over time from stroke onset, the functional recovery over time was simultaneously affected.
  
  
  
  The time-varying effect of psychological distress on functional recovery was significant. Adopting comprehensive instruments and regular assessments for the early detection of various psychological distresses while under clinical care is needed. Effective interventions targeting both physical and mental functions would further improve the functional recovery and overall health of stroke patients.
authors.affiliation: Accelerated Bachelor of Science in Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Huang
authors.affiliation: Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Neurology, School of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.affiliation: School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Meei-Ling
authors.initials: ML
authors.lastname: Shyu
authors.affiliation: Department of Neurology, School of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Chin-I
authors.initials: CI
authors.lastname: Chen
authors.affiliation: Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Chih-Shan
authors.initials: CS
authors.lastname: Huang
authors.affiliation: Accelerated Bachelor of Science in Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Hsiu-Ting
authors.initials: HT
authors.lastname: Tsai
authors.affiliation: School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan. Electronic address: hsiuju@tmu.edu.tw.
authors.forename: Hsiu-Ju
authors.initials: HJ
authors.lastname: Chang
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D013624:Taiwan; D013997:Time Factors
keywords: Mental disorders; Recovery of function; Rehabilitation; Stroke