The Relationship Between Fear Of Disease Progression And Post-stroke Fatigue And Quality Of Life In Stroke Patients

Objectives To explore the status and influencing factors of fear of disease progression,post-stroke fatigue and quality of life in patients with acute ischemic stroke.To establish a structural equation model among the three variables and to clarify the relationship among them.To offer new basis for improving the quality of life in patients with acute ischemic.Methods Three grade A hospitals in Handan city were selected as location of investigation by convenience sampling method.From October 2019 to August 2020,a total of 525 patients with acute ischemic stroke hospitalized in the Department of Neurology were selected as respondents.Face-to-Face interviews were conducted with the general situation questionnaire,SF-36 health survey scale,Fear of Progress Questionnaire-Short Form,Fatigue Severity Scale,Family Care Index Scale,Perceived Social Support Scale,Barthel Index Scale,National Institutes of Health Stroke Scale,Modified Rankin Scale.All the collected data were analyzed by SPSS 23.0 and AMOS 23.0 statistical software package.Descriptive statistical analysis described the general situation.T test and One-way analysis of variance were used for single factor analysis.Multiple linear regression analysis was used for multivariate analysis.Pearson correlation analysis and Structural equation model were used for clarifying the relationship among them.Results 1 The total score of fear of disease progression in patients with acute ischemic stroke was(27.01±9.14),which was in the lower middle level.Multiple linear regression analysis showed that gender,age,occupational status,average monthly household income,family history of stroke,MRS score,living together,family intimacy and perceived social support were independent influencing factors of fear of disease progression in patients with acute ischemic stroke,which could account for 49.4% of the variance.2 The total score of post-stroke fatigue was(27.74±14.60),and the average score of items was(3.08±1.62).Multiple linear regression analysis showed that gender,age,average monthly household income,stroke focus,MRS score,self-care ability,family intimacy and perceived social support affected the occurrence of post-stroke fatigue,which could explain 50.0% of the variance.3 Multiple linear regression analysis showed that the quality of life of patients with acute ischemic stroke was affected by gender,average monthly household income,family history of stroke,MRS score,self-care ability,NIHSS score,living together,family intimacy and perceived social support,which could account for 72.4% of the variance.4 Person correlation analysis showed that: post-stroke fatigue was negatively correlated with quality of life(-0.741,P<0.05).Fear of disease progression was negatively correlated with quality of life(-0.750,P<0.05).Post-stroke fatigue was positively correlated with fear of disease progression(0.623,P<0.05).Multiple linear regression analysis showed that fear of disease progression and post-stroke fatigue had significant effects on quality of life.The structural equation model showed that: the direct effect of post-stroke fatigue on quality of life was-0.46(P<0.05),the direct effect of post-stroke fatigue on fear of disease progression was0.66(P<0.05),and the direct effect of fear of disease progression on quality of life was-0.50(P<0.05).When the fear of disease progression was intermediary,the mediating effect of post-stroke fatigue on quality of life was-0.33,which account for 41.77% of the total effect.Conclusions 1 The fear of disease progression in patients with acute ischemic stroke is in the lower middle level.The level of fear of disease progression is high in patients who are female,young,working,having lower average monthly family income and having family history of stroke,having high MRS score,living alone,low family intimacy and low social support.2 The post-stroke fatigue could easily happen on patients who are female,young,having lower average monthly family income,stroke focus in basal ganglia,having high MRS score,poor self-care ability,living alone,low family intimacy and low social support.3The quality of life of patients is poor,who are female,having lower average monthly family income,having family history of stroke,having high MRS score,poor self-care ability,having high NIHSS score,living alone,low family intimacy and low social support.4 The higher the level of fear of disease progression,the worse the quality of life of patients with acute ischemic stroke.The more serious degree of post-stroke fatigue,the worse the quality of life of patients with acute ischemic stroke.The fear of disease progression played a mediating role in the impact of post-stroke fatigue on the quality of life.Figure3;Table29;Reference 155...