Effect Of Stroke Patients’ Meaning In Life On Post-traumatic Growth

ObjectiveThe purpose of this study is to understand the current situation of post-traumatic growth in stroke patients,explore the factors affecting the level of post-traumatic growth in patients and put forward some nursing suggestions.The Structural equation model was used to study the effect of resilience and active coping style on the relationship between the meaning in life and post-traumatic growth in stroke patients,providing theoretical basis and practical guidance for psychological care.MethodsThe convenient sampling method was used to select stroke inpatients during June to October 2020 from Neurology Department and Rehabilitation Department of 2Grade-A hospitals in Haikou City by using for questionnaire survey.A total of 280 patients were investigated,and 256 valid questionnaires were collected.The content of the questionnaire includes a general information questionnaire,China-Meaning in Life Questionnaire Modified(C-MLQ),Trait Coping Style Questionnaire(TCSQ),ConnorDavidson Resilience Scale(CD-RISC)and post-traumatic Growth Inventory(PTGI).After collecting the data,double-entry was used to enter the data and use the eipdata validity test to check the data.SPSS 23.0 was used for descriptive analysis,independent sample t-test,one-way ANOVA,multiple linear regression analysis and Pearson correlative;AMOS 24.0 was used to construct the relationship model between the meaning in life and post-traumatic growth of stroke patients,and to further verify the mediating effect of resilience and trait coping style between them.Results1.The total score of the post-traumatic growth of stroke patients was 55.68 ± 13.73.According to the rank of the average score of each dimension of the scale,the order from big to small,the result was the appreciation of life(8.92 ± 2.42),personal strength(11.14 ± 3.41),interpersonal relationship(19.48 ± 5.45),new possibility(12.78 ± 4.18)and mental change(3.36 ± 1.81).2.The total score of the meaning in life of stroke patients was 41.42 ± 7.08,the score of the presence of meaning in life(23.50 ± 4.65)was higher than that of the search for meaning in life(17.93 ± 4.22),and the scores of each subdimension were higher than the norm(P < 0.01).3.The total score of resilience in stroke patients was 67.41 ± 15.85,which was not significantly different from the total score of the general population in China(69.64 ±13.25)(P > 0.05).Each subscale was ranked from largest to smallest according to the mean score of the items: self-strength(22.11 ± 5.77),toughness(34.95 ± 8.93),and optimism(10.36 ± 2.93).4.The scores of positive coping and negative coping in the trait coping style scale of stroke patients were 31.68 ± 6.18 and 30.61 ± 5.72,respectively.Compared with the norm,the results showed that the positive coping scores were lower than those of healthy individuals and patients in general hospitals in China(P < 0.01),and the negative coping scores were higher than those(P < 0.01).5.The results of univariate analysis showed that age,residence,religious belief,marital status,personality,per capita monthly family income,presence of traumatic experience,type of stroke,and number of dysfunctions had statistical significance in post-traumatic growth scores(P < 0.05).6.The results of multivariate analysis showed that age,duration of stroke,type of stroke,severity of stroke,presence of traumatic experience,meaning in life,positive coping,and resilience jointly explained 52.7% of post-traumatic growth.7.Post-traumatic growth was positively correlated with the meaning in life(r = 0.525,P < 0.01),resilience(r = 0.522,P < 0.01),and trait positive coping(r = 0.517,P < 0.01)in stroke patients,respectively,but post-traumatic growth was negatively correlated with trait negative coping(r =-0.179,P < 0.01).Meaning in life showed a positive correlation with resilience(r = 0.449,P < 0.01)and trait positive coping(r = 0.400,P< 0.01),respectively.There was a positive relationship between resilience and trait positive coping(r = 0.507,P < 0.01).8.The total effect,indirect effect and direct effect in the relationship model of the presence of meaning in life → post-traumatic growth exist,which is a partial mediation model.Indirect effect: the effect of the presence of meaning in life → resilience →positive coping → post-traumatic growth path(chain intermediary)was 0.064,accounting for 34.8% of the total indirect effect ratio;the effect of the presence of meaning in life → resilience → post-traumatic growth path(resilience intermediary)was 0.120,accounting for 65.2% of the total indirect effect ratio;the total indirect effect accounted for 52.1% of the total effect,and the direct effect accounted for 47.9% of the total effect.9.The total effect,indirect effect and direct effect in the relationship model of the search for meaning in life → post-traumatic growth exist,which is a partial mediation model.Indirect effect: the effect of the search for meaning in life → resilience →positive coping → post-traumatic growth path(chain intermediary)was 0.023,accounting for 22.8% of the total indirect effect ratio;the effect of the search for meaning in life → resilience → post-traumatic growth path(resilience intermediary)was 0.055,accounting for 54.5% of the total indirect effect ratio;the effect of the search for meaning in life → positive coping → post-traumatic growth path(positive coping intermediary)was 0.023,accounting for 22.8% of the total indirect effect ratio.The total indirect effect accounted for 36.3% and the direct effect for 63.7% of the total effect.Conclusion1.Stroke patients’ post-traumatic growth scores was at a moderately low level,and each subscale is ranked from largest to smallest according to the average score of the items: appreciation of life,personal strength,interpersonal relationships,new possibilities,and mental changes.2.Age,whether there is traumatic experience,type of stroke,duration of stroke,severity of stroke,meaning of life,positive coping style,and resilience were important factors for post-traumatic growth in stroke patients.3.Resilience of stroke patients plays a partial mediating effect between the meaning in life and post-traumatic growth;positive coping plays a partial mediating effect between the search for meaning in life and post-traumatic growth;resilience plays a chain mediating effect between the meaning in life and post-traumatic growth by positive coping.